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Neurology / Neuroscience

Parkinson’s: New treatment focuses on two nervous systems at once

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Scientists have found that a technique for targeting a specific group of brain cells associated with Parkinson’s disease is also effective in treating a separate group of brain cells.

A female nurse explaining something to her patient
Researchers may have identified a new two-pronged approach to Parkinson’s disease.

These findings are now published in the journal Neurotherapeutics.

The initial technique is a type of gene therapy that was first used by researchers to target cholinergic neurons in rat brains in 2015. Cholinergic neurons are a type of nerve cell that affects Parkinson’s disease.

Now, using brain imaging techniques, scientists have discovered that their method has also positively affected a group of cells near cholinergic neurons called dopaminergic neurons.

What is Parkinson’s disease?

According to the National Institute of Neurological Disorders and Stroke, Parkinson’s disease is a type of neurological condition that usually affects people over the age of 60.

Symptoms include tremors or tremors, stiffness or stiffness in the trunk or limbs, slow motion, and impaired balance.

These symptoms occur because the condition causes a decrease in the brain cells that produce dopamine or dopaminergic neurons.

Cell-to-cell interaction

The original method demonstrated by the researchers in 2015 was to use the virus to provide genetic modification to the cholinergic neurons of rats genetically modified to develop Parkinson’s disease. The scientists then used a drug that could stimulate the target neurons.

In the new study, the scientists showed how brain imaging technology was used to reveal a clear channel of communication between the cholinergic neurons they were targeting in the 2015 study and the nearby dopaminergic neurons.

The stimulation of the rats ‘ cholinergic neurons also stimulated their dopaminergic neurons through cell-to-cell interactions.This seemed to restore the dopamine-producing function in the dopaminergic neurons

As a result, rats had a complete recovery, including the restoration of movement and the reversal of posture impairment.

According to senior study author Dr. Ilse Pienaar, “When we used brain imaging, we found that when we activated cholinergic neurons, they interacted directly with dopaminergic neurons.”

“This seems to be a knock-on effect, so by targeting this one set of neurons, we now know that we can also stimulate dopaminergic neurons, effectively restart dopamine production, and reduce dopamine production.

“This is really important, as it reveals more about how the brain’s nervous systems interact, but also how we can successfully target two major[…] Parkinson’s disease-affected systems in a more accurate manner.”

– Dr. Ilse Pienaar

Future treatment for Parkinson’s disease?

This means that researchers may be able to develop more effective and less invasive treatment for Parkinson’s disease in humans in the future.

Current Parkinson’s treatments focus on managing the condition through the use of drugs, but these often have significant side effects and usually become ineffective after 5 years.

Alternative treatments include deep brain stimulation, an invasive procedure that releases electronic pulses into a person’s brain. However, the results of this procedure are mixed, which researchers believe is due to the fact that it affects all cells in the brain of a person rather than the specific cells that Parkinson’s disease affects.

What makes the new findings promising is that treatment is both non-invasive and targeted, producing excellent results in rats.

As Dr. Pienaar explains, “Treatments need to be focused and targeted for the highest chance of recovery, but this requires a lot more research and understanding of exactly how Parkinson’s works and how our nervous systems work.”

“The discovery that both cholinergic and dopaminergic neurons can be successfully targeted together is a major step forward.”

– Dr. Ilse Pienaar

“While this kind of gene therapy still needs to be tested on humans, our work can provide a solid platform for future bioengineering projects.”

Co-author Lisa Wells adds: “It has been an exciting journey working with Dr. Pienaar’s team to combine the two technologies to provide us with a powerful molecular approach to neuronal signaling and neurotransmitter release measurement. We can support the clinical translation of this’ molecular switch’ into clinical use through live imaging technology.”

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Cardiovascular / Cardiology

Symptoms, causes, and treatment of transient ischemic attack (TIA)

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A transient ischemic attack (TIA), also known as a ministroke, happens when the brain’s blood supply is interrupted for a short period of time.

