Connection With The Nervous System
Important nerves both innervate and pass through the diaphragm, including the vagus nerve. The link to Parkinsons Disease and the vagus nerve has come to the fore in recent years. Indeed, my own perspective is that Idiopathic PD occurs when the Nervous System gets stuck in a death feigning or immobilizing response to perceived threats, resulting in inhibition of the ventral part of the vagus nerve, and giving control over to dorsal part of the nerve responsible for immobilized defensive states, see
How Do I Know If I Have A Speech Or Voice Problem
- My voice makes it difficult for people to hear me.
- People have difficulty understanding me in a noisy room.
- My voice issues limit my personal and social life.
- I feel left out of conversations because of my voice.
- My voice problem causes me to lose income.
- I have to strain to produce voice.
- My voice clarity is unpredictable.
- My voice problem upsets me.
- My voice makes me feel handicapped.
- People ask, “What’s wrong with your voice?”
Deep Brain Stimulation And Respiratory Failure
DBS is an effective strategy for the treatment of advanced PD, thus improving motor fluctuations and bradykinesia.
Nonetheless, the classical target of the subthalamic nucleus -DBS reserves stimulation-induced side effects in the long-term period, comprising gait and speech impairment, as well as a progressively worsening of tremor. In this scenario, only few papers have specifically investigated respiratory failure. In particular, STN-DBS may increase the risk of a fixed epiglottis and modify velopharyngeal control these effects seem to strictly depend on frequency parameters, with low-frequency stimulation leading to a clinical improvement, whereas higher frequencies are associated with a detrimental effect on velopharyngeal control .
In support of this view, Hammeret al. have recently found that in STN-DBS patients, respiratory changes do not correlate with limb function, but speech-related respiratory and laryngeal control may benefit when the stimulation is delivered at low frequencies and shorter pulse width . In addition to stimulation frequency, other factors may account for these correlations, including variability in localisation of the active DBS electrodes, individual variability in somatotopic organisation of STN, stimulation fields and potential current spread beyond the STN target . Data on the relationship between respiratory changes and novel DBS targets, such as the pedunculopontine nucleus , have not been extensively reported so far.
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Lessons From Fascia Decompression
Another seminal source of information which affirmed for myself the critical role of breathing in health and disease, especially the movement of the diaphragm, was the book
by Deanna Hansen. Deanna writes
It is through proper mechanics of the body that we maintain the optimal tissue temperature. The diaphragm muscle is situated in the core of the body, acting as the ceiling to the abdominal organs and the floor to the heart and lungs. When we inhale, the muscle moves down in the core and the belly extends when we exhale, the muscle moves up and the belly squeezes small. Breathing with the diaphragm muscle is like turning on the furnace in the body. This muscles action regulates the core temperature with its continual movement up and down through proper inhalation and exhalation. Correct posture is required to support the diaphragms shape and action. When we collapse into the core from unconscious posture, the diaphragm doesnt have the opportunity to move in the way in which it is designed.”
Correct posture is required to support the diaphragms shape and action. When we collapse into the core from unconscious posture, the diaphragm doesnt have the opportunity to move in the way in which it is designed.
and that fixing these fascial issues will be key to progressive symptom reduction. Deannas work thus points us to the conclusion that correcting diaphragm dysfunction and unhealthy breathing patterns will, in turn, be vital for mending the fascia.
Anatomy Thorax Phrenic Nerves
“The phrenic nerve originates from the… C3 through C5 nerve roots and consists of motor, sensory, and sympathetic nerve fibers. It provides complete motor innervation to the diaphragm and sensation to the central tendon aspect of the diaphragm.”
“The left phrenic nerve innervates the left diaphragmatic dome, and the right phrenic nerve innervates the right diaphragmatic dome. The motor innervation activation will cause the diaphragm to contract with inspiration, resulting in a flattened diaphragm. During exhalation, the diaphragm relaxes and returns to the dual dome shape.”
