Friday, February 27, 2009

Genetics/Heredity in Parkinson's disease

Posted on February 27th, 2009 by heroteo
There are two categories of Gene cause the disease linked to parkinson disease,
A causal gene alone, without the influence of other genes or environmental factors, guarantees that a person who inherits it will develop PD. This kind of genetic Parkinson’s is very rare, accounting for perhaps one to two percent of people with PD.
The second category of genes, “associated genes,” do not cause Parkinson’s on their own, but increase the risk of developing it. A person may have these genes and never develop PD, while people who do not have these genes can still end up being diagnosed with Parkinson’s. However, those who have the gene are more likely to develop PD then those without it. In order for associated genes to trigger PD, they probably need to be combined with other genes or environmental factors.
Scientists discovered both kinds of genes by studying families in which many members have developed Parkinson’s. It may be helpful to look at some of these families and how they have been affected by genetics.

In my family I have three parkinson's brothers.
They are at different stages of parkinson's diseases.

What category of gene are they? casual or associated gene

Kindly advise

Wednesday, February 25, 2009

Is parkinson an expensive disease?

teokimhoeJoined: 03 Mar 2007Posts: 123Location: Malaysia
Posted: Tue Feb 24, 2009 10:26 pm Post subject: Is Parkinson treatment an expensive?

As parkinson's is a chronic disease. It is not ageing disease PD patients are different from what we define themself as "patient" i.e only during acute, self-limited illness or injury that temporarily impact their lives as an inconvenience or comfort. It is estimated out of 2-3% at the age above 50 years old are Parkinson disease sufferers. Unfortunately we are shortage of PD specialists. As the result some are wrongly diagnosed as a process of ageing. There are reasons that the treatment on Parkinson an expensive: First, PD is a progressive disease, getting worse over time, so that the medications and doses that work well early in the disease are insufficient later on. Second, the most effective drugs have long-term side effects that are troubling and difficult to control. Third, there are a lot of different treatment options, and finding the right combination can be time consuming. Fourth, the PD patient is likely being treated for other conditions associated with advancing age, and these conditions or their treatment may interfere with treatment of PD.

apathy vs depression

Joined: 03 Mar 2007Posts: 121Location: Malaysia
Posted: Tue Feb 24, 2009 9:29 am Post subject: Apathy vs depression

The symptoms of Apathy : indifference, unconcern, lifelessness, uninterested, dullness, listless, uninquisitiveness, lack of emotions or feeling,etc Symptoms of depression: sadness, poor appetite, sleep disturbances, fatigue, feelings of guilt, self-criticism and worthlessness Apathy and depression are different emotional disorders. It is hard to deal people with apathy rather depression. There are so far no medication available for people with apathy. However people with depression started apathy if it is not treated._________________to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
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wheelersceJoined: 02 Mar 2007Posts: 686Location: MI
Posted: Tue Feb 24, 2009 4:53 pm Post subject:

I've heard the doctors say how hard it is to treat apathy, but for me two things helped. 1) stop taking Amantadine. 2) start taking Prozac. I know antidepressants aren't supposed to help with apathy, but after taking them for a very short time I went from not wanting to do anything at all (and believing nothing would ever seem fun again) to a reasonable sense of satisfaction with daily life. Antidepressants are worth a try. I never thought I'd be such a pill-pusher! sw

Question 1Can depression in Parkinson's be avoided?

Answer 1If the Parkinsonian symptoms are well controlled -especially if freezes and off periods are minimised, and pain is controlled, the risk of depression would be reduced. It is important however for carers and patients to be on the look out for signs of depression [low mood and irritability, inability to enjoy things, social withdrawal, reduced interest in life, sleep disturbance etc.] so it can be treated early; the presence of support structures and social contact will also help ...proper diet and exercise and using alcohol safely are also important. I don't think it is ever possible to state that by doing certain things you can prevent depression in every case but these are suggestions that may help to reduce the risk of onset.RC

Question 2What makes depression in Parkinson's different from ordinary depression?

