Comparison Between Pd Patients And Controls
Patients scored higher than controls on anxiety =44.2, p=0.000, Cohens d=0.23) and depressed mood =151.7, p< 0.001, Cohens d=0.45), but lower on dispositional mindfulness =21.7, p=0.000, Cohens d=0.15), all independent of sex or age. Perceived stress was higher in patients than in controls, but this effect was much larger for men than for women =5.7, p=0.017). Self-compassion did not differ between patients and controls . For rumination , the main effect was not significant , but we found a group*sex cross-over interaction =7.6, p=0.006): for women, controls scored higher than patients , whereas for men, patients scored higher than controls . In general, the control responders consisted of more women and mean age was significantly lower than in the PD responders.
Other Causes Of Parkinsonism
“Parkinsonism” is the umbrella term used to describe the symptoms of tremors, muscle rigidity and slowness of movement.
Parkinson’s disease is the most common type of parkinsonism, but there are also some rarer types where a specific cause can be identified.
These include parkinsonism caused by:
- medication where symptoms develop after taking certain medications, such as some types of antipsychotic medication, and usually improve once the medication is stopped
- other progressive brain conditions such as progressive supranuclear palsy, multiple systems atrophy and corticobasal degeneration
- cerebrovascular disease where a series of small strokes cause several parts of the brain to die
You can read more about parkinsonism on the Parkinson’s UK website.
Page last reviewed: 30 April 2019 Next review due: 30 April 2022
Can Parkinsons Disease Be Brought On By Stress
Stress in todays times is the key to all form of physical exhaustion along with mental strain. It has been confirmed that extreme psychological stress like an instance of a holocaust has a definite association with Parkinsons disease. Research studies with respect to ex-prisoners of war prove the presence of significant instance of having Parkinsons disease after a long time of their release. Thus with the recent research and significant associations scientists and authors do speculate the importance of the role of stress in Parkinsons disease.
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What Causes Parkinsons Disease
Parkinsons disease occurs when nerve cells in an area of the brain called the substantia nigra become impaired or die. These cells normally produce dopamine, a chemical that helps the cells of the brain communicate . When these nerve cells become impaired or die, they produce less dopamine. Dopamine is especially important for the operation of another area of the brain called the basal ganglia. This area of the brain is responsible for organizing the brains commands for body movement. The loss of dopamine causes the movement symptoms seen in people with Parkinsons disease.
People with Parkinsons disease also lose another neurotransmitter called norepinephrine. This chemical is needed for proper functioning of the sympathetic nervous system. This system controls some of the bodys autonomic functions such as digestion, heart rate, blood pressure and breathing. Loss of norepinephrine causes some of the non-movement-related symptoms of Parkinsons disease.
Scientists arent sure what causes the neurons that produce these neurotransmitter chemicals to die.
Identify The Cause Of Stress
Thiss the first step in dealing with stress. There could be many things that trigger stress in Parkinsons disease. It could be related to your symptoms like specific movements, difficulty in talking, eating, and falling sleep or it could be due to other problems. If you can recognize them, you can learn to address them.
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What Is The Outlook For Persons With Parkinsons Disease
Although there is no cure or absolute evidence of ways to prevent Parkinsons disease, scientists are working hard to learn more about the disease and find innovative ways to better manage it, prevent it from progressing and ultimately curing it.
Currently, you and your healthcare teams efforts are focused on medical management of your symptoms along with general health and lifestyle improvement recommendations . By identifying individual symptoms and adjusting the course of action based on changes in symptoms, most people with Parkinsons disease can live fulfilling lives.
The future is hopeful. Some of the research underway includes:
- Using stem cells to produce new neurons, which would produce dopamine.
- Producing a dopamine-producing enzyme that is delivered to a gene in the brain that controls movement.
- Using a naturally occurring human protein glial cell-line derived neurotrophic factor, GDNF to protect dopamine-releasing nerve cells.
