Motor System Disorders Associated with Parkinson's Disease

Motor System Disorders is actually an umbrella term used to cover many of the neurological diseases. Parkinson's disease is one of those disorders. For many of these disorders, the main cause of the disorder is a loss of a chemical that is produced in the brain called Dopamine. Dopamine carries messages to the part of the brain that handles body co-ordination and movement. When the dopamine supply is reduced (as in Parkinson's), the messages are reduced or eventually stop altogether which reduces the body's ability to move normally as it should do.

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In general, Parkinson's disease is more frequent in people over the age of 50. But there are many cases where it has developed in people of a much younger age. Regardless of the patient's age at onset, if the disease is diagnosed while still in an early stage, and if the dopamine in the brain has not been severely depleted yet, medical treatments can usually help with decelerating the progress of the disease.

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The more classic symptoms of Parkinson's disease are:

Tremors. This is shaking of the face, jaw, and limbs. Rigidity or stiffness in the torso and limbs Slow movement Decrease in co-ordination and balance.

In the very early stages, these symptoms can seem minor to the point that they are ignored, missed, or overlooked. However, as the disease progresses, the symptoms become more noticeable until at some point they literally control the patient's life.

In addition to the above, other problems are also associated with Parkinson's disease:

Depression: There are two schools of thought on depression. One is that depression may be caused by the disease itself; that it has a chemical origin associated with the disease. The other thought is that depression is caused in some patients simply because they have the disease. In other words, who would not be depressed if they had this disease? What is known is that depression is a very common symptom of Parkinson's disease. Problems with eating and swallowing. Difficulty in speaking clearly Constipation and urinary problems. Sleep disorders Hygiene, skin and hair problems

There is no normal set of symptoms in the progression of Parkinson's disease. Each patient is unique in this regard. Some people will progress rapidly, with their symptoms worsening over a period of months. Others may take several years to get to the same stage.

There are no concrete rules on this, but one reason for this discrepancy may be with the skill level of the treating physician. As mentioned above, many of the symptoms of this disease can go unnoticed, and therefore untreated, for a long time.

Parkinson's disease is treated by specific drugs which include:

pramipexole ropinirole amantadine pergolide bromocriptine

Dosages for these drugs must be exact in order for any to work. This requires some high level of skill on the physcian prescribing the drug and the dosage. All patients are unique and their treatment regime will be unique as well.

Another reason the disease may progress faster in a certain person is that the disease itself is more aggressive in that individual.

While there is currently no cure for Parkinson's disease, thoughtful management can ensure that the majority of sufferers can enjoy a better quality of life for a long time.

Motor System Disorders Associated with Parkinson's Disease

DISEASE

Parkinson's Disease: A Neurodegenerative Disorder

Parkinson's disease is a common disorder that arises due to some imperfection that amends the normal functioning of the central nervous system. Parkinson's disease is the outcome of the death of the dopamine-containing cells of the midbrain region identified as substantia nigra. The reason for the death of these cells is still unidentified. The prompt symptoms of the disease are problems related with movement like shaking, rigidity, slowness of movement and difficulty in walking and gait. As the disease progresses the patient suffers from cognitive impairment as well as behavioural problems. Dementia is the most protuberant feature in advanced phases of the disease. Other secondary symptoms are sleep, emotional and sensory problems. This disease is generally found in the old people who have crossed their fifties. When the main motor symptoms are taken into contemplation then the disease is termed as Parkinsonism or Parkinsonian syndrome. This disorder is sometimes also kept under the idiopathic category although some in unusual cases genetic origin also plays a key role. Studies have clearly indicated that the jeopardy of PD escalates if individuals are exposed to certain pesticides although the risk diminishes in tobacco smokers. From the pathological point of view PD crops up due to the accretion of a protein known as alpha-synuclein in the form of inclusions. These inclusions are designated by the term Lewy bodies that accrues in neurons. Inadequate formation and function of dopamine in certain specialized areas of the midbrain are also considered to be accountable for PD. Apart from the symptoms neuroimaging of brain is very helpful in validation of the disease.

Levodopa and dopamine agonists have been found to be effective in treating early symptoms of the disease. As the disease progresses the dopamine neurons endure to get lost from the midbrain regions and a stage arrives when the drugs become futile for treating the early symptoms. When this stage is reached another impediment known as dyskinesia arises that is associated with involuntary writhing movements. Diet and some types of rehabilitation can however help to reduce some symptoms. When drugs become ineffective then surgery and deep brain stimulation is the ultimate solution as it can reduce motor symptoms. Studies carried out on animal models have shown that stem cell transplants, gene therapy and neuro-protective agents can help to reduce the disastrous symptoms of PD. Medications for the sleep disturbances and emotional problems are also accessible. The disease is named after the English doctor James Parkinson who first gave the detailed account of the disease in An Essay of the Shaking Palsy in 1817. Red tulip is the icon of this disease and world Parkinson's day is celebrated in the memory of Dr. Parkinson on 11th, April. Michael J. Fox and Muhammad Ali are the renowned personalities who also suffered from this disease and helped to engender awareness about the consequences and treatment of PD.

