The 2 P's
 

Paradoxical kinesia
Placebo effect

Anyone point me towards any papers on either of these 2P's please.
Or experience of/theories on. Such as why the Placebo effect is so pronounced in Parkinson's.
It seems strange when we have 2 provable examples of instances where there is a significant improvement in symptoms,albeit temporarily,without treatment that there is so little research.

Nigel

"Paradoxical kinesia"
This is the most recent free-access (though technical) paper about this that I can find; http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4540447/ .

Cheers, just what I was after, touches on motivational stimuli also. I find if I'm struggling to get up giving myself a 3,2,1 countdown helps.....very odd . Which neurotransmitters and neural pathways are involved needs to be determined.

Nigel

This is a big area. One in which PwP are well able to add to the research effort.

It seems to me that a placebo should be a first class citizen of the medical armoury even if it works only for some people and for a limited period of time.

We need to differentiate between placebos which give a purely perceived advantage and those which give an objectively measurable one.

We also need to differentiate between pure placebos - things which have no true therapeutic effect on PD - and those substances (e.g. chocolate) and actions (e.g. flashing lights) whose effect may be both truly therapeutic as well as due to the placebo effect. I call these "therebos" (from THERapy and placEBO).

The task ahead is to discover therebos, to measure their effectiveness, to engineer them to improve their efficacy and to nurture them.

John

I was hoping for your input John, Im intrigued by 'therebos', a while back I came across a article which reported an experiment where placebo DBS operations were carried out.. The subjects having the mock op displayed improvement in line with those who actually had surgery.
Given the usual "does'nt work for everyone" problem that plagues the PD world
I wonder if some of our existing treatments are actually Therebos.

Nigel

You may be interested in an article I posted a year or so ago:

Some practitioners dismiss the placebo effect as irrelevant. Others blame it on neurosis. But scientists are increasingly recognizing the placebo response as an authentic neurochemical reaction in the brain. In the past decade, imaging studies have opened up the possibility that scientists will soon understand the mysterious phenomenon and even harness it in clinical practice — unleashing the power of, well, nothing. The new evidence has established that placebos trigger the brain’s “internal pharmacy” — in essence, a warehouse perpetually stocked to deliver active drugs to itself. In addition to improving Parkinson’s symptoms, that same inner pharmacy can affect conditions like pain, depression, irritable bowel syndrome, anxiety, schizophrenia and more. As the placebo effect emerges from a long history in the shadows, the new question is: How can we use this age-old brain trick to our advantage? or as long as medicine has existed, the placebo effect has been quietly playing a role in treatment.



http://www.erikvance.com/why-nothing-works/

Excellent,many thanks

Nigel

There are many examples of Kinesia paradoxa shown on youtube videos. For example, the man from the Netherlands who could not walk but did quite well riding a bike or the American who could walk well on his hands but not his feet.

My theory is that Parkinson's acts like a slow moving "infection" in the brain. First it starts in one location and then moves on to other regions.

To me it only makes sense that Parkinson's starts to affect those parts of the brain that enable us to do the things that most humans can do without any thought, for example, walking. At the same time it has yet to affect those parts of the brain that require more mental effort such as biking, singing, dancing, or skating.

I don't think that the phenomenon of Kinesia paradoxa is explained by either the limbic system response or neuroplasticity.