Many other investigations are underway too. Much has been learned, much progress has been made and additional discoveries are likely to come.
Mimicking Human Conditions In Animal Models
With the advance of the medical research, it is possible to mimic certain human conditions in selected animals, such as mouse or rat, to study the development of a disease and search for treatment. In addition to being very close to the human physiology, these animal models are reliable and critical to develop new treatment strategy and to understand the pathophysiology of a disease.
In the laboratory of Professor Musa V. Mabandla, we have by exposing pups to early maternal separation once daily, from post-natal day 1 to 14. We thereafter injected these rat models with depressive-like behaviors with a preclinical dose of 6-hydroxydopamine stereotaxically into the medial forebrain bundle to mimic Parkinsonism. This has resulted to a rat model of PD associated with depressive-like behaviors.
We also injected these animal models with Fluvoxamine maleate , an antidepressant widely used for the treatment of psychiatric disorders, to investigate the neuroprotective effects of the drug on a parkinsonian rat model of neurodegeneration.
Our findings show that early maternal separation exacerbated the effects of 6-hydroxydopamine, but FM treatment attenuated neurodegeneration associated with 6-hydroxydopamine toxicity.
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Is Parkinsons Disease Inherited
Scientists have discovered gene mutations that are associated with Parkinsons disease.
There is some belief that some cases of early-onset Parkinsons disease disease starting before age 50 may be inherited. Scientists identified a gene mutation in people with Parkinsons disease whose brains contain Lewy bodies, which are clumps of the protein alpha-synuclein. Scientists are trying to understand the function of this protein and its relationship to genetic mutations that are sometimes seen in Parkinsons disease and in people with a type of dementia called Lewy body dementia.
Several other gene mutations have been found to play a role in Parkinsons disease. Mutations in these genes cause abnormal cell functioning, which affects the nerve cells ability to release dopamine and causes nerve cell death. Researchers are still trying to discover what causes these genes to mutate in order to understand how gene mutations influence the development of Parkinsons disease.
Scientists think that about 10% to 15% of persons with Parkinsons disease may have a genetic mutation that predisposes them to development of the disease. There are also environmental factors involved that are not fully understood.
Avoid Negative Thoughts And Criticism
Thinking about the disease and worrying about the future will make your condition worse. Instead, adapt yourself with the disease and focus on things that bring positive feelings. It can be tricky, but certainly not impossible.
Look at life at a different angle and be grateful for whatever you have, even for small things. It will have a great impact on your positivity and happiness.
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Serotonin Hypothesis Of Depression
Serotonin is mainly produced in the dorsal raphe nucleus . Serotonin transporters take up released serotonin from the synaptic cleft into serotonergic neurons in a manner that helps to modulate various functions in the brain including mood and emotion . The striatum, the amygdala, and the prefrontal cortex are regions of the brain that are innervated by serotonergic neurons . These brain regions including the dorsal raphe nucleus which is part of the brains serotonergic system, are activated during early maternal stress . Abnormal 5-HT levels in these brain areas have been associated with depression . Pre-clinical and clinical studies have demonstrated that early life stress affects 5-HT levels in the brain and this may lead to depression . Selective serotonin re-uptake inhibitors are a class of antidepressant drugs commonly used to treat depression . SSRIs work by blocking 5-HT re-uptake thus increasing the availability of 5-HT in the synaptic cleft as well as its chance to bind to receptors in the post-synaptic membrane . Therefore, by restoring the levels of monoamines and their transporters in the brain, SSRIs drugs are appropriate treatments to address early life stress dysfunction that predisposes to depression later in life.
Stress Management For Pd
It is not uncommon for the stresses of daily life feeling overwhelmed, under prepared and over stimulated to cause anxiety and unrest. These psychological issues can impact your health and even exacerbate the symptoms of Parkinsons disease . That is why it is important to assess what may be causing stress and learn how to deal with the situations that give rise to anxiety. Meditation, yoga or Tai Chi and deep breathing can help restore a sense of calm. Whether you are living with Parkinsons or caring for someone with PD, finding balance can help you cope with the daily stresses of life. This may mean limiting your exposure to environmental stressors or using complementary therapies. Such approaches are wonderful ways to lower anxiety, lower blood pressure and improve your all-around health.