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Classification

The term Parkinsonism is applied for a motor syndrome whose core symptoms are tremors at rest, stiffness, slowing of movement and postural instability. Parkinsonian syndrome can be classified in four categories depending upon the origin of symptoms. These subtypes are primary or idiopathic, secondary or acquired, hereditary Parkinsonism and Parkinson plus syndromes. Parkinson's disease is the most common type of Parkinsonism also known as primary Parkinsonism but the applicable cause of this disease is still mysterious. In the topical years studies have directed that genes play a foremost role in this disorder. PD is generally classified as a movement disorder but it is also accountable for many non-motors problems like sensory problems, cognitive impairments and sleep disruptions. The symptoms of the primary Parkinsonism comprise multiple system atrophy, progressive supranuclear palsy, corticobasal degeneration and dementia with Lewy bodies. From the pathophysiological point of view Parkinsonism is considered a synucleinopathy as there is anomalous amassing of alpha-synuclein protein in the form of Lewy bodies in brain. This condition can be equated with the Alzheimer's disease as there is accretion of tau protein the form of inexplicable neurofibrillary tangles. Studies have indicated that there is a clinical and pathological intersection between the tauopathies and synucleinopathies. The neurofibrillary tangles have been segregated from the brains of patients of PD. Dementia with Lewy bodies (DLB) has resemblances with PD. The meticulous association between PD and DLB is still not clear. They may be studied together or can be treated as discrete categories.

Symptoms

PD causes movement allied difficulties resulting in motor problems. Apart from motor problems non-motor problems like autonomic dysfunction, neuropsychiatric problems followed by sensory and sleep difficulties also show their presence in advanced phases of the disease. Four motor problems are contemplated as serious in this disorder and these are tremors, rigidity, slowness of movement and postural instability. Tremor is the very frequently noticed symptom of PD. In about 30% cases tremors do not arise as the first symptom of the disorder but develop later as the disease progresses. Among the tremors the frequency of the rest tremor is high and it escalates when the limb is at rest but fades when any voluntary action is executed or the patient is sleeping. The rest tremor is known to distress the distal part of the limb first. In the beginning only the single hand or leg is encompassed but as the disease progresses this tremor becomes bilateral. The frequency of the tremor ranges between 4-6 hertz. The index finger of the hand comes in contact with the thumb and performs a circular movement known as pill rolling which is the strategic feature of rest tremor.

Slowness of movement also known as Bradykinesia is another crucial feature of PD. As the name signposts this symptom is acquainted with difficulties in performing movements. Sequential and simultaneous movements become intolerable. This symptom becomes more penetrating in later phases of the disease. The prompt symptoms of Bradykinesia are difficulties in performing daily activities like writing, dressing etc. as fine motor control is required. The next distinctive symptom of PD is rigidity which can be recognized by failure of the limb to carry out movement. Rigidity is caused by increased muscle tone due to disproportionate and incessant contraction of muscles. Rigidity may be uniform or ratchety in Parkinsonism. The term cogwheel rigidity can be applied when tremors and increased muscle tone come into play. Rigidity can be associated with joint pain as it is the earlier symptom of PD. Rigidity may be disproportionate as it tends to upset the muscles of neck and shoulders first. As the disease progresses rigidity affects all the movements of body. Postural instability arises in later phase of the disease causing impaired balance and the bones are at the risk of getting fractured effortlessly. This symptom is generally inattentive in the young patients as it ascends in later phase of the disease. About 40% patients fall very frequently and about 10% patients experience weekly fall showing the severity of the disease. Other motor problems embrace gait and posture disturbances like festination, speech and swallowing disturbances like voice disorders.

Neuropsychiatric problems are also an imperative part of Parkinson's disease and they may range from slight to severe ones. These problems comprise disturbances in cognition, mood, behavior and thought processes. Cognitive problems may arise in the preliminary stages of the disease and can upsurge as the disease advances. The most frequent cognitive disturbance is the executive dysfunction which can be characterized by problems related to abstract thinking, cognitive flexibility, inappropriate actions and selecting relevant sensory information. Slow cognitive speed and fluctuations in attention are other problems. Visuospatial problems are also not uncommon. A person suffering from PD has at two to six times greater risk of getting affected with dementia in comparison to the normal population. Dementia can be coupled with reduced quality of life and resilient support as well as care of the family is necessitated for the patents suffering from PD and dementia.

Mood and behavior alterations are very frequent in patients of PD with dementia. These alterations are also present in patients without cognitive impairment. Depression, anxiety and apathy are the most common mood alterations. Medication overuse and craving, hypersexuality is also common and is related with the medication which is used in the management of the disease. Delusions and hallucinations have been notified in about 4% patients. This symptom is the upshot of the dopaminergic excess. PD can also disturb other functions of body. Sleep problems are very frequent if PD and can be deteriorated by medications. Sleep disturbances comprise drowsiness and insomnia. Alterations in the autonomic nervous system cause oily skin, orthostatic hypotension, excessive sweating, altered sexual function and uncontrolled urination. Gastric problems and constipation also become severe and can jeopardize patient's health. Problems related to eye and vision also come into action and comprise of declined blink rate, dry eyes, saccadic movements, decreased ocular pursuit and blurred vision. Impaired sense of smell and sensation of pain followed by paresthesia are also noticed. These symptoms make their appearance much before the diagnosis of the disease.

Causes

Most patients of Parkinson's disease can be placed in the category of idiopathic disease as the meticulous cause of the disorder is unknown. A very trivial portion of cases can be cogitated under the category of genetic factors. Other factors can be placed under the category of risky elements that may cause PD but the precise relationship between them and the disease is still vague. PD is generally considered a non-genetic disorder but in about 5% cases mutation in some unambiguous genes can result in this disorder. The genes namely SNCA, UCH-L1, PRKN, LRRK2, PINK1, DJ-1 and ATP13A2 code for alpha-synuclein, ubiquitin carboxy-terminal hydrolase L1, parkin, leucin-rich repeat kinase 2, PTEN-induced putative kinase 1 and mutations in any of these gene can result in PD. Mutation in LRRK2 gene proliferates the chances of occurrence of PD in comparison with other genes. SNCA and LRRK2 are the most comprehensively studied PD-related genes. Mutations in SNCA, LRRK2 and glucocerebrocidase (GBA) increase the risk of sporadic PD. Mutations in GBA result in Gaucher's disease.

