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Parkinsons

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Parkinson’s Disease and REM Sleep Behavior Disorder
Sukhwinder Randhawa
Introduction:
“Parkinson’s is a neurodegenerative disease” (7). When the cells that produce dopamine die then Parkinson’s disease arises. Dopamine is a “chemical that carries signals between the nerves in the brain” (7) to control movement. Since movement is no longer monitored and controlled certain body parts start to shake uncontrollably. Although Parkinson’s disease has no cure it can be somewhat controlled through medication. However Parkinson’s disease would be easier to control if it could be diagnosed earlier. By the time Parkinson’s disease is diagnosed, a person has already lost 80% of their dopamine neurons. In order to diagnose Parkinson’s disease earlier on doctors and patients need to see the sign and symptoms beforehand. Researchers have come upon the fact that an earlier way of diagnosing Parkinson’s disease might be through watching the patients sleeping patterns. Researchers are saying that REM sleep behavior disorder might share a common cause with Parkinson’s disease. REM sleep behavior disorder is a disorder in which there is rapid eye movement while a person is sleeping. It is a type of parasomnia in which vivid dreams are associated with the enactment of dreams. This disorder is a “dysfunction in REM sleep and the motor control circuitry in the pontomedullary structures” (2) which causes the loss of control over movement, especially of the eyes. Within this new discovery the REM sleep behavior disorder being associated with Parkinson’s disease, researchers gave two hypotheses. The first hypothesis is that the degeneration of certain region of the brain stem cause REM sleep behavior disorder and play a role in Parkinson’s and some of it’s symptoms like depression and anxiety. The second hypothesis is that REM sleep behavior disorder is an early form of Parkinson’s disease.

Body: Parkinson’s disease is no longer considered just a primary motor syndrome but actually a neurodegenerative disorder. This degenerative nature starts with REM sleep behavior disorder and goes on to cause many neurodegenerative diseases, one of which is Parkinson’s disease. Other than the shaking of body parts, another symptom of Parkinson’s disease is hallucination. Hallucinations are caused by visual dysfunction and dream overflow (5). This dream overflow is caused by the vivid dreams that occur in REM sleep behavior disorder. The degeneration of cells in REM sleep behavior disorder then eventually leads to Parkinson’s disease. An early symptom of Parkinson’s is sleep problems, which is seen quite a while before the major symptoms of Parkinson’s disease have begun. This is why the second hypothesis exists. Researchers think that because sleep disorders are the beginning of Parkinson’s disease and REM sleep behavior disorder also includes the rapid movements of the eyes, it could be the earliest symptom of Parkinson’s disease. This would make the diagnosis of Parkinson’s disease quicker, perhaps saving most cells from degenerating. Another symptom of Parkinson’s disease is blurred vision. This comes from the same degenerative nature of REM sleep behavior disorder. This can be said since “pathological changes in the anterior olfactory nucleus causes olfactory loss” (4) very early in the course of Parkinson’s disease. This olfactory loss is due to the degenerative nature of REM sleep behavior disorder. Olfactory dysfunction from REM sleep behavior disorder occurs in Parkinson’s Disorder at the earliest stage and affects 70-100% of Parkinson’s patients. The rapid eye movement in REM sleep behavior disorder is characterized by loss of the “normal muscle strength that accompanies REM sleep” (4). This leads to olfactory loss and could be a sign of widespread neurodegenerative processes, such as Parkinson’s disease.

Conclusion: In conclusion it can be seen that REM sleep behavior disorder could be a precursor for Parkinson’s disease or an early symptom, although it is most likely a precursor as it was shown that REM sleep behavior disorder causes widespread neurodegenerative process. These could be many processes, one of which is Parkinson’s disease. It cannot be ignored, however, that Parkinson’s disease and REM sleep behavior disorder are closely connected. Is REM sleep behavior disorder a precursor for Parkinson’s disease or an early marker can only be told by further research.

Citations: 1) Herpich, N. (2012). Searching for Early Signs of Parkinson's Disease in Genetics and How We Sleep, Smell and Digest. Retrieved from https://www.michaeljfox.org/foundation/news-detail.php?searching-for-early-signs-of-parkinsons-disease-in-genetics 2) Boeve, B.F. (2013). Idiopathic REM sleep behaviour disorder in the development of Parkinson's disease. Retrieved from http://search.proquest.com.cyber.usask.ca/biologicalsciences/docview/1328376965/13F442B4AA029B813A9/1?accountid=14739 3) Kempfner, J. (2010). REM behaviour disorder detection associated with neurodegenerative diseases. Retrieved from http://search.proquest.com.cyber.usask.ca/biologicalsciences/docview/812133972/13F446B243C407E354C/1?accountid=14739 4) Fantini, M.L., Postuma, R.B., Montplaisir, J., Ferini-Strambi, L. (2012). Olfactory deficit in idiopathic rapid eye movements sleep behavior disorder. Retrieved from http://www.sciencedirect.com.cyber.usask.ca/science/article/pii/S0361923006002358 5) Onofrj, M., Thomas, A., Bonanni, L. (2007). New approaches to understanding hallucinations in Parkinson''s disease: phenomenology and possible origins. Retrieved from http://search.proquest.com.cyber.usask.ca/biologicalsciences/docview/993522343/13F4465B21A4FCD737A/3?accountid=14739 6) Parkinson's Disease and Sleep. (2013). Retrieved from http://www.sleepfoundation.org/article/sleep-topics/parkinsons-disease-and-sleep 7) What is Parkinson’s? Retrieved from http://www.parkinson.ca/site/c.kgLNIWODKpF/b.5184077/

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