Compensatory Mechanisms in Parkinson's Disease
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Bas Bloem, MD reviews compensatory mechanisms, including cerebral plasticity and behavioral adaptation, in persons with Parkinson's disease.
The pathophysiology of Parkinson's disease is related to a large extent to neurodegeneration occurring in the substantia nigra, leading to subsequent changes in the nigrostriatal circuitry. However, the clinical phenotype is not just explained by this pathophysiological process, but is also to a large extent colored by two complimentary types of compensatory mechanisms.
The first is related to adaptive cerebral plasticity, such that intact brain areas in for example, the cerebral cortex, help to support functions that were originally controlled by the basal ganglia. Bas will discuss how such plasticity can be promoted through exercise, for example. The second is related to behavioral adaptation, in the form of compensatory behaviors that are largely self-invented by people living with Parkinson's disease, but which are also increasingly deployed by for example, physiotherapists, as part of their therapeutic approach. He shows compelling video material to demonstrate how many persons living with Parkinson's disease show a remarkable ability to overcome their motor as well as non-motor deficits by developing a wide range of compensatory strategies.
Key Topics Include:
- The clinical phenotype of Parkinson's disease is shaped not just by neurodegeneration in the basal ganglia, but also by adaptive neuro-plasticity taking place in other intact brain areas
- Persons living with Parkinson's disease show a remarkable ability to overcome their motor as well as non-motor deficits by developing a wide range of compensatory strategies
- Recognition of these different types of compensatory strategies opens exciting new avenues for innovative therapies, both as symptomatic treatment for persons with Parkinson's disease, and perhaps also as a disease-modifying strategy
