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Neurodegenerative Diseases

What Are Neurodegenerative Diseases?

Neurodegenerative diseases are a group of disorders characterized by the progressive degeneration of the structure and function of the nervous system. They primarily affect neurons, which are the building blocks of the nervous system responsible for transmitting signals throughout the body. As these diseases progress, they can lead to various symptoms, including cognitive decline, motor dysfunction, and loss of bodily functions, significantly impacting one’s quality of life.


The underlying mechanisms of neurodegenerative diseases often involve abnormal protein accumulation, mitochondrial dysfunction, oxidative stress, and neuroinflammation. These disease processes develop over time with degeneration sometimes beginning decades before symptoms manifest. While some of the factors that contribute to these conditions may be unavoidable, others can be mitigated by opting for healthier lifestyle choices. 


Types of Neurodegenerative Diseases

There are numerous neurodegenerative diseases, each with distinct characteristics and affected regions of the nervous system. Some neurodegenerative diseases that we commonly treat at CFNC include:

  • Alzheimer's Disease (AD)

  • Parkinson's Disease (PD)

  • Multiple System Atrophy (MSA)

  • Amyotrophic Lateral Sclerosis (ALS)

  • Multiple Sclerosis (MS)


Alzheimer's Disease (AD)

Alzheimer's Disease is the most common cause of dementia, accounting for 60-80% of cases. It primarily affects older adults, with the risk increasing with age. The disease often begins with mild memory loss and can progress to severe impairment in cognitive and physical functions. Alzheimer's disease not only affects the patient but also places a significant emotional and financial burden on caregivers and the healthcare system.


Pathology:

AD is characterized by the accumulation of amyloid-beta plaques and tau tangles in the brain, leading to the death of neurons and loss of synaptic connections. This results in the shrinking of brain regions vital for memory and cognitive functions. The exact cause of these protein accumulations is not fully understood, but many have started referring to AD as “Type 3 Diabetes” due to similarities between the two conditions - including the shared characteristic of neuronal insulin resistance that is seen with both diabetes and AD. Further, insulin resistance and insulin insufficiency as seen in obesity, metabolic syndrome, and Type 2 Diabetes may potentially contribute to the pathogenesis of AD.


Symptoms:

  • Memory loss, especially recent events

  • Confusion and disorientation

  • Difficulty in problem-solving and planning

  • Changes in mood and behavior, such as increased anxiety, depression, and aggression

  • Gradual loss of ability to carry out daily activities, leading to complete dependency


Parkinson's Disease (PD)

Parkinson's Disease affects approximately 1% of people over the age of 60. It is a progressive disorder that primarily impacts movement. PD is often associated with both motor and non-motor symptoms, and its progression can vary widely among individuals. The disease significantly impacts daily living and can lead to severe disability in advanced stages.


Pathology:

PD is caused by the loss of dopamine-producing neurons in the substantia nigra, a region of the brain responsible for coordinating movement. The exact cause of this neuronal death is not fully understood but is believed to involve a combination of genetic and environmental factors, including exposure to certain toxins and oxidative stress. A growing body of research has suggested that disruptions to the gut-brain axis may play a crucial role in the development of PD, highlighting the importance of gut health. 


Symptoms:

  • Tremors at rest, often starting in one hand

  • Bradykinesia (slowness of movement), affecting facial expressions and fine motor skills

  • Rigidity and stiffness of muscles, leading to discomfort and pain

  • Loss of postural reflexes, increasing the risk of falls

  • Non-motor symptoms such as depression, sleep disturbances, and cognitive impairment, including problems with attention and executive function


Multiple System Atrophy (MSA)

Multiple System Atrophy is a rare, rapidly progressive neurodegenerative disorder that affects multiple systems of the body. It typically presents in adults over the age of 50. MSA can be classified into two types: MSA-P, which primarily causes Parkinsonian symptoms, and MSA-C, which mainly affects the cerebellum and leads to ataxia. Most people with MSA will present with signs that are characteristic of both types, as well as autonomic dysfunction. 


Pathology:

MSA involves the accumulation of alpha-synuclein protein in neuronal support cells called glial cells, leading to degeneration in several areas of the brain, including the cerebellum, basal ganglia, and brainstem. The exact cause of MSA is unknown, but it is believed to involve a combination of genetic and environmental factors.


