How To Address Symptoms
Although there is no cure for Parkinsons disease, there are many treatments including medications that can help reduce symptoms and slow disease progression. Patients with depression and/or anxiety will need additional treatment strategies.
Treatment usually depends on how severe symptoms are and each patients goals, Dr. Rush says. For mild symptoms, we usually start pretty conservatively with just recommendations to improve behavior and possibly some lifestyle changes.
Try to stay as active as you can, and take steps to minimize stress in your life as much as possible. Learning techniques to help you relax is also often helpful. Try to pace yourself and shift your focus to things that you can control.
When symptoms are moderate to severe, we usually use psychotropic medications in combination, which help balance out the chemical changes in the brain. We also look at how patients thoughts affect their emotions and actions, and we offer suggestions to help address them.
Safely Enhancing Rehabilitation Therapy
For patients with various conditions such as those recovering from orthopedic surgery, stroke, or PD, our goal is to help step up their rehabilitation therapy in a safe manner. The VR experiences we have created with the omnidirectional treadmill allow patients gait and stability to be tested and taxed in a safe and controlled environment. We also have the capability to monitor the rehab progress of a patient due to the subjective nature of the treadmill.
What Lifestyle Changes Can I Make To Ease Parkinsons Symptoms
Exercise: Exercise helps improve muscle strength, balance, coordination, flexibility, and tremor. It is also strongly believed to improve memory, thinking and reduce the risk of falls and decrease anxiety and depression. One study in persons with Parkinsons disease showed that 2.5 hours of exercise per week resulted in improved ability to move and a slower decline in quality of life compared to those who didnt exercise or didnt start until later in the course of their disease. Some exercises to consider include strengthening or resistance training, stretching exercises or aerobics . All types of exercise are helpful.
Eat a healthy, balanced diet: This is not only good for your general health but can ease some of the non-movement related symptoms of Parkinsons, such as constipation. Eating foods high in fiber in particular can relieve constipation. The Mediterranean diet is one example of a healthy diet.
Preventing falls and maintaining balance: Falls are a frequent complication of Parkinson’s. While you can do many things to reduce your risk of falling, the two most important are: 1) to work with your doctor to ensure that your treatments whether medicines or deep brain stimulation are optimal and 2) to consult with a physical therapist who can assess your walking and balance. The physical therapist is the expert when it comes to recommending assistive devices or exercise to improve safety and preventing falls.
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Lean On People You Love
If you have Parkinsons disease and also struggle with frequent depression or anxiety, you dont go it alone. Turn to your family and friends for a strong support structure to help you cope. Joining a support group is often helpful everyone there knows how you feel.
We know from research that good social support is a protective factor against worsening depression and anxiety symptoms, so its incredibly important for patients to utilize the support they have available from family and friends, Dr. Rush says.
She also has advice for those who are providing this support: In some cases this means being an active listener without trying to fix their frustration or sadness, and doing this can often be an incredibly helpful part of the coping process, she says.
Why Choose Cleveland Clinic
At Cleveland Clinic Nevada, we offer you the most advanced and specialized care, complemented by leading programs in research and education. The Center for Neurological Restoration is nationally recognized for expertise in medical management and innovation in the surgical treatment of movement disorders as well as obsessive-compulsive disorders, depression and chronic pain.
Patients benefit from an integrated approach to care. Team members collaborate to develop individualized management and treatment plans designed to enhance patients function and quality of life. A robust research program ensures that patients have access to single-center and multicenter clinical trials.
Cleveland Clinic Nevada has also earned a Parkinsons Foundation Center of Excellence designation and is a CurePSP Center of Care.
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Why Choose The Neurological Institute
Cleveland Clinic’s Neurological Institute includes more than 300 medical, surgical and research specialists dedicated to the treatment of adult and pediatric patients with neurological and psychiatric disorders. The multidisciplinary institute offers a disease-specific, patient-focused approach to care. Cleveland Clinic is ranked as one of the nation’s top hospitals by U.S. News & World Report.
