Parkinson : causes symptoms & treatment

Parkinson : causes symptoms & treatment

The Parkinson is a chronic degenerative disease , progressive central nervous system. In fact, it is characterized by motor slowdown (akinesia, bradykinesia, hypokinesia), muscle stiffness and tremor. But, it is also often associated with cognitive disorders of varying degrees (up to a clinical picture of dementia) and other non-motor symptoms such as depression, urination disorders, constipation and others.

The men are affected by the disease with a greater, albeit minimal, frequently than women (ratio 3: 2). In addition, with the introduction (late 1960s) of L-Dopa (levodopa) as a therapeutic treatment, the survival of those affected has increased, although the mortality rate still remains around 1.6–2.9 times higher. than the general population.

However, the most frequent cause of death is bronchopneumonia , a consequence of reduced mobility, and dysphagia that characterize the very advanced stages of the disease.

Parkinson’s disease was first described in 1817 by James Parkinson in the treatise An Essay on the Shaking Palsy .

Parkinson’s disease: what it is

Parkinson’s is a disease caused by the progressive degeneration of some areas of the brain, especially those responsible for motor functions and coordination of movements. In fact, an alteration of the cells located in the substantia nigra or black substance and anatomo / functional impairment of the basal ganglia are observed . The basal ganglia are aggregates of nerve cells located deep in the brain and responsible for:

  • initiate and regulate voluntary movements
  • inhibit involuntary movements
  • coordinate changes in posture.

The impulse sent by the brain for any movement (for example to raise an arm) passes right through the basal ganglia. But, like all nerve cells, those in the basal ganglia release chemical messengers (neurotransmitters) that activate the next cell in the path traced to send an impulse. One of the most important neurotransmitters in the basal ganglia is dopamine .

But, when the nerve cells of the black substance degenerate, they produce a lower level of dopamine and the number of connections between the nerve cells decreases. In fact, the direct consequence is that the basal ganglia cannot control movements , as they normally would.

Thus, this involves the appearance of tremor, slowing of movements (bradykinesia), reduction of the amplitude of movement (hypokinesia), posture and walking problems and a partial loss of coordination.

Parkinson what it is
Source : healthscareconcept.com
Who hits

Parkinson’s is the second most common degenerative disease of the nervous system after Alzheimer’s disease and affects:

  • about 1 in 250 people over the age of 40
  • about 1 in 100 people over the age of 65
  • about 1 in 10 people over the age of 80.

It usually occurs between the ages of 50 and 79, rarely in children or adolescents.

Parkinson’s disease: historical background

Several ancient sources describe symptoms similar to those of Parkinson’s disease, such as tremors, stiffness, limited movement and posture disorders, including:

  • Egyptian papyrus
  • Ayurveda medical treatise
  • Bible
  • traditional Chinese medicine treatise from 425 BC
  • writings of Galen (129-216)

Subsequently, in 1912, Frederic Lewy first described the “Lewy bodies” , abnormal protein aggregates that settle in the nerve cells, a typical pathological alteration of Parkinson’s disease. In 1919, Konstantin Tretiakoff discovered that the substantia nigra is the main brain structure affected. This area is rich in nerve cells that use dopamine as a neurotransmitter.

James Parkinson

But, Parkinson’s disease was first described as a neurological syndrome in 1817 by James Parkinson , an English physician, in his essay ” Essay on Shaking Palsy ” . In fact, he described patients suffering from tremor at rest who showed a decrease in muscle strength and a particular way of walking, in small steps and with a tendency to tilt the trunk forward, also signaling the progression of the disease over time.

However, Parkinson attributed the cause of the disease to air pollution from the industrial revolution in England. But, many scientists after him sought, without success, the cause of the disease. In fact, this is not yet known, while the mechanism responsible for the symptoms of the disease has been clarified .

Subsequently, it will be Jean-Martin Charcot to describe, more than 50 years later, more accurately the clinical picture of this syndrome, recognizing the independence of the three main symptoms (bradykinesia, rigidity and tremor) and giving it the name of Parkinson’s disease .

Illness of great men

Parkinson is also known as “great men’s disease” . In fact, many famous characters have suffered or suffer from it:

  • Francisco Franco
  • Franklin Delano
  • Roosevelt
  • Arafat
  • Mao
  • Bresniev
  • John Paul II
  • Cassius Clay.
Levodopa

Synthesized for the first time in 1911 by the Polish chemist Kazimierz Funk , it did not attract particular attention from the scientific world.

