Treatment of Parkinson's disease with folk remedies

general information

Parkinson's disease affects men twice as often as women. In most cases, it develops after 60 years of age, but cases of early onset of the disease are recorded (at 30-40 years of age), as well as juvenile forms that develop in people in their twenties.

There are several hypotheses for the formation of pathology. It has now been precisely proven that one of the mechanisms of its development is the gradual degeneration of neurons and a decrease in the production of dopamine. It is an important neurotransmitter involved in the transmission of nerve impulses. As a result, a specific set of disorders is formed, which makes it easy to make a diagnosis.

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Parkinson's disease is the second most common neurodegenerative disorder. It is characterized by the death of neurons in the substantia nigra of the brain. Current therapy aims to limit disease control. There is still no effective cure. A recent study may radically change this deplorable situation. Hao Qian from the University of California, San Diego (USA), together with colleagues from Peking University (China), demonstrated the successful conversion of astrocytes into neurons in situ in a mouse model of Parkinson's disease. However, let's start with the general characteristics of this disease.

Causes

The exact causes of Parkinson's disease have not been identified. Scientists have been able to identify only a number of factors that increase the risk of developing neurodegenerative processes:

• natural processes of aging of the body, accompanied by a decrease in the ability of tissues to regenerate;
• genetic predisposition (this is especially true for forms with early onset);
• chronic lack of vitamin D, which protects neurons from the pathological effects of toxins;
• intoxication with salts of heavy metals, pesticides, alcohol;
• poor environmental conditions in the region of residence;
• taking certain medications (for example, chlorpromazine);
• chronic insufficiency of blood supply to the brain (due to atherosclerosis, osteochondrosis of the cervical spine, etc.);
• infections affecting the central and peripheral nervous system (meningitis, encephalitis, herpes viruses, influenza);
• brain tumors;
• traumatic brain injuries;
• smoking;
• frequent and prolonged stress, chronic fatigue.

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Treatment with drugs

Among neuroprotective drugs, the following groups should be distinguished:

• Antioxidants (including mexidol, glutathione, thioctic acid).
• Growth factors of nervous tissue (brain and glial growth factors).
• Calcium channel blockers.
• Dopa receptor agonists (are drugs related to both lines of therapy).

However, these drugs have not become widespread in the treatment of the disease due to the steady progression of all symptoms and insufficient data on the leading mechanism of development of the disease.

That is why symptomatic therapy is of leading importance in the treatment of Parkinson's disease. Drugs in this group make it possible to significantly (and in the initial stages completely) stop the manifestations of the disease, maintain the social activity of patients, and reduce the risk of complications. However, drugs in this group must be taken continuously throughout life.

There are five lines of symptomatic therapy, and each of them should be briefly considered.

• Increased production of endogenous dopamine. It is achieved by taking the precursor of dopamine - levodopa, because pure dopamine is not able to penetrate the blood-brain barrier. Levodopa preparations have been used in the world for more than half a century. Moreover, according to statistics, before the invention of drugs in this group, the life expectancy of patients was about 9-10 years. Now the life expectancy of patients, with adequate therapy and supervision, practically does not differ from that of the average population. Levodopa therapy currently plays a vital role in the treatment of the disease. There are dozens of drugs (the most famous are Naokm, Madopar, Stalevo, Duellin, etc.). Some limitation on the full-scale use of levodopa drugs is the frequent side effects. They can be divided into early and late:
  — Immediately after taking the drug, side effects from the central nervous system, as well as other systems and individual organs, often develop. These can be headaches, visual disturbances, mood changes, constipation, hypotensive reactions and much more. As a rule, such manifestations are especially noticeable in the first days of prescribed therapy. In case of pronounced negative reactions, the dose should be reduced to a minimum and then gradually increased to the desired effect.

  — Late negative reactions appear 5-8 years from the start of treatment. Among them, violent movements, the effect of lack of dose, and dysfunction of dopa receptors are most often present. Sometimes persistent mental disorders develop, including the development of hallucinations. These effects require close attention from a doctor. Sometimes you have to give up the drug you are using, or reduce the dosage and switch to a combination of drugs from different groups.

