Journalist and presenter Renata Capucci revealed last Sunday (26) on the podcast This is fantastic who has Parkinson’s, a disease that affects about 200,000 Brazilians. “I have Parkinson’s, but Parkinson’s doesn’t have me,” she says, who, at age 49, is among the roughly 10% to 15% of patients with the disease under the age of 50, according to data from the World Health Organization. (WHO). In the program, Renata said that she received the diagnosis four years ago, when she was 45 years old and presented the first symptom: limping without realizing it. According to neurosurgeon Vanessa Milanese, Parkinson’s disease is a movement disorder whose main characteristics are tremor, rigidity and slowness of movement. The condition can manifest itself in the patient about 20 years before the diagnosis, and the main symptoms, at this first moment, are constipation and loss of smell.
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Renata Capucci journalist presenter — Photo: Instagram @renatacapucciofficial
In addition to medication, the treatment of the disease includes the regular practice of physical exercise and nutritional monitoring. O I Athlete explains more about Parkinson’s, which also affects actor Michael J. Fox, from the Back to the Future trilogy. Understand diagnosis, symptoms and treatment.
What is parkinson’s disease and what is its cause?
Parkinson’s is characterized by a disorder of the nervous system that affects movement. Neurosurgeon Vanessa Milanese explains that the cause of the disease is linked to the reduction of dopaminergic neurons, which are produced in a deeper and darker region of the brain (midbrain) called the substantia nigra. Throughout life, degeneration of these neurons responsible for producing dopamine is common. However, Parkinson’s patients have a more accelerated degeneration.
The diagnosis of Parkinson’s disease is slow. This is because it is necessary to follow some international criteria to confirm the disease. The investigations are carried out in parts: first, the doctor makes some clinical evaluations and prescribes the specific medication for the disease. Afterwards, it is necessary to observe for three months how the patient reacts to the drug to proceed with biochemical and blood investigations to try to confirm the diagnosis. There are over twenty symptoms associated with Parkinson’s disease, and not all patients will develop all of them, but a set that includes some of them. The following stand out:
- Rigidity in movements
- muscle contractions
- Slowness of movement (bradykinesia)
- Forward leaning posture
- Difficulty performing sequential movements
- Balance change
- mood change
- reduced sense of smell
- Urinary incontinence
- apathy and depression
- Memory loss (amnesia)
- Dementia (in more advanced cases)
The treatment is done through dopaminergic drugs that will help in the availability of dopamine in the body, since the patient has this degeneration of neurons. Medications can cause a type of change called dyskinesias, typical dance movements, which is related to increased use of levodopa, active drug ingredient that acts by increasing the amount of dopamine in the body. When this happens, there are medications that help with this.
And according to Vanessa, physical exercise was the first medication/treatment that existed for the disease. The literature shows that regular practice helps in the availability of dopamine (which is still in the brain) and increases endorphin production, which ends up improving stiffness and general symptoms of the disease.. In addition, there is neurological physiotherapy with transcranial stimulation, in specific positions in the brain, which optimizes the improvement of motor symptoms (tremor, stiffness and slowness) and those related to anxiety and cognitive issues. As Renata writes in the post above, “doing physical exercises improves balance, muscle endurance and consequently all other symptoms”.
— Follow-up should be multidisciplinary (psychotherapy, speech therapy, nutritionist and physiotherapy). In some cases, after five years of the disease, and when the patient had a good response to levodopa at the beginning, we may have the indication of deep brain stimulation and, thus, the individual may have an improvement in the motor symptoms. doctor.
Physical exercise and Parkinson’s disease
Regular physical activities lessen the impact of the progression of Parkinson’s disease — Photo: Istock Getty Images
There is a considerable range of scientific research pointing to the benefits of regular physical exercise in patients with Parkinson’s disease. A study by researchers at Kyoto University in Japan analyzed the physical activity habits of 237 patients with early Parkinson’s over an average period of five years. The result showed that, in the long term, regular moderate to vigorous exercise is significantly associated with a slower deterioration of postural stability and gait, in addition to a better clinical course of the disease.
According to the study, patients who averaged four hours a week of moderate-intensity physical activity, such as walking or dancing, had a smaller drop in balance and walking ability when they were reassessed five years later. On the other hand, individuals who registered below-average activity, that is, less than one or two hours, once or twice a week, had a more significant increase in the symptom scale.
In addition to motor functions, the study evaluated the impact of physical exercise on patients’ cognitive activity. Practitioners of more than 15.5 hours of physical activity per week, including structured physical exercise and day-to-day activities, had a smaller drop in cognitive test scores over a six-year interval.
Exercises for Parkinson’s patients are primarily aimed at preventing the progression of common motor system symptoms. A characteristic of the person presenting the picture is to present a leaning forward posture. In this case, it is necessary to work the posterior muscles of the trunk for the patient to maintain a more upright posture.
It is also possible to perform physical activities involving balance control. Another study indicates that supervised and adapted slackline training reduces the risk of falls in people with Parkinson’s disease. The practice of the exercise makes the patient use joints such as the knee and hip and leaves the ankle joint rigid, as people who do not have the condition do in situations of imbalance.
According to the neurosurgeon, food is also very important in the multidisciplinary issue of treatment. Therefore, a nutritionist must work together with other professionals. Constipation or constipation characteristic of four can lead to an increase in alpha-synuclein (a protein from the synuclein family) in the intestine and, consequently, lead to an increase in the substance in the brain, which may be related to the faster development of the disease. of Parkinson’s.
— In addition to the possibility that the disease starts in the brain and goes to the intestine, there is the theory that the disease starts in the intestine and then appears in the brain. What can be done in relation to the improvement of the intestine is to make use of probiotics. Also, increase fiber consumption to help with constipation. It is also important to maintain a diet rich in fruits and vegetables to optimize the improvement of constipation symptoms and, in this way, improve the quality of life of patients with Parkinson’s disease – explains the neurosurgeon.
Vanessa Milanese graduated in Medicine from the Federal University of Paraíba and named specialist in Neurosurgery by the Brazilian Society of Neurosurgery. She has a subspecialty in Functional Neurosurgery and Movement Disorders from the University of Florida. She is communication director for the Brazilian Society of Neurosurgery (SBN).