But, the intuition to administer levodopa , to compensate for the lack of dopamine , was instead due to the Swedish scientist Arvid Carlsson , in the sixties. In fact, he was the first to administer levodopa to rodents with symptoms comparable in part to those present in parkinsonian patients, obtaining surprising results.

Thus, the Swedish researcher thus laid the foundations of what soon became the most important cure for Parkinson’s disease, a discovery that earned him the Nobel Prize in 2000 .

Parkinson: epidemiology

Parkinson’s affects about 0.3% of the entire population . Rather rare before the age of 50, the prevalence increases up to 1% in subjects over 60 and 4% in subjects over 80. The incidence is also low before the age of 50 and reaches the highest values in the classes of aged between 70 and 79 years .

But, the disease, in about 90% of cases, is considered sporadic, but in the remaining 10%, especially in juvenile onset forms, it is genetically determined .

Parkinson: causes and risk factors

What are the causes of Parkinson’s? In recent years, numerous studies have shown that the accumulation of altered forms of alpha-synuclein (a brain protein that in physiological conditions helps nerve cells to communicate with each other) forms clusters called “Lewy bodies” in different regions of the brain, especially in the brain stem and cerebral cortex, interfering with brain function.

Hence, the accumulation of Lewy bodies in the cerebral cortex is related to the development of dementia , which occurs in at least a third of people with Parkinson’s.

But, in 90% of cases it is a sporadic disease, with multifactorial origins and linked to an interaction between environmental and genetic causes.

Genetic factors

About 10-15% of people with Parkinson’s have or have had one or more family members with the disease . Some genetic mutations can therefore play an important role, especially in juvenile onset forms .

Environmental factors

There has been a correlation between disease onset and some environmental factors.

These include :

  • exposure to toxic substances or interaction between genetic predisposition and exogenous toxins such as pesticides, metals, industrial chemicals and used in agriculture
  • lifestyle (unbalanced diet and smoking). The latter would appear to have a protective effect on the development of the disease. However, the many smoking-related diseases can worsen the general state of health
  • professional activity (agricultural work).

In addition, in the 1980s, it was shown that a neurotoxin (MPTP), synthesized by mistake in the “domestic” production of heroin and self-injected by drug addicts , induced irreversible parkinsonism and selective destruction of neuronal cells.

Parkinson: symptoms and clinical features

What are the symptoms in Parkinson’s ? The disease has a slowly evolutionary course. The initial symptoms can be modest and sometimes not immediately recognized, since they are “non-specific” or attributed to the normal alterations typical of aging.

Motor symptoms

The bradykinesia (slowness of movement), the rigidity and tremor are the main symptoms of the disease engines.

So, at the onset, the symptoms and motor signs manifest themselves , in most cases, in only one side of the body , and then spread, over the years, also to the other side. However, a certain degree of asymmetry between the two sides persists throughout the disease.

Movement impairment

Impaired movement in Parkinson’s involves:

bradykinesia

By bradykinesia, we mean slowness in the execution of voluntary movements (includes hypokinesia , i.e. the reduced amplitude of movements and akinesia , i.e. the difficulty in starting the desired movement).

It is particularly evident in the execution of normal daily life activities , for example:

  • slowing of pace
  • reduction of limb movements
  • execution of complex movements of the upper limb
  • modification of the writing which becomes progressively smaller (micrograph).

The elements that characterize it are:

  • progressive reduction of the amplitude of voluntary movements
  • reduction of facial mimicry (hypomimia) and blinking frequency
    limitation of eye movements
  • modification of the tone of the voice
  • excess salivation (sialorrhea), a consequence of the reduced frequency of spontaneous acts of swallowing
  • increase in the time required to start a voluntary movement (the person hesitates a few seconds before starting to walk)
  • motor block commonly called freezing (inability to move involving mainly the lower limbs, which remain “glued” to the ground, at the beginning of the step and in the change of direction or in the passage through small spaces – for example the passage of a door ).

Parkinson’s disease and muscle stiffness

Muscle stiffness means the increase in muscle tone in the limbs and head. But, it can be associated, in the advanced stages of the disease, with postural deformities , which mainly involve the neck and trunk, often with a marked latero-deviation of the trunk.