Symptoms:

  • Parkinsonian symptoms (tremors, rigidity, bradykinesia)

  • Autonomic dysfunction (orthostatic hypotension, urinary incontinence, erectile dysfunction)

  • Cerebellar ataxia (loss of coordination and balance, unsteady gait, slurred speech)

  • Speech and swallowing difficulties, leading to risk of aspiration and malnutrition


Amyotrophic Lateral Sclerosis (ALS)

ALS, also known as Lou Gehrig's disease, is a progressive neurodegenerative disorder that affects motor neurons in the brain and spinal cord. It typically manifests in individuals between the ages of 40 and 70. The disease leads to a loss of voluntary muscle control, and its progression can be rapid, with most patients succumbing to respiratory failure within 3 to 5 years of diagnosis.


Pathology:

The exact cause of ALS is unknown, but a combination of genetic and environmental factors is believed to play a role. Current known risk factors correlated with the development of ALS include sports with a high incidence of concussions, military jobs, smoking, exposure to heavy metals (lead, manganese), pesticides, neurotoxins (cyanobacteria), and electromagnetic fields. Mutations in certain genes, such as SOD1, have been linked to familial forms of ALS.


Symptoms:

  • Muscle weakness and atrophy, often starting in the limbs

  • Fasciculations (muscle twitching)

  • Difficulty speaking, swallowing, and breathing as the disease progresses

  • Loss of motor control, leading to paralysis

  • Cognitive and behavioral changes in some patients, known as ALS-frontotemporal spectrum disorder


Multiple Sclerosis (MS)

Multiple Sclerosis is a chronic autoimmune disorder that affects the central nervous system (CNS). It typically manifests in young adults, with a higher prevalence in women. MS is characterized by periods of relapse and remission, but in some cases, it can progress steadily over time. The variability in symptoms and disease course makes MS a particularly challenging condition to manage.


Pathology:

MS involves the immune system attacking the myelin sheath, the protective covering of nerve fibers in the CNS. This leads to inflammation and damage to the nerves, resulting in disrupted communication between the brain and body. The cause of MS is not fully understood, but it is believed to involve a combination of genetic predisposition and environmental triggers, such as viral or bacterial infections.


Symptoms:

  • Fatigue, one of the most common and debilitating symptoms

  • Numbness and tingling, often in the limbs or face

  • Muscle weakness and spasms, leading to difficulties with movement

  • Difficulty with coordination and balance, increasing the risk of falls

  • Vision problems, including blurred or double vision and optic neuritis

  • Cognitive impairment, affecting memory, attention, and problem-solving abilities


Neurodegenerative diseases pose significant challenges for affected individuals and their families. Early diagnosis and a multidisciplinary approach to care are crucial for optimizing outcomes for those living with these complex disorders. At CFNC we can help navigate the uncertainty of these conditions by working to co-manage with your healthcare team and provide you with the necessary support systems.


While there is no known cure for most neurodegenerative diseases, we can utilize lifestyle modifications, address inflammation and autoimmunity, and use targeted therapies aimed at maintaining the vitality of your nervous system and slowing the progression of the disease process to maintain the highest possible quality of life for as long as possible. If you or a loved one are suffering with a neurodegenerative disease and would like our help please schedule a consultation today!


Sources:

Brotman RG, Moreno-Escobar MC, Joseph J, et al. Amyotrophic Lateral Sclerosis. [Updated 2024 Feb 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK556151/



Triarhou LC. Dopamine and Parkinson's Disease. In: Madame Curie Bioscience Database [Internet]. Austin (TX): Landes Bioscience; 2000-2013. Available from: https://www.ncbi.nlm.nih.gov/books/NBK6271/


Ahmed Z, Asi YT, Sailer A, Lees AJ, Houlden H, Revesz T, Holton JL. The neuropathology, pathophysiology and genetics of multiple system atrophy. Neuropathol Appl Neurobiol. 2012 Feb;38(1):4-24. doi: 10.1111/j.1365-2990.2011.01234.x. PMID: 22074330.


de la Monte SM, Wands JR. Alzheimer's disease is type 3 diabetes-evidence reviewed. J Diabetes Sci Technol. 2008 Nov;2(6):1101-13. doi: 10.1177/193229680800200619. PMID: 19885299; PMCID: PMC2769828.


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