Role of SNCA is very vital in PD as this gene is accountable for the formation of a protein known as alpha-synuclein which is the foremost element of Lewy bodies. Missense mutations of the gene followed by duplication and triplication of the locus have been noticed in groups with familial PD. Although missense mutations are intermittent but multiplication of the SNCA locus account for 2% of cases with familial PD. Multiplications have been noticed in the asymptomatic carriers. LRRK2 gene codes for a protein known as dardarin. Mutations in the LRRK2 gene are primarily accountable for sporadic and familial PD. It accounts for 10% of familial and 3% of the sporadic cases of PD. According to a guesstimate about 40 different mutations in genes have been found to be blamable for PD.

Pathology

A group of brain structures which are innervated by dopaminergic system and identified as basal ganglia are severely damaged in Parkinson's disease. The cells in the regions of substantia nigra and pars compact die very frequently. Macroscopic alterations can be identified in the cut surfaces of the brainstem due to neuronal loss. The melanin pigmentation also reduces in the substantia nigra and locus coeruleus. Histopathology of substantia nigra and other regions of brain show heavy neuronal loss as well as heavy accumulation of Lewy bodies. Neuronal loss is followed by death of astrocytes and activation of the microglia. Presence of Lewy bodies in different regions of brain is the key feature of this disorder. The primary symptoms of this disease are due to the reduced activity of dopamine producing neurons especially in the regions substantia nigra and pars compacta.

Basal ganglia are connected to other areas of brain through five major pathways. These pathways are motor, oculo-motor, associative, limbic and orbitofrontal circuits. In PD all these circuits are disturbed and so the patient suffers from the problems associated with movement, attention and learning. Out of all the five circuits, motor circuit has been intensively studied. A conceptual model has been in practice since 1980 which shows direct relationship between alteration of motor circuit and appearance symptoms of PD. The model is however, modified with recent advances in research but is still used even today. According to this model, the basal ganglia exert an inhibitory influence on a wide range of motor systems that prevents them from being active at inappropriate times. When a particular motor action has to be performed then this inhibitory effect is reduced. This inhibitory effect diminishes with the release of dopamine. High levels of dopamine are required in order to perform motor actions but if the level of dopamine declines symptoms of PD get a chance to make their appearance. The condition in which the level of dopamine declines is known as hypokinesia and causes difficulty in motor actions. The drugs that are used to treat PD may produce excessive high levels of dopamine resulting in activation of motor systems at inappropriate times causing dyskinesias.

A number of mechanisms are known in which loss of brain cells is observed. One such mechanism consists of abnormal accumulation of a protein known as alpha-synuclein. This protein combines with ubiquitin and results in neuronal loss. This protein accumulates inside the cells in the form of inclusions known as Lewy bodies. According to Braak staging Lewy bodies first make their appearance in the olfactory bulb, medulla oblongata and pontine tegmentum. As the disease progresses Lewy bodies start accumulating in substantia nigra, areas of midbrain and basal forebrain and later in the neocortex. These areas are the chief sites where heavy neuronal loss occurs. Lewy bodies may not be responsible for cell death and may be protective. In the patients suffering from dementia heavy accumulation of Lewy bodies have been noticed in the cortical areas. Neurofibrillary tangles and senile plaques may be observed in patients of Alzheimer's disease with dementia. Other mechanisms associated with cell death are proteosomal and lysosomal dysfunction followed by reduced mitochondrial activity. Iron accumulation has been noticed in the regions of substantia nigra.

Diagnosis

Parkinson's disease can be diagnosed by medical history and neurological examination. There are at present no definite laboratory tests available that can clearly depict that a person is suffering from PD although brain scans help in disease identification but the chances of accuracy are low. The patients may be given levodopa which results in reduction of problems of motor impairment and the disease can be diagnosed with greater accuracy. Isolation of Lewy bodies from the midbrain by autopsy also confirms that a person is suffering from PD. Alzheimer's disease, multiple cerebral infarctions and drug-induced Parkinsonism can also produce Parkinsonian syndrome. Medical organizations have created certain criteria by which the disease can be diagnosed in early phases. The most widely used criteria have been developed by the UK Parkinson's Disease Society Brain Bank and US National Institute of Neurological Disorders and Stroke. The PD Society Brain Bank focuses on rest tremors, slowness of movements and postural instability.

Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) of brain of the patients of PD appear to be normal. These techniques can be useful in identification of the secondary symptoms of PD like basal ganglia tumors, vascular pathology and hydrocephalus. Diffusion MRI is however, useful in differentiation of typical and atypical Parkinsonism but more research is required in this field. PET and SPECT radiotracers can be used for measuring the activity of dopaminergic neurons in the basal ganglia. Reduced dopaminergic activity in the neurons of basal ganglia can be a clue for this disorder.

Management

In the present scenario there is no possible cure for Parkinson's disease but medication, surgery and multidisciplinary management can help the patients to survive. The most promising drugs used to curing the motor symptoms are levodopa, dopamine agonists and MAO-B inhibitors. These drugs are generally prescribed on the basis of the phase of the disease associated. In general terms two stages of medications are identified. In the initial phase the patient with PD develops some disability for which he or she requires pharmacological treatment and in the second phase the patient develops motor symptoms related to levodopa usage. The treatment in the initial stage aims at minimizing the side effects that have resulted from the enhanced dopaminergic activity. The starting of the levodopa treatment can be delayed by the usage of other drugs like dopamine agonists and MAO-B inhibitors. These drugs can delay the onset of dyskinesias. The second phase of medication aims at reducing the fluctuations that have resulted as a result of treatment. When medications fail to give the desired results then surgery and deep brain stimulation methods are employed. In the final stages of disease palliative care is provided in order to enhance the quality of life.

