[Ronhutton]

Is PD a gradual deterioration or do you go downhill in steps? I seem to deteriorate in steps followed by a long period of level performance.
I can trace back to several significant worsening of symptoms, and have just had another seemingly permanent drop. Maybe they were triggered by infections etc, but I don't go back to what I was. These are permanent moves in the downward spiral.
I recently had a gum infection, following a broken tooth. My symptoms nosedived but I have now cured the infection, but have not recovered to my previous form. I can only just get out of bed in the mornings now, and many other changes.
The medical literature describes PD as a gradual loss of functions, but is it? Is this another one of the myths? What is your experience?
Ron

[reverett123]

It is common for PD symptoms to first "bloom" after an unusually large stress, both physical and psychic. In my own case it was a bout with the flu. I had had a tremor for eight years with little worsening until then. Currently I am dealing with huge mental stresses as a result of the real estate crash and I can feel a need to be very wary-a sense of fragility. I think the answer is clearly yes, we are subject to periodic drops and I do think that stressors are the trigger.
As to what actually happened in Ron's situation, I can only speculate. The infected tooth resulted in at least three changes in the chemical soup beyond the leaking BBB. 1)Exotoxins from the living bacteria, 2)Endotoxins from dying bacteria - was there an antibiotic? and 3)Increased pro-inflammatory cytokines from the immune system's microglia. The first two have presumably been taken care of with the infection but number 3 can be a bear. Liu, Hong, and other researchers at the NIH found that in a rat a single exposure could trigger a response like number 3 that lasted for months.
What to do? I can only tell you what I would do for legal reasons. First, I would look for things that attenuate the microglial response. Medline suggests that likely ones include resveratrol or red wine which should be easy to obtain; others
include blueberry extracts, minocycline, silymarin, etc. Also, our old friends curcumin and dextromethorphan.

I would also keep up my own ginseng and gingko for general toning of my systems.
-Rick

Originally Posted by Ronhutton

Is PD a gradual deterioration or do you go downhill in steps? I seem to deteriorate in steps followed by a long period of level performance.
I can trace back to several significant worsening of symptoms, and have just had another seemingly permanent drop. Maybe they were triggered by infections etc, but I don't go back to what I was. These are permanent moves in the downward spiral.
I recently had a gum infection, following a broken tooth. My symptoms nosedived but I have now cured the infection, but have not recovered to my previous form. I can only just get out of bed in the mornings now, and many other changes.
The medical literature describes PD as a gradual loss of functions, but is it? Is this another one of the myths? What is your experience?
Ron

[reverett123]

It is an NIH piece that hints at the question of progression, equilibrium, etc. From http://science-education.nih.gov/nih...l/biomed1.html

<BEGIN QUOTE>
She and others have shown that the immune system and the brain and the rest of the nervous system "talk" to each other through a number of chemical "mediators" -- cytokines from the immune system and neurotransmitters (like serotonin) and hormones from the nervous system.

The chatter among the mediators is elaborate and complicated, but the goal of all their signalling is a common one -- to keep the body's brain and immune systems in balance (6). When balance is lost and the host encounters an inflammatory trigger or psychological stress, diseases as different as EMS, arthritis, seasonal affective disorder, multiple sclerosis, and chronic fatigue syndrome can develop. It is often difficult to identify which mediator has signalled too much or too little in a sick patient, notes Sternberg, because, by the time the patient seeks medical help, the whole signalling system may already have been thrown out of whack.

<AND>

Sternberg says that every person is born with a unique set of genetic predispositions that affect disease susceptibility. Some of these predispositions may be so strong that, even with the tiniest exposure to a disease-causing or inflammation-causing agent, the person will get sick. Others may be much weaker, and, in those cases, whether the individual will get sick or not will depend on other factors. One such factor is the stress response. <END>

[aftermathman]

cannot comment on the role of infection however I always think of PD progression as a number of small steps which manifest themselves in time as a large noticeable increment.

So I guess my answer to your question is a bit of both as "perception is reality".

Neil.

[dbiker2]

I was diagnosed with PD in 1981 and for about 15 years about the only symptom I had was a slight tremor in my right hand. Then out of nowhere it seemed, I took a major nosedive. Extreme tremor, stiffness, balance problems....Since then I have noticed it takes longer to recover from illness, etc., and I too never seem to "get back to where I was".

[jcitron]

I've noticed a decline as well, and usually after getting over a bad cold or respiratory infection like I had in late January. It took me forever to come back up to close to where I was. Since then I've had to increase my Sinemet to make me feel normal. I agree it's like steps going down with long periods of smooth passage in between as though I coast along with what seems to be a good routine and balance.