Although the diminished blood flow normally only lasts 5 minutes, a TIA is still a medical emergency. It could be a precursor to a massive stroke.

Because the symptoms of a TIA resolve fast, many people do not seek medical care. However, according to the Centers for Disease Control and Prevention (CDC), more than one-third of people who don’t get treatment for a TIA will have a severe stroke within a year.

According to statistics, 20% of persons who have a TIA will have a stroke within three months, and half of these will happen within two days of the TIA.

Knowing the signs and symptoms of a TIA and seeking care as soon as possible can help you avoid a more serious and perhaps life-threatening incident.

In this article, you’ll learn more about what a TIA entails and what to do if one arises.

What is a TIA?

transient ischemic attack (TIA)

A transient ischemic attack (TIA) has symptoms that are similar to those of a stroke, but it causes only a few minutes. The decreased blood flow normally only lasts a few seconds, but the symptoms can last for several minutes. They can last for a few hours on rare occasions.

TIAs occur when a blood clot stops blood flow to the brain cells for a brief period of time, preventing oxygen from reaching the cells. The symptoms usually go away when the clot breaks up or moves on. These events do not stay long enough to cause brain cells permanently.

People should not dismiss a TIA since it could be an indication of a big stroke, according to the American Stroke Association.

According to statistics, TIAs afflict about 2% of the population in the United States.

Causes

When the supply of oxygen to the brain is interrupted, a TIA ensues. This could be as a result of:

  • atherosclerosis, in which fatty deposits cause the arteries to become harder, thicker, narrower, and less flexible
  • blood clots due to heart disease, cardiovascular disease, or an irregular heart rhythm
  • blood clots due to a blood condition, such as sickle cell disease
  • an embolism or blood clot that has traveled from elsewhere in the body
  • an air bubble in the bloodstream

Symptoms

The symptoms of a TIA are determined by which area of the brain isn’t getting enough blood.

The acronym FAST (facial, arms, speech, time) might help people recall the symptoms to look for, just as it can with a severe stroke:

  • F = face: The eye or mouth may droop on one side, and the person may be unable to smile properly.
  • A = arms: Arm weakness or numbness might make it hard to raise one or both arms or keep them raised.
  • S = speech: The person’s speech may be slurred and garbled.
  • T = time: Someone should call the emergency services at once if a person has one or more of these symptoms.

The person may also have:

  • numbness or weakness, especially on one side of the body
  • sudden confusion
  • difficulty understanding what others are talking about
  • vision problems
  • dizziness
  • problems with coordination
  • difficulty walking
  • a very bad headache
  • a loss of consciousness, in some cases

TIA symptoms are only present for a short time. They can last anywhere from a few minutes to several hours, and they normally go away after 24 hours.

However, if anyone experiences symptoms that could signal a TIA, they should seek medical care right away because a massive stroke could result.

The same variables that cause temporary blood flow insufficiency in a TIA can cause a stroke, which can result in irreversible brain damage owing to a longer-lasting blood flow deficit.

Conditions with symptoms that are similar

A TIA’s symptoms can be similar to those of other diseases, such as:

Even if the symptoms of the TIA have subsided, getting an accurate diagnosis can assist a person get the proper treatment to help minimise the risk of a future stroke.

  • having a family history of stroke or TIA
  • being 55 years or above
  • being assigned male at birth
  • being Black or Hispanic, compared with being non-Hispanic white
  • having high blood pressure
  • having cardiovascular disease
  • smoking tobacco
  • having diabetes
  • getting low levels of exercise
  • having high cholesterol levels
  • eating a diet that is high in unhealthy fats and salt
  • having high homocysteine levels
  • having overweight or obesity
  • having a type of heartbeat known as atrial fibrillation

Treatment

Treatment options will be determined by the cause of the TIA. The parts that follow will go over some of the possibilities.

Medications

A doctor may recommend medicine to reduce the risk of a second blood clot and catastrophic stroke.

