The Various forms of Parkinson’s
Being in front of a neurologist who says “you have Parkinson’s” is not exactly the best time of your life, it doesn’t matter that you already lived with the disease for 8-12 years before the diagnosis.
Here you are given a bottle of pills and you are sent home. Here begins the worst moment, in which you wonder what will happen later: wheelchair, no jobs, rejected by everything and everyone? Such a negative vision of one’s future brings over 50% of Parkinsonians to become clinically depressed. It is not uncommon for depression and apathy to leave their loved ones to be shocked to flake the family unit.
It was James Parkinson, an unconventional English doctor, the first to talk about this condition over 200 years ago, which, on the basis of the observation of only six individuals, called “Shaking Palsy” (condition with tremor). Forty years later, a French doctor again examined the pathology and extended its definition and the flow rate to non -motor symptoms, also suggesting the name of “Parkinson’s”.
Parkinson’s is used to describe various conditions from the very mild (shaking hand) to the more serious MSA (Multiple system atrophy)..
Parkinson is a subset of Parkinsonism but very distinctive as it is characterized by a lack of Dopamine and hence a positive reaction to Levodopa which substitutes Dopamine when it reaches the brain. Whilst symptoms are similar, Parkinsonism often does not benefit from Levodopa.
Precisely because of the different symptoms, Dr. Michele Hu (United Kingdom) described Parkinson’s as a group of different conditions grouped under a single name. Will we find a cure for Parkinson’s, but … which Parkinson’s?!
In fact, each person shows several symptoms (there are more than 50!), From tremor, cognitive disability, pain, rigidity, etc. And each of them can be more or less predominant. The most common is Bradykinesia, the slowness of movements. Therefore, starting from the observation that no one has the same manifestation of symptoms, it is clear that Parkinson’s care has now become a multi-tasking challenge.
The drug “levodopa”, in fact, does not improve Parkinson, since, being transformed by our brain into dopamine; it only has the task of making up for the lack of this substance.
Despite the different symptoms, the common denominator among the Parkinsonians is precisely the lack of dopamine. Dopamine is an essential chemical for neurotransmission (movement), but in fact it has effects on many aspects other than movement. It is also a chemical substance is also a chemical that is produced when we do something we like, this can help explain the high levels of apathy and depression in people with less dopamine (Parkinson’s!).
The lack of this substance means that at some stage most people with Parkinson’s will take Levodopa.
If there is no response to levodopa, many doctors use the term parkinsonism, or something that, like the tremor of the hand, imitates Parkinson’s, or speak of “atrophy of the multiple system”.
Levodopa was discovered over a hundred years ago and was used for the first time in Parkinson’s about 60 years ago. That’s right, the drug is still on the front line has been the same for 60 years! The obvious question about levodopa is to ask is it a medicine? Many people think that some drugs can cure, immunize or improve Parkinson’s. We can only say of levodopa that it simply replaces our missing dopamine supply. Not a medicine in the literal sense and first discovered in 1910 and used in Parkinson’s in the 1960’s.
“Parkinson Outcomes Project”, an important research also concerning the quality of life of people with Parkinson’s, has found that
“The quality of life of a person with Parkinson’s is directly related to his mood.” In other words, it is not Parkinson’s that destroys our quality of life, but rather the emotions that we feel in having Parkinson’s. “
In the next ten years, we should witness the arrival of a series of new drugs, especially those which modify the disease (DMD) (Disease Modifying Drugs), by slowing down, stopping or at least improve Parkinson’s. Simon Stott of the Parkinson’s Trust Cure recently wrote an article, in which he stated that 80% of research has been done in last 20 years and this opened many new possibilities and a growing list of drugs that are in experimentation.
Most people with Parkinson’s today live with fear and depression, however they believe that new scientific research is not enough or will arrive too late. It seems that the enthusiasm of the scientific world does not reflect in the minds of the people who already live with this condition.
This is shown by the fact that many of us are reluctant to admit that they have Parkinson’s, almost as if they feared they are considered different or weaker. Still, even the person who arrives last in a competition is applauded, precisely because he has chosen to fight and never surrender, reaching the finish line. Anyone who faces adversity with determination is anything but week
For this reason, with Parkinsonians must not surrender, but face and learn to live with the disease.
Knowing the disease, the effect that drugs have on us, is essential if we want to take control of our life. Only drugs are not enough, but exercise and positive mentality are also essential, with the most expensive people next to us. We are not victims, because the victims have no possibility of choice. On the contrary, we can – and we must – maintain a good quality of life.
The way we see our Parkinson has a huge effect on the way we live with our Parkinson’s.
The advice of the Parkinson Europe and APTC is, in fact, not to live in the hope of a miraculous cure, but in the awareness that movement, lifestyle and attitude can change the quality of your life today.
It is normal to be afraid, because it comes from what we don’t know. Parkinson’s is, from certain points of view, the unknown, given that the truth about this condition is rarely explained correctly. It is estimated that about 80% of us get information on Parkinson’s from the web, unfortunately, from unreliable sources. For this reason, below you will find a list of connections with reliable and accurate information.
Useful links for Parkinson’s
M.J.Fox Foundation https://www.michaeljfox.org/
Parkinson UK https://www.parkinsons.org.uk/
Parkinson Europe Association https://www.parkinsonseurope.org/
Cure Parkinson’s TRUST https://www.cureparkinsons.org.uk/
Davis Phinney Foundation https://www.davisphinneyfoundation.org/
European Parkinson Therapy Centre https://www.ParkinsoTherapy.com
Link to Glossary of Parkinson Terminology
https://www.parkinsonseurope.org/about-parkinsons/glossary/
Link to article on quality of life
https://www.terapiaparkinson.it/en/info-parkinson/four-pillars-parkinson-therapy/
There are two interpretations to this term. Those who have recently been given the diagnosis (the classic definition). Some clinics refer to when the client accepts he or she has Parkinson’s.
Being newly diagnosed is just a term indicating that you have Parkinson’s BUT there are certain elements of great importance.
Accepting (and not ignoring or pretending) as early as possible allows you a greater quality of life, especially if you have the possibility to attend centres like this one. It will allow you the chance to understand (and have less fear) of Parkinson’s. To learn that Diet, exercise, Stress management and lifestyle have a major effect of disease progression and that YOU CAN CONTROL (the a certain extent) Parkinson’s development. More than for any other condition.