Tremor and Parkinson’s disease

Tremor occurs in the resting stages and is often one of the first symptoms felt, particularly when it affects the hand, and is accentuated by emotions; it subsides or disappears with voluntary movement and during sleep.

In addition, it can also involve the lips, chin and lower limbs . It is characterized by repeated hand supination-pronation movements (“making pills” or “counting coins”).

Postural instability

Postural instability characterizes the most advanced stages of the disease. In fact, it is the main cause of falls , as it becomes very difficult to maintain balance with the tendency to fall forward or backward.

Non-motor symptoms

Non-motor symptoms in Parkinson include:

  • depression . It can affect up to 40% of subjects and is characterized by apathy, disinterest and reduction of social activities and relationships and anhedonia (ie the loss of pleasure and interest in carrying out common activities)
  • cognitive disorders . They are generally present in a mild form and can progress in at least 30-40% of cases, up to evolving into dementia (which occurs in 70% of subjects over 80 years of age)
  • urination disorders . Increased urination frequency, sometimes incontinence
  • orthostatic hypotension and impotence in humans
  • sleep disturbances (excessive daytime sleepiness, insomnia, parasomnias and REM sleep disturbances
  • anxiety
  • gastrointestinal disorders (dysphagia, constipation)
  • hyposmia or disturbances in the sense of smell (hyposmia). They occur frequently, even before the onset of motor symptoms
  • dementia or impaired thinking
  • hallucinations , delusions and paranoia , especially if dementia develops.

Evolution of Parkinson’s disease: Hoehn & Yahr scale

The clinical picture in Parkinson’s is classified into 5 progressive stages of disability according to the Hoehn and Yahr scale. But, other scales are used to evaluate:

  • severity of symptoms (Movement Disorder Society Unified Parkinson Disease Rating Scale: MDS UPDRS)
  • quality of life (PDQ-39)
  • Non Motor symptoms Rating Scale.
The 5 stages of the disease

Evolution of Parkinson’s disease: Hoehn & Yahr scale

Stage 1: Unilateral disease

Stage 2: Bilateral disease without balance involvement

Stage 3: Bilateral disease, independent postural instability

Stage 4: Serious illness, autonomous walking, postural deficits

Stage 5: Affected person confined to bed or wheelchair.

Parkinson’s disease: diagnosis and prognosis

How do you recognize early Parkinson’s symptoms? The diagnosis is based solely on clinical evaluation. But, neuroimaging (especially Magnetic Resonance Imaging) does not show specific aspects of the disease. However, they are useful to exclude the presence of structural alterations due to suffering:

  • vascular
  • hydrocephalous
  • normotensive
  • brain tumors, etc.

In some dubious clinical situations, for example in the case of atypical tremor, it may be useful to carry out other investigations, such as cerebral scintigraphy (SPECT) to evaluate the integrity or alteration of the nigro-striatal dopaminergic system.

It may not be easy for the doctor to diagnose the disease at an early stage, as it usually occurs imperceptibly .

But, in older people it is even more difficult because aging causes symptoms such as loss of balance, slowing of movements, muscle stiffness and blockage of posture. So sometimes essential tremor is confused with Parkinson’s.

A complete clinical picture may require diagnostic investigations useful for assessing cognitive, cardiovascular, urological and psychiatric functions. In differential diagnosis, essential tremor, other forms of degenerative parkinsonism and secondary parkinsonisms will be considered in particular.

Finally, recent studies have shown how it is possible to verify the presence of alpha-synuclein and structural modifications of the protein in the cephalorachid liquor, saliva and skin.

Physical examination

During the physical examination, the subject is asked to perform some movements that can help confirm the diagnosis.

For example, in people with Parkinson’s, the tremor disappears or decreases when the doctor asks the person to touch their nose with a finger. In addition, there is difficulty in performing rapid alternating movements , such as putting your hands on your thighs, then quickly turning them several times.

In fact, a very sensitive test to highlight bradykinesia is the so-called finger tapping , i.e. repeatedly beating the index finger on the thumb for 10-15 seconds and assessing the frequency and amplitude of the movement.