“The phrenic nerves provide motor innervation to the diaphragm and work in conjunction with secondary respiratory muscles to allow respiration.”
“The phrenic nerve supplies sensory innervation to the diaphragm. Pain arising from the diaphragm is often referred to the tip of the shoulder. For example, a patient with a subphrenic abscess or a ruptured spleen may complain of pain in the left shoulder. The hiccup reflex is due to irritation of the phrenic nerve.”
Many people also have problems in the cervical vertebrae, especially the C3-C5 region where the phrenic nerves originate, including pain, soreness and a lot of clicking and grinding. It may be worth considering if the origin of these pains is due to diaphragm dysfunction rather than problems with the shoulder itself.
The article also mentions
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Symptomatology Correlations Between The Diaphragm And Irritable Bowel Syndrome
The text reviews the diaphragm’s functions, anatomy, and neurological links in correlation with the presence of chronic symptoms associated to IBS, like chronic low back pain, chronic pelvic pain, chronic headache, and temporomandibular joint dysfunction, vagus nerve inflammation, and depression and anxiety. The interplay between an individual’s breath dynamic and intestinal behaviour is still an unaddressed point and the paucity of scientific studies should recommend further research to better understand the importance of breathing in this syndrome.
This article explains the direct links between diaphragm dysfunction and: issues with the pelvic floor, jaw and tongue lower back pain headaches gastroesophageal reflux perceived pain emotional state and body image pain and inflammation the nervous system.
Runny Nose And Parkinsons Disease
Runny nose, or rhinorrhea in medical jargon, is an annoying symptom that has been shown in a number of studies to be more common among people with PD than those without PD. The rhinorrhea of PD is not associated with a viral infection or environmental allergies, or any other common cause of runny nose.
Rhinorrhea can be an early feature of PD, sometimes present at the time of diagnosis. In fact, studies have shown that rhinorrhea is not correlated with disease duration, disease severity, or whether the PD is characterized more by tremor or gait difficulties. One study tested the smell of those with runny nose versus those without and determined that the presence of rhinorrhea did not correlate with deficits in the sense of smell.
There are no studies in the medical literature addressing how to treat the runny nose associated with PD. Ipratropium bromide is an anti-cholinergic medication that does not cross the blood-brain barrier and is available in two forms an inhaled form to treat asthma, chronic bronchitis and emphysema and a nasal spray that is used to treat allergic and non-allergic runny nose. The nasal spray may be worth a try in PD-related rhinorrhea.
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Inspiratory And Expiratory Muscles Weakness
Several studies have evidenced weakness of both inspiratory and expiratory muscles in PD . The maximal inspiratory mouth pressures seems to be more affected than the maximal expiratory mouth pressure according to several researchers . Besides, in this latter paper, inspiratory muscles weakness is very severe . The correlation with respiratory symptoms remains unclear, since some of the studies included patients with severe PD and limitations in their activities of daily living. There are few studies of the pathophysiology of this respiratory muscle weakness. Tremor may be involved or jerky movements of the diaphragm . Accessory muscles seem to be affected in PD, although data on diaphragm function in PD are scarce. Vercueil et al. observed a differential impact of the disease on inspiratory muscles . A link between respiratory muscles disturbance and impaired lung volumes has been suggested . Spirometry results would be the consequence of a reduced efficiencyduring repetitive motor tasks. Furthermore, respiratory muscles strength seems to decrease with the course of the disease since a negative correlation was highlighted between MIP, MEP and the motor section of UPDRS .
Does Parkinson Affect Hearing To
I hope not! but it definately effects the hearing of the people around me, all of a sudden they keep asking me “what did you say”?LOL!
Thank You, so much!!