Levodopa

Levodopa has been used for the treatment of Parkinson's disease for more than 30 years. In the dopaminergic neurons L-DOPA is converted into dopamine in the presence of dopa decarboxylase. As motor symptoms in PD are caused by the lack of dopamine in the cells of substantia nigra, the administration of L-DOPA can help to diminish the motor symptoms temporarily. Studies have indicated that only 5-10% of the L-DOPA crosses the blood brain barrier. Although L-DOPA is converted into dopamine but it produces a number of side effects also like nausea, dyskinesias and joint stiffness. Carbidopa and benserazide are potent peripheral dopa decarboxylase inhibitors. They block the conversion of L-DOPA to dopamine therefore reduce side effects by increasing bioavailability. Levodopa is also related to dopamine dysregulation syndrome which is the result of overuse of the medication. If the doses of levodopa are given intravenously and through intestinal infusions, then the rate of spread of medication increases.

Tolcapone is known to inhibit the COMT enzyme activity which is responsible for the degradation of dopamine and this in turn prolongs levodopa activity. Usage of levodopa in later phases of the disease results in involuntary movements also known as dyskinesias and fluctuations in response to medication. When this happens the patient of PD switches from good response to medication and few symptoms to no response to medication and significant motor symptoms. Therefore, it is advised to keep the doses of levodopa low in order to maintain the functional stability of the patient. Use of alternatives for levodopa is now in practice.

Dopamine agonists

A number of dopamine agonists are known that have similar effects like that of levodopa and are known to bind the dopaminergic post-synaptic receptors. They are generally used for the individuals suffering from dyskinesias and the common examples are bromocriptine, pergolide, piribedil, apomorphine and lisuride. Although they are known to produce significant effects but also cause some mild side effects namely drowsiness, hallucinations, insomnia, nausea and constipation. Sometimes in very mild doses side effects emerge out so the physician has to search for another drug. These drugs are useful for curing the motor symptoms caused by overuse of medication and are useful for treating the symptoms that arise during the initial phases of the disease. They are more expensive than levodopa and dyskinesias due to dopamine agonists are however, rare in younger people but other symptoms may crop up as the age as well as the disease advances.

MAO-B inhibitors

These drugs are known to increase dopamine levels in the basal ganglia by blocking it metabolism. They are known to inhibit the activity of monoamine oxidase-B that breaks down dopamine secreted by the dopaminergic neurons. Reduction in the activity of MAO-B increases the levels of L-DOPA in striatum. They are used to improve the motor symptoms in early phases of the disease but are less effective than levodopa. They produce more side effects.

Surgery and deep brain stimulation

Researchers earlier believed that surgery and deep brain stimulation can help to treat the motor symptoms of PD but with the discovery of levodopa the number of operations experienced a heavy downfall. Surgery is generally performed in those cases where drugs fail to produce significant effect. Surgery in case of PD can be placed under two group namely lesional and deep brain stimulation (DBS). The target areas for lesions and DBS are thalamus and subthalamic nucleus. DBS is the most commonly used surgical treatment and it involves use of brain pacemaker that sends electrical impulses to specific areas of brain. DBS is generally used for the individuals who suffer from motor fluctuations and uncontrolled tremors or those who suffer from sever neuropsychiatric problems.

Rehabilitation and diet

Speech problems can be cured with rehabilitation although more research is required in this area. Regular physical exercise with or without physiotherapy can be helpful for treating the problems associated with mobility, flexibility, gait etc. although the exercise program must be practiced under the strict supervision of the physiotherapist. Muscles and nerves that take control over the digestive process are generally affected in PD resulting in constipation and gastroparesis. A balanced diet is recommended by the doctors as swallowing difficulties may occur as the disease advances. In some cases gastrotomy is practiced where food is directly delivered in the stomach. Strong competition occurs between proteins and levodopa as both uses the same transportation system in the intestine and blood brain barrier. When both are taken together the effectiveness of the drug decreases. Therefore, when levodopa is taken heavy protein diets are discarded and the patient is suggested to take balanced Mediterranean diet.

Palliative care and research directions

Palliative care is generally required in the final stages of the disease when all the medication strategies become ineffective. The prime aim of palliative care is to enhance the quality of life of the patient. Strong family support is very effect in this regard. PD is the second most dangerous neurodegenerative disorder after Alzheimer's disease. We can end up by saying that PD must be taken seriously as it bears the potential of making the life of an individual worse if neglected.

Parkinson's Disease: A Neurodegenerative Disorder

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A Positive Link Between the Relief of Parkinson's Disease And Nicotine

If governments were serious about stopping everyone smoking they would stop importing tobacco and its related products and close down the production factories. However the subsequent loss of revenue from tobacco far outweighs the health risk of the smoker. Therefore governments are only pandering to the lobbyists and not really concerned who enjoys a cigarette or not.

According to new research Nicotine can dramatically reduce the symptoms of Parkinson's disease. The findings by scientists support dozens of earlier studies suggesting smokers are less likley to suffer sever symptoms from the disease. In tests, patients with the disease who were given very high dose patches had better movement and needed fewer drugs to manage the condition.

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Parkinson's disease affects millions of people worldwide and in the United Kingdom ten thousand new cases are diagnosed every year. The condition develops when the cells in the brain that control movement die off. Symptoms include shaking, muscle stiffness, and slowness of movement, and many sufferers eventually find it difficult to walk,talk swallow or write.

Although there is no known cure for the disease, there are drugs to control the severity of the symptoms by compensating for the lack of dopamine - a chemical that acts as a "signal agent" between parts of the brain involved in movement and co-ordination.But their effects can start to wear off after a few years.