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Parkinsons Disease And Stress
Stress may play a role in the development of PD. The principle risk factor for PD is aging, which may also be associated with elevated levels of cortisol . Cortisol is also elevated in PD patients compared to healthy age-matched controls . Acute treatment with levodopa can reduce plasma cortisol levels in PD patients , suggesting a connection between dopamine hypofunction and HPA axis hyperactivity. Stressful life events may also precipitate the development of PD. For example, prisoners of war had a much higher incident rate of PD development thirty-five years after release . Emotional stress can transiently increase motor symptoms , consistent with acute effects on nigrostriatal function. Appearance of the clinical PD symptoms during a stressful period may reflect damage to the nigrostriatal system that had been masked during the preclinical stage . Loss of mesocortical dopamine neurons, which occurs in more advanced stages of PD, may result in the system becoming more vulnerable to stress, as dopamine release in the cortex inhibits stress-activated neurons in the nucleus accumbens . Individuals with PD also have reduced hedonic responses after exposure to emotional stress, but stress did not affect the selected motor symptoms studied .
How Does Stress Develop Parkinsons Disease
Parkinsons disease occurs as a result of the severe loss of certain cells in the brain that produce dopamine, which is a neurotransmitter that controls body movements.
Stress may contribute to the loss of dopamine-producing cells. Research studies in animals suggest that chronic stress preferentially exert neurotic effects on brain cells and affect their ability to produce dopamine .
While the exact mechanism of how it could cause damage, researchers think that it acts by developing oxidative stress condition that harm DNA, protein, and lipid of brain cells and ultimately caused their death .
The other possible way through which chronic stress causes damage to dopamine-producing cells in the brain is by decreasing the levels of T-lymphocytes, which are the special type of cells present in our blood and are involved in immunity. A study on mice brain has shown that dysfunction of T-lymphocytes results in the loss of dopamine-producing cells and develop Parkinsons disease-like changes . Another study found a profound reduction in T-lymphocytes levels in the blood of Parkinsons disease patients .
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Advancing The Understanding Prediction And Prevention Of Freezing Of Gait In Parkinson’s Disease
Up to 80 percent of people with Parkinsons disease will eventually experience freezing in place, a debilitating symptom precipitating falls and curbing peoples independence.
At the University of Waterloo, Assistant Professor Kaylena Ehgoetz Martens, a neuroscientist, studies whether anxiety helps cause or results from freezing of gait.
Previously, a lot of my work focused on whether anxiety was an underlying factor that led the brain to jam because of all this information it was trying to process, says Ehgoetz Martens.
Now, she wants to understand whether anxiety lies at the core of all of freezing of gait episodes, or only in a select subset in certain situations or in a certain subset of people.
Working with people who have Parkinsons, Ehgoetz Martens will show them pictures of environments that could cause freezing, as well as place them in virtual situations that could provoke freezing of gait. Shell measure their movements, heart, and brain wave activity during these virtual reality exercises to determine the role anxiety plays.
Ideally, at the end of this two years, were going to understand whether different subtypes of freezing of gait exist, and if people need different treatment strategies, we can make different recommendations.
In one exercise, for example, people will walk across a virtual high plank versus a flat surface. Another virtual scenario would see them maneuvering across thresholds or around corners in an apartment.
Psychological And Physiological Anxiety Measures
Repeated measures ANOVA indicated a significant effect on phase and group × phase interaction for VAMS anxiety factor . However, no difference was found between the groups . With regard to other VAMS factors, there was a significant effect of phase on mental sedation , physical sedation , and other feelings . However, there were no significant effects of these parameters on group × phase interaction and the groups.