In an 8 year program done by European Parkinson Therapy Centre (EuPaTh) with Parkinson’s UK and followed by Oxford Brookes University. A group every month was given a day free explanation and discussion about Parkinson’s. Presented by people with Parkinson’s but developed by leading experts connected to EuPaTh. Another “control” group was identified and not given the course. After 8 years the groups were compared. The Group that did the course had higher (often double) the score of the control group
In the early years you may not have significant symptoms. But your actions in this period will have a massive effect on how you cope with Parkinson’s in the long term. Increasing strength, flexibility and movement being essential. The more you learn about Parkinson’s the easier it will be to live with Parkinson’s (we are afraid of what we do not know). Don’t be afraid, learn the truth about Parkinsons.
This is not any different from Parkinson’s, On the Hoehn and Yahr scale stage 4 and 5 are often considered Advanced. Some Neurologists automatically call people with 15 years or more as Advanced. Neither is a good classification.
The European Parkinson Therapy Centre and some others have had a good success in slowing and controlling symptoms keeping people in stage 3. Advanced Parkinson’s often is not only a more complicated stage with these complications MAY include motor fluctuations, dyskinesia, unpredictable or absent response to medications, falls, loss of autonomy, dementia, hallucinations, sleep disorders, depression, and psychosis. But another factor may be secondary conditions unconnected to Parkinson’s, back pain, other diseases like pneumonia can be complicated by having Parkinson’s and problems may become multiple. Autonomy is another major guide. Losing your autonomy means losing your freedom. That is why the advice and therapy outlined in our protocol (link protocol to https://www.terapiaparkinson.it/en/info-parkinson/four-pillars-parkinson-therapy/ )and the advice given above for newly diagnosed is essential.
FACT you can manage, to a large extent, the development of the condition.
FACT you can maintain autonomy and quality of life if you learn how to.
FACT Every has a different form of Parkinson’s, so you cannot look at another person and assume their good or bad condition is relevant to you.
Two other major factors are an increase in fatigue, this is more than just feeling sleepy, It can be overwhelming, Short rest stops during the day do help. The other is increased Apathy, this is linked to decreased dopamine but can give rise to a state of “I don’t care” Definitely to be avoided. Both these symptoms may show themselves earlier but are more common in Advanced Parkinson’s
Still Parkinson’s but there are subtle differences and pressures. Parkinson’s was once thought as an old mans condition. But todat it effects more and more people under the age of 50. Usually under the age of 50 is defined as early onset. At the centre we have had people as young as 23!
Under normal conditions YOPD is milder than later onset but then you have to live with PD for longer and it presents challenges affecting your family, your ability to pay off mortgages etc and it is very devastating for a young person. I got PD at the age of 42, Young onset, and now I have “advanced parkinson’s” 18 years later but remain autonomous and still work a full day. Our research together with Parkinson Europe showed people generally stop working after 4 and a half years.
- Slower progression of PD symptoms over time, .
- Less likely to have cognitive problems such as dementia
- More side effects from dopaminergic medications, example dyskinesia’s (involuntary body movements)
- More problems with dystonias (cramping and abnormal postures) such as arching of the foot
YOPD people are more lokely to abuse ( take more than is necessary) of Levodopa so as to main a higher motor and cognitive performance and continue working to pay the bills.
Symptoms and Causes
The primary symptoms of parkinsonism include tremors, bradykinesia (slowness of movement), rigidity, and postural instability. These symptoms are caused by the degeneration of dopamine-producing neurons in the brain. Parkinson’s disease is the most well-known cause of parkinsonism, and it is characterized by the accumulation of abnormal protein deposits called Lewy bodies in the brain. Other causes of parkinsonism may include certain medications, head trauma, stroke, or other neurological conditions.
Diagnosis and Treatment
Diagnosing parkinsonism involves a thorough medical history review, physical examination, and sometimes imaging tests such as MRI or CT scans. There is no specific test for parkinsonism, so the diagnosis is often based on the presence of characteristic symptoms. Treatment for parkinsonism aims to alleviate symptoms and improve quality of life. Medications such as levodopa and carbidopa can help manage motor symptoms. Physical therapy, occupational therapy, and speech therapy may also be beneficial in managing the condition.
Prognosis and Research
The prognosis for individuals with parkinsonism varies depending on the underlying cause. While Parkinson’s disease is a progressive condition with no cure, its progression can be managed with medication and therapy. Research into parkinsonism and related disorders continues to advance our understanding of these conditions and may lead to improved treatments in the future.
In conclusion, parkinsonism encompasses a group of neurological disorders characterized by symptoms similar to those seen in Parkinson’s disease. It can be caused by VARIOUS underlying conditions and requires careful diagnosis and management to address its impact on individuals’ lives.
Multiple system atrophy (MSA) is a rare and progressive neurological disorder that affects the autonomic nervous system and movement. It is characterized by a combination of symptoms that affect both movement and the autonomic nervous system, leading to problems with balance, coordination, and autonomic functions such as blood pressure control, bladder function, and digestion.
Types of Multiple System Atrophy
There are two main types of multiple system atrophy: MSA with predominant parkinsonism (MSA-P) and MSA with predominant cerebellar ataxia (MSA-C). MSA-P is characterized by symptoms similar to Parkinson’s disease, such as tremors, stiffness, and slow movement. On the other hand, MSA-C primarily involves symptoms related to coordination and balance, resembling those of cerebellar ataxia.
Symptoms
The symptoms of multiple system atrophy can vary widely among individuals but generally include:
- Motor symptoms: These may include muscle stiffness, tremors, slow movements, difficulty walking, and poor coordination.
- Autonomic symptoms: These may involve problems with blood pressure regulation, bladder control, digestion, and temperature regulation.
- Other symptoms: Individuals with MSA may also experience sleep disturbances, breathing difficulties, and cognitive impairment.
The exact cause of multiple system atrophy is not fully understood. However, it is believed to involve the accumulation of a protein called alpha-synuclein in the brain, which leads to damage in the nervous system. Genetic factors may also play a role in some cases.
Diagnosis
Diagnosing multiple system atrophy can be challenging due to its similarity to other neurodegenerative disorders such as Parkinson’s disease. It often involves a thorough medical history review, neurological examination, imaging studies (such as MRI or PET scans), and sometimes specialized tests like autonomic function testing.
Treatment
Currently, there is no cure for multiple system atrophy. Treatment focuses on managing symptoms and improving quality of life. Medications may be prescribed to alleviate specific symptoms such as movement difficulties or low blood pressure. Physical therapy and lifestyle modifications can also help manage the condition.