The treatment options will vary depending on the cause of the TIA, however they usually include:

  • anti-platelet drugs to prevent clotting, such as include aspirin, ticlopidine (Ticlid), and clopidogrel (Plavix)
  • anticoagulants such as warfarin (Coumadin) and heparin, which also help prevent clotting
  • medications to manage high blood pressure, or hypertension
  • drugs to help manage cholesterol levels
  • medications to manage heart disease and regulate irregular heart rhythms

All of these medications can cause side effects and may interact with other medications.

As a result, people should tell their doctor about any other prescriptions they’re taking, including over-the-counter drugs, supplements, and herbal therapies.

If a person has negative side effects while taking a medication, they should consult a doctor. It’s possible that another option exists.

Surgery

A doctor may propose surgery to remove a blockage or a portion of a damaged artery in some instances.

Preventive actions and lifestyle changes

A risk of lifestyle changes can help minimise your chances of having a TIA or stroke. These are some of them:

  • avoiding or quitting smoking
  • avoiding exposure to secondhand tobacco smoke
  • eating a nutritious and varied diet, with plenty of fresh fruits and vegetables
  • managing one’s intake of salt and unhealthy fats
  • getting regular exercise
  • avoiding the use of recreational drugs
  • managing body weight, if appropriate
  • following any treatment plan for heart disease, diabetes, or other conditions

Before making any major lifestyle changes, such as beginning a new workout plan, it is best to consult with a healthcare practitioner to determine the best course of action.

Diagnosis

Anyone who has signs or symptoms of a TIA should seek medical help right away to figure out why it happened and how to avoid a recurrence or a more serious occurrence.

Symptoms can fade fast, and by the time the person sees a doctor, they may be gone. A witness who was present at the time, on the other hand, may be able to assist the individual in explaining the situation to the doctor.

The doctor will likely:

  • ask what happened and ask about any ongoing symptoms
  • ask how long the symptoms lasted for and how they affected the person
  • consider the individual’s personal and family medical history
  • carry out a neurological examination, which may include memory and coordination tests

If the doctor suspects the patient suffered a TIA, he or she may be referred to a neurologist for further evaluation.

The following are some examples of possible tests:

  • blood tests to check blood pressure, cholesterol levels, and clotting ability
  • an electrocardiogram to measure the electrical activity and rhythms of the heart
  • an echocardiogram to check the pumping action of the heart
  • a chest X-ray to help rule out other conditions
  • CT scan to reveal any signs of an aneurysm, bleeding, or changes to blood vessels in the brain
  • an MRI scan to help identify damage to the brain

The doctor may also request that the patient wear a Holter monitor for a few days or weeks in order to track their heart rhythms over time.

Conclusion

The symptoms of a TIA can last anywhere from a few minutes to several hours. However, it is critical to seek medical help because a TIA can be a symptom of a massive stroke.

A TIA is marked by weakness and numbness on one side of the body, facial drooping on one side, and difficulty speaking. If you or someone you know is experiencing these symptoms, call 911 right away.

Following a TIA, lifestyle changes and the use of medicine to lower the risk of future blood clots are two choices for treatment.

Sources:

  • http://stroke.ahajournals.org/content/strokeaha/45/7/2160.full.pdf
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4832890/
  • https://www.nhs.uk/conditions/transient-ischaemic-attack-tia/
  • https://www.medicalnewstoday.com/articles/164038
  • https://www.ncbi.nlm.nih.gov/books/NBK459143/
  • https://www.nhlbi.nih.gov/health-topics/stroke
  • https://www.stroke.org/en/about-stroke/stroke-symptoms
  • https://www.stroke.org/en/about-stroke/types-of-stroke/tia-transient-ischemic-attack
  • https://www.cdc.gov/stroke/types_of_stroke.htm

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Mental Health

Types, conditions, and treatments of facial tics

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A facial tic is an uncontrollable, involuntary spasm of the facial muscles. The tic is unwelcome and occurs frequently enough to be bothersome to the individual who has it.

A person can keep in a tic for a short period of time, similar to how a person can hold in a sneeze, but doing so frequently causes the individual to become progressively uncomfortable.