• The second line of possible therapy is to stimulate the release of dopamine. The most commonly prescribed amantadine is 100-200 mg. Also, using drugs from this group, it is possible to stop many unwanted drug reactions that occur when taking dopa-containing drugs. The best effect is achieved with the rigid-tremorous form of Parkinson's disease. The drug should be prescribed carefully to patients with kidney disease; sometimes drugs in this group lead to the development of edema.
• The third treatment option is the use of dopamine receptor agonists (stimulants). Medicines in this group are classified into ergoline and non-ergoline agonists. Among the ergoline drugs, the most famous is bromocriptine, which has found greater use in gynecological practice, and is rarely used as a drug for the treatment of Parkinson's disease. Non-ergoline drugs are widely used, among them the following drugs should be noted: mirapex, pronoran, requip-modutab. The advantages of the drugs are their good effect on all symptoms of patients, the presence of a slight antidepressant effect. The disadvantages are relatively frequent side effects.
• Drugs that inhibit the reuptake of dopamine (cyclodol, akineton, etc.) are used relatively rarely. This is due to pronounced side effects, primarily from the mental sphere. Tricyclic antidepressants (the classic representative is amitriptyline) can be used as drugs of this type of action, if necessary.
• The drugs of the latter group inhibit the destruction of dopamine. Among them are the drugs selegiline, umex, entacapone. The latter, in turn, is used in the combination preparation stalevo.

Currently, the following drug therapy regimen has been developed: In the early stages of the disease, neuroprotection can be used as the only means of treatment. The prescription of symptomatic therapy for Parkinson's disease depends on age:

— If the patient is under 50 years of age, it is necessary to initially prescribe amantadine or a drug from the group of dopamine receptor agonists. - Age 50-70 years - treatment should be started with dopa receptor agonists or amantadine. — Age over 70 years is an indication for prescribing levodopa.

If the effect of monotherapy is insufficient, a combination of drugs is resorted to.

Neurosurgical treatment of Parkinson's disease is carried out when conservative therapy is ineffective, the appearance of motor fluctuations, drug-induced dyskinesias, and the rapid progression of manifestations of Parkinson's disease. The main type of intervention is the destruction of some structures of the thalamus and globus pallidus. Approximately 50% of patients note a persistent, pronounced positive effect, 25-30% experience slight positive dynamics, 10-15 percent do not notice an improvement in their condition, while the rest noted a deterioration, in some cases pronounced.

Symptoms

Parkinson's disease is manifested by specific symptoms, which together form a clear picture of the disease:

• tremor: fine trembling begins in one hand and then spreads to both limbs and head; the movement of the fingers is somewhat reminiscent of counting coins; while performing purposeful movements (for example, while working at a computer);
• general slowness of movements (bradykinesia): the patient often freezes in one position;
• specific gait: a person moves with small, shuffling steps, as if he is constantly on very slippery ice;
• poor facial expressions: a mask effect is formed due to low mobility of facial muscles;
• monotonous, quiet speech;
• increased muscle tone (muscle rigidity): the figure becomes stooped, arms and legs are slightly bent, the head is tilted forward;
• postural instability: a person has difficulty starting and ending movements, resulting in decreased ability to maintain balance;
• disorders of the autonomic nervous system: oily skin, excessive secretion of saliva and sweat;
• decreased sense of smell;
• constipation, urinary disorders.

Unlike other neurodegenerative diseases, Parkinson's disease has little effect on intelligence in early and middle stages of development. As the pathology progresses, there is a decrease in the speed of thinking and speaking, decreased mood, depression and indifference to everything that happens.

Folk remedies for rubbing and rubbing in Parkinson's

Parkinson's can be treated in the elderly with folk remedies in the form of rubbing or rubdowns. The solution for rubbing is prepared quickly enough, and the positive effect is visible almost immediately:

1. Blood circulation improves.
2. The acid-base balance is normalized, since toxins and other harmful substances are eliminated faster.
3. The functioning of the entire nervous system improves.

The easiest way to achieve the result is with a vinegar-salt solution. To prepare it, you need to mix half a liter of warm water, 100 g of apple cider vinegar (its effect on the body will be milder), and a tablespoon of coarse table salt. All ingredients are thoroughly mixed and used as rubs. The procedure can be carried out up to 4 times a day, and after it, change the patient into dry, warm clothes.