Differential diagnosis

A correct differential diagnosis between Parkinson’s and other secondary forms of parkinsonism is essential to identify the appropriate treatment. Therefore, in addition to an accurate medical history, it is necessary to carry out all the diagnostic tests necessary to exclude other related pathologies.

Main forms of parkinsonism

By secondary parkinsonism , we mean a series of disorders that have characteristics similar to those of Parkinson’s, but which have a different etiology.

Drug parkinsonism

All drugs that can block dopaminergic receptors or cause a decrease in presynaptic dopamine can cause symptoms typical of Parkinson’s, including:

  • neuroleptics
  • lithium salts
  • some antiemetics, antihypertensives and antiepileptics.

Parkinsonism from vascular causes

The clinical picture involves the lower limbs, with changes in the gear and rigidity and absence of tremor. Hence, cognitive impairment is often associated as a manifestation of vascular damage. This parkinsonism is observed mainly in the elderly, with vascular risk factors.

Parkinsonism from infectious causes

Several infectious diseases may be responsible for the onset of secondary parkinsonism such as, for example, some forms of viral encephalitis .

But, currently, the most common infectious cause of parkinsonism is AIDS by direct action of the virus or by infections of the central nervous system associated with this disease.

Parkinsonism from hydrocephalus (accumulation of CSF in the brain)
In normal pressure hydrocephalus, early changes in gait and posture with cognitive impairment may be present.

Space-occupying injury Parkinsonism

Different types of injuries (bleeding, benign and malignant tumors, abscesses) can cause parkinsonian syndrome. But more frequently, these are brain tumors.

Head injury Parkinsonism

Parkinsonism can be secondary to repeated and protracted head injuries, for example in professional boxers . In this case, the most frequent neurological consequence is dementia , but symptoms similar to Parkinson’s may also be associated.

Parkinsonism from toxic substances

Exposure to environmental toxic substances and taking drugs can cause forms of parkinsonism. But, the most frequent is that which can affect miners and workers due to manganese exposure.

In this form, fatigue and cognitive and behavioral disorders (aggressiveness and irritability) are associated with bradykinesia and rigidity . However, other toxic causes are methanol and carbon monoxide poisoning.

Parkinson’s disease: prognosis

How old can you live with Parkinson’s? The disease is not fatal, but over time it tends to get worse and there is currently no cure that can block the degenerative process. But life expectancy in Parkinson’s is generally slightly lower than that of a person without the disease.

However, complications can occur in the later stages, such as respiratory changes, falls and dysphagia, and lead to a fatal outcome.

But, the progression of symptoms can develop over a period of about 20 years , although in some people the disease progresses faster.

However, with appropriate drug treatment, most people with Parkinson’s can live productive lives for several years after diagnosis.

Nonetheless, although well controlled by drugs, Parkinson’s still remains a pathology from which it cannot heal and whose progression, especially in the advanced stages, can seriously compromise the quality of life of those affected.

Parkinson’s disease: treatment and therapy

How is Parkinson’s disease treated? Therapy is still essentially symptomatic , as there is currently no possibility of interfering with the mechanisms of neuronal damage. Hence, the treatments are mostly pharmacological and rehabilitative. In addition, benefits are also obtained with Deep Brain Stimulation .

Exercise and proper nutrition certainly play an important role in functional maintenance.

Pharmacological therapy

The basic treatment consists in increasing the concentration of dopamine in the basal ganglia, using some drugs. The main ones are:

Levodopa

The decrease in the concentration of dopamine in the brain is related to the clinical severity of the motor symptoms of the disease. In fact, there must be a reduction of at least 60-80% of the dopamine concentration for the disease to manifest itself clinically.

But, since dopamine is not able to cross, if not in a small part, the blood brain barrier, the therapy is based on the use of levodopa (or L-Dopa), an amino acid capable of crossing this barrier and then being transformed by the body in dopamine. But, the intestinal absorption of L-Dopa can be limited by the presence in the intestine of high concentrations of other amino acids, as happens, for example, after a high protein meal . This is why nutrition in Parkinson’s plays an important role.

The most frequent side effects of levodopa are:

  • gastro-intestinal : nausea, vomiting;
  • vegetative : postural hypotension;
  • motors : involuntary movements;
  • neuropsychiatrists : hallucinations and psychotic phenomena or confusional states.