Facial tics can be caused by a variety of conditions, but they rarely signify a serious medical condition.

Facial tics are more common in children than in adults, according to a study published in Pediatric Neurology, and males appear to be significantly more prone to them than girls. After a few months, most children’s facial tics disappear.

When to consult your doctor

facial tics

Facial tics are frequently temporary and fade away on their own. If a person has a tic that lasts more than a year, they should contact a doctor.

Anyone who has severe, chronic tics that affect a variety of muscle groups should see their doctor for a correct diagnosis.

Although it is not always possible to prevent facial tics, many of them do not require treatment and will go away on their own.

For persistent tics, there are treatments that can help people manage the tic. Some people may benefit from learning stress relief techniques and consulting a therapist.

Facial tics

Involuntary muscular movements that occur anywhere on the face are known as facial tics. However, they normally occur in the same location each time and are frequent enough to annoy the individual. Tics that are severe can have a negative impact on a person’s quality of life.

The following are examples of common facial tics:

  • raising the eyebrows
  • opening and closing the mouth
  • mouth twitching
  • rapid eye blinking or winking
  • squinting
  • flaring the nostrils
  • scrunching the nose
  • clicking the tongue
  • sucking the teeth

Some people may also have vocal tics, such as clearing their throat or grunting, in addition to muscle tics.

A person can temporarily repress a tic, but it will eventually emerge.

Types of tic disorders

Facial tics can be caused by a variety of conditions. The severity of the tic, as well as the existence of other symptoms, can assist a doctor figure out what’s wrong.

Transient tic disorder

Tics are only present for a short time. A regular facial or vocal tic may be caused by transient tic condition, however the tic usually lasts less than a year.

Tics are usually only present when a person is awake with transient tic disorder. Tics are uncommon when people are sleeping.

The majority of causes of tics in children are due to transient tic disorder. They normally go away on their own without any treatment.

Chronic motor tic disorder

Chronic motor tic disorder is a type of tic disorder that lasts longer. A person with chronic motor tic disorder must have had tics for more than a year, for periods of at least 3 months at a time, in order for a doctor to diagnose them.

Chronic motor tic disorder, unlike transitory tic condition, causes tics that can occur while sleeping.

Both toddlers and adults can develop chronic motor tic condition. Young children with persistent motor tic disorder may not require treatment since their symptoms are more tolerable or go away on their own.

Adults with the illness may require medication or other forms of treatment to keep their tics under control.

Tourette’s syndrome

Tourette’s syndrome, often known as Tourette’s condition, is a persistent disorder that causes one or more motor or vocal tics.

Tourette’s syndrome affects the majority of people throughout their childhood, however it can also affect adults. Tics normally get less acute as a person gets older.

Both physical and verbal tics are present in people with Tourette’s syndrome. They may unintentionally create sounds or pronounce words.

Small motor tics, such as fast blinking or throat clearing, are common in people with Tourette’s syndrome. They may, however, have more complex motor tics, such as:

  • saying inappropriate words
  • making inappropriate gestures
  • yelling out
  • shrugging one or both shoulders
  • shaking the head uncontrollably
  • flapping the arms

Behavioral therapy can help people with Tourette’s syndrome manage their symptoms. People with any other underlying problems, on the other hand, may require medicine.

Treatment

Treatment for facial tics varies according to the tic’s nature and intensity. Many tics, such as those caused by transitory tic condition, may fade away over time if not treated.

Tics that interfere with school or work performance may require treatment. Tics that endure a long time, such as those caused by Tourette’s syndrome, may require more intensive treatment.

Tics can be treated in a variety of ways, including:

Medication

Alpha-adrenergic agonists, neuroleptic medications, and dopamine blockers are some of the pharmaceuticals used to treat tics.

Doctors may recommend Botox injections in the case of persistent facial tics or twitches. Botox injections can temporarily block facial muscles, which may be enough to prevent tic recurrence.

Any underlying diseases causing the tic, such as Tourette’s syndrome or ADHD, can also be treated with medication.