Important. Any folk remedies for Parkinson's in the elderly can cause allergic reactions, so after the first procedure the patient must be monitored, noting the occurrence of side effects or atypical reactions.

You can supplement the rubbing procedure by rubbing in a specially prepared herbal-based oil, which is rubbed into the skin of the hands and feet. A folk remedy made from jasmine will be pleasant and effective to use. Its flowers are filled with vegetable oil and infused for a month in a well-lit place. It is recommended to shake the solution periodically. The finished product can be applied to the skin with massage movements after taking a bath or performing a therapeutic rubdown.

Stages of development

Currently, doctors distinguish 5 stages of Parkinson's disease, manifested by a certain set of symptoms:

• Stage 0: no clinical manifestations;
• Stage 1: there are slight difficulties in moving one arm, a slight tremor, first with excitement, then at rest; the sense of smell and sleep are disrupted, fatigue and apathy appear;
• Stage 2: disturbances involve the second hand, trembling of the tongue and lower jaw appears; salivation; hypokinesia is formed; the ability to self-care is preserved;
• Stage 3: stiffness and impoverishment of movements increases, facial expressions are almost absent; a specific gait and posture is formed; during a conversation, the patient begins to get stuck on the same word; self-care is difficult, but possible;
• Stage 4: postural instability develops, the patient begins to fall frequently; the intellect begins to suffer, depression increases; At this time, suicide attempts are common; a person needs help to perform simple actions;
• Stage 5: manifestations reach their climax, the person cannot sit down, stand up and walk independently, eating is difficult due to swallowing disorders; loss of control over bowel movements and urination; the patient requires constant care.

Traditional infusions to relieve Parkinson's symptoms

The most effective treatment for Parkinson's with folk remedies is the preparation of tinctures and decoctions. There are many herbs that can reduce or eliminate certain manifestations of the disease. They are usually used in combination, that is, in the form of medicinal preparations, to enhance the effect. But even in the first stages, it is necessary to treat Parkinson’s using traditional methods simultaneously with the use of medications.

Folk gatherings to relieve stiffness of movement

To improve motor function, 2 collections have proven themselves to be effective. The first is made from valerian root along with oregano and yarrow herbs. The second includes the leaves of stinging nettle and the grass of cinquefoil, white mistletoe, and motherwort.

Important: The simultaneous use of two infusions at once is unacceptable. Stop your choice on one collection.

The plants are mixed in equal quantities, and then poured with boiling water at the rate of 1 tablespoon of the mixture per 1 glass, and infused in a warm place for an hour. It is best to use a thermos for this. The resulting infusion is taken half a glass three times a day before main meals. These herbs for Parkinson's disease are effective only in the first stages of development of the disorder.

Community training against hand tremors

In this case, 2 main herbal mixtures are recommended and prepared using the same technology: 1 tablespoon of the mixture is poured into a glass of boiling water, infused for an hour in a thermos and taken three times a day. Although there are still differences:

1. The first collection includes hawthorn flowers (3 parts), cordate linden flowers, peppermint leaves and chamomile flowers (one part of each herb). The finished infusion is taken half a glass before meals.
2. The second collection consists of stinging nettle leaves (2 parts), valerian root, wormwood and hop cones (one part each). It should be consumed in a whole glass an hour after the main meals.

As in the first case, you should not mix or alternate the infusion. You should choose one and prepare it before each meal.

Folk remedies for drooling

If the patient is worried about excessive salivation, you can prepare an infusion of bearberry leaves (2 parts), rose hips (2 parts), oak bark and sage herb (one part each). The preparation scheme is the same: 1 tablespoon per glass of boiling water. It is enough to take half a glass twice a day, half an hour after meals.

If such an infusion seems too unpleasant to taste, you can replace it with another, based on: strawberry leaves or berries (2 parts), sage (2 parts), willow bark (1 part). It should also be taken twice a day, half a glass, but an hour after meals. Typically, this option turns out to be more aromatic and pleasant to the taste and is a good substitute for tea.