Prognosis
The prognosis for individuals with multiple system atrophy varies but generally involves a progressive decline in function over time. The average life expectancy after diagnosis is around 6 to 10 years.
In conclusion, multiple system atrophy is a complex neurological disorder that affects both movement and autonomic functions. Its impact on individuals can be profound, requiring comprehensive management strategies to address its diverse array of symptoms.
Corticobasal degeneration (CBD) is a rare neurodegenerative disorder that affects both movement and cognition. It is characterized by the progressive deterioration of nerve cells in certain areas of the brain, leading to a range of symptoms that can significantly impact an individual’s quality of life.
CBD typically presents with a combination of movement disorders, such as stiffness, rigidity, and tremors, which may initially affect one side of the body but can eventually spread to both sides. These movement difficulties are often accompanied by cognitive impairments, including problems with language, memory, and executive function.
The exact cause of CBD is not fully understood, but it is believed to involve the accumulation of abnormal tau proteins in the brain, which disrupts normal cellular function and leads to the degeneration of brain tissue. The specific mechanisms underlying this protein accumulation are an area of ongoing research.
Diagnosing CBD can be challenging due to its overlapping symptoms with other neurodegenerative conditions, such as Parkinson’s disease and progressive supranuclear palsy. A definitive diagnosis often requires a combination of clinical evaluation, neuroimaging studies, and sometimes post-mortem examination of brain tissue.
Currently, there is no cure for CBD, and treatment primarily focuses on managing symptoms and improving quality of life. This may involve a multidisciplinary approach that includes physical therapy, speech therapy, medications to alleviate movement difficulties, and support for cognitive impairments.
As CBD is a complex and relatively rare condition, ongoing research efforts are aimed at better understanding its underlying mechanisms, improving diagnostic techniques, and developing targeted therapies to address the specific challenges faced by individuals affected by this disorder.
In summary, Corticobasal Degeneration (CBD) is a rare neurodegenerative disorder characterized by a combination of movement and cognitive impairments. While its exact cause remains under investigation, ongoing research aims to improve diagnostic methods and develop effective treatments for this challenging condition.
Dementia with Lewy bodies (DLB) is a progressive neurological disorder that shares symptoms with both Alzheimer’s disease and Parkinson’s disease. It is the second most common form of degenerative dementia after Alzheimer’s disease. DLB is characterized by the presence of abnormal protein deposits in the brain, called Lewy bodies, which can lead to a decline in thinking, reasoning, and independent function.
Symptoms:
The symptoms of dementia with Lewy bodies can vary widely from person to person but often include:
- Fluctuating cognition: People with DLB may experience variations in their attention and alertness from one moment to the next.
- Visual hallucinations: These are often detailed and well-formed visual hallucinations that are frequently of people or animals.
- Parkinsonism: Many individuals with DLB develop symptoms similar to those of Parkinson’s disease, such as a shuffling walk, stiffness, and tremors.
- REM sleep behavior disorder: This condition causes people to physically act out their dreams while asleep.
- Cognitive changes: These can include problems with executive function, attention, and visual-spatial abilities.
Diagnosis:
Diagnosing dementia with Lewy bodies can be challenging because its symptoms overlap with other conditions such as Alzheimer’s disease and Parkinson’s disease. A comprehensive evaluation by a neurologist or geriatric psychiatrist is typically necessary to make an accurate diagnosis. This evaluation may include a thorough medical history, physical examination, cognitive testing, and sometimes brain imaging studies.
Treatment:
There is no cure for dementia with Lewy bodies, but treatment focuses on managing symptoms. Medications used to treat Alzheimer’s disease and Parkinson’s disease may be prescribed to help manage cognitive and movement symptoms. Additionally, non-pharmacological interventions such as physical therapy, occupational therapy, and speech therapy can be beneficial in managing the functional impairments associated with DLB.
Prognosis:
The progression of dementia with Lewy bodies varies from person to person. On average, individuals live about 5 to 7 years after the onset of symptoms, although this can range from 2 to 20 years depending on various factors such as age at onset and overall health.
In conclusion,
Dementia with Lewy bodies is a complex neurodegenerative disorder that presents unique challenges for both patients and caregivers due to its combination of cognitive, motor, and psychiatric symptoms.
Introduction to PSP Parkinson
PSP, or Progressive Supranuclear Palsy, is a rare neurological disorder that belongs to the group of Parkinsonian disorders. It is a progressive condition that primarily affects the brain’s basal ganglia, resulting in various motor and non-motor symptoms. This essay will provide a detailed overview of PSP Parkinson, its causes, symptoms, diagnosis, and treatment options.
Causes of PSP Parkinson
The exact cause of PSP Parkinson remains unknown. However, research suggests that it may involve a combination of genetic and environmental factors. In some cases, specific genetic mutations have been linked to the development of PSP, but these are considered rare. Environmental factors, such as exposure to toxins or head injuries, might also play a role in the onset of the disease.
Symptoms of PSP Parkinson
The symptoms of PSP Parkinson typically develop gradually over time, with the progression of the disease varying from person to person. Some common symptoms include:
- Balance and coordination issues: Patients with PSP often experience difficulties in maintaining balance and walking, which can lead to falls.
- Eye movement problems: Impaired eye movements, such as reduced upward gaze and problems with smooth pursuit eye movements, are characteristic of PSP.
- Cognitive changes: Patients may experience memory loss, difficulty with planning and organizing, and changes in personality or behavior.
- Speech difficulties: Slurred speech, reduced speech volume, and difficulty swallowing are common speech-related issues in PSP.
- Mood changes: Depression and anxiety are often seen in individuals with PSP.
Diagnosis of PSP Parkinson
Diagnosing PSP can be challenging due to the overlapping symptoms with other Parkinsonian disorders. A neurologist typically conducts a thorough physical examination, reviews the patient’s medical history, and assesses their symptoms. Diagnostic tests, such as brain imaging (MRI or CT scans), blood tests, and neurological assessments, may also be performed to rule out other neurological conditions.
Treatment Options for PSP Parkinson
There is currently no cure for PSP, but various treatment options can help manage the symptoms and improve the patient’s quality of life. These include:
- Medications: Medications such as levodopa, dopamine agonists, and anticholinergic drugs can help alleviate some motor symptoms.
- Physical therapy: Regular physical therapy can help maintain strength, balance, and mobility.
- Occupational therapy: Occupational therapy can assist patients in adapting to daily activities and maintaining independence.
- Speech therapy: Speech therapy can help address speech and swallowing difficulties.