Answer 2This is a difficult one. I guess it is different in that the person now has [at least] 2 disorders to cope with and that itself brings on frustration...there is some evidence that guilt feelings and suicidal ideas are less common in Parkinson's Depression; the big problem is that many of the symptoms of Parkinson's are similar to those of Depression so accurate diagnosis is not easy; in any event the principles of treatment are the same as in non-Parkinsonian Depression.RC

Monday, February 23, 2009

Nutrient and PD

A balanced, nutritious diet is important in Parkinson’s.
Many people with Parkinson’s disease lose weight because of poor appetite and inadequate food intake. Others who take levodopa may find that protein interferes with the dose of their medications taken immediately before, during or after the meal.
When it comes to nutrition, what matters most?
Eat a balanced diet with all of the daily nutritional requirements
Maintain bone health
Maintain bowel regularity
Balance medications and food
Adjust nutritional priorities for your situation and stage of disease
If you progressively lose weight for no clear reason you should bring this symptom to the attention of your physician, and undergo a careful and thorough medical evaluation.
Extra fresh fruits and vegetables provide fiber that will help or prevent constipation.
Limiting protein intake or staggering the levodopa dosing to avoid conflicts with meals can help solve this problem.
Take your medications before mealtimes on an empty stomach. For people who have swallowing difficulties, a diet of soft foods may be recommended.
Drink plenty of fluids during the day to keep hydrated, which helps to prevent constipation.

The stages of PD

Can you please explain the stages of Parkinson's disease? I need to know what to expect as the disease progresses so that I can be prepared for it. (CH)Hide Answer
The "staging" of Parkinson's disease (PD) is not based on symptoms seen but rather on the level of limitations the person with PD is experiencing. For example, Stage 1 is defined as minor involvement on only one side of the body with no limitations in daily activities. Stage 5 is defined as sigificant limitations, bed or wheelchair-bound and requiring assistance with all daily activities. There are many symptoms that can be seen as part of Parkinson's, but not every person with this diagnosis is going to experience every one or any symptom in a particular order. And because everyone's activities of daily life can differ greatly, a symptom such as tremor that might limit or bother one person may not interfere in someone else's life which doesn't require a steady hand. Therefore, I would rather encourage you to learn about Parkinson's disease itself to understand what symptoms are possible to be seen and what therapies are available to help limit the severity of these symptoms should they be experienced. I would encourage you to learn about exercise and dietary considerations and coping strategies for different symptoms that may arise. Know what's possible AND that there are things that can be done so IF such problems arise, you can recognize them and are prepared to tackle them. We can help as we offer a wide variety of printed materials which cover most all aspects of Parkinson's (re-visit our website at; we have four counselors available to help via our toll-free HelpLine (800)457-6676. We have resources to other organizations, agencies, foundations, etc. which, should the need arise, we are happy to share. Let us know how we can help

physical therapy for PD patients

The traditional view of how to treat people with
neurodegenerative conditions is that exercise has little
or no effect, or that it can actually worsen the disease!
However, recent research in both humans and
animal models suggests that physical therapy — including
gait and balance training with external cues
to improve walking, resistance training for the lower
extremity muscles, balance training, and regular exercise
— can be an important component of an exercise
programthatmay help improve or hold the signs
and symptoms of Parkinson’s disease (PD) at bay.
Gait and Balance
Gait and balance impairments are cardinal symptoms
of PD. If left untreated, impairment in walking
or balance can lead to falls, fractures, hospitalization
and loss of independence. In fact, roughly 40 percent
of nursing home admissions are preceded by a fall,
and falls occurmore frequently in people with Parkinson’s
than they do among other individuals.
Recently, a large number of studies have focused
on improving gait in peoplewith Parkinson’s through a
training exercise known as “cueing.” People with PD
sometimes have difficulty generating internal cues to
take a step. Theymay “freeze” while standing or walking,
which in turn can cause falls and injuries. External
cues, such as providing a cane to trigger a stepping
movement, placing horizontal lines on the floor, giving
instructional cues (such as asking the person to “take
long steps”) or walking to a rhythmicmetronome, can
all improve a person’s stride length and walking velocity,
and reduce shuffling and freezing.
In one such study — cueing training was used to
improve walking in participants’ home environments.
The results, thoughmodest, showedmeasurable improvements
in gait and balance, as well as reduced
freezing and greater confidence to carry out functional
activities. However, after the training ended,
the improvements were gradually lost, reminding us
that it is important to continue exercising if those improvements
are to be long lasting.
Recent research has also suggested that a person
with PD needs to exaggerate his or her effort (amplitude)
of movement for it to have the same impact of
normal movement in a person without PD.
Improving Strength
Studies have generally shown that exercise improves
speech and swallowing, posture, tremor, dexterity,
cognition and depression. Other studies have
shown that treadmill training, and lower extremity resistance
and balance training, can be effective at improving
muscle strength, gait and balance.
There has been considerable interest recently in
therapies designed to increase muscle mass, known
as “muscle hypertrophy.” Several studies have shown
that individuals who improved the size of their muscles
also demonstrated improvements in functional
activities such as climbing or descending stairs or balancing.
Muscles shrink when they are not used; conversely,
muscle tissue increases in girth with intense
resistance training. As we age, we often become
more sedentary and muscle loss becomes inevitable
— underscoring the need for exercise.
In the late 1980s, studies began to show that older
adults—many already in their 80s and 90s, and some
of them in nursing homes—could improve strength,
muscle bulk and function in response to high-intensity
resistance training. Despite this evidence — and
because some researchers and therapists believed
that resistance training might itself increase muscle
stiffness—strengthening was not advised for people
with PD out of fear that it might be harmful.
More recent studies have further challenged this
view. Results of one study of people with mid-stage
Parkinson’s suggest that high-intensity resistance
training results in a six percent increase inmuscle volume,
17 percent improvement on how far participants
could walk in six minutes, and a 22 percent and 13
percent improvement in stair descent and ascent
time. In another study, high-intensity resistance training
for the lower extremity muscles was found to im-

