Parkinson’s disease is a progressive, non-curable neurodegenerative disease characterised by motor symptoms (including tremors, stiffness, slow movements, difficulty walking,) and non-motor symptoms (including memory difficulties, anxiety, depression, apathy) . The symptoms progressively worsen over time.

Parkinson’s disease is difficult to diagnose as the symptoms are common to other diseases and this often delays the correct diagnosis.

Since the cause of the symptoms is the reduction of dopamine production in the body of those who have the disease at a higher rate than in those who do not, late diagnosis can mean that when the disease is recognised the symptoms are already invalidating for the person.

Another subtle aspect of the disease is that each person has a different mix of the multiple symptoms of the disease: each of us has our own Parkinson’s.

Over time, research has also classified three different and identifiable MACRO categories.

1. Parkinson’s syndrome: the classic condition, which we usually call “Parkinson’s disease”, which has common symptoms, but with a mix that varies greatly from patient to patient;
2. Parkinsonism: the symptoms follow the traditional ones of Parkinson’s but there is no lack of dopamine in the individual; shaking hand syndrome and so-called Vascular Parkinson disease belong to this category.
3. AAtypical Parkinson’s PLUS: they have totally different symptoms from the common ones of the disease, and  do not respond to drugs. They are usually faster onset with a high fatality rate.. The following belong to this category:
   • Progressive Supranuclear Palsy (or Steele-Richardson-Olszewski disease) PSP;
   • MSA multi System Atrophy;
   • CBD Corticobasal degeneration;
   • Dementia with Lewy bodies.

Symptoms of classical syndrome (Parkinson’s disease)

We begin this journey with the symptoms of the “classic” form of the disease, what we call “Parkinson’s disease”.

The first distinction is between motor symptoms and non-motor symptoms; each patient manifests a specific combination, different from all the other patients.

MOTOR SYMPTOMS:

• Most common is slow movements (bradykinesia) and rigidity.
• tremor: it can affect the hand or foot (more frequently) at rest, and may disappear during the execution of an action but appear under stress.
  Loss of muscle agility and stiffness that often presents as pain in the arm or foot, flexed posture of the elbow, hand or leg
• cessation or reduction of movements (akinesia);
• balance and coordination problems;
• walking problems: posture, shortened steps, lack of arm movement, sudden block (freezing of gait);
• loss of muscle strength, cramps;
• Pisa syndrome (lateral trunk flexion);

NON-MOTOR SYMPTOMS:

they are many but often not recognized, underestimated, not specifically cared for, and therefore lead to a deterioration in the quality of life of patients:

• loss of smell (hyposmia);
• generalized fatigue;
• tension, muscle pain, cramps;
• sleep disturbances, which can be schematically classified into three different categories:
  1. specific disorders that occur during night sleep (parasomnias)
  2. riduzione del sonno notturno (insonnia)
  3. sonnolenza diurna.

Specific sleep alterations include:

• hypersensitivity to stress;
• sweating disorders: both an excess of sweating (hyperhidrosis) and an abnormal reduction of sweating (hypohidrosis);
• lowering of the voice;
• excessive salivation (sialorrhea);
• constipation, due to the slow transit of the intestine;
• acid reflux, due to the difficulty in properly disposing of food from the stomach;
• problems urinating: it can be necessary to urinate as soon as the stimulus is felt, or the feeling of not having completely emptied the bladder, or the need to urinate several times at night (nocturia);
• disorders of sexual function: they include erectile dysfunction (achieving and maintaining an erection) and ejaculation problems in male patients, and loss of lubrication and involuntary urination during sex in female patients;
• difficulty writing and / or keeping legible handwriting (micrography);
• anxiety, fear;
• depression;
• apathy;
• psychosis: the mild symptoms are the “not annoying illusions” like seeing something in the corner of the eye without it being actually real; they can then evolve into true visual hallucinations and, less frequently, auditory hallucinations. Far more dangerous are fixed illusions or false beliefs (paranoia), for example about marital infidelities, plots of which you are victims, etc.
  In the early stages of psychosis, patients are aware of their symptoms, but this decreases over time to alter the knowledge of reality and the patients are more able to distinguish personal subjective experiences from the reality of the external world.