While previous studies have looked at nicotine patch therapy, they used smaller doses that the latest research. Volunteers in the study were given patches containing over 100mg a day, about five times more than would be needed to help a heavy smoker quit over a period of seventeen weeks. Researchers said in a report on their findings: "The beneficial effects may be explained by the direct effect of nicotine on the central nervous system".

A Positive Link Between the Relief of Parkinson's Disease And Nicotine

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The Facts About Glutathione and Parkinson's Disease

Parkinson's Disease (PD), a devastating illness, occurs in one of every 100 people over 65.

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It is a slowly progressing disease of the nervous system that results in progressive destruction of brain cells (neurons) in an area of the brain called the substantia nigra. Death occurs usually as a result of secondary complications such as infection.

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One of the mechanisms known to destroy neurons is damage by free radicals or reactive oxygen species - destructive molecules produced by oxidation of the neurotransmitter dopamine.

The Role of Dopamine

The cells of the substantia nigra use dopamine - a chemical messenger between brain or nerve cells - to communicate with cells in another region of the brain called the striatum.

When nigral cells are lost, nigral dopamine levels fall, resulting in a decrease in striatal dopamine.

The typical symptoms of PD - motor function deficiencies characterized by muscle rigidity, jerky movements, rhythmic resting tremors - are the result of low levels of striatal dopamine.

Most dopaminergic drugs used to treat PD, are aimed at temporarily replenishing or mimicking dopamine. They improve some symptoms, but do not restore normal brain function nor halt brain cell destruction.

Dopaminergic drugs are generally effective at first in reducing many PD symptoms, but over time they lose their effect.

They also cause severe side effects because they overstimulate nerve cells elsewhere in the body and cause confusion, hallucinations, nausea and fluctuations in the movement of limbs.

The Role of Antioxidants

When dopaminergic neurons are lost in the course of Parkinson's disease, the metabolism of dopamine is increased - which in turn increases the formation of highly neurotoxic hydroxyl radicals.

The most important free radical scavenger in the cells of the substantia nigra is the powerful brain antioxidant, glutathione. Glutathione levels in PD patients are low.

And as we age, levels of glutathione in the dopaminergic neurons of the substantia nigra decreases. This appears to hasten cell death and advance the progression of PD.

At least 80 percent of the substantia nigra cells are lost before symptoms of Parkinson's disease become apparent. This is why it becomes essential to protect or maintain these cells under oxidative stress.

How does Glutathione help in Parkinson's Disease?

Several factors explain why glutathione is so beneficial in Parkinson's disease.

1. Glutathione increases the sensitivity of the brain to dopamine. So although glutathione doesn't raise dopamine levels, it allows the dopamine in the brain to be more effective.

2. Glutathione's powerful antioxidant activity protects the brain from free radical damage.

3. An even more intriguing benefit of glutathione lies in its powerful detoxification ability.

Its a well known fact that most Parkinson's patients are deficient in their ability to detoxify chemicals to which they are exposed.

The unfortunate few who harbor an inherited flaw in their detoxification pathways are at far greater risk to the brain damaging effects of a wide variety of toxins.

Glutathione is one of the most important components of the liver's detoxification system. Glutathione therapy is one of the most effective techniques for enhancing liver and brain detoxification.

Glutathione treatments considerably improve some of the symptoms of Parkinson's disease including difficulties with rigidity, walking, movement, coordination and speech. A marked reduction of tremor has been observed as well as a decrease in depression.

Glutathione and N-acetyl-L-cysteine (a glutathione precursor) have been shown to be very effective in protecting the nerves in the substantia nigra from being destroyed by oxidative stress.

Glutathione Therapy in Parkinson's Disease

The practical problem in increasing glutathione levels is that taking glutathione itself as a supplement does not boost cellular glutathione levels, since glutathione breaks down in the digestive tract before it reaches the cells.

However, intravenous glutathione therapy and taking glutathione precursors are both effective in boosting intracellular levels of glutathione.

Intravenous Glutathione Therapy:

Intravenous glutathione injections have been shown to have amazing and quick results.

Dr. David Perlmutter, a pioneer in this therapy, has developed a protocol utilized at the Perlmutter Health Center for administering intravenous glutathione to Parkinson's patients.

Following even a single dosage of intravenous glutathione - often in as little as 15 minutes - the ability to walk, turn around and move their arms is almost completely restored.

Glutathione Precursors:

Dietary antioxidants and supplements that increase cellular glutathione, such as alpha lipoic acid, NAC, pycnogenol, the herb silymarin (milk thistle), are effective in restoring normal function.

N-acetyl-cysteine (NAC) and un-denatured, whey protein both supply glutathione precursors intracellularly, enhance the body's production of glutathione and aid the detoxification process.

Other nutritional supplements which aid the detoxification process include selenium, vitamins E and C.

The Facts About Glutathione and Parkinson's Disease

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Parkinson's Disease

Parkinson's disease is a degenerative condition of the nervous system. It can over the course of 10 to 25 years result in total loss of mobility. In all but a few cases of Parkinson's disease there is no identifiable cause or even any obvious contributing factor.

disease

The onset of Parkinson's disease is usually between the ages of 50 and 70. The difference in incidence between men and women is not statistically significant. While the symptoms are certainly troublesome and can eventually result in the total loss of mobility, death as a direct result of Parkinson's disease is uncommon and the life expectancy for a Parkinson's patient has over the last decade or so grown very close to that of the population in general.

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The most common and usually first obvious symptom of Parkinson's disease is a tremor. The tremor is often observed in the hand and lower arm but tremors of the leg are also quite common. There is a large variation from patient to patient as to where in the body the tremor appears. Early in the disease process the tremor often decreases substantially with muscle activity. For example the tremor will often decrease or appear to go away when a patient reaches for an object. Once the hand is back at rest the tremor will return. It is also unusual to see any tremors during sleep.