Question and Answer

I have heard of Parkinson's Disease. I don't understand how you get it. I was told you are born with it. Is this true and how do you know if you have it or not? (anonymous)Hide Answer
At this time, we really don't know if one is "born" with Parkinson's disease or becomes affected with it as he grows older. One theory suggests that some people are born with fewer dopamine-producing cells (either genetically or that there is some problem during pregnancy - such as trauma or a virus - which contributes to being born with fewer dopamine-producing cells). Then, as the individual ages and naturally loses cells, this person would pass the 80% dopaminergic neuronal loss that is needed before PD symptoms appear. Other theories suggest some sort of environmental insult causing the drop in dopamine cells. Unfortunately, we just don't know yet as these are theories that must either be proven or disproven via research. How do you know you have Parkinson's disease? The best way is to consult a neurologist who specializes in movement disorders. Neurology, while a specialty itself, is split into sub-specialties. Parkinson's disease is a movement disorder so one who has additional training in movement disorders, and thus sees primarily patients with such movement disorders, is the best type of physician to consult for a diagnosis.

Sunday, February 22, 2009

How long has the PD been present?

Prior to the first evidence, or symptoms of Parkinson's disease, how long has the disease likely been present? Is there a period of dopamine loss or disease process going on before symptoms occur? (RH)
What we do know is that approximately 80% of the dopamine-producing cells in the substantia nigra need to have died off before the first motor signs of Parkinson’s (tremors, slowness of movement, difficulty initiating movement, balance instability, etc.) appear. This has long suggested that the processes of PD may begin years before the symptoms become apparent so that a diagnosis CAN be made. Newer research is now suggesting that other areas of the brain may be affected as part of PD long before the substantia nigra and these changes are actually producing non-motor symptoms associated with PD such as depression, a loss of the sense of taste and/or smell, chronic constipation, etc. Keep in mind that these ideas are estimates based on research techniques with limited power. It is possible that the disease is present for only a few months before symptom onset. At this time, we have no definitive answers with regard to when the processes of Parkinson’s disease begin in the brain.

Monday, February 16, 2009

Why I am not the same?

Have been looking for something I wrote about PD and Depression several years ago and fouond this. I gave copies of this to several of my friends to try to make them understand why I am not always the same person they knew. Hope it will help some of you. (Since I did NOT write it originally, you do not need to ask my permission to copy it for your friends.)

