Measurement Of Mitochondrial Dna In Early Stages Of Parkinsons Disease
Study Rationale: People with a form of idiopathic REM sleep behavior disorder experience nightmares and lash out physically during a stage of sleep when the body’s muscles are normally relaxed. Most of these individuals develop Parkinsons disease a few years after this disorder first appears. Therefore, iRBD represents an early stage of PD that offers a unique opportunity for identifying the cellular changes that underlie the neuronal damage associated with the disease. Neurons depend on energy provided by mitochondria, a subcellular structure that contains its own DNA. Defects in mitochondrial DNA can cause a failure in energy production, which initiates neurodegeneration a process that can lead to irreversible neuronal damage.
Hypothesis:We hypothesize that alterations in mitochondrial DNA bring about neurodegeneration early in PD. In this study, we seek to establish whether changes in the content or integrity of mitochondrial DNA precede or are already present at the earliest stages of the disease.
Study Design:We plan to measure the amount of mitochondrial DNA present in each cell and the proportion of that DNA contains large deletions in people with iRBD, late-stage PD, and in control volunteers. These measurements will allow us to assess whether mitochondrial DNA damage precedes, or is a consequence of, Parkinsons disease.
Stiffness And Slow Movement
Parkinsons disease mainly affects adults older than 60. You may feel stiff and a little slow to get going in the morning at this stage of your life. This is a completely normal development in many healthy people. The difference with PD is that the stiffness and slowness it causes dont go away as you get up and start your day.
Stiffness of the limbs and slow movement appear early on with PD. These symptoms are caused by the impairment of the neurons that control movement. A person with PD will notice jerkier motions and move in a more uncoordinated pattern than before. Eventually, a person may develop the characteristic shuffling gait.
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This study strives to determine phenotypes of speech disorder based on the age of the PD onset, the team wrote.
The study included 24 early-onset patients and 24 late-onset patients , all of whom were newly diagnosed and never had been treated for Parkinsons. There also were matched groups of 24 younger healthy people and 24 older healthy people. Across all groups, slightly more than half the participants were men.
Each of the participants made speech recordings, and the recordings were analyzed with a technique called acoustic analysis, which provides objective, sensitive and quantifiable information for the precise assessment of speech performance from very early stages of PD, the researchers wrote.
Results suggested that, compared to healthy people their age, people with early-onset disease had weak inspirations . Inspirations in early-onset patients were generally similar to those in older individuals, with or without Parkinsons.
These differences based on age at onset may reflect differences in brain damage that occurs in early- and late-onset patients, or may have to do with differing compensatory strategies, the researchers said, noting a need for further research.
Further exploration of the pathophysiologic differences among PD speech phenotypes defined according to the gender and/or different clinical criteria is warranted to shed light on the underlying mechanisms of speech problems in Parkinsons, they concluded.
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What Causes Parkinsons Disease
Parkinsons disease occurs when nerve cells in an area of the brain called the substantia nigra become impaired or die. These cells normally produce dopamine, a chemical that helps the cells of the brain communicate . When these nerve cells become impaired or die, they produce less dopamine. Dopamine is especially important for the operation of another area of the brain called the basal ganglia. This area of the brain is responsible for organizing the brains commands for body movement. The loss of dopamine causes the movement symptoms seen in people with Parkinsons disease.
People with Parkinsons disease also lose another neurotransmitter called norepinephrine. This chemical is needed for proper functioning of the sympathetic nervous system. This system controls some of the bodys autonomic functions such as digestion, heart rate, blood pressure and breathing. Loss of norepinephrine causes some of the non-movement-related symptoms of Parkinsons disease.
Scientists arent sure what causes the neurons that produce these neurotransmitter chemicals to die.
Early Symptoms Of Parkinson’s Disease
Parkinson’s disease is a progressive disease of the nervous system that affects movement. Approximately 1 million people in the U.S. are living with the disease. This year, about 60,000 more will be diagnosed with Parkinson’s disease.
Many people associate Parkinson’s disease with tremors or shaking of their hands. While this is a common symptom, other important symptoms include stiffness of muscles and slowing of movement.
Symptoms of Parkinson’s disease usually start on one side of the body. They usually remain worse on that side even after symptoms begin to affect both sides.
The early signs and symptoms are different for each person. The symptoms may be mild enough to go unnoticed for months or years.
Here are early symptoms that can raise concern for Parkinson’s disease:
- Smaller handwriting
- Family members may observe that one arm swings less on one side when walking.
- Soft or low voice Again, it is family members or friends who may ask one to speak louder. The speech may be more of a monotone without the usual inflections.
It is the combination of several symptoms that would raise suspicion for Parkinson’s disease. A single symptom is not enough to make a diagnosis of Parkinson’s disease.
It is important to talk with your health care provider if you have any of the symptoms associated with Parkinson’s disease. This is to properly diagnose the condition and rule out other conditions with similar symptoms.
Leonardo Fugoso, M.D., is a neurologist in Eau Claire, Wisconsin.