Infusion against muscle spasms

An infusion of harmala herb will help to avoid regular spasmodic attacks. A teaspoon of this plant is enough to brew in a glass of boiling water. It is infused for a couple of hours, and taken after straining, one tablespoon three times a day.

Important. Before you begin to treat Parkinson's disease with folk remedies using internal preparations, you should consult your doctor.

Treatment of Parkinson's with traditional methods does not always help; if attacks of muscle spasms recur, it is better to seek additional advice from a specialist. He may change your medication regimen to treat the symptom in a different way.

Diagnostics

The diagnosis of Parkinson's disease is made based on the characteristic clinical picture. The patient is examined by a neurologist who notes typical signs. Complaints must be clarified and an anamnesis of the disease (history of the appearance of symptoms) and life history (information about previous injuries, chronic diseases, surgical interventions) is collected. Laboratory and instrumental diagnostics are used to clarify concomitant pathology and exclude other causes of neurological disorders.

Treatment of parkinsonism, drugs

There are two types of medications used in the treatment of parkinsonism:

• antiparkinsonian anticholinergic drugs, which include dynesin, bellazone, cyclodol, etpenal, tropacin, norakin;
• antiparkinsonian dopaminergic drugs levopa, glutantan, midantan, deprenyl.

Medicines have contraindications. Many are capable of provoking negative reactions. Including provoking hallucinations.

Treatment of Parkinson's disease

At the moment, successfully selected treatment for Parkinson's disease can stop the process of degradation and reduce the severity of pathological symptoms. The disease begins to progress more slowly, which allows patients to stay in good shape longer.

Drug treatment

Drug treatment is aimed at restoring the balance of dopamine in the central nervous system. The following drugs are used:

• Levodopa and its analogues: serve as the basis for the production of dopamine;
• dopamine receptor agonists: stimulate receptors similar to a natural neurotransmitter and reduce the severity of symptoms;
• MAO-B inhibitors: reduce the breakdown of dopamine;
• COMT inhibitors: prescribed in combination with levodopa and reduce its breakdown;
• anticholinergics: aimed at reducing symptoms.

There are combination products that combine several active ingredients for the fastest possible effect.

Non-drug treatment

Drug treatment is complemented by physiotherapy, exercise therapy and massage. Physiotherapy is used to activate metabolic processes and increase blood flow in the brain. Depending on the patient’s condition and concomitant diseases, the following may be prescribed:

• magnetic therapy;
• ultrasound stimulation;
• electrosleep;
• mineral baths;
• acupuncture.

The massage is aimed at improving motor activity. Intensive muscle kneading and passive gymnastics reduce muscle stiffness and have a general strengthening effect.

Physical therapy exercises allow you to:

• reduce muscle stiffness and strengthen it;
• increase sense of balance;
• improve the patient's emotional state.

Most exercises are aimed at training the sense of balance. The complex is selected individually depending on the patient’s condition, age and concomitant diseases.

Surgery

The help of surgeons is relevant in the last stages of the disease. The most effective and safest operation is the installation of a brain stimulator. The intervention does not require opening the skull. Thin electrodes are inserted into the brain and a small stimulator is placed under the skin of the collarbone. The device is programmed for a specific pulse frequency; in addition, the patient and his relatives can change the settings depending on the condition. Using a stimulant allows you to reduce the dosage of medications and keep symptoms under control for a long time.

Other surgical treatment options require working on an open brain:

• thalamotomy: destruction of part of the thalamus, allowing to get rid of tremors, but maintaining other symptoms;
• pallidotomy: partial removal of one area of ​​the brain (globus pallidus), significantly reducing all the main symptoms of the pathology.

Parkinson's disease: how to cope with it

What are the main diagnostic criteria for Parkinson's disease? When should a patient be referred to a specialist? What drugs to start drug therapy with? How to eliminate the side effects of specific therapy?

The causes of parkinsonism are still unknown, and treatment remains symptomatic, despite the fact that a quarter of a century has passed since levodopa became firmly established in the lives of patients with parkinsonism.

