There are diseases that do not distinguish between social class or condition. This is the case of Parkinson’s disease, a neurological pathology that affects about 90,000 people in Spain and suffered by such relevant figures as Katharine Hepburn or the pontiff John Paul II himself.
In Parkinson’s disease, there is a degeneration of neurons that secrete a neurotransmitter called ‘dopamine’, with more intensity in some brain structures such as the Substance Black and the Striated Nucleus. Dopamine is important because it helps regulate our movements and because it participates in balance and walking.
Those affected by this pathology suffer varied symptoms. Among the motor alterations we find the recognized tremor at rest, rigidity, slowness in movements and frequent falls due to balance problems.
Although back in 1817 James Parkinson did not contemplate them, more and more importance is given to other difficulties that seriously affect the quality of life of patients. These alterations have to do with cognitive functioning and with personality changes as a consequence of brain alterations. Thus, Parkinson’s patients tend to be slower when processing information and responding, they find it difficult to access the knowledge they have in memory or to maintain their concentration, and they have less verbal fluency. They also present what is known as dysexecutive syndrome, which causes problems when solving problems, planning, making decisions, being creative and mentally flexible, or maintaining a good working memory. Problems with the perception of space are also relevant because they make it difficult for them to act as simple as reaching an object or distinguishing the altitude of a step. Finally, many of them can present obsessions, compulsions, apathy and hallucinations, partly as a side effect of drug treatments, with depression being the most frequent, in up to 40% of those affected.
Drug treatment for Parkinson’s disease usually includes levodopa, dopamine agonists, or certain monoamine oxidase and catechol-O-methyltransferase inhibitors. Another more invasive type of intervention is deep brain stimulation of brain structures such as the subthalamic nucleus or the globus pallidus. Therapeutic approaches with fewer unwanted effects often include physical exercise, virtual reality, and cognitive rehabilitation. In this sense, an article published in the journal Movement Disorders in 2011 showed how, with only four weeks of a training program with multimedia techniques and other more traditional ones, patients improved their levels of attention, memory, perception, verbal fluency, functions executives and information processing speed. Taking into account that between 15% and 30% of patients usually progress to dementia, cognitive intervention seems to be a relevant element that favors the development of a greater cognitive reserve and delays the effects of cognitive deterioration to the maximum.
Marisa Fernández, Senior Neuropsychologist, Unobrain
