What is parkinson disease?
Parkinson disease (PD) belongs to a group of conditions called motor system disorders, which are the result of the loss of dopamine-producing brain cells. The four primary symptoms of PD are tremor, or trembling in hands, arms, legs, jaw, and face; rigidity, or stiffness of the limbs and trunk; bradykinesia, or slowness of movement; and postural instability, or impaired balance and coordination. As these symptoms become more pronounced, patients may have difficulty walking, talking, or completing other simple tasks. PD usually affects people over the age of 60 but may also affect people under the age of 50 (young onset Parkinson’s disease). Early symptoms of PD are subtle and occur gradually. In some people the disease progresses more quickly than in others. As the disease progresses, the shaking, or tremor, which affects the majority of people with PD may begin to interfere with daily activities. Other symptoms may include depression and other emotional changes; difficulty in swallowing, chewing, and speaking; urinary problems or constipation; skin problems; and sleep disruptions. There are currently no blood or laboratory tests that have been proven to help in diagnosing sporadic PD. Therefore, the diagnosis is based on medical history and a neurological examination. The disease can be difficult to diagnose accurately. Doctors may sometimes request brain scans or laboratory tests in order to rule out other diseases.
Source: National Institute of Neurological Disorders and Stroke
Scientists looking for the cause of PD continue to search for possible environmental factors, such as toxins, that may trigger the disorder, and study genetic factors to determine how defective genes play a role.
Source: National Institute of Neurological Disorders and Stroke
Is parkinson's hereditary?
What causes pd?
Although significant research advances have been made, including the recent identification of possible environmental and genetic risk factors for PD, further research is required to elucidate underlying causes of PD. Scientists looking for the cause of PD continue to search for possible environmental factors, such as toxins, that may trigger the disorder, and study genetic factors to determine how defective genes play a role.
Source: National Institute of Neurological Disorders and Stroke
Coping
How can people cope with parkinson disease?
While PD usually progresses slowly, eventually daily routines may be affected—from socializing with friends to earning a living and taking care of a home. These changes can be difficult to accept. Support groups can help people cope with the disease’s emotional impact. These groups also can provide valuable information, advice, and experience to help people with PD, their families, and their caregivers. Support groups can deal with a wide range of issues, including locating movement disorder specialists (doctors who specialize in Parkinson disease), education, and coping mechanisms to help with physical limitations. Individual or family counseling may also help people find ways to cope with PD.
People with PD may also benefit from being proactive and educating themselves as much as possible about the disease to alleviate fear of the unknown and to take a positive role in maintaining their health. Many people with PD continue to work either full- or part-time, although they may need to adjust their schedule and working environment to accommodate their symptoms.
Source: National Institute of Neurological Disorders and Stroke
What are some tips to stay positive?
We need to give and receive a hug every day. Hormones released from a hug can combat blood pressure problems, increase immunity to disease and increase levels of serotonin and dopamine in our system.
Laughter both decreases tension and enhances oxygen intake, therefore improving one’s mood. So make some time to laugh!
Be flexible and accommodating the ideas and behaviors of others without surrendering to them. If the only disability in life is a bad attitude, what are you really capable of doing now?
Source: Dr. Ted Barrett, 2016 Spring Forum presenter
Memory Problems
What are some tricks to help make daily life with memory issues easier?
Keep paper clips handy for clipping reminders and notes. We all have memory problems stemming from the aging process and/or cognitive issues of PD, but tools like reminder words or clues can help us. Try keeping a “don’t lose it” basket for your keys, wallet, cell phone, mask, and other important items so you can always find them in a hurry.
Source: Dr. Ted Barrett, 2016 Spring Forum presenter
Treatment Options
Besides drug therapy and surgery, what other treatment programs are available?
Exercise can help people with PD improve their mobility and flexibility. Some doctors prescribe physical therapy or muscle-strengthening exercises to tone muscles and to put underused and rigid muscles through a full range of motion. The effects of exercise on disease progression are not known, but it may improve body strength so that the person is less disabled. Exercises also improve balance, helping people minimize gait problems, and can strengthen certain muscles so that people can speak and swallow better. Exercise can improve emotional well-being and general physical activity, such as walking, gardening, swimming, calisthenics, and using exercise machines, can have other benefits.
Other complementary and supportive therapies that are used by some individuals with PD include massage therapy, yoga, hypnosis, acupuncture, and the Alexander technique, which optimizes posture and muscle activity.