- Cognitive rehabilitation: Cognitive rehabilitation can help patients compensate for cognitive changes and maintain their mental abilities.
In summary, Parkinson Plus refers to a group of neurodegenerative disorders that present with parkinsonian features alongside additional neurological deficits. These conditions include multiple system atrophy (MSA), progressive supranuclear palsy (PSP), corticobasal degeneration (CBD), and dementia with Lewy bodies (DLB). While they share some similarities with Parkinson’s disease, they have distinct characteristics and require specific management approaches.
Vascular Parkinson is a neurological disorder that results from the impairment of blood flow to certain regions of the brain, specifically the basal ganglia. This condition is characterized by the presence of both motor and non-motor symptoms, which can include tremors, muscle rigidity, bradykinesia, and postural instability. It is important to differentiate Vascular Parkinson from other Parkinson-related conditions, such as Idiopathic Parkinson’s disease and Parkinsonism.
Vascular Parkinson is often caused by cerebrovascular diseases, such as strokes or small vessel diseases, which can lead to the degeneration of brain cells and the disruption of the blood supply to the brain. This, in turn, affects the normal functioning of the basal ganglia, a group of nuclei responsible for motor control, cognition, and emotion regulation.
The symptoms of Vascular Parkinson can vary greatly depending on the location and severity of the vascular lesions. In some cases, the symptoms may resemble those of Idiopathic Parkinson’s disease, while in other cases, they may be more severe or progressive. It is crucial for medical professionals to differentiate between the two conditions to ensure appropriate treatment and management.
In the management of Vascular Parkinson, various therapeutic approaches can be employed, such as medication, physiotherapy, occupational therapy, and speech therapy. In some cases, surgery may be considered, although it is less common than in Idiopathic Parkinson’s disease.
In conclusion, Vascular Parkinson is a complex neurological disorder that results from impaired blood flow to the brain, specifically the basal ganglia. It is crucial for medical professionals to differentiate between Vascular Parkinson and other Parkinson-related conditions to ensure appropriate treatment and management. By understanding the underlying pathophysiology, diagnostic criteria, and potential treatment options, healthcare providers can better serve patients with Vascular Parkinson and help them achieve the best possible outcomes.
Parkinson’s disease is a progressive nervous system disorder that affects movement. While there is currently no cure for Parkinson’s, there are several treatments available to help manage its symptoms. The latest treatments for Parkinson’s include medication, surgical interventions, and emerging therapies.
Current Medication
Several medications are commonly used to manage the symptoms of Parkinson’s disease. Levodopa, often combined with carbidopa (Sinemet), is one of the most effective medications for controlling the motor symptoms of Parkinson’s, such as tremors and stiffness. Other medications, including dopamine agonists such as pramipexole (Mirapex) and ropinirole (Requip), can also be prescribed to help manage symptoms. In recent years, new formulations and delivery methods for existing medications have been developed to improve their effectiveness and reduce side effects.
Surgical Interventions
For individuals with advanced Parkinson’s disease whose symptoms are not adequately controlled with medication, surgical interventions may be considered. Deep brain stimulation (DBS) is a surgical procedure that involves implanting electrodes in specific areas of the brain to help regulate abnormal brain activity associated with Parkinson’s symptoms. This treatment has shown promising results in improving motor function and reducing medication-related complications in some patients.
Focused ultrasound may be used for those with resting tremor
Emerging Therapies
Researchers are continually exploring new therapies and treatment approaches for Parkinson’s disease. Some of the latest developments in this area include:
Gene Therapy: Experimental gene therapy approaches are being investigated as potential treatments for Parkinson’s disease. These therapies aim to modify the activity of specific genes involved in the progression of the disease.
Stem Cell Therapy: Stem cell research holds promise for developing regenerative treatments for Parkinson’s disease. Scientists are exploring the use of stem cells to replace damaged neurons and restore normal brain function in individuals with Parkinson’s.
Immunotherapy: Immunomodulatory approaches are being studied as potential strategies to modify the immune response in Parkinson’s disease, potentially slowing down its progression.
In addition to these specific treatments, ongoing research into the underlying mechanisms of Parkinson’s disease is contributing to a better understanding of the condition, which may lead to more targeted and effective therapies in the future. Already this has lead to the a way to test for Parkinson’s using spinal fluid or just a blood sample.
It is important for individuals with Parkinson’s disease to work closely with healthcare professionals to determine the most appropriate treatment plan based on their unique symptoms and needs.
Alpha-synuclein research
is a protein that is abundant in the human brain, particularly in the presynaptic terminals of neurons. It plays a role in regulating the release of neurotransmitters. In Parkinson’s disease, there is an accumulation of abnormal alpha-synuclein protein in the form of Lewy bodies, which are characteristic pathological features of the disease. This accumulation is believed to contribute to the degeneration of dopaminergic neurons in the substantia nigra region of the brain, leading to the motor symptoms associated with Parkinson’s disease.
The abnormal aggregation of alpha-synuclein is thought to disrupt normal cellular processes and contribute to neuronal dysfunction and death. This process is linked to the development of Parkinson’s disease and other neurodegenerative disorders known as synucleinopathies.
Research into alpha-synuclein and its role in Parkinson’s disease has led to a better understanding of the underlying mechanisms of the condition. It has also opened up avenues for potential therapeutic interventions aimed at targeting alpha-synuclein aggregation and toxicity.
Understanding alpha-synuclein pathology has become a key focus in Parkinson’s disease research, with ongoing efforts to develop treatments that can modulate alpha-synuclein levels or prevent its abnormal aggregation. While much progress has been made, further research is needed to fully elucidate the complex interplay between alpha-synuclein and Parkinson’s disease pathology.
Therapy overview
In the past 20 years ago drug symptomatic therapy was the only pillar or treatment. Simon Stott (Cure Parkinson Scientific director of Cure Parkinson’s stated that 80% of research has been done in last 20 years).
Today we have 4 pillars ( link 4 pillars to https://www.terapiaparkinson.it/en/info-parkinson/four-pillars-parkinson-therapy/ ) all proven and put together have a major impact on quality of life.
This is includes Parkinson specific movement therapy
Lifestyle therapy, nutrition, staying active, being positive, avoiding the fear anxiety trap and much much more. Many of these therapies were developed at our centre.
In the not so distant future we can expect long release levodopa cardiodopa (Symptomatic) and Desease modifying drugs or procedures.