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Stooping Or Hunching Over
Are you not standing up as straight as you used to? If you or your family or friends notice that you seem to be stooping, leaning or slouching when you stand, it could be a sign of Parkinson’s disease .
What is normal?If you have pain from an injury or if you are sick, it might cause you to stand crookedly. Also, a problem with your bones can make you hunch over.
Stage Four Of Parkinsons Disease
In stage four, PD has progressed to a severely disabling disease. Patients with stage four PD may be able to walk and stand unassisted, but they are noticeably incapacitated. Many use a walker to help them.
At this stage, the patient is unable to live an independent life and needs assistance with some activities of daily living. The necessity for help with daily living defines this stage. If the patient is still able to live alone, it is still defined as stage three.
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Stage One Of Parkinsons Disease
In stage one, the earliest stage, the symptoms of PD are mild and only seen on one side of the body , and there is usually minimal or no functional impairment.
The symptoms of PD at stage one may be so mild that the person doesnt seek medical attention or the physician is unable to make a diagnosis. Symptoms at stage one may include tremor, such as intermittent tremor of one hand, rigidity, or one hand or leg may feel more clumsy than another, or one side of the face may be affected, impacting the expression.
This stage is very difficult to diagnose and a physician may wait to see if the symptoms get worse over time before making a formal diagnosis.
Signs Of Parkinsons Disease
In 1817, Dr. James Parkinson published An Essay on the Shaking Palsy describing non-motor, as well as, motor symptoms of the illness that bears his name. Parkinsons is not just a movement disorder, explained Dr. Shprecher. Constipation, impaired sense of smell, and dream enactment can occur years before motor symptoms of Parkinsons. The latter, caused by a condition called REM sleep behavior disorder, is a very strong risk factor for both Parkinsons and dementia . This has prompted us to join a consortium of centers studying REM sleep behavior disorder.
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How Can I Deal With My Diagnosis
Here are some of the common problems faced by people with Parkinsons who have been recently diagnosed-
1. You are unsure & afraid of telling your loved ones about your diagnosis, not knowing how they would react. Remember that support from others is a factor that will have a huge positive impact on your journey ahead with Parkinsons. Sharing your diagnosis with close family members is important and will help you deal better. Here is one way you could tell your loved ones or someone about your illness I have Parkinsons which is a neurological illness which mainly affects my movements . However, I am taking steps to manage the condition, with the help of medications and exercise prescribed by my doctor. There are a number of therapies and activities available to help fight Parkinsons
Its Time To Redefine Early Stage Parkinsons
The Parkinsons Foundation has shared 10 early signs of PD, including tremor, small handwriting, and loss of smell.
While younger people with early-onset PD may have some of the same signs and symptoms as older individuals, the onset may look different, so their issues may not be attributed to PD.
The American Parkinson Disease Association notes that, Because the majority of people who get Parkinsons disease are over the age of 60, the disease is often overlooked in younger people, leading many to go undiagnosed or misdiagnosed for extended periods of time.
My sister was finally referred to a neurologist at the Cleveland Clinic Center for Neurological Restoration in Ohio, as her symptoms slowly but consistently progressed. After multiple tests, including an MRI, cognitive testing, and a movement and balance analysis, she was diagnosed with PD.
One of Bevs early signs was weakness in her left hand, which she attributed to carpal tunnel syndrome. She regularly conducted echocardiograms and electrocardiograms, which required a lot of constant hand movement. She did not have stiffness or balance issues initially, but she did have a slight head tremor.
As Bevs PD progressed, she noticed that her writing was changing. She now has stage 3 PD and said, Sometimes I cant read my own writing. I feel like it looks like chicken scratch!
Bev also has cognitive issues, mostly related to her short-term memory.
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Causes Of Parkinson’s Disease
Parkinson’s disease is caused by a loss of nerve cells in part of the brain called the substantia nigra. This leads to a reduction in a chemical called dopamine in the brain.
Dopamine plays a vital role in regulating the movement of the body. A reduction in dopamine is responsible for many of the symptoms of Parkinson’s disease.
Exactly what causes the loss of nerve cells is unclear. Most experts think that a combination of genetic and environmental factors is responsible.
What Are The Stages Of Parkinson’s Disease
Parkinson’s disease is a progressive neurological disorder. There are five generally recognized stages of Parkinson’s disease. The progression of the disease may vary from one patient to the next, and not all patients will experience all five stages of Parkinson’s disease in their generally accepted order. Symptoms may also vary throughout the progression of Parkinson’s disease.
While doctors have currently identified five distinct stages of Parkinson’s disease, not all patients will experience a straightforward disease progression that passes through all five stages, one after the other. Nor will all patients remain in all stages for the same length of time. The five stages of Parkinson’s often vary in duration from patient to patient. Disease progression is generally considered impossible to predict, with some patients experiencing all stages while other patients skipping from an early stage to an advanced stage without passing through the stages in between.
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Changes To Your Walking
- Smaller steps
- Not swinging your arms while walking
- Multiple steps required to turn around when walking, possibly tripping up the feet
- One foot turning inward or outward a bit, causing tripping
- One arm could also be bent inward
The turning of the arm or foot, called dystonia, is often one of the first signs we see, so were always on the lookout for it, Dr. Joseph says.
