Parkinson’s disease: a disease beyond tremor

Although tremor is one of the three main motor symptoms in people with Parkinson’s disease, the most important and always present in all patients with this disease is bradykinesia or motor slowness in addition to rigidity. Tremor occurs in 70% of patients, which means that there are 30% of patients with this disease who do not and never will have tremors.

On the other hand, it should be noted that this is not exclusively a motor disorder, there are non-motor symptoms that are present in people suffering from this disorder, which can be even more disabling than the motor symptoms themselves, such as pain, changes in sleep, difficulty thinking , fatigue, and possible emotional changes associated with depression, stress, fear, anxiety, or loss of motivation, just to name a few.

These non-motor symptoms can affect the patient’s quality of life in the long term, given that their emotional well-being, interpersonal relationships, personal development, and physical well-being are at risk, affecting their relationship with the environment and family. .

According to data provided by the Individual Registry of Health Services (RIPS) in Colombia, between 2016 and 2020, 148,224 Colombians with Parkinson’s disease were treated, of whom 55.8% were men and 44.2% were women.

In Colombia, there are various drug alternatives for Parkinson’s disease that are included in the Health Benefits Plan (PBS). However, not all drugs control non-motor symptoms; in fact, their primary purpose is to control motor symptoms.

“There are compounds like safinamide that help improve a patient’s quality of life because its dual mechanism of action has a positive effect on both motor and non-motor symptoms. In addition, it allows the dopaminergic effect of levodopa to be prolonged, optimizing its response and achieving adequate control for more hours per day due to its inhibitory action on the enzyme monoamine oxidase (MAOI) and its anti-NMDA receptor, the receptor for the main excitatory neurotransmitter in the human brain. . It also allows for better control of dyskinesias. It is important to clarify that safinamide is approved for the treatment of motor fluctuations in the middle and advanced stages of the disease.” Said Dr. Claudia Moreno, neurologist, specialist in Parkinson’s disease and abnormal movements of the Fundación Cardio Infantil.

Recognizing that Parkinson’s disease is a disease that goes beyond tremors and motor symptoms, and also presents with non-motor symptoms, Dr. Claudia Moreno shares some additional tips that help Parkinson’s patients feel better overall. Carrying out music therapy activities: According to a study by Dr. Natalia Garcia Casares, neurologist and professor at the Faculty of Medicine at the University of Malaga, music therapy activates the motor cortex and improves movement through the brain connections that exist between the auditory system and the brain. , engine system.

In fact, one could observe how involuntarily people’s bodies tried to synchronize with the rhythm of the music, making people’s movements much more fluid. Also very well known are Argentine group studies of the effects of tango in Parkinson’s patients by the same mechanism.

Another benefit of non-motor music therapy is the improvement in the patient’s mood.

Exercise regularly: exercise can help in many ways. Both physically and emotionally. Staying active allows you to develop strength, balance, flexibility and posture.

In addition, exercise provides an opportunity to create social interactions and avoid isolation. It also helps control stress, depression and improves sleep quality.

Dance, boxing, tai chi, yoga, and Pilates are some of the most common workouts for Parkinson’s patients because they combine aerobic exercise, strength, flexibility, and memory work.

On the other hand, many studies support the fact that exercise somehow delays the progression of Parkinson’s disease, suggesting a neuroprotective effect.

Mindful eating: Proper nutrition means regularly eating a wide variety of foods from all food groups (grains, vegetables, fruits, dairy products, meats and legumes).

To control constipation, a common symptom in patients with Parkinson’s disease, it is important to consume enough fiber-rich foods. Also, eating vegetables and fruits contributes to dehydration and regulates digestion.

The Mediterranean diet has also been shown to be neuroprotective through its antioxidant effects on neurons, delaying disease progression, and improving response to various treatments.

Pharmacotherapy: As mentioned above, there are a wide range of treatments available to help control the motor symptoms of the disease. However, taking into account the patient’s history and stage of the disease, the attending physician could supplement standard therapy with an adjuvant such as safinamide, which, due to its mechanism of action and positive effect not only on motor symptoms, but also on neurological symptoms. -motor symptoms can improve the quality of life and well-being of patients.

Rely on Patient Support Programs: these programs provide a wide range of tools for people with this condition. Its purpose is to provide them with complete information about the disease and help them manage it, including the importance of the correct use of medicines and a healthy lifestyle so that patients can continue their daily lives and have a good quality of life. .

In Colombia, over 100,000 people have Parkinson’s disease, and more than half a million people have Parkinson’s disease in their families or caregivers.

For this reason, it is important to learn how to manage the disease through treatments and interventions that help the patient improve their quality of life, which controls all aspects of the disease and controls the motor and non-motor symptoms that directly affect the emotional health of people who suffer from it.