I’m getting a lot of the “what did you say, also”
my husband has been diagnosed with Menier’s Disease. he feels that the ear not being able to drain properly is a relation to PD. The doctores did not say this but…… if he drools now and his body can not control this properly anymore due to PD then why would it not be the same for his ears? I agree with my husband. I think it is due to PD. He did not ever have hearing problems before PD. When he asked the doctors about it being related they say,”we are not sure. There is no studies showing this relation.”
Thanks all of you that answered my question.The lady i take care of is having her ears drained, and plugs put in them. she is 81 years old, she had Parkinson for a few years now.
P.S. to my asnwer: He is now on a diaretic to dry up the extra fluid in his ears. He is still having problems hearing though. He can’t tell which direction a sound is coming from and he can’t hear me well anymore. I have to repeat alot.
Hi I have had premature hearing loss 4 about 15 yrs
A nd now wear hearing aids
Imhave PSP
Actually, I find this is interesting. I have never seen anything about hearing being affected, but my hearing is certainly not as good as it used to be. Wonder if there is any connection?
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Apnoea In Parkinson’s Disease
The presence of apnoea syndrome has been studied in PD as well. Apnoea syndrome is probably related to a central dysfunction of the brainstem respiratory centres and/or a peripheral airways involvement. However, different studies have produced conflicting results, probably according to the different samples of patients and methods used.
Apnoea occurring during sleep could be classified as central , obstructive and mixed nonetheless, these patterns have not been studied systematically in PD and a clear stratification is not available in the current literature. Most studies focused on obstructive apnoea rather than central.
Conflicting results have been reported about the prevalence of obstructive apnoea syndrome in PD patients Mariaet al. identified a higher prevalence of obstructive apnoea in PD populations, whereas others found less occurrence of obstructive apnoea compared to controls , or even no apnoea or sleep abnormalities . De Cocket al. tried to explain this phenomenon, postulating a possible protective contribution due to rapid eye movement sleep behaviour disorder , in which the physiological muscle atonia during REM sleep is absent and may prevent upper airway closure.
The Heart Of The Matter: Cardiovascular Effects Of Parkinsons Disease
It has long been understood that Parkinsons disease does not just cause movement symptoms, but also causes a litany of non-motor symptoms with effects throughout the body. One of the organ systems that is affected is the cardiac system, encompassing the heart, as well as the major and minor blood vessels. I received this topic as a suggestion from a blog reader and we will be discussing this important issue today. Please feel free to .
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Billy Connolly Jokes About Parkinsons During Drug Discussion
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Parkinson’s disease is a progressive nervous system disorder that cannot be cured, although the sooner it is picked up the better. Steps can be taken to slow down its progression, helping a person with Parkinson’s to maintain quality of life for as long as possible. The symptoms of Parkinson’s are mainly related to movement because it leads to a reduction in a chemical called dopamine in the brain. However, occasionally the symptoms can appear in unusual areas of the body including in the way you .
Symptoms That May Be Related To Pd
These symptoms can be associated with PD, but are also commonly associated with other medical conditions, so more testing is necessary. For example, weight loss may be associated with PD, but may also be a sign of a gastrointestinal problem or cancer. Pain may be associated with PD, but could be also due to arthritis, spinal stenosis, cancer, or a whole host of other causes.
There is a fourth category of non-motor symptoms that I would like to focus on now:
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Impact Of Treatments On Dyspnea
However, dopamine does not seem to be the only neurotransmitter involved in dyspnea. Although there is still a doubt about the role of serotonin , anti-inflammatory drugs like steroids may interfere in dyspnea sensation . After the administration of L-DOPA, improvements in lung function were not correlated with the reduction in the symptoms reported by the patients . Paradoxically, antiparkinsonian medications can trigger dyspnea. Thus, L-DOPA-induced dyskinesia has been reported as a possible cause of dysregulated breathing , perhaps as a result of the loss of muscle control. Likewise, a longitudinal study has shown that dyspnea can be a side effect of subthalamic nucleus deep brain stimulation . The authors mentioned the following mechanisms underlying this phenomenon: An alteration of dyspnea perception, a bronchoconstriction, a disturbance in upper airway control or a disturbed respiratory muscle control. Surprisingly, a fixed epiglottis has been observed in subthalamic nucleus deep brain stimulation patients .
