Parkinson's

Stress

How Stress And Mind-Body Therapies Impact Parkinson’s Disease

The Parkinson’s Solution Summit 2.0

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<h6>Barbara Pickut, MD, MPH</h6>
Hello, everyone, and welcome to the. Parkinson's Solution Summit 2.0. I'm your co-host, Dr. Barbara Pickut. Today, together with your host, Dr. Kenneth Sharlin, and the whole Dr. Talks team our goal is to pave the way for a healthier future and enhance the quality of life for those living with Parkinson's. Now, whether you're a patient, a caregiver, or someone seeking knowledge. This summit is designed to offer useful insights and hope for the future. Parkinson's impacts millions of people worldwide while its exact cause has remained elusive. A growing body of research points to stress as a significant contributing factor. Today, we'll discuss the role of stress in Parkinson's and the promise of mind-body therapies. I'll provide an introduction to the intricate relationship between stress and Parkinson's and the role that mind-body therapies may play in managing Parkinson's.

There's growing evidence that people living with Parkinson's are highly sensitive to the impact of psychological stress. The prevalence of stress-related neuropsychiatric symptoms in people with Parkinson's is significant with depression affecting between 30 and 40% and anxiety affecting between 25 and 30%. When we encounter stress our body initiates a complex biochemical cascade known as the biological stressor response. It involves the release of stress hormones such as adrenaline and cortisol which affect multiple body systems including the nervous system, endocrine, and immune systems. This response is designed to protect us in the short term but can become harmful when activated chronically. Perhaps you know that we have part of a nervous system that's called the autonomic nervous system. It acts automatically to govern our body's involuntary functions. The autonomic nervous system is made up of two parts the sympathetic and the parasympathetic. 

The sympathetic is responsible for the stress response or survival response and when called upon, prepares our body to respond to perceived threats. This response triggers physiological changes such as increased heart rate, heightened alertness, and a surge of adrenaline to equip us for immediate action whether to fight or flee. When the stressor is removed our body activates more of the parasympathetic nervous system known as the rest and digest system. This promotes relaxation and recovery. In summary, the autonomic nervous system manages our involuntary bodily functions and maintains a balance between the sympathetic system, which activates the body's fight or flight response, and the parasympathetic system which promotes rest and digest activities. So this is much like a teeter-totter where each side keeps the other in check. 

For individuals with. Parkinson's, a triggered sympathetic nervous system response can exacerbate symptoms such as tremors, dyskinesia, or freezing of gait. Then having this happen a cycle of more stress enters and more symptom aggravation. This is reported by patients, observed by clinicians, and confirmed in the scientific literature. When we're under chronic stress elevated levels of cortisol can have detrimental effects on our body and its good functioning cortisol is essential for energy regulation and the body's response to stress. But when it's consistently high levels can add to what we call allostatic load to the body which means adds to the cumulative burden of chronic stress and life events on the body's physiological systems and this may lead to a range of health issues. Including inflammation, impaired immune function, and increased risk of chronic disease. 

In recent years, there's been a renewed interest in understanding the interaction between stress and Parkinson's. And it's generally accepted that when under acute stress symptoms may increase in some people with Parkinson's. Some contemporary studies suggest, however, that chronic physiological stress or psychological stress may exacerbate the neurodegenerative process while the exact mechanisms remain an active area of research. There's a growing recognition that chronic stress could potentially act as a risk modifier, influencing the onset and progression of Parkinson's because of this emphasis is shifting toward using stress management as a non-pharmacological therapeutic strategy to improve the quality in life and potentially slow disease progression. 

So what is the evidence for these mind-body practices? Mind-body practices such as mindfulness-based stress reduction, meditation, yoga, breath work, heart rate variability training, tai chi, ballet, and boxing for Parkinson's, for example, have gained increased interest from researchers. Let's dive into some of these practices and see what the evidence may be. A study published by researchers at Harvard found that meditation can reduce the severity of motor and non-motor symptoms in people with Parkinson's by promoting relaxation and reducing stress. Meditation can help modulate cortisol levels and improve overall well-being. Ours and others' work published on mindfulness-based interventions includes mindfulness meditation, mindful yoga, and the body scan have shown an improvement in quality of life and a positive impact on some Parkinson's symptoms. 