I hope this will help some that are having problems with family,friends, co-workers or who ever that needs a little help understanding what we go through having PD.have Parkinson's disease. It is not contagious. No one knows what causes it, but some of the dopamine cells in the brain begin to die at an accelerated rate. Everyone slowly loses some dopamine cells as the grow older. If the cells suddenly begin to die at a faster rate, Parkinson's disease develops. It is a slowly progressive disease usually occurring as people get older. Medicine can help. I'll take newer, stronger kinds over the years. Some make me sick and take lots of adjustments. Stick with me. I have good days and bad days.Emotions: Sometimes I cry and appear to be upset and you think you have done something to hurt my feelings. Probably not. It is the Parkinson's Keep talking to me. Ignore the tears. I'll be ok in a few minutes.Tremors: You are expecting me to shake. Maybe I do, maybe I don't. Medicine today takes care of the tremors. If my hands, feet, or head are shaky, ignore it. I'll sit on my hands or put them in my pockets. Treat me as you always have. What's a little shakiness between friends.My face: You think you don't entertain me anymore because I'm not grinning or laughing. If I appear to stare at you, or have a wooden expression, that's the Parkinson's I hear you. I have the same intelligence, it just isn't easy to show facial expressions. If swallowing, I may drool. This bothers me, so I will mop it up.Stiffness: We are ready to go somewhere and I get up. I can hardly move. Maybe my medicine is wearing off. The stiffness or rigidity is part of Parkinson's Let me take my time, keep talking.Exercise: I need to walk each day. Two to three miles is good. Walk with me. Company makes walking fun. It may be a slow walk, but I'll get there. Remind me if I slump or stoop. I don't always know I'm doing this. My stretching, bending, exercises must be done everyday. Help me with them if you can.My voice: As my deeper tones disappear, you'll notice my voice is getting higher and wispy. That's the Parkinson's I know you can talk louder, faster and finish my sentences for me. I don't care for that. Let me talk, get my thoughts together and speak for myself. I'm still there. My mind's okay. Since I'm slower in movement, my thoughts are slower too. I want to be part of the conversation. Let me speak.Sleeplessness: I may complain that I can't sleep. If I wander around in them middle of the night, that's Parkinson's It has nothing to do with what I ate or how early I went to bed. I may nap during the day. Let me sleep when I can. I can't always control when I'm tired or feel like sleeping. Be patient, my friends. I need you. I'm the same person, I've just slowed down. It's not easy to talk about Parkinson's, but I'll try if you really want to know. I need my friends. I want to continue to be part of life. Please remain my friend.Author Unknown

Sunday, February 15, 2009

Apathy and depression in Parkinson's Disease

I have a friend who is parkinson’s disease for many years though he is wealthy but he does not believe and trust doctor he prefers to stay what he is. He is believing it will go away “magically. Apathy is one of symptoms of PD besides depression.

The symptoms of Apathy : indifference, unconcern, lifelessness, uninterested, dullness, listless, uninquisitiveness, lack of emotions or feeling,etc

Apathy is a characteristic of Parkinson disease. Apathetic behavior is not something the patient can voluntarily control, and it is not laziness or the patient trying to be difficult — it is a symptom of Parkinson disease.”

Depression is common in Parkinson's and can occur at any stage of the condition.

Symptoms of depression: sadness, poor appetite,
sleep disturbances, fatigue, feelings of guilt, self-criticism and worthlessness

Many believe it is caused by chemical imbalances in the brain, which may be hereditary or caused by events in a person's lifestlye

The study shows how dopamine shapes the two main circuits of the brain that control how we choose to act and what happens in these disease states, ” said D. James Surmeier, lead author and the Nathan Smith Davis Professor and chair of physiology at the Feinberg School. The paper is published in the August 8 issue of the journal Science.
These two main brain circuits help us decide whether to act out a desire or not. For example, do you get off the couch and drive to the store for an icy six-pack of beer on a hot summer night, or just lay on the couch?
One circuit is a “stop” circuit that prevents you from acting on a desire; the other is a “go” circuit that provokes you to action. These circuits are located in the striatum, the region of the brain that translates thoughts into actions.
In the study, researchers examined the strength of synapses connecting the cerebral cortex, the region of the brain involved in perceptions, feelings and thought, to the striatum, home of the stop and go circuits that select or prevent action.

Unlike depression, which has a negative component, apathy is distinguished by a lack of motivation with behavioral, cognitive, and affective features. "The behavioral domain includes lack of effort, lack of productivity, and dependence on others to structure activities .

I some times have emotional depression (upset) by helping a friend who has apathy in parkinson's disease who refuses to cooperate.

Saturday, February 14, 2009

Nutrition in Parkinson's disease

Living with parkinson’s disease have many impacts of their lifestyle.