How Is Parkinsons Disease Treated
There is no cure for Parkinsons disease. However, medications and other treatments can help relieve some of your symptoms. Exercise can help your Parkinsons symptoms significantly. In addition, physical therapy, occupational therapy and speech-language therapy can help with walking and balance problems, eating and swallowing challenges and speech problems. Surgery is an option for some patients.
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Cleveland Clinic Nflpa To Use Artificial Intelligence To Improve Diagnosis And Treatment Of Neurological Disease
Jay Alberts, of the Cleveland Clinic’s Lerner Research Institute and vice chair for innovation at the Clinic’s Neurological Institute, is serving as principal investigator on a Clinic partnership with the NFLPA to use artificial intelligence to study neurological diseases and how they progress. Courtesy Cleveland Clinic
CLEVELAND, Ohio The Cleveland Clinic and the NFL Players Association are working together to use artificial intelligence and machine learning to improve the diagnosis of neurological diseases and guide treatment, the health system and players union announced Tuesday.
The joint initiative seeks to use technology to identify neurological diseases like Parkinsons and Alzheimers and determine how they might progress. The goal is to use artificial intelligence and machine learning to inform interventions and treatment, said principal investigator Dr. Jay Alberts from the Clinics Lerner Research Institute. Alberts is also vice chair for innovation for the Clinics Neurological Institute.
The opportunity we have here is that were going to be looking at a tremendous amount of data, Alberts said. By looking at all of that data and then using machine learning we are going to be able to work together and create these interesting, impactful models.
The research will provide insight for prevention and treatment programs for current and former football players, the news release says.
What Are The Different Stages Of Parkinsons Disease
Each person with Parkinsons disease experiences symptoms in in their own unique way. Not everyone experiences all symptoms of Parkinsons disease. You may not experience symptoms in the same order as others. Some people may have mild symptoms others may have intense symptoms. How quickly symptoms worsen also varies from individual to individual and is difficult to impossible to predict at the outset.
In general, the disease progresses from early stage to mid-stage to mid-late-stage to advanced stage. This is what typically occurs during each of these stages:
Early stage
Early symptoms of Parkinsons disease are usually mild and typically occur slowly and do not interfere with daily activities. Sometimes early symptoms are not easy to detect or you may think early symptoms are simply normal signs of aging. You may have fatigue or a general sense of uneasiness. You may feel a slight tremor or have difficulty standing.
Often, a family member or friend notices some of the subtle signs before you do. They may notice things like body stiffness or lack of normal movement slow or small handwriting, lack of expression in your face, or difficulty getting out of a chair.
Mid stage
Mid-late stage
Standing and walking are becoming more difficult and may require assistance with a walker. You may need full time help to continue to live at home.
Advanced stage
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Commit To The Right Lifestyle
If you commit to lifestyle changes, your doctors treatment advice, and the support of family and friends, you give yourself the best chances of seeing improvement in your day-to-day life.
Dr. Rush advises patients: Take the tools you have and make them work for you.
The patients who often do well are those who come in for treatment consistently, because theyre utilizing resources to their advantage, Dr. Rush says. It isnt a matter of learning how to get rid of these symptoms, but the goal is to make the symptoms milder and less intrusive so they can still have a good quality of life.
Cleveland Clinic Florida Recognized For Parkinsons Care
Parkinsons is a debilitating disease that affects more than one million Americans, with as many as 60,000 new cases diagnosed each year. Because there is no cure at this time, it is important that patients with Parkinsons disease be treated at a hospital focused on providing advanced care. Cleveland Clinic Florida was recently designated as a Center of Excellence by the Parkinsons Foundation. There are only 31 Centers of Excellence in this country and 45 worldwide to receive this honor.
