Non-movement symptoms of Parkinson's disease

- When we think of Parkinson's disease we might just picture the shakiness, the tremors that someone has, those things that we can see. And I remember that's kind of what I used to imagine before I started learning a little bit more about the disease. And Parkinson's does cause these things, it does cause shakiness and other problems that relate to movement. But it's a lot more than just a movement disease. And the reason it's able to be this, the reason it's able to do all of these things and cause more problems than just movement is because a big part of the disease is this breakdown of these really important neurons in our brain called dopamine neurons. And this breaking down of these neurons, it's actually a pretty big deal. It's a big deal because neurons really rely on each other to send messages. So to send messages all across the brain, to complete the tasks that we kind of count on them for. Like maybe allowing us to remember where we left our keys, or letting us calculate something in our head. And all this communicating, it kind of works like that telephone game that you might have played when you were younger. And that telephone game, it goes a little something like this: So we've got a bunch of people that kind of are in this sort of network and the aim of the game is to get the first person to send a message to the last person. But the trick is that all these people in the middle, all these people in between tell each other the message and it has to stay the same so that the last person can get the message that the first person said. So Person A will tell Person B the message, maybe the message is instructions on how to get from one part of the city to the other. And we need Person B to tell Person C the message, and Person C will then tell Person D and so on and so on until the message reaches our final person, the person that needs to get across the city. So in order for the correct message, the correct instructions on how to navigate the city, in order for these to get from this first person to the last person, we really need all these people here in this little network. We need them to each pass along the correct message. Because if even one of them kind of messes it up a little bit, maybe says the wrong street name, or the wrong bus number, the whole message will be changed. This is kind of how neurons talk to each other in the brain. This is kind of how they talk to each other to get things done, they work in this network that really relies on each other neuron. So when these neurons break down, as they do in Parkinson's disease, this whole network can be kind of thrown off because the telephone game, it doesn't work very well without everyone's help. And all these different tasks that these different neurons were involved in well when the network is thrown off these tasks can be thrown off too. So to see what kind of happens when this goes on in Parkinson's disease let's first head over here to the nose. So what can happen in this part of the brain and this little area here which we call the Olfactory Bulb, so we can see the Olfactory Bulb here, this area, it helps us smell things. So when neurons in this little area here, when they stop functioning and they stop communicating in this way that we just kind of talked about the person can actually start to have trouble with their sense of smell. So maybe they can't really smell at all, so if you put something in front of them like a bowl of chicken noodle soup they might not really be able to tell you what it was if their eyes were closed. Or, instead of not being able to actually smell they might have trouble deciding the difference between two different smells. So these problems with smell are actually really really common in Parkinson's disease and they can actually be one of the first things that goes wrong. Sometimes before even those movement problems that we think about when we think of the disease. So if we head back over here and we look at these regions in the brain, so here we've go one of the frontal lobes and this area here called the limbic system, well these areas, they kind of work together to help us with our moods. They deal with mood related things. So when neurons in these areas have trouble with their communication, when the break down, what can happen is the person can have trouble with their mood. So some of these things that happen in Parkinson's disease can be depression, and they might also start to feel really flat. Kind of like they're just, they're not interested in anything at all. They don't want to go outside for a run like they used to, or they really don't want to watch their favorite TV show. And we call this kind of flat feeling apathy. Or maybe they actually start to fell really anxious. A lot of anxiety, like they're really worried about things that would have never bothered them before. Or they can even start to feel quite panicky in certain situations, maybe when a lot of people are around or they're doing something new. So these are some of the mood problems that can kind of arise when these areas in the brain have neurons that just aren't really communicating very well. And maybe because of a combination of these problems with their mood, or some of the other symptoms that they're having, or because of their medication, or these neurons miscommunicating the person can start to have trouble with their sleep. They may find it really hard to even get to sleep, or they might have trouble staying asleep. And you know how it's really hard to focus at school or to focus at work after you've only had a few hours of sleep? Well the person with Parkinson's disease can also have this feeling but it can happen again and again, day after day. So it can become quite a big problem all of this kind of adds up. And it can also make some of their other symptoms worse because they're lacking all this sleep. Some of the things that can get worse are things like depression, or their anxiety. And as time goes on and on and more and more of these neurons are impaired and lost the person with Parkinson's disease may have trouble doing things like multitasking . So they may find it really difficult to maybe be on the phone and write down a number at the same time while someone else in the room is watching television. These sorts of things that normally wouldn't distract them may start to really make it hard for them to accomplish a task. And they also might find that they're getting a little forgetful. They might maybe be at the grocery store and they'll come out to go to their car and just kind of forget where they parked it. And over time this can get worse and worse and it might actually develop into dementia. So, dementia's kind of this general term that we use and we use it to sort of describe people who are having a lot of trouble with these things like memory and multitasking. And they're having trouble to the point where it really, it affects their day to day life. So kind of different than the things that we've already been talking about some other things that can happen is Parkinson's disease can affect this really important system that we have that we call the autonomic nervous system. It's autonomic nervous system. And we call it the autonomic system, the autonomic nervous system because the neurons in this system they kind of control things that we think of as automatic. Like digesting our food or controlling our heart rate or even keeping our body at the right temperature. So when these neurons stop talking properly, when they start having trouble with the telephone game, the person with Parkinson's disease may experience things like constipation, because they're not digesting their food very well, or lightheadedness when they stand up because their heart rate it's not really changing to account for them sitting down or standing up. Or maybe they'll find that they're sweating a lot and that's because their body isn't regulating their temperature properly. So these are just some of the examples, and they're some of the examples of some of the more common symptoms that aren't related to movement. But people with Parkinson's disease they have a really individual experience so they may find that they experience different symptoms than these and they may find that certain symptoms are a lot worse for them than they are for maybe someone else with the disease. And one thing that can really change between each person with Parkinson's disease is when all these symptoms start. There's no strict rule or strict guideline in the body for when these symptoms start. It's very different from person to person.