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  • Dr Ashleigh Bhanjan

Parkinson's Disease

Updated: Jan 16

Introduction


Parkinson's disease (PD) is a progressive neurodegenerative disorder that affects the central nervous system. It is characterized by the loss of dopamine-producing neurons in the substantia nigra region of the brain, leading to motor and non-motor symptoms.


The most common symptoms of PD include tremors, rigidity, bradykinesia, and postural instability. Non-motor symptoms include depression, anxiety, sleep disturbances, and cognitive impairment




The severity of PD varies from person to person, and the progression of the disease is unpredictable. In the early stages, the symptoms may be mild and may not interfere with daily activities. As the disease progresses, the symptoms become more severe, and the patient may experience difficulty in performing routine tasks.

The conventional treatment options for PD include medications, surgery, and lifestyle changes.


Medications such as levodopa, dopamine agonists, and MAO-B inhibitors are used to manage the motor symptoms of PD.


Surgery, such as deep brain stimulation, is used in advanced cases of PD when medications are no longer effective.


Lifestyle changes such as exercise, physical therapy, and speech therapy can also help manage the symptoms of PD


 

What are the side effects of Parkinson's medication?

Parkinson's medication can cause several side effects, and it is important to be aware of them. Some of the common side effects of Parkinson's medication are:

  • Nausea

  • Involuntary movements

  • Worsening of constipation

  • Low blood pressure

  • Confusion and hallucinations

  • Vomiting

  • Lightheadedness

  • Appetite loss

  • Trouble falling or staying asleep

  • Headache

  • Joint pain

  • Indigestion

  • Depression

  • Impulsive and compulsive behavior such as a shopping or gambling addiction, an insatiable hunger or sexual desire, or constantly repeating aimless tasks such as putting objects into a certain order

It is important to report any side effects to the doctor right away. The doctor can help manage them by changing the dose or switching to another drug. Patients should not stop taking any medication without consulting with their doctor.


 

Why Neuroprotection is VITAL in PD


Neuroprotection is defined as the ability for a therapy to prevent neuronal cell death by intervening in and inhibiting the pathogenetic cascade that results in cell dysfunction and eventual death.

 

Which therapies are NEUROPROTECTIVE in Parkinsons disease?


There are several neuroprotective therapies that have been investigated for Parkinson's disease.

These therapies aim to slow down the progression of the disease and protect the neurons from further damage. Some of the neuroprotective therapies for Parkinson's disease are:


  1. Pharmacological interventions : Neuroprotection is mostly a pharmacological intervention that slows the natural progression of Parkinson's disease or helps to save the most vulnerable neurons1. Some of the promising neuroprotective agents for Parkinson's disease include rasagiline, minocycline, and creatine

  2. Deep brain stimulation : Deep brain stimulation is a surgical treatment that involves implanting electrodes in the brain to stimulate specific regions. It has been shown to improve motor symptoms and quality of life in patients with Parkinson's disease

  3. Amantadine : Amantadine is a partial NMDA antagonist that has been used in Parkinson's disease for over 30 years. Its role in neuroprotection is currently being investigated

  4. Exercise : Exercise has been shown to have neuroprotective effects in Parkinson's disease. It can improve motor symptoms, balance, and quality of life

  5. Antioxidants : Antioxidants such as coenzyme Q10, vitamin E, and glutathione have been investigated for their neuroprotective effects in Parkinson's disease

  6. Photobiomodulation therapy : Researchers have proposed that PBM could improve functional recovery and decrease neurological impairment by controlling inflammation processes and oxidative stress in neurodegenerative diseases such as PD



In conclusion, there are several neuroprotective therapies that have been investigated for Parkinson's disease.


These therapies aim to slow down the progression of the disease and protect the neurons from further damage.


Some of the neuroprotective therapies for Parkinson's disease include pharmacological interventions, deep brain stimulation, amantadine, exercise, and antioxidants.


 

Is PBMT NEUROPROTECTIVE in Parkinsons disease ?


Yes, photobiomodulation therapy (PBM) has been shown to be neuroprotective in Parkinson's disease (PD).

A prospective proof-of-concept study showed that PBM improved the clinical signs of PD, including motor symptoms, cognition, and mobility.


Another study showed that PBM improved the symptoms of PD by promoting neuro-regeneration and inhibiting tremors.


Researchers have proposed that PBM could improve functional recovery and decrease neurological impairment by controlling inflammation processes and oxidative stress in neurodegenerative diseases such as PD.


PBM has wide applicability in the treatment of stroke, traumatic brain injury, PD, Alzheimer's disease, major depressive disorder, and other diseases.




 

Our Experience using PBMT, in PD

In our experience, we have seen sustained improvements in patient's motor scores, UPDRS scales, pain, fatigue, as well and gait speed, with PBMT, with a maintenance therapy treatment program.
The changes and improvements are sustained as long as patients are on a long term maintenance therapy program, as it seems to be neuroprotective, in nature.
 

Neuroinflammation in the Development of Neurodegenerative Diseases


Neuroinflammation is a complex process that involves the activation of immune cells in the brain in response to injury or infection. It is a normal physiological response that helps to protect the brain from damage. However, chronic neuroinflammation can lead to the development of neurodegenerative diseases such as PD.


In PD, neuroinflammation is thought to play a key role in the loss of dopaminergic neurons in the substantia nigra region of the brain. The activation of microglia and astrocytes in response to the accumulation of misfolded proteins such as alpha-synuclein leads to the release of pro-inflammatory cytokines and chemokines, which can cause neuronal damage and death.


Researchers have proposed that PBM could improve functional recovery and decrease neurological impairment by controlling inflammation processes and oxidative stress in neurodegenerative diseases such as PD

PBM has wide applicability in the treatment of stroke, traumatic brain injury, PD, Alzheimer's disease, major depressive disorder, and other diseases

 

Clinical research : Photobiomodulation Therapy in Parkinsons disease


Photobiomodulation therapy (PBM) is a non-invasive treatment that uses low-level light therapy to stimulate cellular function and reduce inflammation. PBM has been shown to be a safe and potentially effective treatment for a range of clinical signs and symptoms of PD.


A prospective proof-of-concept study showed that PBM improved the clinical signs of PD, including motor symptoms, cognition, and mobility [BMC Neurol. 2021]


Another study showed that PBM improved the symptoms of PD by promoting neuro-regeneration and inhibiting tremors.


The latest clinical study, using photobiomodulation therapy, in Parkinsons disease, published in Lancet, November, 2023.



  • The aim was to determine the safety and feasibility of transcranial photobiomodulation (tPBM) to reduce the motor signs of Parkinson's disease.

  • Conclusion : Our findings add to the evidence base to suggest that tPBM is a safe, tolerable, and feasible non-pharmaceutical adjunct therapy for Parkinson's disease.




Neuroinflammation plays a key role in the development of PD. Conventional treatment options for PD include medications, surgery, and lifestyle changes.





PBM is a non-invasive treatment that has shown promising results in treating neuroinflammation and improving the symptoms of PD.





Further research is needed to fully understand the potential of PBM in the treatment of neurodegenerative diseases.


 

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