For me my piano plaing isn't anywhere near what it was 4 years ago, yet I seem to be playing better now than I did a year ago due to my Sinemet dose timing and adjustment. Now if I could have what I had 4 years ago, and combine it with what I have now musically, I'd be totally on cloud nine.

Now I don't make my living at it, but I can't give up my music either. This is my entity, and should I lose this, it would defintely lead to my demise.


John

[EmptyNest68]

Hi ron-
I was diagnosed in 2003. The progression I noticed has been pretty slight..I don't have avisible tremor, though when excited or anxious I have a major internal tremor throughout my right side, and I do have the stiffness and slowness. Up until recently, I could perfomr my normal daily activities without any problem (and I still also work 40 hrs a week)..lately i ahve noticed my chores take three times as long due to my slowness, clumsiness and inability to compartmentalize. The slowness of movement seems to be more pronounced so I am more wary of what I am doing, and I am more unsteady on my feet, too. I am stumbling and dropping things more than ever, and movement is very jerky.
I did not have an infection...BUT for the past 12 months or so have had huge stressors in my life, which I believe directly correspond to the progression of my symptoms.

[Howardh]

went throuigh a difficult period April 14th this year. the end result meant an increase in meds, a worsening of condition, and plenty of off time as the body tried to adapt to the stronger and more frequent medication. As we approach the end of the second month the body has adjusted well to the new meds and i am strengthening the body through cardio, pilates, and plenty of stretching. My theory is make the body stronger than yesterday and any sickness that comes around i am more able to cope. the process is not easy.....use it or lose it.....there is no half way here. Stay on top of it guys.....in my view it is worth the effort.

[RLSmi]

I've begun noticing a slight worsening of balance and return of early morning shuffle-step in the evening before bedtime, and have just this week increased sinemet by one-half a 25/100 each day. Seems to be working. Still faithfully taking DM and CoQ10 to hopefully slow the decline. No major medical issues or psychological stressors, except for the passing of my brother-in-law, for the last couple of years.
Robert

[olsen]

http://psychcentral.com/news/2008/06...sick/2434.html


Why Mental Lethargy When Sick
By: Rick Nauert, Ph.D.
Senior News Editor

Reviewed by: John M. Grohol, Psy.D.
on June 10, 2008

Tuesday, Jun 10 (Psych Central) -- A recent study examines why it is hard to concentrate when you feel sick. This problem very likely reflects the effects of substances that are released by immune cells in the brain.


The research, published in Biological Psychiatry, describes how the immune cells, called inflammatory cytokines, help your body cope with infection.

During an infection, humans typically experience a set of physiological and psychological symptoms, including fever, confusion, decreased motivation, depression and anxiety that are accompanied by a slowing of movements.

These changes, collectively known as “sickness behavior,” are the body’s way of conserving energy during illness so that an effective immune response can be launched. This new study helps researchers further understand how cytokines communicate between the immune system and the brain to promote sickness behavior.

Brydon and colleagues utilized brain imaging to assess the impact of a typhoid vaccine, which prompts a low-grade immune response, on cognitive performance and brain activity in healthy young men. The scientists found that men with larger inflammatory cytokine responses to the vaccine had significantly slower reaction time responses during performance of a cognitive task and perturbed neural activity within a brain region facilitating movement known as the substantia nigra.

The substantia nigra is an important part of the motor system, releasing a chemical called dopamine to other brain regions to facilitate movement and motivate behavior.

The findings of this important study provide a valuable insight into the mechanisms by which infection and inflammation change the way we act and feel, specifically indicating

that chemical messengers released in the blood stream to combat infection can influence motivational centers in the brain leading to ‘psychomotor’ features of sickness.

John H. Krystal, M.D., Editor of Biological Psychiatry and affiliated with both Yale University School of Medicine and the VA Connecticut Healthcare System, comments on the value of this study: “The findings add to our growing knowledge of the intimate involvement of the brain, and by implication our patterns of thought and behavior, in the biology of the body.”

Dr. Lena Brydon, corresponding author on this article, agrees, adding that “understanding the link between the body’s immune defenses and the brain mechanisms responsible for sickness-related behavior may assist the development of novel interventions to control the depressive symptoms that accompany a wide range of inflammatory diseases.”

As the authors note, these mechanistic findings are critical to the development of interventions to control symptoms in inflammatory diseases as varied as obesity and cancer, or even neurodegenerative disorders such as Parkinson’s.

Source: Elsevier