But let’s not be too pessimistic - modern treatment methods prolong the life of such patients and make it more or less normal [1]. One person in a thousand suffers from Parkinson's disease. Diagnosis is based on a clinical syndrome including hypokinesia, rigidity, tremor, and impaired postural reflexes. Dopamine levels are reduced by almost 80% by the time clinical signs appear, so it is not surprising that it is impossible to accurately pinpoint the time of onset of symptoms.

It is not always easy to distinguish idiopathic Parkinson's disease from other conditions, including such common ones as essential tremor, and less common diseases that have other neurological symptoms - supranuclear palsy, autonomic disorders or cerebellar symptoms [2].

Pathological and anatomical studies show that every fifth diagnosis in this group of diseases is erroneous. Before making a diagnosis, it is important to ensure that at least two of the four main clinical signs are present, keeping in mind that most patients have asymmetric symptoms. In doubtful cases, trial treatment with levodopa or dopamine agonists helps [3].

The main problem in controlling Parkinson's disease today remains late failure of dopaminergic therapy, manifested in the disappearance or fluctuations of the response to the drug or the development of dyskinesias and other side effects in 75% of patients after five years of treatment [4].

The expansion of the range of drugs and renewed interest in surgical treatment is explained by the desire to avoid or reduce the problems of long-term treatment.

A general practitioner who suspects a patient has Parkinson's disease must decide whether to refer the patient to a neurologist, a geriatrician, or other specialists. This is especially important in chronic, progressive cases in young people who require long-term treatment.

It is imperative to tell the patient about his illness, prognosis and the essence of the treatment used. As with asthma, diabetes and other chronic illnesses, physician and patient must work together, with the latter actively participating in treatment decisions.

As a rule, such patients are easy to negotiate, but as the disease progresses, they must be persuaded to take various drugs several times a day.

Disease control is not limited to drug therapy alone; on the contrary, psychotherapy, occupational therapy, speech skills training and psychological methods significantly improve the condition of patients [5]. Regular physical therapy, prescribed before dopaminergic drugs, slows the progression of the disease [6], so immediately after diagnosis, patients should be advised to exercise, diet, and occupational therapy.

Quite often, such methods are used in later stages of the disease, when nothing else helps, while they should be used to prevent the development of the disease. The Parkinson's Disease Society produces information books for hospital staff and special educational material for patients.

In a number of centers, specially trained caregivers help patients and those caring for them. Although specific scientific evidence is lacking, many patients acknowledge the benefits of music therapy, education, yoga, and other complementary therapies.

• Drug therapy

The number of available drugs and their new forms has increased significantly in the last ten years and promises even greater increases in the near future. In table Table 1 shows the main groups of drugs.

Table 1. Drugs used to treat parkinsonism

Anticholinergic drugs have been used since the last century. They still help to cope with tremor and, to a lesser extent, rigidity, with virtually no effect on hypokinesia. The choice among them is small. All of them have side effects: dry mouth, impaired accommodation, constipation and urinary retention. In older patients, they tend to cause confusion and other psychiatric problems.

It should be noted that all antiparkinsonian drugs can cause similar problems and any impairment of mental function requires a review of the appropriateness of use and the adequacy of drug dosages. Levodopa, currently prescribed together with a peripheral decarboxylase inhibitor (PDI), remains the most effective drug so far. At the beginning of the course of treatment, nausea and vomiting may occur, so patients prefer to take them with food or with antiemetic drugs - domperidone and metoclopramide.

It should be taken into account that high protein intake may interfere with the absorption of levodopa.

In addition to psychological disorders, other side effects that should be noted are dyskinesia or involuntary movements. They can be different: movements of the tongue and lips, grimaces, painful muscle tension, choreoathetosis, motor restlessness. Reducing the dose of the drug, as a rule, also reduces dyskinesia, but patients often prefer the latter to the inability to move at all.

Another element of impairment that occurs with long-term treatment is fluctuations in drug response. Initially, this is manifested by the “off” phenomenon - the duration of action of levodopa-IPD decreases all the time. In severe cases, the person suddenly switches from movement, usually with dyskinesias, to complete immobility.

To overcome such problems, dosed-release forms of the drug have been developed to avoid fluctuations in drug concentrations in the blood, and powder forms have been developed to provide a rapid increase in drug levels in the blood.