Parkinson’s disease is not an inherited disease, with the exeption of very particular and selected cases. Some people have genetic mutations that predispose them to disease, but this is not enough to cause it; symptoms are triggered by exposure to environmental factors encountered during life.

This theory is supported by the discordant presence of the disease in mono zygotic twins (i.e. having an identical genetic heritage): it is not always the case that both develop the disease.

The symptoms of vascular parkinson

Vascular parkinsonism means a clinical picture with parkinsonian symptoms that do not derive from dopamine deficiency but from vascular factors at the brain level (e.g. stroke).

The symptoms of Parkinsonisms

Parkinsonism also presents with the same symptoms as Parkinson’s disease even if in this case they have a different cause than the lack of dopamine since they are normally the consequence of ailments or brain injuries, of taking some drugs or toxins.

Symptoms of Atypical Parkinsonisms

This heterogeneous group of diseases were once called Parkinson-plus for the presence of a symptom or additional sign compared to Parkinson’s disease.
These are often more aggressive, do not respond to Parkinson drugs and are often fatal

• Progressive supranuclear palsy (PSP): 0rvosis (as defined by the name), for example the extrapyramidal system (classically involved in Parkinson’s disease), signs of suffering of the cerebellum that cause disturbances in balance and motor coordination.
• Multisystem atrophy (MSA): It is characterized by the involvement of multiple nervous systems (as defined by the name)
• CBD Conticobasal Degeneration: presents asymmetric parkinsonism, mainly with movement disorders
• Lewy body dementia: it is a rare neurodegenerative disease, due to unknown cause, which manifests itself with a progressive decline in cognitive functions, capable of interfering with the social and occupational activities of the subject, and by signs / symptoms of parkinsonism.

As we have been able to verify from the reading of the preceding paragraphs, the symptoms of Parkinson’s are manifold and derive from multiple causes, they cross and overlap deeply undermining the health of the body and mind of the person affected by the disease. In the face of damage caused to 360 ° in the life of the patient and his family, a single treatment cannot be enough to reduce the symptoms of Parkinson’s disease, but a multilevel therapy that takes care of the patient’s health at 360 ° is necessary to combat the disease wherever it occurs.

The importance of physical activity is now known and it is now scientifically accepted that it must be done every day to produce and maintain results. Regularity is better than quantity!

It is important to accept the disease and with it that life changes, but who says that we are unable to decide how it should change? If we choose to do less, but at the same time also to do what makes us happy more often, then the quality of our life will be maintained. Let’s not confuse quantity with quality of life.

There are many contributing factors to getting Parkinson’s including the enviroment, stress and factors beyong our control. Often this is the first question you ask yourself yet there is no easy answer. Here at the Centre we would suggest that it is the WRONG question to ask. Far more important question is: “How can I make my life full now that I know it’s me”. Often, in the early and mid years, patients avoid talking openly about Parkinson’s and also avoid hospital therapy. We want you to feel welcome for the time you are with us,  we will speak openly and tell you the truth about Parkinson’s in a non hospital wellness enviroment and the truth is that YOU CAN TAKE CONTROL.

The actor Michael J Fox has been at the forefront of the fight against Parkinson, he has been living with Parkinson for over 20 years and in his book “The Adventures of an Incurable Optimist, Always looking up” shows how awareness of the disease and the acceptance that “yes it is you” are the first steps on the road to a better life.

Widely accepted in many counties and radically changes the way we approach therapy and life. Pills are NOT ENOUGH (maybe too much!) but the fourth pillar (our Psychological response is worth mentioning. The Centre developed the ACMA protocol which has had great success in applying.

ACMA

The first step is to ACCEPT the disease, which means accepting something you don’t want but, just like aging, disease is a fact. Accepting the disease and not hiding it from ourselves is also essential if we want to fight it.

UNDERSTANDING and COMPREHENSION  about how Parkinson’s effects us and what it really is and that we CAN FIGHT BACK  with great success makes us stronger, as we continue to discover that our behaviour  can influence its progression and symptoms.

Only if we accept and understand can we be MOTIVATED to fight the disease, to defend ourselves from it.

Accepting, understanding and being motivated therefore leads us to ACTION against Parkinson, an action that will be all the more effective the more we will have learned to overlap what we have to do with what we like to do (we must create and maintain dopamine through our happiness).