Parkinson’s Disease Neurohealth Training

Many factors contribute to debility in Parkinson’s disease. At Mindful Neurology, our neurohealth approach strives to evaluate all systems which may be affected – systemic, cellular, neural networks, and overall well-being.

A unique aspect of Mindful Neurology approach to Parkinson’s disease is emphasis on mind-body techniques and complementary therapies to support well-being.  An additional areas of focus include nutrition and cellular health.

Rehabilitation Strategies using Mind-Body Therapies

Mind-Body medicine refers to a class of therapies that facilitate self-regulation or alter the body physiology using physical or mental interventions.  There are many different types of therapies that fall into this category, including but not limited to:

  • Yoga or meditation
  • Biofeedback
  • Craniosacral therapy
  • Massage
  • Feldenkrais/Alexander
  • Acupuncture
  • Sound-based therapies

The contrast with medications lies in the philosophy. Medications work on very specific receptors in our body, whereas Mind-Body strategies or complementary therapies can use any aspect of the body, mind or lifestyle as an entry point to re-balance disarrayed processes.

Often times, choosing to use mind-body strategy or complementary therapies is a personal choice and Mindful Neurology can help guide you on this journey.  Dr Mulukutla is familiar with a range of complementary therapies. We try to collect objective or detailed subjective data / reports about the impact of the therapies so that we understand how they truly affect you.

Here is a short video that demonstrates how a therapy such as relaxation can help the motor symptoms of Parkinson’s disease.

Becoming aware of the connection between thought patterns, emotional reactivity, and integrity of body movements is one of the principle therapies at Mindful Neurology for addressing symptoms of Parkinson’s disease. 

Nutrition & Cellular Health in Parkinson’s Disease

At Mindful Neurology, we understand that what we put into our digestive tracts has a huge influence on how the rest of our body functions. The recommended approach is a whole foods diet consisting of diverse vegetables and fiber and nutrient dense foods. Elimination of processed or packaged foods is often a first step in the process of cleaning up diet.

A basic nutritional evaluation is included in every initial visit.

For some individuals, it would be worthwhile to order laboratory tests that look at underlying cellular function, such as nutrient status or cellular metabolites. See below for some of the research that supports why this can be an important part of managing Parkinson’s disease.

What does the research say on the role of yoga & meditation in Parkinson’s disease? 

A recent study published in April 2019 showed that 8 weeks of Mindful Yoga improved mobility in people with mild-moderate stage Parkinson’s disease, and also reduced depression and anxiety.

The authors, Kwok J et al, posit that connection between breath, body and movement – even when challenging – helps promote equanimity and increased resilience in face of hardship off of the mat.

In 2015, Pickut et reported on the results of a randomized trial of Mindfulness Based Stress Reduction for people with PD. The 8 week program was associated with a myriad of significant benefits: a 5.5 point decrease on UPDRS motor score, an increase in mindfulness score, and structural changes on MRI.  We know from prior studies that 8 weeks of regular meditation practice produces changes in the neural networks, and this is the first study to confirm similar effect in those with Parkinson’s disease. Important areas such as the hippocampus, caudate nucleus and occipital lobe demonstrated increased gray matter density in the intervention group compared to controls.

Another interesting area of research involves Neurofeedback.  Several studies have demonstrated that visualization of motor tasks leads to re-arrangement of motor networks in people with Parkinson’s disease.  This is important because the networks are not functioning properly; and any attempt at correcting the networks has potential to facilitate motor functioning.

Putting the above research together:  Meditation has profound impact on our neural networks, and we can use this capacity of the brain to rewire itself to help support healthy neural learning among those with Parkinson’s disease. Quieting noisy networks in the brain is the first step to allowing neural re-learning, and breathing exercises or complementary therapies can promote deep rest. Lastly, engaging in mind-body training can be empowering and provide translatable skills that minimize psychological distress among those with Parkinson’s disease.

Sources: 

Kwok JY et al. Effects of mindfulness yoga vs stretching and resistance training exercises on anxiety and depression for people with Parkinson’s disease. A randomized clinical trial.  JAMA Neurol 2019. Published online April 8, 2019. doi:10.1001/jamaneurol.2019.0534

Pickut et al. Mindfulness training among individuals with Parkinson’s disease: neurobehavioral effects. Parkinson’s Dis 2015. 2015: 816404

Pickut B et al. Mindfulness based interventions in Parkinson’s disease leads to structural brain changes on MRI. A randomized controlled longitudinal trial. Clin neurol neurosurg. 2013. 115:2419-2425.

Ehgoetz Martens K et al. Does anxiety cause freezing of gait in Parkinson’s disease? PLOS One 2014. 9(9): e106561

Kwok JY et al. Effects of mind-body exercises on the physiological and psychosocial well-being of individuals with Parkinson’s disease: a systematic review and meta-analysis. Complement ther med 2016. 29; 121-131

Subramanian L et al. Real-time functional MRI neurofeedback for treatment of Parkinson’s disease. J Neurosci 2011. 31(45):16309-16317

Baudrexel S et al. Resting state fMRI reveals increased subthalamic nucleus-motor cortex connectivity in Parkinson’s disease. Neuroimage 2011. 55:1728-1738

Disssanayaka N et al. Mindfulness for motor and nonmotor dysfunctions in Parkinson’s disease. Parkinsons Dis 2016. 2016:7109052

Brewer J et al. Meditation experience is associated with differences in default mode network activity and connectivity. PNAS 2011. 108(50): 20254-20259