Myth : Parkinsons Medications Cause Symptoms
Fact: Even though the myth that Parkinsons disease medicines are toxic and make the condition progress faster was completely debunked, it persists. Levodopa is the main drug therapy for Parkinsons disease. Its a potent drug that helps patients with motor symptoms. But many people got the idea that over time, it makes the disease progress faster. The myth was that levodopa is somehow toxic and is somehow making the Parkinsons progression faster, hurting patients.
This misconception was debunked decades ago with a large clinical trial, where it was found that people exposed to levodopa versus a placebo werent worse. In fact, they were better at the end of the study.
Its true that levodopa isnt a cure as yet, there is no cure for Parkinsons disease but its not toxic.
Myth : Deep Brain Stimulation Is Experimental Therapy
Fact: Deep brain stimulation, or DBS, is a procedure in which doctors place electrodes in the brain at the point when medications are less effective in masking motor symptoms, such as tremor, stiffness and slowness of movement.
While it may sound frightening and futuristic, its been around and successfully used for decades. DBS works very similarly to a pacemaker, except the wire is in the brain, not in the heart. Its been a standard procedure for the past two decades.
What Causes Tremor In Ms
A brain area called the cerebellum is thought to be responsible for co-ordinating body movements and balance. A nearby brain area called the thalamus relays sensory and motor signals around the brain and body. It is thought that MS symptoms such as tremor, ataxia, speech problems and eye twitches arise from damage caused by lesions to the cerebellum, thalamus, and the nerve pathways in and out of them, shown in this diagram
Stress, anger and anxiety can make tremor worse, as can caffeine and extremes of temperature. Having poor eyesight, numbness in the body or a loss of the sense of where your body is in space can also make tremor worse, and harder to manage. These problems can contribute to people affected by tremor having more frequent falls.
Tremor can be a progressive condition, getting worse over time. However, it is found in people with both relapsing and progressive forms of MS.
Tremor in MS is different to that experienced with other conditions, so treatments are not automatically the same. For example, tremor in Parkinson’s Disease relates to a lack of dopamine, and the tremor is normally seen at rest rather than with movement.
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Myth : Parkinsons Is Only A Motor Condition
Fact: While its true that Parkinsons disease symptoms include shaking and tremor, rigid muscles, slowness of movement, and a frozen or flat expression, its a lot more than that.
Nonmotor symptoms deserve and are getting more attention from doctors and researchers. These symptoms include cognitive impairment or dementia , anxiety and depression, fatigue, sleep problems and more.
For some patients, nonmotor symptoms are more disabling than motor symptoms, which are the focus of treatment. Be sure to talk to your doctor about other issues so you can get all of your symptoms addressed.
Causes And Risk Factors
The causes of Parkinsons disease are multifactorial and still not entirely agreed upon. Researchers now know that both genetic factors and certain environmental/lifestyle habits contribute to Parkinsons development. While the exact combination of factors causing Parkinsons disease have yet to be proved definitively, a few theories show strong validity.
Factors that contribute to Parkinsons disease include:
- Genetics: Recently theres been some major advances in the field of cognitive disorders, including identifying several genes that put someone at a great risk for disorders like Parkinsons, as well as locating regions of the brain involved in age-related cognitive decline.
- Brain cell deterioration and inflammation: The latest research suggests that deterioration of an area of the brain called the substantia nigra plays a role in cognitive disorders, including Parkinsons. The substantia nigra normally produces brain cells that are responsible for neurotransmitter production, including making the chemical dopamine, which is crucial for learning, muscle control, memory and behavior regulation.
- Toxicity and exposure to chemicals
- Poor diet and unhealthy lifestyle
- Hormonal imbalances and other medical conditions
Research shows that risk factors for Parkinsons disease can include:
Ask The Expert: Movement Disorders
Is there any connection between Parkinson’s and drug abuse, or multiple sclerosis and drug abuse?
There is no known connection between drug abuse and either Parkinson’s disease or multiple sclerosis . There was a particular illegal opiate-like intravenous drug used in the 1980’s, which caused an irreversible condition that looked like PD, but that has not appeared again. As for the question about MS, I have seen patients with both PD and MS, but this is a rare occurrence. There is no known link between the two diseases or drug abuse and the development of either disease.
Is loss of bladder control a side effect of Parkinson’s? We have tried all the bladder medications with little success. Is there anything that can be done?
What are the early signs of Parkinson’s versus Huntington’s diseases?
Parkinson’s disease and Huntington’s disease are very different disorders and generally look quite different however, in young people, they may look the same. Children who develop HD may appear to have very young onset PD, in which case the early signs begin with progressive slowing down, changes in facial expression, or possibly a tremor at rest.
HD, unlike PD, is always inherited, meaning one of the parent’s of the person with Huntington’s must have had the disease. It may not always seem that way if the parent died before they began to show symptoms of the disease.
When treating PD, is Mirapex better to start with or Sinemet?
What’s new for MS?
Is There A Connection Between The Two
Researchers have recently begun investigating a possible connection between MS and PD.
In a 2020 case study, researchers note a potential link between MS and PD. They find that people living with MS who have a mutated GBA1 gene may have a higher risk of developing PD. However, it is not clear why this is the case.