Dopamine agonists act at different sites on the dopamine receptor. Their actions vary accordingly. When used alone, dopamine agonists are less effective than levodopa, but are also less likely to cause hesitations and dyskinesias [4]. Gastrointestinal side effects and mental effects are the same. Apomorphine differs from the other drugs mentioned in that it is administered by injection.

According to a study conducted in the United States, seligine delays the need for levodopa, has neuroprotective properties and can slow the progression of the disease [7]. Since then, however, selegiline itself has been shown to have mild dopaminergic effects as well as amphetamine-like and antidepressant effects; its protective properties are currently in doubt [8].

The mechanism of action of selegiline is the blockade of monoamine oxidase B, one of the main enzymes of dopamine metabolism. There is an opinion that it potentiates the effect of levodopa.

Catechol-o-methyltransferase (COMT) inhibitors simply slow down the metabolism of dopamine. At least two such drugs are already being prepared for mass production [9, 10].

The dopaminergic effect of the antiviral drug amantadine was noticed many years ago, but it is less effective than levodopa. The exact mechanism of its action is unknown, but still they are trying to use it in cases resistant to levodopa therapy; in addition, its administration together with levodopa makes it possible to reduce the dose of the latter.

• Early Treatment Strategies

Undoubtedly, when prescribing medications, the patient’s age, degree of impairment, and individual characteristics should be taken into account, but neurologists, like other specialists, have not yet developed a unified approach to the sequence of drug use. Some people believe that there is no point in delaying the use of levodopa, and start with standard regimens of its use.

Another approach is to use a long-acting formulation first, using a dopamine agonist alone or in combination with low-dose levodopa; or selegiline alone is prescribed for a while, and then levodopa is added.

Whatever regimen you follow, it is advisable to start with low doses, carefully and gradually adjusting the required daily dose. If possible, sudden changes in dosage regimen or rapid dose increases should be avoided.

• Correction of late disorders

When the “off” phenomenon develops, it may often be useful, albeit for a short time, to divide the daily dose of the drug into several smaller doses. You can try adding selegiline and/or a dopamine agonist to levodopa, and also use long-acting dosage forms instead of levodopa (or more often in addition to it). The bioavailability of such forms is less than that of conventional drugs, and their dose is usually slightly higher. In some patients, good results are achieved by taking the drug before rather than after meals or by reducing protein intake.

In cases with a pronounced on-off phenomenon, the same techniques are used, combined with individual selection of the most effective treatment regimen.

If there is no success with oral administration of the drug, new methods such as subcutaneous administration of apomorphine can be used. True, this requires trained personnel, best of all - a special nurse for patients with parkinsonism.

Another approach is neurosurgery. Stereotoxic pallidotomy or stimulation of the thalamus is performed for the on-off phenomenon, as well as for persistent tremor [11]. The data available to date is encouraging. They indicate a decrease in dyskinesia and an extension of the on-time period. However, like fetal tissue transplantation, such surgical methods should still be considered experimental and require further study and evaluation.

In addition to dyskinesia and tremor, many patients develop cognitive and mental disorders as the disease progresses. In this case, it is necessary to reduce the dose of the drug.

Short breaks in taking medications, stopping dopaminergic drugs for a short time - such “vacations” (one or two days every week) can reduce psychotoxicity [10]. Long-term withdrawal of medications is not recommended, as it may lead to serious or even irreversible impairment of the ability to move.

• Other types of symptomatic treatment

Parkinson's disease is accompanied by sleep disturbances, depression, urinary retention, constipation, pain, disorders of the autonomic nervous system and sexual deviations. All this can be corrected with medication. You just need to give the patient the opportunity to describe in detail everything that worries him. The limited consultation time, coupled with the severe communication problems that plague many patients, can be overcome through a pre-prepared description of the patient's or caregiver's condition.