Therefore, the precise mechanisms of dyspnea and the effect of treatments remain unknown.
More Research Is Needed
Based on a review of medical literature, there is no clear thought on the underlying mechanisms that cause shortness of breath in Parkinsons disease.
There are no records of how common it is or the effect of medicationspecifically levodopaon respiration. Limited clinical research is available relating to this often-ignored non-motor symptom.
Additional clinical studies may provide improved understanding and potential treatments.3
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Correlation Between Pneumological Drugs And Pd
In this scenario, the effects of drugs commonly used by the pneumologist should also be considered. For instance, some studies recently reviewed by Hopfneret al. postulated the possible correlation between -adrenoreceptors and PD . Anticholinergic drugs are frequently used for obstructive pulmonary disorders and systemic anticholinergics may play a part in PD . Acetylcholine has a key role in modulating dopaminergic activity in the basal ganglia, and its inhibition may increase central dopaminergic tone . Anticholinergic bronchodilators might have central effects, as reported by some authors . An effect on motor disturbances in PD may be reasonable, even if to our knowledge this has not been investigated in the current literature. However, it should be considered that anticholinergics may be associated with cognitive impairment and delirium , and these adverse effects may be even more common in the advanced stage of PD, when dementia is a very common feature.
Dystonia Recovery Program Neuroplasticity Training For Dystonia: A Full Body Recovery Experience
teaches that re-training breathing is one of the top priority areas in any progressive symptom reduction plan. Dr Farias views PD as a form of generalized dystonia. However, Dr Farias also coaches that breathing techniques which force the diaphragm to move will actually make the situation worse for people with dystonia and PD, causing the diaphragm muscle to go into even greater spasm. This matches my own experience, since I have always found deep breathing exercises from other modalities to be more triggering of my symptoms, and hence detrimental, rather than being helpful/relaxing. Indeed, he teaches that deep breathing does not mean forced breathing, or even taking in lots of air, but breathing small amounts with controlled finesse of the diaphragm. He talks about small breaths going “all the way down”, and demonstrates how to breathe from the diaphragm without the neck or ribs engaging at all. Apparently, forms of cervical dystonia can be completely recovered from through breathing exercises alone, but this has to be done ever so gently over a very long time.
Dr Fariass success with clients at least shows that unhealthy breathing habits can be changed over time even with movement disorders, and doing so can greatly benefit quality of life. I personally know it is possible to fix breathing issues, even with Parkinsons Disease, as some time ago I sorted out my lifelong mouth breathing habits, and now naturally default to nose breathing,
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Breathing Problems In Parkinsons Disease: A Common Problem Rarely Diagnosed
Parkinsons disease is the second most common neurodegenerative disorder after Alzheimers disease. It is characterized by bradykinesia tremor, rigidity, and postural instability. Potential non-motor manifestations of PD include depression, anxiety, constipation, overactive bladder symptoms, dementia, and sleep disturbances.
Although James Parkinson, in 1817, described breathing abnormalities in his Essay on the shaking palsy, there has been limited research on this important non-motor symptom.
People living with Parkinsons may present with a wide variety of respiratory symptoms, ranging from shortness of breath at rest to acute stridor. Shortness of breath can be very distressing for patients and clinicians alike. Multiple investigations may be undertaken, looking for infection, blood clots and heart problems. Although these potential causes of breathing abnormalities need to be excluded, clinicians must remember that PD itself and its medications can cause SOB and that normal investigations should not automatically lead to a diagnosis of anxiety, depression or lead to inappropriate treatment plans.
Several different patterns of breathing abnormality may be found in PD:
KM Torsney, D Forsyth