According to an earlier 2014 literature review , MS may affect a persons brain tissue and brain structure in a way that triggers the development of PD. Nonetheless, this connection is unlikely to be strong. The study authors note that there are only 34 reported cases of coexisting MS and PD, indicating that it is rare for people to develop both conditions.
More research is necessary to establish any firm connection between MS and PD.
Doctors treat both MS and PD using a combination of medications and therapies.
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Is There A Link Between Parkinsons And Multiple Sclerosis
The chances of developing both multiple sclerosis and Parkinsons disease is less than
where a formal diagnosis can be made clinically based on your signs and symptoms during a physical and neurological exam. For your doctor to make a diagnosis, you need to have 2 out of 3 of the following:
- shaking or tremors
- slowness of movement
- muscle stiffness
One of the clearest signs of Parkinsons is a positive response to the medication Levodopa.
Imaging techniques such as single photon emission computed tomography scans and magnetic resonance imaging may help rule out other conditions.
A dopamine transporter scan may be used to identify loss of dopaminergic uptake in a part of your brain called the basal ganglia. However, interpreting the results can be difficult, and it isnt routinely used.
Neither Parkinsons nor multiple sclerosis currently have a cure. Treatment aims to slow progression and minimize symptoms.
How Is Parkinson Disease Treated
Parkinson disease can’t be cured. But there are different therapies that can help control symptoms. Many of the medicines used to treat Parkinson disease help to offset the loss of the chemical dopamine in the brain. Most of these medicines help manage symptoms quite successfully.
A procedure called deep brain stimulation may also be used to treat Parkinson disease. It sends electrical impulses into the brain to help control tremors and twitching movements. Some people may need surgery to manage Parkinson disease symptoms. Surgery may involve destroying small areas of brain tissue responsible for the symptoms. However, these surgeries are rarely done since deep brain stimulation is now available.
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Gait In People With Ms
Long double-support time, slow gait speed, and short swing time were significantly different daily life gait measures in MS from MS-Ctl. Indeed, gait speed double-support time and swing time as a percent of the gait cycle all discriminated gait in people with MS from gait in healthy control people over a week of daily life with a similar, excellent area under the curve . In contrast, in the laboratory, the toe-off angle was the only laboratory gait measure that discriminated our mild-moderate MS from MS-Ctl group during comfortable-pace gait after Bonferronis correction for 13 gait characteristics. This result is consistent with our previous report of a small toe-off angle in a separate group of people with MS during a 2-min walk in the laboratory . The toe-off angle is a surrogate for the push-off phase of gait produced by the power in the gastrocnemius-soleus complex, responsible for stride length and gait speed.
Dementia With Lewy Bodies
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Stooping Or Hunched Posture
People who have Parkinsons disease may notice changes in their posture due to other symptoms of the disease, such as muscle rigidity.
People naturally stand so that their weight is evenly distributed over their feet. However, people who have Parkinsons disease may start bending forward, making them appear hunched or stooped over.
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Benefits Of Inpatient Rehabilitation
Inpatient rehabilitation hospitals are required to provide an interdisciplinary approach to patient caremeaning specialists from many disciplines are involved in creating and implementing a patients care plan. Interdisciplinary team members include physical, speech and occupational therapists, rehabilitation physicians, nurses, case managers, dietitians and pharmacists. Patients participate in three hours of therapy each day for a total of 15 hours per week, and an individualized plan of care is created for each patient to meet their needs while providing necessary intervention to make functional gains. Inpatient rehabilitation can be beneficial for both MS and Parkinsons disease.
Educational sessions with the patient and family members can also improve understanding for all involved in the patients care about the progression of each disease and ways to combat symptoms.
Bethany Moss is a physical therapist at Encompass Health Rehabilitation Hospital of Jonesboro. She is a PWR! certified therapist and a LVST BIG certified clinician.
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Early Weight Loss With Parkinson’s May Be Red Flag
Researchers suspect this could indicate worse form of disease
MONDAY, Jan. 11, 2016 — People who lose weight in the early stages of Parkinson’s disease may have a more serious form of the movement disorder, according to a new study.
Parkinson’s is a chronic and progressive disease marked by tremors, impaired coordination, and slowness and/or stiffness. The cause and cure are unknown.
Weight loss is common in Parkinson’s patients, according to background information from the study. But the study findings, published online Jan. 11 in the journal JAMA Neurology, suggest that weight loss in the early stages of the disease could be a red flag for doctors.
“I suspect we may be looking at several subtypes of this disease,” study lead author Dr. Anne-Marie Wills, of Massachusetts General Hospital’s neurological clinical research institute, said in a hospital news release.
“The patients who experience early weight loss appear to have a more severe, systemic form of the disease, possibly due to involvement of the neuroendocrine system or the gastrointestinal nervous system, while those who gained weight may have a milder form of the disease,” she explained.
For the study, conducted between 2007 and 2013, the researchers examined data from more than 1,600 people who had been diagnosed with Parkinson’s within the previous five years.
It’s not known if maintaining or increasing weight could slow the progression of Parkinson’s.