L’autore Alexander Reed
Fondatore e direttore dell’European Parkinson Therapy Centre
The Various forms of Parkinson’s
Being in front of a neurologist who says “you have Parkinson’s” is not exactly the best time of your life, it doesn’t matter that you already lived with the disease for 8-12 years before the diagnosis.
Here you are given a bottle of pills and you are sent home. Here begins the worst moment, in which you wonder what will happen later: wheelchair, no jobs, rejected by everything and everyone? Such a negative vision of one’s future brings over 50% of Parkinsonians to become clinically depressed. It is not uncommon for depression and apathy to leave their loved ones to be shocked to flake the family unit.
It was James Parkinson, an unconventional English doctor, the first to talk about this condition over 200 years ago, which, on the basis of the observation of only six individuals, called “Shaking Palsy” (condition with tremor). Forty years later, a French doctor again examined the pathology and extended its definition and the flow rate to non -motor symptoms, also suggesting the name of “Parkinson’s”.
Parkinson’s is used to describe various conditions from the very mild (shaking hand) to the more serious MSA (Multiple system atrophy)..
Parkinson is a subset of Parkinsonism but very distinctive as it is characterized by a lack of Dopamine and hence a positive reaction to Levodopa which substitutes Dopamine when it reaches the brain. Whilst symptoms are similar, Parkinsonism often does not benefit from Levodopa.
Precisely because of the different symptoms, Dr. Michele Hu (United Kingdom) described Parkinson’s as a group of different conditions grouped under a single name. Will we find a cure for Parkinson’s, but … which Parkinson’s?!
In fact, each person shows several symptoms (there are more than 50!), From tremor, cognitive disability, pain, rigidity, etc. And each of them can be more or less predominant. The most common is Bradykinesia, the slowness of movements. Therefore, starting from the observation that no one has the same manifestation of symptoms, it is clear that Parkinson’s care has now become a multi-tasking challenge.
The drug “levodopa”, in fact, does not improve Parkinson, since, being transformed by our brain into dopamine; it only has the task of making up for the lack of this substance.
Despite the different symptoms, the common denominator among the Parkinsonians is precisely the lack of dopamine. Dopamine is an essential chemical for neurotransmission (movement), but in fact it has effects on many aspects other than movement. It is also a chemical substance is also a chemical that is produced when we do something we like, this can help explain the high levels of apathy and depression in people with less dopamine (Parkinson’s!).
The lack of this substance means that at some stage most people with Parkinson’s will take Levodopa.
If there is no response to levodopa, many doctors use the term parkinsonism, or something that, like the tremor of the hand, imitates Parkinson’s, or speak of “atrophy of the multiple system”.
Levodopa was discovered over a hundred years ago and was used for the first time in Parkinson’s about 60 years ago. That’s right, the drug is still on the front line has been the same for 60 years! The obvious question about levodopa is to ask is it a medicine? Many people think that some drugs can cure, immunize or improve Parkinson’s. We can only say of levodopa that it simply replaces our missing dopamine supply. Not a medicine in the literal sense and first discovered in 1910 and used in Parkinson’s in the 1960’s.
“Parkinson Outcomes Project”, an important research also concerning the quality of life of people with Parkinson’s, has found that
“The quality of life of a person with Parkinson’s is directly related to his mood.” In other words, it is not Parkinson’s that destroys our quality of life, but rather the emotions that we feel in having Parkinson’s. “
In the next ten years, we should witness the arrival of a series of new drugs, especially those which modify the disease (DMD) (Disease Modifying Drugs), by slowing down, stopping or at least improve Parkinson’s. Simon Stott of the Parkinson’s Trust Cure recently wrote an article, in which he stated that 80% of research has been done in last 20 years and this opened many new possibilities and a growing list of drugs that are in experimentation.
Most people with Parkinson’s today live with fear and depression, however they believe that new scientific research is not enough or will arrive too late. It seems that the enthusiasm of the scientific world does not reflect in the minds of the people who already live with this condition.
This is shown by the fact that many of us are reluctant to admit that they have Parkinson’s, almost as if they feared they are considered different or weaker. Still, even the person who arrives last in a competition is applauded, precisely because he has chosen to fight and never surrender, reaching the finish line. Anyone who faces adversity with determination is anything but week
For this reason, with Parkinsonians must not surrender, but face and learn to live with the disease.
Knowing the disease, the effect that drugs have on us, is essential if we want to take control of our life. Only drugs are not enough, but exercise and positive mentality are also essential, with the most expensive people next to us. We are not victims, because the victims have no possibility of choice. On the contrary, we can – and we must – maintain a good quality of life.
The way we see our Parkinson has a huge effect on the way we live with our Parkinson’s.
The advice of the Parkinson Europe and APTC is, in fact, not to live in the hope of a miraculous cure, but in the awareness that movement, lifestyle and attitude can change the quality of your life today.
It is normal to be afraid, because it comes from what we don’t know. Parkinson’s is, from certain points of view, the unknown, given that the truth about this condition is rarely explained correctly. It is estimated that about 80% of us get information on Parkinson’s from the web, unfortunately, from unreliable sources. For this reason, below you will find a list of connections with reliable and accurate information.
Useful links for Parkinson’s
M.J.Fox Foundation https://www.michaeljfox.org/
Parkinson UK https://www.parkinsons.org.uk/
Parkinson Europe Association https://www.parkinsonseurope.org/
Cure Parkinson’s TRUST https://www.cureparkinsons.org.uk/
Davis Phinney Foundation https://www.davisphinneyfoundation.org/
European Parkinson Therapy Centre https://www.ParkinsoTherapy.com
Link to Glossary of Parkinson Terminology
https://www.parkinsonseurope.org/about-parkinsons/glossary/
Link to article on quality of life
https://www.terapiaparkinson.it/en/info-parkinson/four-pillars-parkinson-therapy/
There are two interpretations to this term. Those who have recently been given the diagnosis (the classic definition). Some clinics refer to when the client accepts he or she has Parkinson’s.
Being newly diagnosed is just a term indicating that you have Parkinson’s BUT there are certain elements of great importance.
Accepting (and not ignoring or pretending) as early as possible allows you a greater quality of life, especially if you have the possibility to attend centres like this one. It will allow you the chance to understand (and have less fear) of Parkinson’s. To learn that Diet, exercise, Stress management and lifestyle have a major effect of disease progression and that YOU CAN CONTROL (the a certain extent) Parkinson’s development. More than for any other condition.
