Understanding the brain, to help the patient

Jean-Philippe Giroux

IJL – Réseau.Press – The Nova Scotia Courier

Special report in four articles – second part

Parkinson’s is a progressive condition that can progress in people of any age, but the risk increases significantly in people aged 60 and over.

It affects dopamine nerve cells located in the substantia nigra (substantia nigra) of the midbrain, a region that helps regulate various functions, including movement.

“Dopamine is important for a number of different functions. It is therefore important for motor function and allows fluid and coordinated movements.explains Dr. Heather Rigby, a neurologist working in Nova Scotia.

Signs and symptoms

Before agreeing on a diagnosis, there are several steps to follow. The first thing a doctor should do is review the patient’s medical records and perform a physical exam. The doctor asks questions about the symptoms, when they started, how they progressed, etc.

Subsequently, we move on to the neurological examination and look for characteristics of the condition, including common symptoms, such as tremors, muscle stiffness and slowness of movements (bradykinesia). The person walks more slowly, it is more difficult to get out of a chair, there are changes in the handwriting, perhaps becoming messier or smaller, for example.

Beyond therapy and medication, there is exercise that plays a crucial role in patients’ lives. “The type of exercise may be a little less important than whether you participate in physical activity,” says Dr. Heather Rigby.

If research focuses on risk factors, prevention work, through diet and physical activity, also takes its place in the discussion, underlines Karen Lee, Karen Lee, President of Parkinson Canada. “If you continue to exercise, it helps improve your quality of life,” says the president.

Further research needed

Karen Lee mentions that, for the moment, “we do not know the direct cause of Parkinson’s disease, but a lot of work focuses on risk factors.”

Age is, combined with genetic and environmental risks (herbicides, pesticides, metals, etc.), one of the main causes of its evolution.

Dr. Heather Rigby emphasizes that there are “weak links” to environmental factors influencing the nervous system. “These dopaminergic neurons seem to be sensitive to these toxic effects, in certain individuals,” specifies the neurologist.

Ms Lee reiterates that research is underway to see what the relationship is between pesticides from agricultural lands and toxins from industrial areas and human health.

To move forward

According to Dr. Heather Rigby, one solution to help patients with the condition would be to increase resources to consult specialists more quickly: more staff, more neurologists, more specialized nursing care, etc.

“We need more paramedical support in the form of occupational therapy, physiotherapy, social work,” adds the neurologist.

In Cape Breton, for example, as in many rural regions, certain individuals are still on lists to access care.

It was difficult for Ian Lee, diagnosed seven years ago, and Wendy King, his wife, in the early years, since many neurologists and movement disorder specialists work in the Capital Region.

It took traveling from Glace Bay to Halifax a few times – an added expense for them – before finding their neurologist, Dr. Laith Shimon.

Today, their travel for medical reasons is very rare. “Fortunately, we don’t have to go back and forth to Halifax. Initially, that was the case, but we don’t have to travel, whereas others do, and so we consider ourselves lucky in that respect.says Ms. King.

Two years ago, six people from the Cape Breton East Chapter of Parkinson Canada took on the challenge of establishing a medical clinic specializing in neurology for the people of the region. They have already found a neurologist to work there and are awaiting a green light for government funding.

“That, in itself, will save many people from having to travel to Halifax and will certainly reduce the burden on many of them,” concludes Mr. Lee.