Neurodegenerative diseases: Parkinson’s Day: Staying alive with a therapy mix

This Thursday marks the 269th anniversary of James Parkinson’s birthday. We owe the first description of shaking paralysis to the busy British doctor, surgeon and paleontologist. The later namesake primarily had rest tremor (i.e. shaking at rest) in mind when he described the neurological disease. It was not until several decades after Parkinson’s death in 1824 that the phenomenon was named after him. Since 1997, April 11th has been celebrated as World Parkinson’s Day.

Prominent sufferers such as Michael J. Fox or the boxer Muhammad Ali brought additional attention to the second most common neurodegenerative disease, right after Alzheimer’s dementia. The diagnosis is being made more frequently in an increasingly older population. This names one of the most important risk factors for the disease: age. Most of the up to 400,000 people who suffer from it in Germany are over 60 years old at the time of diagnosis. Men are twice as likely to become ill as women.

In Parkinson’s disease, more and more of the nerve cells that transmit movement stimuli from the brain to the muscles are destroyed. Typical symptoms are slowed movements, noticeable tremors and muscle stiffness. Because the ability to control one’s own movements is lost, processes become slower and more uncertain, for example the steps become shorter and the gait overall becomes more of a shuffle.

As the condition progresses, it becomes increasingly difficult to maintain an upright posture, gait becomes even more unsteady, and the risk of falling increases. Various accompanying symptoms cause increasing need for support as the disease progresses, including difficulty swallowing and concentrating, severe tiredness during the day and sleep disorders at night, and problems with circulation and emptying the bladder. Last but not least, depression and anxiety disorders should be mentioned.

Given the serious nature of the disease, it is obvious to identify possible causes of Parkinson’s disease and reduce their effects. Research here is still leading in different directions; In addition to age, other illnesses play a role. It was noticed here that diabetics have an increased risk of Parkinson’s and that the disease progresses more quickly and more severely.

So far, some genes have been identified that are likely to be the causes of Parkinson’s disease. Certain environmental causes are easier to influence. It appears to be proven that pesticides and organic solvents increase the risk of disease. Just at the beginning of the month, an expert advisory board at the Federal Ministry of Labor recommended that Parkinson’s syndrome be diagnosed chemical pesticides to be included in the relevant regulation as a new occupational disease. This would then entitle people who have used herbicides, fungicides or insecticides professionally, especially farmers, to receive support from the professional association.

Although it is Parkinson’s cannot be cured, but in contrast to Alzheimer’s dementia, the disease can be easily controlled for a longer period of time using various means. Overall, therapy has made some progress in recent years. Most patients today are treated with drugs that either act like dopamine – the messenger substance that is necessary for signal transmission between the brain and muscles – or inhibit its breakdown.

If the pill form is no longer effective enough, the active ingredient can be pumped directly into the small intestine via a tube or injected under the skin. For patients under 70 years of age with severe motor impairments, a brain pacemaker may be considered, in which impulses from electrodes the typical tremor alleviate. A therapy using ultrasound waves is still experimental, in which diseased cells in the brain are targeted and heated so that they die as a result.

However, an indispensable part of Parkinson’s therapy are approaches that counteract the loss of abilities, including occupational therapy, in which the use of aids can also be trained. Speech therapy measures are intended to improve speaking and swallowing skills. Movement therapy is very important. A common problem is that patients actually need to become more active than they have been in recent years (or ever in their lives). Here it can be difficult to motivate those affected. This speaks for the still rare but possible complex treatment of the disease, in which doctors work together with trained nursing staff and therapists.

Physical therapy, strength exercises, and exercise can help improve mobility and balance. The activity should be chosen according to the respective needs; tai chi, dancing, cycling, swimming or Nordic walking are suitable. Rhythmic walking, even to marching music, has long been successful in rehabilitating Parkinson’s patients. Conscious walking and trying out new walking patterns can also help those affected – ideally initially under therapeutic guidance. According to a new meta-study, sport of any kind has a positive effect on movement symptoms and quality of life.