References
1.
Clarke CE Mortality from Parkinson's disease in England and Wales 1921-89.
J. Neurol. Neurosurg Psychiatry 1993; 56:690-3. 2.
Quinn N. Parkinsonism—recognition and differential diagnosis.
BMJ 1995; 310:447-52. 3.
Hughes AJ, Lees AJ, Stern GM Challenge test to predict the dopaminergic response in untreated Parkinson's disease.
Neurology 1991; 41:1723-5. 4.
Marsden CD Parkinson's disease.
J. Neurol. Neurosurg Psychiat 1994; 57:672-81. 5.
Patti F., Reggio A., Nicoletti F. et al.
Effects of rehabilitation therapy on Parkinsonians' disability and functional independence. J. Neurol. Rehab 1996; 10:223-231. 6.
Doshay LJ Method and value of physiotherapy in Parkinson's disease.
N.Eng. J. Med. 1962; 266:878-80. 7.
Parkinson Study Group.
Effects of tocopherol and deprenyl on the progression of disability in early Parkinson's disease. N.Eng. J. Med. 1993; 328:176-83. 8.
Jankovic J., Shoulson I., Weiner WJ Early-stage Parkinson's disease: to treat or not to treat.
Neurology 1994; 44(suppl1):S4-S7. 9.
Pouttinen HM, Rinne UK A double-blind pharmacokinetic and clinical dose-response study of entacapone as an adjuvant to levadopa therapy in advanced Parkinson's disease.
Clin. Neuropharmac 1996; 19:283-96. 10.
Stocchi F., Nordera G., Marsden CD Strategies for treating patients with advanced Parkinson's disease with dysastrous fluctuations and dyskinesias.
Clin. Neuropharmac 1997; 20:95-115. 11.
Obeso JA, Guridi J., Delong M. Surgery for Parkinson's disease. J. Neurol. Neurosurg. Psychiat 1997; 62:2-8.

Note!

• The diagnosis of Parkinson's disease is based on a clinical syndrome that includes hypokinesia, rigidity, tremor, and impaired postural reflexes. Make sure that at least two of the four signs are present and remember that in most patients, symptoms manifest asymmetrically.
• Special physiotherapy, occupational therapy, training in speech skills, as well as psychological correction methods significantly improve the condition.
• Anticholinergic drugs are still used to reduce tremor and, to a lesser extent, rigidity, but not to treat hypokinesia.
• Levodopa, especially in combination with a peripheral decarboxylase inhibitor, remains the drug of choice.
• Besides psychological disturbances, the main side effect of levodopa is involuntary movements. Response to the drug varies; the process develops gradually and finally an on-off phenomenon may appear. In the latter case, dispensers and loose forms of drugs help.
• There is no consensus on which drug to prescribe first. Helpful advice: Start with low doses of drugs, whatever regimen you use, and then increase them carefully.

Complications

Restriction of muscle function in Parkinson's disease inevitably leads to a decrease in the intensity of blood flow and a decrease in the level of metabolism. Already in the middle stages of the development of the disease, the risk of blood clots and the development of dangerous conditions increases significantly:

• ischemic or hemorrhagic stroke;
• myocardial infarction, angina pectoris, heart failure;
• pulmonary embolism.

Bedridden patients often face severe complications associated with a recumbent position:

• congestive pneumonia;
• aspiration pneumonia (due to impaired swallowing, food enters the respiratory tract);
• bedsore infection and sepsis.

Most patients experience apathy and severe depression, which lead to suicidal thoughts. Some patients carry out plans and commit suicide.

Correctly selected treatment significantly reduces the risk of complications, which is why it is important to consult a doctor in a timely manner.

Parkinson's disease: history and molecular pathogenesis

In 1817, the English physician James Parkinson [1] published “An Essay on the Shaking Palsy,” in which he described the neurological disease, and also carried out an analysis and identified general patterns. The name reflects the unusual combination of the main symptoms - tremors, muscle stiffness and inability to maintain balance [2].

For a long time, medicine did not understand the causes of this disorder. A breakthrough in the study of Parkinson's disease occurred already in the 20th century.

By the way, one of the scientists who helped unravel the mysteries of the pathogenesis of Parkinson’s disease was the Russian neuropathologist Konstantin Nikolaevich Tretyakov, who in 1916–1923 held the position of head of the Charcot Brain Laboratory of the Department of Nervous Diseases of the University of Paris (France). He proposed the nigral theory of the pathogenesis of Parkinson's disease, according to which the manifestations of the disease were associated with the loss of the substantia nigra of the brain.