I have experience constipation, stomach emptying,bloating,saliva,eye vision,and swallowing problems.

Sideeffect of medications caused me nausea,dry mouth, dizzinness, sleepliness, vivid dreaming and appetite loss/loss of taste or smell.

Therefore people with PD are at increased risk for malnutrition.

The impact of malnutrition are as follows.
1.Bone thinning 2.Dehydration
3.Bowel movement 4.unplanned weight loss
5.medication sideeffects 6.protein -levodopa interaction; levodopa (Sinemet, madopar) compete for absorption from the small intestine with proteins in food

Parkinson's disease is a complicated disease that affect each person differently, nutrition are important for your bone strengthening, dehydration, bowel movement and weight loss.

Though nutrition would not cure PD or slow its progression but it would improve your quality living.

As for my nutrition I have blood test on my antioxidant level twice in a year and top up by supplements.

Wednesday, February 11, 2009

Depression and Exercise

People with depression may be one of symptoms of parkinson’s diseases, a disorders nervous systerm (lack of dopamine in your brain cell), a voluntary movement disorders.

Depression is a serious medical illness that involves the brain. Whilst depression can sometimes go away, in many cases it can continue for a long period of time affecting enery levels, productiviy aned close relationship.

Depression on people with parkinson’s disease weaken your immune function against illness .

There are nearly twice as likely to develop Parkinson’s disease for those who were taking antidepressants.

It increases your high blood pressure and causes insomina, sleepless, stress,vivid dreaming, anxiety, depression,slurred speech, loss of taste which are part of emotional disorder of parkinson’s.

Exercises, medication, diet and supplements are the way to release you from depression.
Activiate your exercise daily help you to reduce/ease your depression besides medication and diet .

Exercise regularly reduces your risk of stroke in many ways.

It can lower your blood pressure, increase your level of HDL cholesterol, and improve the overall health of your blood vessels and heart.

It also helps you lose weight and control diabetes, and can reduce stress.Gradually work up to 30 to 45 minutes of activity — such as walking, jogging, swimming or bicycling .
Research has shown that regular exercise benefits people with Parkinson’s disease. Exercise reduces stiffness and improves mobility, posture, balance and gait. Exercise may also reduce depression also.

I have depression for the past of 20 years before I was diagnosed as Parkinson's disease.

My symptoms:

Sadness,Loss of interest or pleasure in activities you used to enjoy,Change in weight,Difficulty sleeping or oversleeping,Energy loss,Feelings of worthlessness,Thoughts of death or suicide.

I am on antidepressants.

Thursday, February 5, 2009

strengthen your core muscle and parkinson's

Parkinson’s disease is a movement disorders disease. It is also a neurological voluntary movement disorders that causes trembling, stiffness of the limbs, and impaired balance and coordination.

Cultivate a strength core muscle are helpful for Parkinson’s patients.

They monitor and corridinate our body movement smoothly and orderly. It is also good for sport and fitness but also for daily life.

Practice deep breathing for core stabilization besides other exercises regularly working together to strengthen and coordinate are important. These muscles work together to support your spine. When you strengthen your core, you gain greater balance and stability.

Therefore building core strength is important for your better posture, body balance, speed, and power, protect you from lower back pain and less likely fall.

In short core stability benefits everyone, from older people to top professional athletes.

Deep breathing exercises for core stabilization should be part of every conditioning program, along with flexibility, strength, and aerobic training.

Your core is composed of three muscle regions on your body: 1) abdominal, 2) pelvic, and 3) lower back. Basically, your core is any muscle located between your pelvis and the base of your ribcage. These muscles work together to support your spine. When you strengthen your core, you gain greater balance and stability.

There are exercise to do strengthen your core muscle;abdomen, lower back, and pelvis lie roughly between the rib cage and the hips.

I do deep breathing in yoga, and weight liftling classes to breath in my abdomen, peliv and breath out my lower back to strengthen my core muscle, physical speed and stamina. The deep breathing exercises are helpful for my stoop posture, slow movement, poor balance and stabiliIty.

You will feel tired easily for the first times by using three core muscles to stabilize your movement and strength at time during exercises. However they strenghten your immune function and endurance. Learning to relax at times during exercise relief your tiredness, depression and anxiety.