Research on yoga, published in the Journal of Neurology Neurosurgery and Psychiatry suggests that yoga may improve balance, flexibility, and quality of life in individuals living with Parkinson's. Tai chi has been an area of interest, and a publication from the University of Pittsburgh conducted a study showing that tai chi can improve. Postural. Stability. Reduce falls. In individuals with people with. Parkinson's. Heart rate variability training has been looked at, and published in the Journal of Alternative and Complementary Medicine, and highlights the potential of heart rate variability and biofeedback in improving autonomic function and reducing stress in individuals with Parkinson's. 

In the Journal of Neuro Rehabilitation and Neuro Repair, there was a study published finding that dance including ballet, could improve balance, mobility, and quality of life in individuals with Parkinson's. And then regarding boxing for Parkinson's, some research has shown that non-contact boxing programs can be beneficial for people with Parkinson's with improvements in agility, strength, and coordination. All in all, in case studies and also in people with Parkinson's who've incorporated these practices into their daily routines. This together with scientific research and experience in the clinic. These combined reports underscore the promise of mind-body practices in Parkinson's disease. 

And then regarding boxing for Parkinson's, research has shown that non-contact boxing programs may be beneficial for people with Parkinson's by improving agility, strength and coordination. Ongoing research continues to uncover the potential benefits of integrating mind-body practices into a comprehensive treatment plan for people with Parkinson's. For example, The National Center For Complementary and Integrative Health supports the use of meditation, yoga, and tai chi to improve the quality of life for individuals with Parkinson's based on a review of various clinical studies. The Practice Guidelines update of the American Academy of Neurology on non-pharmacological management of Parkinson's Disease emphasizes the inclusion of stress management techniques in a therapeutic regimen for Parkinson's advocating for a holistic approach to treatment. So all in all case studies of people with Parkinson's who've incorporated these practices into their daily routines have reported improvements of mood, motor function, and overall quality of life. These anecdotal reports combined with scientific research underscore the promise of mind-body therapies in managing Parkinson's disease. 

In conclusion, the link between stress and Parkinson's highlights the importance of managing stress to mitigate its impact on the brain, the body, and behavior. Mind-body practices may help people with Parkinson's develop internal resources and increase resilience in the face of Parkinson's. A holistic approach to reducing stress and enhancing Neuroplasticity. And improving the quality of life for people with. Parkinson's can be transformative. Dr.Kenneth Sharlin, the host of Dr. Talks, and I encourage you to explore the Mind-body practices we discussed with you today and consider incorporating those that resonate with you into your daily routine. Please enjoy the engaging and informative interviews we've curated in the Dr. Talks. Parkinson's Solution Summit. 2.0. And remember, the journey toward better health and well-being is deeply personal, and Mind-body practices may be a powerful tool in navigating this path. Thank you.

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Dr. Barbara Anne Pickut, MD, MPH, is a Neurologist and Movement Disorders specialist with profound expertise in Parkinson&#8217;s disease and mindfulness-based training as a non-pharmacological intervention to enhance wellness for People with Parkinson&#8217;s and their Care Partners. She has an extensive background in clinical research for Parkinson&#8217;s, having been an investigator in multiple international new drug development trials.
Dr. Pickut&#8217;s ground-breaking research has demonstrated the benefits of mindfulness-based training in reducing Parkinson&#8217;s disease symptoms, showing measurable changes on MRI brain scans and improvements in quality of life. Her latest research involves a focus group analysis of the lived experiences of people with Parkinson&#8217;s after an 8-week mindfulness training.
Dr. Pickut is a certified teacher of mindfulness-based stress reduction (MBSR) from the University of Massachusetts Center for Mindfulness and a certified yoga instructor.
Contact: barbara@parkinsonsmindfulness.com

How Stress And Mind-Body Therapies Impact Parkinson’s Disease

Barbara Pickut, MD, MPH

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Barbara Pickut, MD, MPH