Today we know that Parkinson's disease develops due to the degeneration of dopaminergic neurons in the substantia nigra, which leads to a decrease in the production of dopamine, a neurotransmitter responsible for feelings of satisfaction and attachment. Clinical manifestations are associated with a neurotoxic effect: as the disease progresses, the protein alpha-synuclein accumulates in cells [3]. Alpha-synuclein is normally involved in the transport and release of vesicles containing neurotransmitters. However, in patients with Parkinson's disease, phosphorylation and abnormal folding of this protein are observed with the formation of aggregates - Lewy bodies (Fig. 1). In 2021, a group of scientists from the Scripps Research Institute (USA) discovered that the phosphorylated form of alpha-synuclein is localized in mitochondria, causing their fragmentation [4].

Figure 1. Lewy body in a neuron of the substantia nigra of the brain

[15]

Prevention

Prevention of Parkinson's disease includes:

• proper nutrition with a minimum amount of preservatives and artificial additives, a sufficient amount of vitamin D, omega-3, antioxidants;
• regular physical activity to prevent physical inactivity;
• adequate sleep of at least 8 hours a day, adherence to a work and rest schedule;
• minimizing stress and fatigue;
• quitting smoking and drinking alcohol;
• regular medical examinations, compliance with all doctor’s recommendations;
• timely contact a specialist if any suspicious symptoms appear.

Make an appointment

Treatment at the Energy of Health clinic

Neurologists at the Energy of Health clinic will come to the rescue at any stage of Parkinson’s disease. We offer comprehensive treatment in accordance with modern standards:

• selection of drug therapy;
• physiotherapeutic procedures: magnetotherapy, laser treatment, etc.;
• therapeutic massage courses;
• Exercise therapy directly in the clinic;
• training in physical exercises for exercise at home;
• organization of sanatorium-resort treatment if indicated;
• training relatives in the rules of caring for the sick;
• work with a psychologist and psychiatrist if necessary.

Advantages of the clinic

The Health Energy Clinic has experienced doctors, skilled nurses and modern equipment for diagnosing and treating various diseases. We offer:

• diagnostics using instrumental, functional and laboratory studies;
• consultations with experienced specialists in various fields;
• obtaining the opinion of foreign colleagues if necessary;
• individual selection of treatment;
• complex therapeutic regimens using medications, physiotherapy and other methods;
• extensive screening programs for early diagnosis of diseases;
• detailed consultations on disease prevention;
• any certificates and conclusions.

Parkinson's disease begins very slowly, but it is almost impossible to stop the process. If you or your family have suspicious signs, do not delay contacting a doctor. Sign up for diagnostics at the Energy of Health clinic.

Rules for taking medicinal baths

Treatment of Parkinson's with folk remedies will be ineffective if certain rules are not followed. They also exist for baths:

1. Using traditional methods of treatment, Parkinson's disease cannot be completely cured. The use of baths must be coordinated with the attending physician. The course of procedures begins only after its approval and in a strictly designated order.
2. You should take a bath no earlier than 2 hours after eating.
3. The body should only be submerged up to the top of the chest and not up to the neck.
4. The course consists of 5-10 procedures, depending on the specific type.
5. The duration of the bath should not exceed 20 minutes.
6. Procedures should be carried out every other day, not daily.
7. The temperature should not exceed 37 degrees.

It is recommended to spend the next hour after taking a bath calmly. It is best to lie down in silence or drink a cup of herbal tea, which enhances the effect of the procedure. Traditional medicine for Parkinson's should be used with caution. If side effects occur during a visit to the bath or immediately after it, the course must be canceled and the current situation discussed with your doctor.

It is impossible to cure Parkinson's with folk remedies. Traditional medicines do not provide complete relief from this disease. But a competent combination of several methods can seriously improve the patient’s condition, reduce the manifestation of symptoms, and improve the quality of life. The use of one or another treatment method should always be agreed with a doctor, since it is necessary to take into account not only the characteristics of the underlying disease, but also associated problems and chronic disorders.