ABSTRACT
Parkinson's disease (PD) is the second most common neurodegenerative disease, with the prevalence increasing as the population ages. Many mechanisms have been implicated in the pathogenesis of PD including oxidative stress, mitochondrial dysfunction, protein aggregation, and inflammation. Current treatment strategies focus on symptomatic improvement. However, therapies to modify disease progression are lacking. A whole food, plant-based diet contains many compounds that fight oxidative stress and inflammation. Evidence from animal models show that various phytochemicals may alter the mechanisms contributing to PD pathophysiology. Epidemiological studies show a relationship between reduced risk of PD and diet. We hypothesize that phytochemicals in plant-based foods may contribute to neuroprotection in PD and that adopting a plant-based diet may provide symptomatic improvement and alter disease progression in PD.
Subject(s)
Diet , Parkinson Disease/diet therapy , Animals , Antioxidants/chemistry , Curcumin/chemistry , Ergothioneine/chemistry , Fragaria/chemistry , Humans , Inflammation , Isothiocyanates/chemistry , Mitochondria/metabolism , Nervous System , Neurons/physiology , Oxidative Stress , Phytochemicals/chemistry , Plants , Quercetin/chemistry , SulfoxidesABSTRACT
BACKGROUND: Lightheadedness on standing is a disabling symptom in Parkinson's disease associated with orthostatic hypotension and is thought to represent cardiovascular autonomic dysfunction. Traditional orthostatic blood pressures are normal in some patients with lightheadedness and other measures of cardiovascular dysautonomia can be insensitive. In this study, we used continuous non-invasive arterial pressure monitoring to measure beat-to-beat changes in blood pressure and heart rate on standing and during Valsalva as a potential marker of autonomic dysfunction. METHODS: Subjects had a diagnosis of Parkinson's disease with or without documented orthostatic hypotension. Each participant underwent traditional measurement of orthostatic blood pressure and heart rate as well as measurement of beat-to-beat blood pressure and heart rate using continuous non-invasive arterial pressure monitoring during Valsalva maneuver and in response to standing. Orthostatic change in blood pressure and heart rate, and frequencies of normal and abnormal blood pressure responses to Valsalva maneuver were analyzed. RESULTS: In subjects without documented orthostatic hypotension, there was a higher proportion of abnormal blood pressure responses to Valsalva in subjects with symptoms of lightheadedness or dizziness upon standing compared to those without symptoms (p = 0.03). Additionally, the proportion of abnormal blood pressure responses during Valsalva observed in symptomatic subjects without orthostatic hypotension was indistinguishable from those with documented orthostatic hypotension (p = 0.7). CONCLUSIONS: Our findings suggest that continuous non-invasive arterial pressure monitoring may be more sensitive than traditional measurement of orthostatic blood pressure to detect subtle cardiac dysautonomia in Parkinson's disease and helpful in the diagnosis of unexplained lightheadedness.
Subject(s)
Autonomic Nervous System Diseases/diagnosis , Autonomic Nervous System Diseases/physiopathology , Blood Pressure Monitoring, Ambulatory/methods , Parkinson Disease/diagnosis , Parkinson Disease/physiopathology , Aged , Autonomic Nervous System Diseases/epidemiology , Blood Pressure/physiology , Heart Rate/physiology , Hospitals, Veterans , Humans , Hypotension, Orthostatic/diagnosis , Hypotension, Orthostatic/epidemiology , Hypotension, Orthostatic/physiopathology , Male , Middle Aged , Parkinson Disease/epidemiologyABSTRACT
BACKGROUND: Parkinson's disease (PD) is a disabling neurodegenerative disease that typically affects the geriatric population and requires a caregiver. Although caregiver burden reduces quality of life of the caregiver, support groups for caregivers have not been studied. Offering a tele-support group to PD caregivers would be an innovative approach to extending a novel resource. METHODS: A single-center pilot study was conducted, enrolling caregivers in an 8-week tele-support group program. Mood state and caregiver burden were assessed at baseline and conclusion of the program using self-report questionnaires. Qualitative feedback was obtained at the conclusion of the program. RESULTS: Seven female spouse caregivers enrolled; 86% completed the program. Although no statistically significant changes in questionnaire scores were found, the mean Geriatric Depression Scale decreased from 4.2 to 3 and qualitative feedback was universally positive. CONCLUSIONS: The use of tele-support groups for PD caregivers is a feasible and innovative resource to address caregiver burden.