Summary Parkinsons Vs Myasthenia Gravis
Parkinsons and myasthenia gravis are neurological disorders that have a very deteriorating impact on the quality of life of the patient. The main difference between Parkinsons and myasthenia gravis is their autoimmune component.
1. Kumar, Parveen J., and Michael L. Clark. Kumar & Clark clinical medicine. Edinburgh: W.B. Saunders, 2009.
1. Sir William Richard Gowers Parkinson Disease sketch 1886 2 By Sir_William_Richard_Gowers_Parkinson_Disease_sketch_1886.jpg:derivative work: Malyszkz Sir_William_Richard_Gowers_Parkinson_Disease_sketch_1886.jpg via Commons Wikimedia2. DiplopiaMG1 By James Heilman, MD Own work via Commons Wikimedia
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What Are The Symptoms Of Parkinson Disease
Parkinson disease symptoms usually start out mild, and then progressively get much worse. The first signs are often so subtle that many people don’t seek medical attention at first. These are common symptoms of Parkinson disease:
- Tremors that affect the face and jaw, legs, arms, and hands
- Slow, stiff walking
Sonda Is Clinically Relevant
The SONDA paradigm allows for a comprehensive examination of eye-movements that provides detailed information on the dynamics and statistical properties of saccades, as well as a novel set of spatio-temporal properties that quantify both smooth and saccadic pursuit behavior. Given the large number of parameters, our technique also opens up possibilities for machine-learning-aided diagnosis of neuro-ophthalmic and neurological impairment based on eye movements. We and others have previously demonstrated the feasibility of such an approach for identifying ophthalmic disorders , and for neurological conditions . Compared to other high-throughput eye-tracking tests, SONDA has two main advantages. First, excluding calibration , the whole assessment takes only 4 min . Second, our task and stimulus were designed to be as intuitive and simple as possible to avoid confounding factors that may be caused by natural or more complex stimuli, or complicated instructions resulting in a higher cognitive load.
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Comparing Multiple Sclerosis And Parkinsons Disease Causes
Multiple sclerosis is an autoimmune disease in which the immune system attacks the myelin, causing damage and thus exposing nerve fibers. Like many autoimmune diseases, the exact cause is unknown, but environmental, immunologic, infectious, and genetic factors have all been found to play a role in the onset of multiple sclerosis.
When certain nerve cells in the brain begin to die or break down that is what causes Parkinsons disease, but why this occurs is unclear. Some factors that contribute to nerve cell death include genetics as specific gene mutations have been identified to contribute to Parkinsons disease, environmental factors such as exposure to certain toxins, the presence of Lewy bodies in the brain as well as alpha-synuclein found in Lewy bodies.
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Cidp And Not Something Else
To diagnose CIDP, doctors rule out other causes of your symptoms. Itâs often a process of elimination, nerve conduction tests, MRI and nerve biopsy to list of tests you may get. But there are differences.
Guillain-Barre syndrome comes on and goes away quickly. People with it may recover within 3 months. CIDP gets worse more slowly and often lingers for several months or even years.
Both multiple sclerosis and CIDP involve damage to the sheath that surrounds nerves, called myelin. But multiple sclerosis is a disease affecting the central nervous system, which includes the brain and spinal cord. CIDP doesnât affect these areas of the body.
People with multifocal motor neuropathy or Lewis-Summer syndrome usually have weakness on one side of the body. In CIDP, the symptoms are on both sides. The symptoms of MMN donât usually include loss of sensation, as CIDP does.
Even if a doctor isnât certain you have CIDP, they may decide to treat you for it. Left untreated, 30% of people diagnosed with CIDP will need a wheelchair to get around. Early recognition of the condition and prompt, thorough treatment will aid in your recovery.
Metabolite Of Multiple Sclerosis Drug Could Be Safe Effective Therapy For Parkinsons Disease
The metabolite of a drug that is helping patients battle multiple sclerosis appears to significantly slow the onset of Parkinsons disease, researchers say.
The oral drug, dimethylfumarate, or DMF, and its metabolite, monomethylfumarate, or MMF, both increase activity of Nrf2, a protein that helps protect the body from oxidative stress and inflammation, hallmarks of both diseases, said Dr. Bobby Thomas, neuroscientist in the Department of Pharmacology and Toxicology at the Medical College of Georgia at Augusta University.
But the new study provides the first evidence that the metabolite, which is essentially the active portion of the parent drug, more directly targets Nrf2, potentially reducing known side effects of the parent drug that include flushing, diarrhea, nausea, vomiting, abdominal pain and the brain infection encephalopathy, said Thomas, corresponding author of the study in The Journal of Neuroscience.
Particularly, the gastrointestinal side effects can exacerbate some problems patients with Parkinsons already experience, said Dr. John Morgan, neurologist, neuroscientist and Parkinsons disease specialist in the MCG Department of Neurology. In addition to destroying neurons in the brain that produce dopamine, a neurotransmitter that enables movement and learning, Parkinsons causes nerve cell death in the gastrointestinal tract and related problems such as severe constipation.
Nrf2 is a natural protective mechanism we have for oxidative stress, Thomas said.
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