Because of the similarity to other diseases the rate of misdiagnosis among all of the conditions that cause tremors is quite high. This is especially true if the diagnosis is made by anyone other than a neurologist who is very familiar with this specific condition and the patients affected by it. Some of the diseases with similar symptoms are supranuclear palsy (PSP), Alzheimer's disease and essential tremor. Certain types of drugs can even cause Parkinson's like symptoms. While there is no specific test for Parkinson's disease, lab and other diagnostic testing may help in the diagnosis and also help to eliminate other possible diseases. You need to remember that while most patients with Parkinson's disease have tremors not every patient with a tremor has Parkinson's disease.

Some other common symptoms are muscle stiffness and ache, problems with balance, a shuffling type of step when walking, problems with swallowing and talking, and postural changes. Although these are a few of the more common symptoms, many other symptoms are also possible and may in fact be a significant problem for a given patient.

Drugs therapy is of primary importance in the treatment of Parkinson's disease. There are a number of drugs that can significantly decrease the symptoms of Parkinson's disease. For most patients the drugs are not started early in the disease process but are held until the symptoms begin to affect daily activity. However, new studies are indicating that earlier treatment with certain drugs may slow the progression of the disease so we will probably begin to see drug therapy used earlier in the disease process. Levodopa has been used for years to effectively treat the symptoms of Parkinson's disease but newer drugs and questions about negative effects from long term levodopa use have increased interest in and the use of newer drugs.

Surgery can be an option for some patients with advanced Parkinson's disease or who do not tolerate the medications. Years ago surgery for Parkinson's disease required attempting to remove specific small areas of the brain that were involved in the symptoms. Today this type of invasive surgery is done only in rare cases. Instead of the old style surgery, the current technique involves implanting electrical stimulators into the brain. These stimulators send electrical impulses through tiny wires deep into the brain and can have a significant positive effect that is more predictable and much safer than the old type of Parkinson's brain surgery.

Changes in lifestyle will need to be made as the disease progresses. The patient should have an easy access living space (no stairs) safety rails in the bathroom and other modification to make life easier and safer. The patient will also need assistance devices such as a cane, walker or wheelchair as the disease progresses. It may also be beneficial to consider a variety of therapies as necessary. These can include such areas as speech therapy, physical therapy, and certainly in many cases psychological therapy to help deal with some of the difficult psychological adjustments that will need to be made.

Although as accurate as possible, the information in this article may not relate to your particular medical condition and is not intended to be used in the diagnosis or treatment of any medical condition. In addition any sites to which we link may or may not contain information appropriate to your medical condition.

Parkinson's Disease

DISEASE

Disease Management - How is Parkinson's Disease Treated?

Parkinson's disease (also known as Parkinson disease or PD) is a degenerative disorder of the central nervous system that often impairs the sufferer's motor skills and speech. It is characterized by muscle rigidity, tremor, a slowing of physical movement (bradykinesia) and, in extreme cases, a loss of physical movement (akinesia).

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There is currently no cure for Parkinson's disease. The goals of treatment are to minimize disability, reduce the possible side effects of drug therapy, and help the patient maintain the highest possible quality of life.

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Prescription drugs help manage symptoms, but they can't stop the disease from progressing. When a drug no longer effectively controls symptoms, another drug may be added to existing therapy. Disease management is highly individualized and is best determined by a doctor who specializes in the treatment of Parkinson's disease.

Surgery remains the only option for patients with severe or fast-progressing Parkinson's disease when other therapies have failed. This may involve:Pallidotomy. Pallidotomy involves an electric probe used to destroy a small portion of the brain that is overactive and is thought to cause the symptoms of Parkinson's disease. Thalamotomy. Thalamotomy involves the removal of the thalamus region of the brain (the thalamus is responsible for involuntary movements; destroying it prevents involuntary movements). Thalamic stimulation. Thalamic stimulation is a procedure where an electrode wire is inserted into the thalamus. The other end of the wire is connected to a pulse generator, and the generator is placed under the skin in the chest area. This device can produce the benefit of thalamotomy without causing wound or scars on the skin and has shown to be very effective in management of tremor in Parkinson's disease. Deep brain stimulation. Deep brain stimulation is an alternative procedure used to destroy small regions of the brain. A thin electrode implanted into the brain blocks brain waves that can cause uncontrollable movements. This procedure must be continued lifelong. It is especially useful in patients that have severe symptoms associated with tremor, involuntary movements (dyskinesia), and problems with gait.

Disease Management - How is Parkinson's Disease Treated?

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Potentials of a Parkinson's Disease Physical Therapy

Two areas of physical therapy are Geriatric physical therapy and Neurological physical therapy. Geriatrics focus on the conditions that affect many people as they grow older - arthritis, osteoporosis, cancer, Alzheimer's disease, hip and joint replacement, balance disorders, incontinence, Parkinson's and more. Neurological PT focus on individuals who have a neurological disorder or disease - ALS, brain injury, cerebral palsy, Alzheimer's disease, multiple sclerosis, spinal cord injury, stroke, and Parkinson's Disease - again - a major predicament for therapists, such an immense challenge it could be separate discipline - Parkinson's Disease Physical Therapy.

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Parkinson's Disease Physical Therapy has been nobly shouldering the development of specialized programs to help restore mobility, reduce pain, increase fitness levels. Parkinson's Disease Physical Therapy works with patients to improve their areas of dysfunction - paralysis, vision impairment, poor balance, inability to ambulate, and loss of functional independence.

