What is Parkinson’s Disease?

Parkinson’s Disease can be a confusing and scary diagnosis, and one that comes with a lot of unknown factors and questions. At NeuroLab 360, we want to provide you with information that helps you feel empowered to ask questions and seek the right treatment. Below is a summary about Parkinson’s Disease and we will continue to add other posts about the specifics of living with this diagnosis.

Parkinson’s Disease is a progressive disorder that affects a part of your brain called the basal ganglia. The job of the basal ganglia is to modify the signals that are sent to and from your brain by producing a hormone called dopamine. These signals are meant to make your movements more controlled, coordinated, and automatic. The basal ganglia also has connections with the pathways in your brain that control emotions and cognitive functions. With Parkinson’s Disease, the cells that produce dopamine begin to become less effective and start to die off. By the time of diagnosis, 50-60% of the cells that produce dopamine in the basal ganglia can be gone. We will discuss later howe exercise can help with this! It can be diagnosed as early as 30 years old and the prevalence of it increases with age. Typically it is diagnosed between 55-65 years of age with those over 65 at a much higher risk.

The cause of Parkinson’s disease is still not entirely known, but there is starting to be a growing body of evidence to show that it is a combination of many factors. Researchers are starting to find that certain genes may make you predisposed to getting Parkinson's Disease, although it is not these genes alone that will determine if you will develop this disease. Researchers are finding that it is exposure to environmental factors in combination with this genetic predisposition that results in many cases of Parkinson’s disease. Factors such as pesticide exposure, dairy consumption, melanoma and traumatic brain injuries all have some association with increased risk for developing this disease.

Parkinson’s must be diagnosed by a neurologist. Beacuse there is no known medical test that can definitively diagnose Parkinson's disease, a neurologist must look for signs that indicate Parkinson’s as an indirect method of diagnosing the patient. A neurologist may use a clinical test, such as an MRI or DAT scan, but only in order to rule out other diagnoses. The cardinal signs of Parkinson’s are: bradykinesia (slow movement), a resting tremor (usually seen in one side of the body first), rigidity, and imbalance not caused by another diagnosis. The neurologist may also look for other non-motor signs, such as constipation, loss of smell or difficulty with sleep, to help confirm their diagnosis of Parkinson’s disease.

It is important to see a Neurologist that is a Movement Disorder Specialist due to the complicated nature of Parkinson’s disease and its progression. This means that the Neurologist has completed a fellowship for additional training in Parkinson’s Disease and other movement disorders.

WHAT DOES PARKINSON’S DISEASE LOOK LIKE?

The effects of Parkinson’s disease are different for every person, although there are some symptoms that are more common than others:

Physical: resting tremor, rigidity, bradykinesia (slow movement), hypokinesia (small movement), falls, freezing of gait, and difficulty with turning

Emotional: hyperemotional, depression, apathy, and anxiety

Cognitive: deficits in problem solving, multitasking, initiating an activity, and memory

Other symptoms: constipation, day time sleepiness, sexual symptoms, drooling, and difficulty sleeping at night

EXERCISE AS MEDICINE:

As the body starts to produce less dopamine, a person’s movements start to become slower, less automatic, and they have an increased risk of falling. A physical therapist (especially one that is a Board Certified Neurologic Clinical Specialist and is PWR! Moves Certified!) can develop an exercise program to help teach you how to safely move and help slow the progression of the disease. Exercise has been shown to help slow disease progression by making your medications more efficient, improving the energy utilization within your cells and increasing the health of the functioning cells within your brain.

Aerobic exercise, specifically, has been shown to help release a hormone called Brain Derived Neurotrophic Factor (BDNF). This hormone is produced in your brain and has been shown to protect the nervous system. With moderate to high intensity aerobic exercise, BDNF is produced and can have lasting effects for protecting dopamine cells, whether they have been affected by the disease yet or not. Additionally, in Parkinson’s disease, it has been shown that there is a build up of protein called alpha-synuclein. This build up around your cells makes them work less effectively. Exercise has also been shown to help improve the efficiency of the mechanisms within your brain that help rid your body of this build up of protein.

The type of exercise an individual with Parkinson’s Disease performs is important. It has been shown that moderate to high intensity, big and powerful movements have been the most beneficial for affecting the neural changes associated with Parkinson’s disease. It’s also important to include some sort of cognitive challenge in your exercises, such as multitasking, to maximize the benefits.

Below are examples of these exercises:

● Large amplitude movements: PWR! Exercises, boxing, dance, and weight training

● Aerobic exercise: cycling, swimming, and power walking

● Balance Exercises: tai chi, pilates, and yoga

Exercise should be started as soon as possible, even without a definite diagnosis of Parkinson’s Disease, as it may help slow the progression over time. However, it is never too late to get started either! Remember, always get approval from your doctor prior to starting an exercise program.

A TEAM APPROACH TO PARKINSON’S DISEASE TREATMENT

A comprehensive approach from a team of therapists (physical therapy, occupational therapy, speech therapy, and psychology) is really the most effective way to address the multitude of difficulties associated with this disease. Each discipline can specifically address your individual needs and help you develop a plan to start working improving your quality of life. Ask your doctor about a referral for an assessment with any one of these specialists.

Support groups, both for those with Parkinson’s and for their families, are a great way to learn more information about Parkinson’s Disease. The Parkinson’s Foundation is a great resource for more information on local support groups and can be reached via phone at: 1-800-4PD-INFO (473-4636) or via email at: helpline@parkinson.org.

Please don’t hesitate to reach out to us with any questions! Join our mailing list (below) to stay up to date on new classes, opportunities, and blog posts. We hope to see you in an exercise class soon!