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Parkinson’s Disease

Parkinson’s Disease. Sheila Mulhern. Parkinson’s Disease Stats (PDF). One million Americans live with Parkinson's disease, - more than the combined number diagnosed with multiple sclerosis, muscular dystrophy and Lou Gehrig's disease.

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Parkinson’s Disease

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  1. Parkinson’s Disease Sheila Mulhern

  2. Parkinson’s Disease Stats (PDF) • One million Americans live with Parkinson's disease, - more than the combined number diagnosed with multiple sclerosis, muscular dystrophy and Lou Gehrig's disease. • Approximately 60,000 Americans are diagnosed with PD each year, • Worldwide: an estimated seven to 10 million people are living with Parkinson's disease. • Men are 1.5 times more likely to have Parkinson's than women.

  3. Healthcare Costs & PD • The combined direct and indirect cost of Parkinson’s, including treatment, social security payments and lost income from inability to work, is estimated to be nearly $25 billion per year in the United States alone. • Medication costs for an individual person with PD average $2,500 a year, and therapeutic surgery can cost up to $100,000 per patient.

  4. Parkinson’s Disease • A degenerative disorder of the central nervous system as a result from the death of dopamine-generating cells in the substantia nigra, a region of the midbrain • Nerve cells can’t send signals properly causing loss of muscle function • In response the adjacent thalamus and globus pallidus interna become overactive resulting in a tremor • Most often develops after age 50 and one of the most common NS disorders of the elderly • Named after English doctor James Parkinson, who published the first detailed description in An Essay on the Shaking Palsy in 1817

  5. Etiology of PD • Cause not officially known but genetic and environmental factors are linked • Genetic: modern research shows six genes have been identified as causing familial PD • alpha-synuclein, parkin, UCHL1, DJ1, PINK1, and LRRK2 • Environmental: not direct but demonstrated to have the ability to cause nigrostriatal cell death appear to interact by interfering with mitochondrial function, inducing oxidative stress, and modifying proteasomal function. • DJ1 and PINK1 are mitochondrial proteins and overexpression of alpha-synuclein and parkin induce mitochondrial defects

  6. Parkinson’s Disease Characteristics • Tremor at rest • Bradykinesia – slowness of movement • Rigidity and stiffness • Increased resistance to passive movement of limbs or trunk • Micrographia – small, constricted handwriting • Poor balance • Diminished arm swing • Dysphagia • Hypomimia – lack of facial expression - “Parkinson mask” • Dysarthria – diminished voice volume, stuttering • Depression • Dementia

  7. PD & Nutritional Implications

  8. Medical Interactions: Levodopa

  9. Focus on drug-nutrient interactions Minimize dietary protein at breakfast/lunch Recommend antioxidants and anti-inflammatory diet PD & MNT

  10. Study #1: TheMediterranean diet and Parkinson's disease • Official Journal of the Movement Disorder Society – funding NIH & Parkinson's Disease Foundation (FEB 2012) • 250 PD patients and 198 controls – diet questionnaire for past year • Higher Mediterranean-type diet adherence was associated with reduced odds for PD after adjustment. • Lower Mediterranean-type diet score was associated with earlier PD age at onset. • PD patients adhere less than controls to a Mediterranean-type diet. Dietary behavior may be associated with age at onset. • 2009 study on 1,410 French adults showed higher adherence to Med-diet was associated with slower MMSE cognitive decline (not other tests or assoc. with dementia

  11. Study #2

  12. Study #3

  13. Other study topics • Caffeine may improve motor PD symptoms • Flavonoids may aid PD risk • Concussions as contributing factor to later developing PD

  14. Resources • Case study: The association between Mediterranean diet adherence and Parkinson's diseasehttp://onlinelibrary.wiley.com/doi/10.1002/mds.24918/abstract?systemMessage=Wiley+Online+Library+will+be+disrupted+on+8+December+from+10%3A00-12%3A00+GMT+%2805%3A00-07%3A00+EST%29+for+essential+maintenance&userIsAuthenticated=false&deniedAccessCustomisedMessage= • Parkinson’s Disease Foundation http://www.pdf.org/en/parkinson_statistics • Dopamine signaling in PD http://www.cellsignal.com/reference/pathway/parkinsons_disease.html • https://www.michaeljfox.org/ • Etiology of PD http://www.ncbi.nlm.nih.gov/pubmed/16717248 • http://www.pdf.org/en/science_news/release/pr_1330379372

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