The 5 Stages Of Parkinsons Disease
Getting older is underrated by most. Its a joyful experience to sit back, relax and watch the people in your life grow up, have kids of their own and flourish. Age can be a beautiful thing, even as our bodies begin to slow down. We spoke with David Shprecher, DO, movement disorders director at Banner Sun Health Research Institute about a well-known illness which afflicts as many as 2% of people older than 65, Parkinsons Disease.
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How Is Parkinsons Diagnosed
Doctors use your medical history and physical examination to diagnose Parkinson’s disease . No blood test, brain scan or other test can be used to make a definitive diagnosis of PD.
Researchers believe that in most people, Parkinson’s is caused by a combination of environmental and genetic factors. Certain environmental exposures, such as pesticides and head injury, are associated with an increased risk of PD. Still, most people have no clear exposure that doctors can point to as a straightforward cause. The same goes for genetics. Certain genetic mutations are linked to an increased risk of PD. But in the vast majority of people, Parkinsons is not directly related to a single genetic mutation. Learning more about the genetics of Parkinsons is one of our best chances to understand more about the disease and discover how to slow or stop its progression.
Aging is the greatest risk factor for Parkinsons, and the average age at diagnosis is 60. Still, some people get PD at 40 or younger.
Men are diagnosed with Parkinsons at a higher rate than women and whites more than other races. Researchers are studying these disparities to understand more about the disease and health care access and to improve inclusivity across care and research.
Aging is the greatest risk factor for Parkinsons, and the average age at diagnosis is 60. Still, some people get PD at 40 or younger.
The Michael J. Fox Foundation has made finding a test for Parkinsons disease one of our top priorities.
What Medications Are Used To Treat Parkinsons Disease
Medications are the main treatment method for patients with Parkinsons disease. Your doctor will work closely with you to develop a treatment plan best suited for you based on the severity of your disease at the time of diagnosis, side effects of the drug class and success or failure of symptom control of the medications you try.
Medications combat Parkinsons disease by:
- Helping nerve cells in the brain make dopamine.
- Mimicking the effects of dopamine in the brain.
- Blocking an enzyme that breaks down dopamine in the brain.
- Reducing some specific symptoms of Parkinsons disease.
Levodopa: Levodopa is a main treatment for the slowness of movement, tremor, and stiffness symptoms of Parkinsons disease. Nerve cells use levodopa to make dopamine, which replenishes the low amount found in the brain of persons with Parkinsons disease. Levodopa is usually taken with carbidopa to allow more levodopa to reach the brain and to prevent or reduce the nausea and vomiting, low blood pressure and other side effects of levodopa. Sinemet® is available in an immediate release formula and a long-acting, controlled release formula. Rytary® is a newer version of levodopa/carbidopa that is a longer-acting capsule. The newest addition is Inbrija®, which is inhaled levodopa. It is used by people already taking regular carbidopa/levodopa for when they have off episodes .
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Acting Out What Youre Dreaming
- People with REM sleep behavior disorder might talk in their sleep and flail their arms and legs during dreams, accidentally hitting or kicking a person in the same bed.
When people learn about the sleep disorder, they often say, Ive been doing that for years. Theyre sometimes astonished to learn its an early symptom of Parkinsons, Dr. Joseph says.
Living With Parkinsons Disease
Depending on severity, life can look very different for a person coping with Parkinsons Disease. As a loved one, your top priority will be their comfort, peace of mind and safety. Dr. Shprecher offered some advice, regardless of the diseases progression. Besides movement issues Parkinsons Disease can cause a wide variety of symptoms including drooling, constipation, low blood pressure when standing up, voice problems, depression, anxiety, sleep problems, hallucinations and dementia. Therefore, regular visits with a neurologist experienced with Parkinsons are important to make sure the diagnosis is on target, and the symptoms are monitored and addressed. Because changes in your other medications can affect your Parkinsons symptoms, you should remind each member of your healthcare team to send a copy of your clinic note after every appointment.
Dr. Shprecher also added that maintaining a healthy diet and getting regular exercise can help improve quality of life. Physical and speech therapists are welcome additions to any caregiving team.
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Stages Of Parkinsons Disease
As supported by Parkinsons disease foundation there are five stages of this disease,
Stage 1: At this stage, the patient presents mild symptoms which do not affect the quality of life.
Stage 2: As the disease progresses the symptoms start worsening and the completing daily activities become difficult and the patient takes more time to complete them.
Stage 3: This stage is considered as the mid-stage of Parkinsons disease. The patient starts losing balance and a tendency to fall is very common. The patient movement becomes slow. There is visible impairment in performing daily activities such as dressing, eating or brushing teeth.
Stage 4: The disease further progresses at this stage and the patient presents the need for assistance in walking and performing daily activities.
Stage 5: This is the most advanced stage of Parkinsons disease. The patient now needs full-time assistance with living as he is unable to walk on self. The patient is bed ridden and might also experience hallucinations and delusions.