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The benefit of physical therapy and general forms of exercise in Parkinson's disease patients has been recognized for years. These days, one of the most exciting areas in rehabilitation science is the continuing of the intervention of Parkinson's Disease Physical Therapy in advocating symptomatic relief, improved function and the general benefits of improved muscle strength, aerobic fitness, and balance for their patients, plus also driving the limits in setting their exercise parameters into an intensified level to challenge impaired systems, promote recovery, and eventually to modulate the progression of the disease on the patients.

More and more, individuals with Parkinson's disease are expectant to benefit from treadmill training wherein their walking behavior is driven more automatically and at significantly higher intensities. Increasingly more exercise research in Parkinson's Disease Physical Therapy is investigating the effect of challenging, highly intensive exercise on the brain and functional improvement of their patients.

Over the last 15 years has been the recognition that the brain's capacity for recovery from injury is far greater than previously thought. Current studies being made on the correlation of physical exercise and its effect on the brain have been a spark of hope for patients as well as practitioners of Parkinson's Disease Physical Therapy. An entire team in a Parkinson's Disease Physical Therapy ward are encouraged ever more to give their patients a longer mobility and agility in their life, packaged with a full support system to hearten the patients in the long life waiting for them. With a 'move it or lose it motto', Parkinson's disease therapists may just find that winning their play may only take exercising to delay.

Potentials of a Parkinson's Disease Physical Therapy

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Parkinson's Disease Holistic Cure

For people suffering from Parkinson's disease, there is no holistic cure that has been conclusively proven to be effective yet. If your loved one is suffering from this disease, you do, however, have the choice of exploring your options and see which ones may at least make the life of your loved one more comfortable and easier.

liver disease

Diet - There are always the "right" and "wrong" food to eat when you are suffering from a certain disease and it's the same for Parkinson's. This shouldn't be surprising, however, since we exist because of food and we naturally become weak or even die without it. People suffering from Parkinson's disease could see improvement in their conditions if they eat smaller but more frequent meals a day and increase their consumption of fiber. If the latter's impossible for whatever reason, consider having your loved one take fiber supplements instead.

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Exercise - Like food, exercise is also a vital element of having excellent health and this is especially true when you are suffering from Parkinson's disease. With regular exercises - of the right kind, of course - people suffering from this will have less difficulties maintaining control of their movements, balance, mobility, and even their emotions! Generally, any physical activity is ideal. If it's of the strength-building type then so much the better! Affected individuals should however be conscious of not overtaxing yourself as exhaustion can cause them to become less careful and at this point, even the smallest accident can cause great complications.

People suffering from Parkinson's disease often chafe at their helplessness in overcoming their condition. With a simple Parkinson's disease holistic cure [http://parkinsons-disease-treatment.blogspot.com/2007/09/parkinsons-alternative-treatment.html] like diet and exercise, however, they are given something concrete to do and work on and consequently make them feel that they're doing something about their condition.

Parkinson's Disease Holistic Cure

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Parkinson's Disease - The Cause And Symptoms

Parkinson's Disease, or PD, is most common amongst the elderly. In most cases, Parkinson's cannot be predicted or prevented. The disease is a movement disorder characterised by the loss of or slow physical movement, trembling of the arms, hands, legs, jaw or head, stiffness of the limbs and impaired balance.

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The non-motor aspect of PD

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Apart from the physical symptoms, patients suffering from PD also show signs of mood disturbances. As much as 90% of PD patients suffer from anxiety that consequently leads to depression, abulia or apathy. Parkinson's sufferers have noted experiencing sleep disturbances causing excessive daytime drowsiness or insomnia.

Cognitive disturbances include dementia in almost 40% of Parkinson's sufferers. They suffer from short term memory loss, lack of impulse control, prioritising and evaluating the clarity of surrounding situations, varying time awareness and lack of social consciousness. These symptoms of the physical and emotional seem to worsen over time.

In some cases, as the condition worsens, symptoms such as lack of facial expression, speech impediments, difficulty in swallowing, constipation, bladder problems, sweating, sexual difficulties and alterations in their sense of smell.

Disease vs. Syndrome

Although Parkinson's is referred to as a disease, its definite cause has not been specified. Common causes that have been indicated as being responsible for causing Parkinson's Disease include genetics, toxins, cerebral anoxia, head trauma and drug related issues. Despite these causes, an ailment qualifies as a disease because of a collection of signs and symptoms which emerge together. In order to qualify as a disease, the problem would have to have a root cause incorporating that a single cure should work in every Parkinson's case.

Treatment

As such drugs have only been able to improve the symptoms, but have not been able to cure the disease. Some even suggest delaying treatments as the effectiveness of the drug has a restricted lifetime. The main treatment for Parkinson's Disease has been drugs that include: Propranolol, Primidone, Anticholinergics, Selegiline, Amantadine, Levodopa, COMT inhibitors and Dopamine agonists. Levodopa is the main agent used to treat Parkinson's and is combined with carbidopa when given in a pill form.

Surgery has also been used in cases where the medication is no longer having any effect in controlling the symptoms. Alternatively, deep brain stimulation is applied. It works similarly to a pacemaker and is implanted in the chest with wires that penetrate deep into the part of the brain that controls motor function, where electrical impulses are sent. So far this has been the dominant treatment with severe cases where medication is no longer effective.

Alternative medicine and Parkinson's Disease

Alternative medicine and treatments have been incorporated into treatment of the symptoms of Parkinson's. Exercises such as Pilates, tai chi and yoga help increase body flexibility, enhancing balance and coordination. The muscles of the spine are elongated, strengthened and stabilised through the stretching movements specific to Pilates. This increases blood circulation and balance and improves posture.