In an 8 year program done by European Parkinson Therapy Centre (EuPaTh) with Parkinson’s UK and followed by Oxford Brookes University. A group every month was given a day free explanation and discussion about Parkinson’s. Presented by people with Parkinson’s but developed by leading experts connected to EuPaTh. Another “control” group was identified and not given the course. After 8 years the groups were compared. The Group that did the course had higher (often double) the score of the control group
In the early years you may not have significant symptoms. But your actions in this period will have a massive effect on how you cope with Parkinson’s in the long term. Increasing strength, flexibility and movement being essential. The more you learn about Parkinson’s the easier it will be to live with Parkinson’s (we are afraid of what we do not know). Don’t be afraid, learn the truth about Parkinsons.
This is not any different from Parkinson’s, On the Hoehn and Yahr scale stage 4 and 5 are often considered Advanced. Some Neurologists automatically call people with 15 years or more as Advanced. Neither is a good classification.
The European Parkinson Therapy Centre and some others have had a good success in slowing and controlling symptoms keeping people in stage 3. Advanced Parkinson’s often is not only a more complicated stage with these complications MAY include motor fluctuations, dyskinesia, unpredictable or absent response to medications, falls, loss of autonomy, dementia, hallucinations, sleep disorders, depression, and psychosis. But another factor may be secondary conditions unconnected to Parkinson’s, back pain, other diseases like pneumonia can be complicated by having Parkinson’s and problems may become multiple. Autonomy is another major guide. Losing your autonomy means losing your freedom. That is why the advice and therapy outlined in our protocol (link protocol to https://www.terapiaparkinson.it/en/info-parkinson/four-pillars-parkinson-therapy/ )and the advice given above for newly diagnosed is essential.
FACT you can manage, to a large extent, the development of the condition.
FACT you can maintain autonomy and quality of life if you learn how to.
FACT Every has a different form of Parkinson’s, so you cannot look at another person and assume their good or bad condition is relevant to you.
Two other major factors are an increase in fatigue, this is more than just feeling sleepy, It can be overwhelming, Short rest stops during the day do help. The other is increased Apathy, this is linked to decreased dopamine but can give rise to a state of “I don’t care” Definitely to be avoided. Both these symptoms may show themselves earlier but are more common in Advanced Parkinson’s
Still Parkinson’s but there are subtle differences and pressures. Parkinson’s was once thought as an old mans condition. But todat it effects more and more people under the age of 50. Usually under the age of 50 is defined as early onset. At the centre we have had people as young as 23!
Under normal conditions YOPD is milder than later onset but then you have to live with PD for longer and it presents challenges affecting your family, your ability to pay off mortgages etc and it is very devastating for a young person. I got PD at the age of 42, Young onset, and now I have “advanced parkinson’s” 18 years later but remain autonomous and still work a full day. Our research together with Parkinson Europe showed people generally stop working after 4 and a half years.
- Slower progression of PD symptoms over time, .
- Less likely to have cognitive problems such as dementia
- More side effects from dopaminergic medications, example dyskinesia’s (involuntary body movements)
- More problems with dystonias (cramping and abnormal postures) such as arching of the foot
YOPD people are more lokely to abuse ( take more than is necessary) of Levodopa so as to main a higher motor and cognitive performance and continue working to pay the bills.
Symptoms and Causes
The primary symptoms of parkinsonism include tremors, bradykinesia (slowness of movement), rigidity, and postural instability. These symptoms are caused by the degeneration of dopamine-producing neurons in the brain. Parkinson’s disease is the most well-known cause of parkinsonism, and it is characterized by the accumulation of abnormal protein deposits called Lewy bodies in the brain. Other causes of parkinsonism may include certain medications, head trauma, stroke, or other neurological conditions.
Diagnosis and Treatment
Diagnosing parkinsonism involves a thorough medical history review, physical examination, and sometimes imaging tests such as MRI or CT scans. There is no specific test for parkinsonism, so the diagnosis is often based on the presence of characteristic symptoms. Treatment for parkinsonism aims to alleviate symptoms and improve quality of life. Medications such as levodopa and carbidopa can help manage motor symptoms. Physical therapy, occupational therapy, and speech therapy may also be beneficial in managing the condition.
Prognosis and Research
The prognosis for individuals with parkinsonism varies depending on the underlying cause. While Parkinson’s disease is a progressive condition with no cure, its progression can be managed with medication and therapy. Research into parkinsonism and related disorders continues to advance our understanding of these conditions and may lead to improved treatments in the future.
In conclusion, parkinsonism encompasses a group of neurological disorders characterized by symptoms similar to those seen in Parkinson’s disease. It can be caused by VARIOUS underlying conditions and requires careful diagnosis and management to address its impact on individuals’ lives.
Multiple system atrophy (MSA) is a rare and progressive neurological disorder that affects the autonomic nervous system and movement. It is characterized by a combination of symptoms that affect both movement and the autonomic nervous system, leading to problems with balance, coordination, and autonomic functions such as blood pressure control, bladder function, and digestion.
Types of Multiple System Atrophy
There are two main types of multiple system atrophy: MSA with predominant parkinsonism (MSA-P) and MSA with predominant cerebellar ataxia (MSA-C). MSA-P is characterized by symptoms similar to Parkinson’s disease, such as tremors, stiffness, and slow movement. On the other hand, MSA-C primarily involves symptoms related to coordination and balance, resembling those of cerebellar ataxia.
Symptoms
The symptoms of multiple system atrophy can vary widely among individuals but generally include:
- Motor symptoms: These may include muscle stiffness, tremors, slow movements, difficulty walking, and poor coordination.
- Autonomic symptoms: These may involve problems with blood pressure regulation, bladder control, digestion, and temperature regulation.
- Other symptoms: Individuals with MSA may also experience sleep disturbances, breathing difficulties, and cognitive impairment.
The exact cause of multiple system atrophy is not fully understood. However, it is believed to involve the accumulation of a protein called alpha-synuclein in the brain, which leads to damage in the nervous system. Genetic factors may also play a role in some cases.
Diagnosis
Diagnosing multiple system atrophy can be challenging due to its similarity to other neurodegenerative disorders such as Parkinson’s disease. It often involves a thorough medical history review, neurological examination, imaging studies (such as MRI or PET scans), and sometimes specialized tests like autonomic function testing.
Treatment
Currently, there is no cure for multiple system atrophy. Treatment focuses on managing symptoms and improving quality of life. Medications may be prescribed to alleviate specific symptoms such as movement difficulties or low blood pressure. Physical therapy and lifestyle modifications can also help manage the condition.