The sought-after Center of Excellence designation identifies hospitals and academic medical centers with specialized teams of neurologists, movement disorders specialists, physical and occupational therapists, and mental health professionals who are the leading edge of the latest medications, therapies and innovations in Parkinsons disease.
Innovation in clinical research, patient care and education is at the forefront of our mission, said Badih Adada, MD, Neuroscience Institute Director at Cleveland Clinic Florida. To be distinguished as a Parkinsons Foundation Center of Excellence is a testament to our unwavering commitment to the world-class treatment and research of Parkinsons disease, and we are incredibly honored to receive this recognition.
The Center of Excellence designation is awarded based on a rigorous application and peer-review process with the following criteria:
Promote access to wellness programs for patients
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How Is Parkinsons Disease Diagnosed
Diagnosing Parkinsons disease is sometimes difficult, since early symptoms can mimic other disorders and there are no specific blood or other laboratory tests to diagnose the disease. Imaging tests, such as CT or MRI scans, may be used to rule out other disorders that cause similar symptoms.
To diagnose Parkinsons disease, you will be asked about your medical history and family history of neurologic disorders as well as your current symptoms, medications and possible exposure to toxins. Your doctor will look for signs of tremor and muscle rigidity, watch you walk, check your posture and coordination and look for slowness of movement.
If you think you may have Parkinsons disease, you should probably see a neurologist, preferably a movement disorders-trained neurologist. The treatment decisions made early in the illness can affect the long-term success of the treatment.
How Do I Prevent Falls From Common Hazards
- Floors: Remove all loose wires, cords, and throw rugs. Minimize clutter. Make sure rugs are anchored and smooth. Keep furniture in its usual place.
- Bathroom: Install grab bars and non-skid tape in the tub or shower. Use non-skid bath mats on the floor or install wall-to-wall carpeting.
- Lighting: Make sure halls, stairways, and entrances are well-lit. Install a night light in your bathroom or hallway and staircase. Turn lights on if you get up in the middle of the night. Make sure lamps or light switches are within reach of the bed if you have to get up during the night.
- Kitchen: Install non-skid rubber mats near the sink and stove. Clean spills immediately.
- Stairs: Make sure treads, rails, and rugs are secure. Install a rail on both sides of the stairs. If stairs are a threat, it might be helpful to arrange most of your activities on the lower level to reduce the number of times you must climb the stairs.
- Entrances and doorways: Install metal handles on the walls adjacent to the doorknobs of all doors to make it more secure as you travel through the doorway.
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Research Updates In Parkinsons Disease
Click here to view Dr. Yus presentation on Thursday, August 26, 2021, titled: Research Updates in Parkinsons Disease
Xin Xin Yu, M.D. is a Movement Disorders neurologist in the Neurological Institutes Center for Neurological Restoration at Cleveland Clinic. She received her medical degree from the University of Kentucky College of Medicine in 2011, and completed a Neurology Residency and 2-year Movement Disorders Fellowship at the Cleveland Clinic. She is an active member of the International Parkinson and Movement Disorder Society and the American Academy of Neurology. In May 2021, Dr. Yu joined InMotions Board of Directors.
Changes In Brain Chemistry
Parkinsons causes a drop in chemicals in the brain called neurotransmitters especially dopamine which affect movement and the brains reward center.
An imbalance of neurotransmitters and low levels of dopamine are also at work in depression. This shows why the two are frequently connected.
Parkinsons affects brain chemistry, so thats part of why depression and anxiety symptoms are common in these patients, Dr. Rush says. Their brains are often affected in ways that make it more likely to develop symptoms.
She says the mental effects can sometimes make physical symptoms worse. The signs she sees most often include:
- Fatigue
The interplay between physical and emotional symptoms can lead to a downward spiral.
If patients are developing physical symptoms, they may begin to move less, which can lead to more fatigue and a worse physical condition, Dr. Rush says. Then they start feeling even worse. So its a vicious cycle between depression and a sense of helplessness that feeds into some of their physical symptoms.