Psychotherapy

Doctors may prescribe that a person meet with a psychotherapist on a regular basis to help them change or remove their tics.

Some people may benefit from behavioural modification and habit reversal strategies to assist them overcome their tics and improve their quality of life.

The person is usually taught to recognise when the tic is about to happen as part of the therapy. When a person is able to accomplish this, the therapist will encourage them to try to replace the tic with another behaviour.

This may assist a person replace a physical habit with one that is less distracting or does not interfere with daily functioning over time.

Surgery

In severe cases of facial tics, such as those caused by Tourette’s syndrome, several surgical treatments may be helpful.

Deep brain stimulation is one surgical treatment option. Electrical currents may be able to reach specific parts of the brain via electrodes implanted in the brain, according to some experts, which could assist control brain waves and eliminate tics.

Deep brain stimulation may help ease symptoms of Tourette’s syndrome, according to a recent study, but further research is needed to find the appropriate parts of the brain to stimulate.

Natural treatments

Natural therapies for facial tics may also be recommended by doctors. Because stress is thought to play a role in the development and maintenance of tics, natural treatments will focus on lowering stress in the individual’s life.

Among the stress-relieving activities are:

  • yoga
  • imaginative play
  • meditation
  • light exercises

For people wanting to minimise stress and find relief, getting a full night’s sleep is also essential. A doctor may suggest counselling in some cases.

Sources:

  • https://www.pedneur.com/article/S0887-8994(12)00215-9/abstract
  • http://docshare02.docshare.tips/files/13658/136588307.pdf#page=607
  • https://www.medicalnewstoday.com/articles/322174
  • https://www.mayoclinicproceedings.org/article/S0025-6196(11)60071-2/fulltext
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4737687/

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Bones / Orthopedics

Spinal problems causing tremors: What to know

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Tremors are uncontrollable shaking movements in one or more bodily parts. Muscle contractions are the cause of these unusual movements.

Tremors are usually caused by a problem with the region of the brain that governs movement. Multiple sclerosis, Parkinson’s disease, and traumatic brain damage are all examples of neurological illnesses. Anxiety, an overactive thyroid, alcohol use disorder, and certain drugs are all possible causes of tremors. Doctors, on the other hand, are frequently unable to pinpoint the source of the cause.

The majority of sources do not mention spinal issues as a possible cause of tremors. Tremors have been reported in people with spinal cord compression on a rare occasion.

Continue reading to learn more about the links between spinal problems and tremors, treatment options, and when to seek medical attention.

When to consult a doctor

Anyone experiencing tremors should see a doctor for a diagnosis and to rule out any dangerous causes.

To assess the tremor, the doctor will begin the diagnosis process by doing a physical and neurological examination. They’ll also ask about the person’s medical history. Medical tests, such as diagnostic imaging to examine brain and spinal injury and an electromyogram to diagnose muscle and nerve abnormalities, may be ordered after that.

They can prescribe the best treatment based on the results of these tests.

Tremors and spinal problems

spinal problems

Tremors are uncommon in people with spinal problems, but there have been instances of tremors in people with spinal cord compression.

In one case, a 91-year-old man got tremors as a result of cervical myelopathy, which is caused by spinal cord compression in the neck. The man developed tremors in both arms and legs over the course of two weeks, rendering him unable to feed himself or move without assistance.

Doctors initially suspected the man had Parkinson’s disease, but they eventually ruled it out because he exhibited no other symptoms. The individual had a herniated disk at vertebrae C3–C4 in his neck, according to an MRI study.

Tremors can also be caused by a condition known as cervical dystonia. This uncommon neurological condition starts in the brain and causes to uncontrollable neck muscular contractions. These contractions might be continuous or come in the form of spasms that seem like tremors. The severity of the condition varies, but it can cause in severe pain and incorrect posture, both of which can have a negative impact on one’s quality of life.

What are tremors?

Tremors are involuntary movements of the body that are difficult to control. The hands are the most common site of involuntary muscle contractions, but they can also affect the arms, hands, head, torso, legs, feet, or face muscles.