Prognosis
The prognosis for individuals with multiple system atrophy varies but generally involves a progressive decline in function over time. The average life expectancy after diagnosis is around 6 to 10 years.
In conclusion, multiple system atrophy is a complex neurological disorder that affects both movement and autonomic functions. Its impact on individuals can be profound, requiring comprehensive management strategies to address its diverse array of symptoms.
Corticobasal degeneration (CBD) is a rare neurodegenerative disorder that affects both movement and cognition. It is characterized by the progressive deterioration of nerve cells in certain areas of the brain, leading to a range of symptoms that can significantly impact an individual’s quality of life.
CBD typically presents with a combination of movement disorders, such as stiffness, rigidity, and tremors, which may initially affect one side of the body but can eventually spread to both sides. These movement difficulties are often accompanied by cognitive impairments, including problems with language, memory, and executive function.
The exact cause of CBD is not fully understood, but it is believed to involve the accumulation of abnormal tau proteins in the brain, which disrupts normal cellular function and leads to the degeneration of brain tissue. The specific mechanisms underlying this protein accumulation are an area of ongoing research.
Diagnosing CBD can be challenging due to its overlapping symptoms with other neurodegenerative conditions, such as Parkinson’s disease and progressive supranuclear palsy. A definitive diagnosis often requires a combination of clinical evaluation, neuroimaging studies, and sometimes post-mortem examination of brain tissue.
Currently, there is no cure for CBD, and treatment primarily focuses on managing symptoms and improving quality of life. This may involve a multidisciplinary approach that includes physical therapy, speech therapy, medications to alleviate movement difficulties, and support for cognitive impairments.
As CBD is a complex and relatively rare condition, ongoing research efforts are aimed at better understanding its underlying mechanisms, improving diagnostic techniques, and developing targeted therapies to address the specific challenges faced by individuals affected by this disorder.
In summary, Corticobasal Degeneration (CBD) is a rare neurodegenerative disorder characterized by a combination of movement and cognitive impairments. While its exact cause remains under investigation, ongoing research aims to improve diagnostic methods and develop effective treatments for this challenging condition.
Dementia with Lewy bodies (DLB) is a progressive neurological disorder that shares symptoms with both Alzheimer’s disease and Parkinson’s disease. It is the second most common form of degenerative dementia after Alzheimer’s disease. DLB is characterized by the presence of abnormal protein deposits in the brain, called Lewy bodies, which can lead to a decline in thinking, reasoning, and independent function.
Symptoms:
The symptoms of dementia with Lewy bodies can vary widely from person to person but often include:
- Fluctuating cognition: People with DLB may experience variations in their attention and alertness from one moment to the next.
- Visual hallucinations: These are often detailed and well-formed visual hallucinations that are frequently of people or animals.
- Parkinsonism: Many individuals with DLB develop symptoms similar to those of Parkinson’s disease, such as a shuffling walk, stiffness, and tremors.
- REM sleep behavior disorder: This condition causes people to physically act out their dreams while asleep.
- Cognitive changes: These can include problems with executive function, attention, and visual-spatial abilities.
Diagnosis:
Diagnosing dementia with Lewy bodies can be challenging because its symptoms overlap with other conditions such as Alzheimer’s disease and Parkinson’s disease. A comprehensive evaluation by a neurologist or geriatric psychiatrist is typically necessary to make an accurate diagnosis. This evaluation may include a thorough medical history, physical examination, cognitive testing, and sometimes brain imaging studies.
Treatment:
There is no cure for dementia with Lewy bodies, but treatment focuses on managing symptoms. Medications used to treat Alzheimer’s disease and Parkinson’s disease may be prescribed to help manage cognitive and movement symptoms. Additionally, non-pharmacological interventions such as physical therapy, occupational therapy, and speech therapy can be beneficial in managing the functional impairments associated with DLB.
Prognosis:
The progression of dementia with Lewy bodies varies from person to person. On average, individuals live about 5 to 7 years after the onset of symptoms, although this can range from 2 to 20 years depending on various factors such as age at onset and overall health.
In conclusion,
Dementia with Lewy bodies is a complex neurodegenerative disorder that presents unique challenges for both patients and caregivers due to its combination of cognitive, motor, and psychiatric symptoms.
Introduction to PSP Parkinson
PSP, or Progressive Supranuclear Palsy, is a rare neurological disorder that belongs to the group of Parkinsonian disorders. It is a progressive condition that primarily affects the brain’s basal ganglia, resulting in various motor and non-motor symptoms. This essay will provide a detailed overview of PSP Parkinson, its causes, symptoms, diagnosis, and treatment options.
Causes of PSP Parkinson
The exact cause of PSP Parkinson remains unknown. However, research suggests that it may involve a combination of genetic and environmental factors. In some cases, specific genetic mutations have been linked to the development of PSP, but these are considered rare. Environmental factors, such as exposure to toxins or head injuries, might also play a role in the onset of the disease.
Symptoms of PSP Parkinson
The symptoms of PSP Parkinson typically develop gradually over time, with the progression of the disease varying from person to person. Some common symptoms include:
- Balance and coordination issues: Patients with PSP often experience difficulties in maintaining balance and walking, which can lead to falls.
- Eye movement problems: Impaired eye movements, such as reduced upward gaze and problems with smooth pursuit eye movements, are characteristic of PSP.
- Cognitive changes: Patients may experience memory loss, difficulty with planning and organizing, and changes in personality or behavior.
- Speech difficulties: Slurred speech, reduced speech volume, and difficulty swallowing are common speech-related issues in PSP.
- Mood changes: Depression and anxiety are often seen in individuals with PSP.
Diagnosis of PSP Parkinson
Diagnosing PSP can be challenging due to the overlapping symptoms with other Parkinsonian disorders. A neurologist typically conducts a thorough physical examination, reviews the patient’s medical history, and assesses their symptoms. Diagnostic tests, such as brain imaging (MRI or CT scans), blood tests, and neurological assessments, may also be performed to rule out other neurological conditions.
Treatment Options for PSP Parkinson
There is currently no cure for PSP, but various treatment options can help manage the symptoms and improve the patient’s quality of life. These include:
- Medications: Medications such as levodopa, dopamine agonists, and anticholinergic drugs can help alleviate some motor symptoms.
- Physical therapy: Regular physical therapy can help maintain strength, balance, and mobility.
- Occupational therapy: Occupational therapy can assist patients in adapting to daily activities and maintaining independence.
- Speech therapy: Speech therapy can help address speech and swallowing difficulties.