In addition, levodopa reduces muscle stiffness , improves movement and substantially decreases tremor. The drug allows many individuals with mild pathology to return to an almost normal level of activity.

Dopamine-agonist

They are drugs that act directly on dopaminergic receptors. Those most used are:

  • pramipexole and ropinirole, administered orally
  • rotigotine, administered with a skin patch
  • apomorphine administered subcutaneously.

Although less effective than L-Dopa, these drugs can be used alone in the early stages of the disease or in combination with L-dopa in the later stages.

However, the most frequent side effects are:

  • nausea
  • He retched
  • orthostatic hypotension
  • excessive daytime sleepiness
  • sudden sleep attacks
  • hallucinations
  • psychosis and impulse control disorder (pathological gambling)
  • hypersexuality
  • hyperphagia
  • compulsive shopping.

MAO-B inhibitors

They are substances that inhibit the metabolism of dopamine by increasing its residence time at the level of the intersynaptic space. In fact, they are used both in the initial phase of treatment and in the advanced phase , in association with L-Dopa. Between these:

  • rasagiline
  • selegiline
  • safinamide.

COMT inhibitors

These substances slow down the metabolism of levodopa and increase its half-life (i.e. the residence time of the drug in the blood).

The main ones are:

  • entacapone
  • opicapone
  • tolcapone.

The latter also crosses the blood brain barrier and also works centrally. But, these drugs must always be administered in combination with L-Dopa and can cause a significant increase in dyskinesias (involuntary movements). In addition, tolcapone can cause liver toxicity.

Anticholinergic

They are the least used because of the side effects. In a few cases they can help control tremor. In addition, they are to be avoided in the elderly because, if taken for a long time, they increase the risk of mental decline and for side effects:

  • confusional state
  • drowsiness
  • dry mouth
  • blurred vision
  • dizziness
  • constipation
  • difficulty urinating and loss of bladder control.

Other drugs

Amantadine, a drug sometimes used to treat flu, is used in Parkinson’s especially for the control of involuntary movements induced by levodopa.

Parkinson’s disease: rehabilitation therapy

Do you need physiotherapy in Parkinson’s? The disease causes important movement disorders, therefore constant physical exercise helps to counteract slowness, poor fluidity and lack of coordination of movement .

Rigidity and motor slowdown involve changes in posture, gait and balance in general, with repercussions also at the level of the spine and of the individual joints that “fix” themselves in spoiled positions.

Therefore, the exercise, under the supervision of a physiotherapist or an occupational therapist , aims to correct these attitudes and prevent the onset of painful pathologies affecting the osteo-articular structures.

On the other hand, not much can be done to counteract the tremor, although acquiring more confidence in movement can improve mood and reduce anxiety.

Furthermore, subjects who constantly carry out rehabilitation programs often report that they have obtained an increase in the degree of autonomy in the activities of daily life.

Medical-surgical treatments

The deep brain stimulation . This technique consists of surgically implanting small electrodes in some structures of the basal ganglia (especially pale globe and subthalamic nucleus).

In fact, the electrodes send small amounts of electricity to specific areas that are involved in the symptoms of the disease. The electrode implantation area is identified by specific Magnetic Resonance Imaging (MRI) techniques and electrophysiological recordings of the cells. Hence, this therapy is currently indicated in people with advanced disease, cognitively intact, relatively young and with difficulty controlling motor symptoms.

Focused ultrasound

Furthermore, the focused ultrasound technique (FUS) has also recently been introduced . Through Magnetic Resonance Imaging (MRI), the area is identified which will then be affected with focused ultrasound which, through the generation of heat, causes an injury to the area to be deactivated.

This procedure does not involve invasive surgery and can mainly relieve tremor.

Parkinson: importance of nutrition

A healthy and balanced diet is important for everyone’s well-being, especially for people with Parkinson’s, especially if they are being treated with levodopa.

In fact, levodopa is an amino acid that uses active transport with energy consumption to absorb it, that is to pass from the intestine to the blood and from this to the brain.

So anything that can slow down intestinal absorption , such as protein-rich foods, can reduce the amount of drug available for transportation to the brain, thereby reducing the effect of drug therapy.