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Parkinson’s Foundation Center Of Excellence
Cleveland Clinic’s Parkinson Disease Program is the first multi-site program to receive designation as a Center of Excellence. Programs included in this designation serve patients at Cleveland Clinic in Cleveland, Ohio, Cleveland Clinic Abu Dhabi, Cleveland Clinic Florida, and Cleveland Clinic Lou Ruvo Center for Brain Health – Las Vegas.
A Parkinson’s Foundation Center of Excellence is an academic medical center with a specialized team of neurologists, movement disorder specialists, physical and occupational therapists, mental health professionals and others who are up to date on the latest Parkinson disease medications, therapies and research to provide the best care.
Every Center of Excellence designation is awarded based on a rigorous application and peer-review process with the following criteria:
- Must see at least 700 unique patients with Parkinson disease annually
- Conduct research relevant and/or clinical trials for Parkinson disease
- Provide exemplary team care, including a neurologist with training in movement disorders, nurse, social worker, physical therapist, occupational therapist and speech-language pathologist
- Promote access to wellness programs for patients
- Facilitate educational events for patients and families
To learn more about this distinguishing designation, visit Parkinson.org.
Curepsp Foundation Psp Care Center
Cleveland Clinics Center for Neurological Restoration is designated as a PSP Care Center through the CurePSP Foundation.
The CurePSP Center of Care network was established in 2018 with a main focus of helping referring physicians and patients diagnosed with progressive supranuclear palsy and corticobasal degeneration find the best medical care in convenient locations across the United States and Canada.
The network also seeks to:
- Increase knowledge and overall awareness of PSP and CBD spectrum disorders by providing educational materials to patients, caregivers, and health professionals.
- Provide local/regional resources for physicians seeking information about PSP and CBD, helping to facilitate easy patient referral to clinical trials and better overall disease management.
- Promote collaboration between care centers that will optimize standards of patient care and establish hubs for PSP/CBD clinical research.
To learn more about this designation, visit PSP.org.
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What Are The Symptoms Of Parkinsons Disease
Symptoms of Parkinsons disease and the rate of decline vary widely from person to person. The most common symptoms include:
Other symptoms include:
- Speech/vocal changes: Speech may be quick, become slurred or be soft in tone. You may hesitate before speaking. The pitch of your voice may become unchanged .
- Handwriting changes: You handwriting may become smaller and more difficult to read.
- Depression and anxiety.
- Sleeping disturbances including disrupted sleep, acting out your dreams, and restless leg syndrome.
- Pain, lack of interest , fatigue, change in weight, vision changes.
- Low blood pressure.
What Are The Surgical Treatments For Parkinsons Disease
Most patients with Parkinsons disease can maintain a good quality of life with medications. However, as the disease worsens, medications may no longer be effective in some patients. In these patients, the effectiveness of medications becomes unpredictable reducing symptoms during on periods and no longer controlling symptoms during off periods, which usually occur when the medication is wearing off and just before the next dose is to be taken. Sometimes these variations can be managed with changes in medications. However, sometimes they cant. Based on the type and severity of your symptoms, the failure of adjustments in your medications, the decline in your quality of life and your overall health, your doctor may discuss some of the available surgical options.
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Identifying And Monitoring Neurodegenerative Disease
We also hope to use our VR platform to evaluate activities of daily living in older people who could potentially be at risk for conditions like Alzheimers disease and PD. ADLs are activities that require motor skills along with cognitive ability to complete tasks that allow individuals to live independently. Some of these activities would include house cleaning, cooking, keeping up with personal finances, administering their own medications, and being in control of their transportation.
Through our monitoring in these virtual environments, we could catch the decline in ADLs, and could likely identify these neurodegenerative diseases very early on. Early detection would prove extremely beneficial so effective treatments could be administered. Our treadmill also enables subjective quantitative assessment of ADL function. We would ultimately love to see these assessments become part of the annual examinations for geriatric patients.