- Cognitive rehabilitation: Cognitive rehabilitation can help patients compensate for cognitive changes and maintain their mental abilities.
In summary, Parkinson Plus refers to a group of neurodegenerative disorders that present with parkinsonian features alongside additional neurological deficits. These conditions include multiple system atrophy (MSA), progressive supranuclear palsy (PSP), corticobasal degeneration (CBD), and dementia with Lewy bodies (DLB). While they share some similarities with Parkinson’s disease, they have distinct characteristics and require specific management approaches.
Vascular Parkinson is a neurological disorder that results from the impairment of blood flow to certain regions of the brain, specifically the basal ganglia. This condition is characterized by the presence of both motor and non-motor symptoms, which can include tremors, muscle rigidity, bradykinesia, and postural instability. It is important to differentiate Vascular Parkinson from other Parkinson-related conditions, such as Idiopathic Parkinson’s disease and Parkinsonism.
Vascular Parkinson is often caused by cerebrovascular diseases, such as strokes or small vessel diseases, which can lead to the degeneration of brain cells and the disruption of the blood supply to the brain. This, in turn, affects the normal functioning of the basal ganglia, a group of nuclei responsible for motor control, cognition, and emotion regulation.
The symptoms of Vascular Parkinson can vary greatly depending on the location and severity of the vascular lesions. In some cases, the symptoms may resemble those of Idiopathic Parkinson’s disease, while in other cases, they may be more severe or progressive. It is crucial for medical professionals to differentiate between the two conditions to ensure appropriate treatment and management.
In the management of Vascular Parkinson, various therapeutic approaches can be employed, such as medication, physiotherapy, occupational therapy, and speech therapy. In some cases, surgery may be considered, although it is less common than in Idiopathic Parkinson’s disease.
In conclusion, Vascular Parkinson is a complex neurological disorder that results from impaired blood flow to the brain, specifically the basal ganglia. It is crucial for medical professionals to differentiate between Vascular Parkinson and other Parkinson-related conditions to ensure appropriate treatment and management. By understanding the underlying pathophysiology, diagnostic criteria, and potential treatment options, healthcare providers can better serve patients with Vascular Parkinson and help them achieve the best possible outcomes.
Parkinson’s disease is a progressive nervous system disorder that affects movement. While there is currently no cure for Parkinson’s, there are several treatments available to help manage its symptoms. The latest treatments for Parkinson’s include medication, surgical interventions, and emerging therapies.
Current Medication
Several medications are commonly used to manage the symptoms of Parkinson’s disease. Levodopa, often combined with carbidopa (Sinemet), is one of the most effective medications for controlling the motor symptoms of Parkinson’s, such as tremors and stiffness. Other medications, including dopamine agonists such as pramipexole (Mirapex) and ropinirole (Requip), can also be prescribed to help manage symptoms. In recent years, new formulations and delivery methods for existing medications have been developed to improve their effectiveness and reduce side effects.
Surgical Interventions
For individuals with advanced Parkinson’s disease whose symptoms are not adequately controlled with medication, surgical interventions may be considered. Deep brain stimulation (DBS) is a surgical procedure that involves implanting electrodes in specific areas of the brain to help regulate abnormal brain activity associated with Parkinson’s symptoms. This treatment has shown promising results in improving motor function and reducing medication-related complications in some patients.
Focused ultrasound may be used for those with resting tremor
Emerging Therapies
Researchers are continually exploring new therapies and treatment approaches for Parkinson’s disease. Some of the latest developments in this area include:
Gene Therapy: Experimental gene therapy approaches are being investigated as potential treatments for Parkinson’s disease. These therapies aim to modify the activity of specific genes involved in the progression of the disease.
Stem Cell Therapy: Stem cell research holds promise for developing regenerative treatments for Parkinson’s disease. Scientists are exploring the use of stem cells to replace damaged neurons and restore normal brain function in individuals with Parkinson’s.
Immunotherapy: Immunomodulatory approaches are being studied as potential strategies to modify the immune response in Parkinson’s disease, potentially slowing down its progression.
In addition to these specific treatments, ongoing research into the underlying mechanisms of Parkinson’s disease is contributing to a better understanding of the condition, which may lead to more targeted and effective therapies in the future. Already this has lead to the a way to test for Parkinson’s using spinal fluid or just a blood sample.
It is important for individuals with Parkinson’s disease to work closely with healthcare professionals to determine the most appropriate treatment plan based on their unique symptoms and needs.
Alpha-synuclein research
is a protein that is abundant in the human brain, particularly in the presynaptic terminals of neurons. It plays a role in regulating the release of neurotransmitters. In Parkinson’s disease, there is an accumulation of abnormal alpha-synuclein protein in the form of Lewy bodies, which are characteristic pathological features of the disease. This accumulation is believed to contribute to the degeneration of dopaminergic neurons in the substantia nigra region of the brain, leading to the motor symptoms associated with Parkinson’s disease.
The abnormal aggregation of alpha-synuclein is thought to disrupt normal cellular processes and contribute to neuronal dysfunction and death. This process is linked to the development of Parkinson’s disease and other neurodegenerative disorders known as synucleinopathies.
Research into alpha-synuclein and its role in Parkinson’s disease has led to a better understanding of the underlying mechanisms of the condition. It has also opened up avenues for potential therapeutic interventions aimed at targeting alpha-synuclein aggregation and toxicity.
Understanding alpha-synuclein pathology has become a key focus in Parkinson’s disease research, with ongoing efforts to develop treatments that can modulate alpha-synuclein levels or prevent its abnormal aggregation. While much progress has been made, further research is needed to fully elucidate the complex interplay between alpha-synuclein and Parkinson’s disease pathology.
Therapy overview
In the past 20 years ago drug symptomatic therapy was the only pillar or treatment. Simon Stott (Cure Parkinson Scientific director of Cure Parkinson’s stated that 80% of research has been done in last 20 years).
Today we have 4 pillars ( link 4 pillars to https://www.terapiaparkinson.it/en/info-parkinson/four-pillars-parkinson-therapy/ ) all proven and put together have a major impact on quality of life.
This is includes Parkinson specific movement therapy
Lifestyle therapy, nutrition, staying active, being positive, avoiding the fear anxiety trap and much much more. Many of these therapies were developed at our centre.
In the not so distant future we can expect long release levodopa cardiodopa (Symptomatic) and Desease modifying drugs or procedures.
L’autore Alexander Reed
Fondatore e direttore dell’European Parkinson Therapy Centre