Figure 1
Repeated measures ANOVA showed a significant effect of phase on heart rate without differences between the groups or group × phase interaction. Moreover, there were no differences in systolic or diastolic blood pressure between the phases, groups, or group × phase interaction.
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Depression And Parkinsonism In An Animal Model Of Neurodegeneration
Early post-natal maternal separation is widely used to create an animal model that exhibits some depressive/anxiety-like behaviors . This established model of depression is useful to study 6-OHDA lesion of the medial forebrain bundle to lesion nigrostriatal DA neurons. We recently investigated the antiparkinsonian effects of Fluvoxamine maleate in a parkinsonian rat model of neurodegeneration associated with anxiety/depressive-like behaviors . Although these studies were a small exploratory open-label trial, they anticipated outcomes on a larger double-blind placebo-controlled study that include non-depressive animals with Parkinsonism. Fluvoxamine maleate treatment has shown potential in decreasing dopaminergic neuronal loss as well as potential to regulate neuronal pro- and anti-inflammation markers in the striatum . Therefore, a combined animal model of chronic stress-induced depression with a 6-OHDA lesioned parkinsonian animal model is an appropriate model to investigate the relationship between depression and PD. This association suggests that the stressor needs to be applied prior to the injection of the neurotoxin 6-OHDA to combine depressive-like behaviors with a potential risk of developing motor-symptoms that characterize Parkinsonism. This combination showed the double advantage of investigating a non-motor symptom as part of an early onset of PD together with the neuroprotective effects of a treatment on the development of the disease.
Cerebral Effects Of Chronic Stress In Pd
As outlined earlier, chronic stress influences the brain both at the systems level and at the molecular level . Through these changes, chronic stress may affect PD brains by increasing the susceptibility to depressive and anxiety disorders, while also potentially impacting the already injured dopaminergic nigrostriatal system in patients with PD. Although this remains highly speculative at this stage, the following mechanisms may contribute to these effects.
FIG. 2
Another way in which stress might influence PD disease progression is by depleting compensatory mechanisms. In PD, clinical symptoms usually become apparent when > 50% of dopaminergic cells are lost. This suggests that compensatory mechanisms must take place in the early phase of PD to prevent overt clinical symptoms. These compensatory mechanisms are thought to take place both in the striatal dopamine system and at the level of large-scale brain networks. Under stressful conditions, the residual dopaminergic function is compromised, and attentional resources are depleted, in a similar way as dual tasking does. This may âunmaskâ clinical symptoms that were not seen before or increase the severity of already manifest symptoms.
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What Happens To The Body At A Neural Level When Exposed To Uncontrollable Stress
The mechanisms at the neural level due to stress may be quite alarming-
Nerve Degeneration: It has been seen that chronic stress can degenerate the nigrostriatal nerves. This is particularly common who cannot seem to work out their coping mechanisms.
HPA Hormones: Extreme amount of stress for prolonged period may lead to activation of the certain hormones like the HPA which eventually leads to inconsistent coping mechanisms.
These cases of stress related damages in the bodily activities like the striatal damage results in decreased motor abilities which is a major symptom of Parkinsons disease.
High Levels of Glucocortisoles: Extreme levels of stress are seen to reduce the motor performance level due to high levels of glucocortisoles.
Loss of Nigral Neurons: Research studies have also proven that high levels of corticosterone may at times lead to loss of nigral neurons which may be permanent.
Extreme stressful situations may also lead to a reduction in the secretion of dopamine. The decreased dopamine levels are responsible for bringing the symptoms of Parkinsons disease come to action.
Neurodegenerative Diseases: Stressful life events and situations characterized by extreme levels of stress bring the neurodegenerative diseases come into play, Parkinsons disease being a major one in it.
Can Parkinsons Disease Be Prevented
Unfortunately, no. Parkinsons disease is long-term disease that worsens over time. Although there is no way to prevent or cure the disease , medications may significantly relieve your symptoms. In some patients especially those with later-stage disease, surgery to improve symptoms may be an option.
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