Another important therapeutic approach involves speech and swallowing evaluation and therapy. Certain techniques can help with the low voice volume that individuals with Parkinson’s often experience.
Source: National Institute of Health: National Institute of Neurological Disorders and Stroke
Additionally, our November 2020 PD Edu speaker, Jennifer Woods discusses Integrative Medicine and Tai Chi in the video below.
Doctor's Visits & Hospitalizations
How can I plan ahead to have a more positive doctor’s visit or hospital stay?
Our October 2020 PD Edu speakers, Carol Simons and Cheryl Wirtley talked about their experiences with planned (and unplanned) medical visits as part of PD Edu. They share some tips in the video below.
Sleep & PD
How is sleep affected by PD?
Sleep disorders and PD have a wide range of symptoms and few treatments. People with Parkinson’s disease often have excessive daytime sleepiness. They also fall into REM sleep more quickly than the average person, according to their brain activity. As PD progresses and symptoms worsen, sleep problems may become more serious. Insomnia could be caused by pain and uncontrollable movements, or even certain medications used to treat PD symptoms.
could adjusting my medication help me to get better sleep?
If you’re experiencing insomnia due to pain or uncontrollable movements, taking medication earlier in the day may improve sleep. Keep in mind that any change in medication—including the addition of sleep aids or changes to timing of doses—should be prescribed by a physician. Over-the-counter sleep aids usually contain diphenhydramine (Benadryl), an anti-histamine which blocks absorption of dopamine. Melatonin however, does not block absorption of dopamine, so it can be helpful in falling asleep if you take it at least one hour before bedtime. You can take up to 12 mg/night.
Daytime sleepiness may also increase as Parkinson’s disease progresses. Using stimulant or alerting medications during the day may prevent sleep attacks and help patients avoid excessive napping, which also may contribute to insomnia. The most common drug used is methylphenidate (Ritalin). The other drug is modafinil (Nuvigil) which is difficult to get insurance to approve as it is only approved for narcolepsy.
Source: Maureen Gartner, NPC
What are some tips to better regulate sleep without adjusting medication?
In addition to drug therapies, behavioral techniques can also be used for sleep and sleepiness problems in Parkinson’s patients.
Keep a regular sleep schedule; go to bed and get up at the same time each day.
Take sedating medication later in the day so symptoms don’t increase as you sleep.
Use satin sheets and pajamas to help you get into and out of bed.
Minimize beverages before bedtime to avoid nocturia (frequent nighttime urination).
Get exercise and exposure to light early in the day.
Source: Maureen Gartner, NPC
LET’S TALK ABOUT CORONAVIRUS (COVID19)
Courtesy of The Medical and Research Staff of The James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology, University of Cincinnati, Cincinnati, OH.
This is a translated opinion statement graciously provided by Prof., Dr. Alessandro Tessitore, an Italian Neurologist and expert in Parkinson’s disease and movement disorders. It has been adapted for our community in the Greater Cincinnati area.
We are neurologists, not epidemiologists or virologists. We are experts in Parkinson’s disease, a condition in which 80% of patients are 65 years old and up. While we are not emergency doctors, we recognize that people with Parkinson’s disease are not at a higher risk of contagion due to the Coronavirus, also known as COVID19. Moreover, being affected by Parkinson’s disease does not expose you to a greater risk of complications, unless you have other chronic diseases that are not adequately controlled.
Anti-Parkinsonian drugs DO NOT reduce your immune system. Disease duration has to be taken into account as a possible factor to consider, given the higher frailty of elderly patients.
Please follow the suggestions of the CDC, or Centers for Disease Control and Prevention. The CDC is the US agency charged with tracking and investigating public health trends. It publishes key health information, including weekly data on all deaths and diseases reported in the US and health advisories. The CDC also fields special rapid-response teams to halt epidemic and pandemic diseases, such as COVID19.
Some guidelines to follow:
Never shake hands
Wash your hands frequently
Avoid crowded places
Avoid gatherings with people in close proximity (sporting events, religious services)
Avoid close contacts with people affected by acute flu-like symptoms
Cancel/avoid all travel
Moderate and regular physical activity should be done at home
It is important to be cautious at this moment; we all need to play a role in limiting the spread of the virus. To do so, our clinic has asked patients, if possible, to hold off coming for their regular appointment –whenever possible, we will move to phone-based visits. The clinical team will still see patients who have urgent needs to keep them from having to seek emergency care at the hospital. Always ask your PCPs and your neurologists if you have any doubts.