Tremors have varied effects on different people. They are able to:

  • come and go or occur continuously
  • happen on their own or occur in response to another issue
  • be mild or severe
  • affect one or both sides of the body

Tremors can be classified as follows:

  • Essential tremor: This condition is known as benign essential tremor by doctors. It’s the most frequent tremor, and it’s caused by nervous system issues. The hands are most affected, although it can also affect the head, tongue, voice, legs, and trunk.
  • Dystonic tremor: This movement issue can occur in people who have dystonia. Dystonia is a condition that causes incorrect posture due to involuntary muscular contractions. Twisted and repetitive movements can harm any muscle in the body, according to some people.
  • Parkinsonian tremor: This tremor is common in people with Parkinson’s disease. It usually affects one or both hands while lying down, although it can also affect the face and legs.

Why might spinal, back, or neck issues cause tremors?

If the spinal cord is compressed, back and neck disorders might cause tremors. Millions of nerve cells in the spinal cord connect the brain to motor neurons, which allow the body to move.

Compression of these nerves in the back and neck may impair how they communicate, resulting in tremors. However, this is a rare occurrence, with only a few accounts of people suffering tremors as a result of spinal abnormalities.

Treatment

Treatment options for tremor-related back pain may be determined by the cause.

Doctors may propose surgery in the case of a disk herniation. An anterior cervical discectomy and fusion (ACDF) technique may be used by a surgeon to treat the condition. The aberrant, bulging section of the disk that presses on the nerves in the spinal cord is initially removed during an ACDF. The bones will then be fused together to prevent them from rubbing against one another.

Cervical dystonia cannot be cured by doctors. They may, however, suggest one or a combination of the following treatment options:

Botulinum toxin (Botox) injections

This neurotoxin is injected into the neck muscles in modest dosages by a doctor. It stops nerves from sending out signals that cause muscle contractions.

Oral medications

At this time, the Food and Drug Administration (FDA) has not approved any oral drugs. Doctors may, however, suggest the following to alleviate symptoms:

  • baclofen
  • clonazepam
  • anticholinergic agents, such as benztropine
  • dopaminergic agents, such as levodopa

Surgery

There are two surgical procedures available to you. The first involves severing the nerves that supply dystonic muscles, although this can have serious adverse effects and take a long time to recover from.

Another approach is deep brain stimulation (DBS). DBS entails a surgeon implanting electrodes in the globus pallidus, a specific portion of the brain. Stimulators then provide little electrical pulses to the brain, which help to improve dystonic movements.

Prevention

People with spinal disorders may likely find it difficult to prevent tremors. Cervical spondylotic myelopathy, for example, is caused by the degenerative changes in the spine that occur as people age, and tremors are common in the elderly.

Reduced spinal strain and injury risk can help people prevent herniated disks. However, disk material degrades gradually with age, and even modest strains or twisting movements might cause disk rupture.

The cause and prevention of cervical dystonia are frequently unknown to clinicians. However, because up to 25% of people have a family history of the condition, researchers have discovered linked gene abnormalities.

Conclusion

Tremors are involuntary shaking motions that can affect the muscles of the limbs, trunk, or face. Tremors are rarely caused by spinal issues. However, if the spinal cord is squeezed, the nerves’ ability to communicate is disrupted, which can result in tremors.

Surgery, injections, and medication may be used to treat tremor-related back disorders, depending on the cause.

People who avoid putting undue strain on their spine and are aware of potential injuries can lower their risk of having tremors as a result of spinal disorders.

Anyone who has tremors should seek medical advice for a diagnosis and treatment.

Sources:

  • https://rarediseases.org/rare-diseases/cervical-dystonia/
  • https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Herniated-Disc
  • https://www.christopherreeve.org/living-with-paralysis/health/how-the-spinal-cord-works
  • https://medlineplus.gov/tremor.html
  • https://www.medicalnewstoday.com/articles/can-spinal-problems-cause-tremors
  • https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Tremor-Fact-Sheet

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