Nutrients and herbs are also prescribed in a patient's diet, but this is to be used solely in conjunction with other treatments. Homeopathy is used for symptoms and can alleviate the trembling, painless paralysis, restless legs, anxiety, depression, arteriosclerosis and general restlessness. Massages help with circulation and to decrease muscle spasms, while acupuncture helps with tremors.

Manual Nerve Release technique, or MNR, has been showing great benefits for Parkinson's sufferers. Although still categorized as an alternative healing technique, Parkinson's Disease patients have experienced many benefits due to the treatment. Because MNR is also a somatic healing technique, both the physical and mental aspect of Parkinson's is treated.

With all this considered, it does show that there is hope for those suffering with Parkinson's, whether a disease or syndrome. You no longer have to suffer the symptoms and agony of this disease like before.

Parkinson's Disease - The Cause And Symptoms

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Parkinson's Disease - Ayurveda

Ayurveda is an ancient Indian medical system. It appears that is might hold one of the very first references to Parkinson's disease, over 2,500 years ago. Everybody is different, but some people with Parkinson's disease have found that following the principles of Ayurveda can help to control the symptoms and signs of Parkinson's disease. Treatment of disease with Ayurveda consists of a number of approaches including yoga and meditation.

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This therapy is a traditional Indian complementary therapy. It is many years old. The overall objective is to cleanse the body and develop harmony in the individual. If it works, it should reduce symptoms and increase resistance to Parkinson's disease.

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There may be a range of therapies used and this can include diet, herbal remedies, stress relieving massage and physical exercise. In general, the hope is to promote good health. However, some of the medicinal components may have similar effects to those drugs used to treat Parkinson's. But, more research is needed. It is therefore important that medical advice is sought before embarking on such a course of action. This is especially so because practitioners that advocate this type of therapy have no regulation. You cannot be sure about the safety or efficacy of any medication.

Many people believe this type of therapy to be harmless and it may, indeed, be. But there have been identified a number of potential risks - or at least some concerns - which should mean that if you suffer from Parkinson's disease you should always seek the help and advice from a professional.

Parkinson's Disease - Ayurveda

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Parkinsons Disease Patches

As a good method of treatment, Parkinson's disease patch is being developed for treating Parkinson's disease. This is being developed as a good method of treating it orally. The need to develop a skin patch for Parkinson's existed, due to the digestive tract of people affected by the disease.

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Skin patches are available for smoking cessation, heart problems, and pain control. A major research is going on for exploring new ways of treatment except oral medicines, of Parkinson's. The silicon patch that is being used in the clinical trials have Dopamine agonist , a drug commonly used to reduce the symptoms and help people lead a more normal life. 'Neupro' is the first trans-dermal patch that has been approved to treat symptoms of Parkinson's disease.

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The main symptoms of Parkinson's include memory loss, decrease of cognitive skills, dementia. As it is a disorder of the central nervous system, motor skills are lost over time. These Parkinson's disease patch medicines help in prolonging normal activity and suppressing the symptoms of the disease.

The main symptoms of this disease include stiffness and tremors in the limbs which is due to the reduction of Dopamine, chemical in the brain which controls movement in the body. Dopamine agonists clone dopamine and also stimulate the cells of the brain, just the way the normal chemical reacts.
Another Parkinsons disease patch that has been marketed is an active ingredient Rotigotine, which is a Dopamine receptor delivered through a skin patch. It is applied once to the skin and releases Ritigotine throughout 24 hours. Every day the patch needs to be changed. It is delivered to maintain stable rotigotine plasma in concentration level. The oral Dopamine agonists come in multiple doses but a patch is more effective and easy.

Parkinsons Disease Patches

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Why is Parkinson's Disease Difficult to Diagnose?

While Parkinson's disease has very distinctive features, it is rather a difficult disease to identify, particularly while it is in its early stages. Unfortunately there are no precise tests, which doctors can do to establish an exact diagnosis of Parkinson's disease and regrettably especially in its early stages it might be mistaken for other diseases. If and when this happens, it delays or prevents the appropriate action being administered in the quickest feasible time.

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The trouble with diagnosing Parkinson's disease accurately is just that the symptoms are not always as clear as doctors would like them to be, Actually there are suggestions that up to 25% of those people presently being treated for Parkinson's disease might have been wrongly diagnosed and are thus getting inappropriate treatment.

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Generally patients that are suspected of suffering from Parkinson's disease are given tests to guarantee they are certainly not suffering from an illness that can be diagnosed using common methods such as CT scanning, urine sampling X-ray and blood tests etc. However just because these tests may have an inconclusive answer, it doesn't always mean the person is definitely suffering from Parkinson's disease. Regrettably some doctors think this is the case, and will automatically offer a diagnosis of Parkinson's disease.

Tests that can be carried out to test for Parkinson's disease involve systematic neurological assessments that comprise testing the person's reflexes, balance, muscle strength walk and common movement. Because there are a range of neurological disorders that have similar characteristics to Parkinson's disease, it's not very surprising that Parkinson's disease is so regularly misdiagnosed. If you or a loved one has been diagnosed with Parkinson's disease, it doesn't always hurt to ask your doctor for a second opinion or even better to request to be referred to a physician who specialises in this kind of disease.

An early accurate diagnosis of Parkinson's disease is normally the key to the sufferer being able to preserve their independence and a decent quality of life for fairly a long time.

Some neurological conditions that are regularly confused with Parkinson's disease include: -

Multiple system atrophy

Supranuclear palsy

Benign Essential Tremor

Multiple Sclerosis

Huntington's disease

Striato-Nigral Degeneration

Brain tumour

Remaining as independent as feasible is vital to the wellbeing of most sufferers of Parkinson's disease, and ensuring the symptoms are kept to a minimum by both an accurate diagnosis and treatment is the key to achieving this.

Why is Parkinson's Disease Difficult to Diagnose?

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