Also, if the drugs stay in the stomach for a long time, they fail to act on schedule. It is therefore important to limit foods that inhibit gastric emptying , such as:

  • fat
  • protein
  • fibers.
  • Limit proteins

Therefore, limiting the use of food proteins in the first part of the day is useful to improve the effectiveness of the therapy.

However, the total amount of protein to be taken with the diet must be adequate (around 0.8 g per kg of ideal body weight) to avoid deficiencies and malnutrition.

In fact, a balanced diet and a correct distribution of food throughout the day is important. But, it is also essential not to drastically reduce some foods, such as fiber, for example , which, while slowing down gastric emptying, are also indispensable for improving constipation.

Parkinson’s and constipation

For constipation, the following can help:

  • high-fiber diet, including foods such as plums and fruit juices
  • physical activity
  • drink lots of fluids
  • faecal emollients, laxatives or enemas to stimulate intestinal regularity.
  • Altered nutritional status

According to some studies, 65% of people with Parkinson’s have a change in their nutritional status . In fact, in the early stages of the disease, also due to a reduction in physical and motor activity, there is generally an increase in weight , also thanks to dopaminergic drugs that sometimes lead to an increase in appetite. Therefore, this implies a worsening of the motor activities, already compromised in the disease.

Instead, in the final stages of the disease , we are witnessing the opposite phenomenon, that is, weight loss and malnutrition , also due to difficulty in swallowing (dysphagia) and other symptoms such as:

  • sense of smell
  • taste
  • digestive difficulties
  • depression
  • nausea.

But among these, the most difficult symptom to manage is dysphagia , which can result in aspiration of food into the airways with the risk of lung infections.

Dysphagia patients: foods to avoid

In dysphagia patients it is therefore advisable to:

avoid too hard foods that need to be chewed (e.g. crackers, rice, biscuits, etc.)
favor soft or well-chopped, homogeneous and well-blended foods (with a consistency similar to purees and puddings).

Parkinson’s disease: dietary program to follow

In general, the diet program is as follows. However , a nutritionist’s advice is essential in managing the disease .

  • Increase calories in the presence of dyskinesias, to prevent excessive weight loss (since there is an increase in energy expenditure), increasing the amount of carbohydrates (bread, pasta, cereals) and unsaturated fats such as olive oil.
  • Combat constipation with the consumption of whole grains and 4-5 portions a day between fruit and vegetables. Drink a lot of water.
  • Reduce saturated fats (butter, lard, salami, fatty meats, etc.)
  • The amount of protein consumed should be 0.8 grams per kilogram of ideal body weight.
  • (For example, a person weighing 70 kg should introduce about 56 grams of protein during the day).
  • In case of modest motor fluctuations, proteins can be equally distributed throughout the day. For more severe fluctuations, all proteins, in particular animal ones (meat, fish, eggs), should be taken preferably in the evening, introducing mainly bread and pasta or non-protein biscuits for breakfast and lunch.
  • In case of reduced intake of calcium or iron, supplements can be used. Since iron has been shown to interfere in the efficacy of levodopa, it is advisable to take the supplement as far as possible from taking the drug.
  • In the preparation of food, in case of difficulty in chewing and swallowing, it is necessary to chop, blend and give the right density to the food. In case of dysphagia thickeners can be used and for the hydration of the gel water.
Parkinson’s and coffee: an excellent ally

American researchers recently highlighted that caffeine , combined with another compound found in coffee beans, can slow down brain degeneration in Parkinson’s and Lewy body dementia patients.

In fact, the protective function of coffee has long been the subject of research in Parkinson’s. In a study published in the Proceedings of the National Academy of Sciences ( PNAS ), the researchers analyzed the function of EHT , a fatty acid derivative of the neurotransmitter serotonin, which is found in the coffee wax that lines the seed.

However, coffee is a complex blend and a lot also depends on the collection and roasting and whether it is filtered or not.

In fact, EHT levels are appreciable in unfiltered coffee, much less in other types of preparation. The researchers then wanted to test whether EHT and caffeine could have a combined role in the neuroprotection of brain cells.

Through laboratory mice, they saw that the two compounds used individually were not effective, while together they enhanced the activity of an enzyme (PP2A) that helps prevent the accumulation of alpha-synuclein protein aggregates in the brain.

Hence, these findings suggest that EHT and caffeine, combined in specific quantities, could slow the progression of some neurodegenerative diseases such as Parkinson’s . However, more research will be needed to confirm this hypothesis.

