Dr. Giselle Petzinger on Exercise for Parkinson's Disease



Hello everyone I'm sitting here with Dr Sell pet singer who is a clinical psychologist who specializes in Parkinson's disease she is at the University of Southern California, where she splits her time between clinical care and research one of the reasons I reached out to just sal is because I'm particularly interested in some of her research on the role of exercise and Parkinson's disease. Excellent. So Can you talk a little bit about? What Parkinson's diseases maybe just from from a basic standpoint. Absolutely. So Parkinson's disease is a progressive degenerative disorder. It's a disorder that affects individuals that are over the age of fifty generally speaking. So we consider it a disorder of aging. and. Generally speaking, we think of Parkinson's disease as a problem with mobility. In fact, clinically that's how we tend to recognize it and most people when they're trying to are feeling that something's changed its often because of mobility problems and what I mean by that is slowness people will describe feeling slow dragging a leg. And or stiffness. So it has a kind of a set kind of motor movement big strong moving component. then. Of course there's tremor I think one thing though that people in general don't realize trimmer isn't necessary. So tremor definitely brings people into see neurologist and and certainly can be Parkinson's tremor can have other causes besides Parkinson. So generally speaking, it's really more I'd say about the slowness and the stiffness and it can affect any part of the body meaning it can affect lakes and therefore costs. So walking an example, but it can also affect the hands in arms where people can actually feel that they can't use arms well, they feel that things are taking longer to do. And sometimes, that might even be associated with some pain element of pain. So as I mentioned, Parkinson's is as sort of recognized as a motive problem. What we're realizing recognizing more over time is that there's what we call it non motor issue meaning on motor related phenomenon that occur and some of these non motor phenomena can occur even before the motor and people don't connect it necessarily with Parkinson's examples of that may be loss of smell. Now again, some of these other features are not specific. So none of these are specific. Kind of evaluating everything together. But the non motor features as I said could be the smell teaches and smell. Other non motor. So that means things that aren't affecting mobility. Could be mood, for example, society depression back we're now realizing recognizing these number papers that have come out you know years ago that excited pressure may be predate motor symptoms, two years, and then exactly depression me manifest in functional things like not be able to drive in a car in the on the highway feeling really anxious about that. Any family members may comment that the person just seems a little bit more depressed. So those things are now really well appreciated and recognized other things that are nominated that again, me precede motor features or even what we call the autonomic nervous system. The autonomic nervous system is part of the nervous system that involves or innovate smooth muscles. So this is things like your gut. Your heart. Your sweat. Glands. And those smooth muscles are part of your your gut in your blood vessels when they're not acting normally or behaving normally, it can cause disruption in your gut like constipation. So constipation again, in retrospect we find people may have problems with constipation even before they describe a note problems with movement of blood pressure changes in blood pressure may be dropping him blood pressure or heart rate abnormalities because of. Changes in the innovation to the heart. These are all kind of examples of nominal that aren't necessarily specific to Parkinson's disease but kind of come to once we see the motor features we can say, Oh yeah before that, there were these other sorts non motor features that were really predating it. So the point is, is that Parkinson's certainly more than that and We're appreciating that more and it finally. I would say now really coming on the forefront again, even more is a cognitive issue of Parkinson's and I think what we're recognizing again, cognitive issues a pretty predominant in Parkinson's literature sort of all over the place but essentially, the reporting about forty percent even upon diagnosis may already have some cognitive issues. Now, that's not the same thing as dementia. So this is called mild cognitive impairment in cognitive impairment is defined by the idea that a person may be noticing memory related issue or their family members noting that but they're not functioning paired meaning. They can do all the Adl's but they themselves were noting this and we can actually pick that up on some diagnostic testing as well So these things again haven't quite there's some understanding of why this may be happening but they're certainly part of park disease. And also the idea that they are very much interrelated. So. Motor and cognition probably had some relationship to in terms of the idea that cognitive issues can sometimes contribute to more motor problems or cognitive issues can get you more mood related issues. So they're they're not really separated. They're very much interrelated and we'll begin understand how and why that may be happening either from a chemical point of view from circuit point of view

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