Parkinson’s disease and exercise

Exercise in people with Parkinson’s can be hindered by symptoms such as:

  • weakness
  • fatigue
  • long reaction times
  • postural instability
  • impaired motor functions.

In addition, Parkinsonian subjects who perform regular physical activity have been shown to have a better quality of life, greater autonomy and longer life expectancy .

Parkinson: theater and dance

Besides the activities of physiotherapy and physical training, a modern approach to the disease also includes therapies that use and EXERCISES motor and cognitive, combining them with disciplines such as dance , the theater and music . In fact, these activities increase neuronal functions, stimulating sensory experiences and associated pleasure.

So, the goal is to teach you how to learn strategies to manage those symptoms that are not mitigated by drug therapies. Furthermore, they are very useful activities to support the subject psychologically and emotionally in the relationship with the disease, helping him to regain familiarity with his own skills and facilitating social relationships .

Theater workshop

For example, theatrical workshops stimulate the knowledge of one’s body, movement and communication skills. Professional actors teach:

  • control and modulation of mimicry
  • breathing
  • manual coordination
  • posture
  • deambulation
  • verbal and non-verbal communication.
  • Real-life episodes are then staged, both individually and in groups.

These exercises stimulate mental activities that affect the well-being not only of the mood but of the brain itself.

Dance and Parkinson’s disease

Even the dance plays an important role in the stimulation of motor function and body image, partially compromised in people with Parkinson’s.

In particular, dance in Parkinson helps to exercise:

  • balance and coordination
  • stretching and muscle strength
  • orientation in space and time
  • attention, memory and learning
  • imagination and creativity.

In theater and dance, group participation in various activities facilitates social sharing and integration. The results so far are very promising, but scientific validation studies are needed.

Parkinson and yoga

The practice of yoga in Parkinson’s is particularly useful for depressive states, one of the typical symptoms of the disease.

Research published in the Journal of Parkinsonism and Restless Leg Syndrome has highlighted the benefits of yoga, especially for:

  • improvement of balance
  • flexibility
  • lower limb mobility.

In addition, there were also benefits on sleep quality and in social interactions.

But, generally, most research agrees that yoga improves motor parameters and posture , increases strength and ability to move, decreasing the fear of falling. To these physical benefits are added those connected to the discipline, that is a certain inner serenity and a greater willingness to accept coexistence with the disease.

In addition, attention to breathing is able to unlock emotional resistances and stiffness.

How to prevent Parkinson’s disease

Can Parkinson’s be prevented? Not knowing, at present, the causes that trigger the disease, it is not possible to give a certain answer. Even the slow progression over time does not help, however it is confirmed that physical activity can have a neuro-protective effect in Parkinso n, lowering the risk of developing the disease.

Mediterranean diet

Numerous studies are exploring the relationship between diet and low probability of developing Parkinson’s . In fact, the scientific world agrees that the Mediterranean diet reduces mortality and protects against cognitive impairment in the elderly population.

In addition, an American study involved around 132,000 participants, whose diet has been studied for 16 years. The result indicated that the Mediterranean diet, rich in vegetables, fruit and fish , is associated with a reduced incidence of Parkinson’s disease.

The intake of nuts, soybeans, cereals, white meats and polyunsaturated fats also showed significant benefits in terms of overall health.

But, in particular, a team of Swedish researchers has found that a protein present in abundance in most fish, parvalbumin , is able to attract the alpha-synuclein protein by preventing the formation of the typical alpha-synuclein aggregates, the bodies of Lewy , which are deposited in the nerve cells in people with Parkinson’s.

The same team has started other studies to verify how parvalbumin is distributed in the human body, to evaluate if it arrives where it really is needed.

The richest fish in parvalbumin are:

  • cod
  • carp
  • herring
  • salmon.
Antioxidants

A number of antioxidants are also being studied as Parkinson’s protective factors. Between these:

  • coenzine Q10
  • polyphenols
  • green tea
  • folic acid
  • glutathione
  • Vitamin E
  • C vitamin
  • alpha lipoic acid.

However, it has not yet been shown that multivitamin and antioxidant supplements have a direct and specific effect on Parkinson’s disease.

External links:

Parkinson’s Disease at Curlie

World Parkinson Disease Association

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