Early after my dx in late 2011 I could walk for miles, do errands in morning and afternoon. All on 3 of 1/2 of 25\100 c\l. Yet even during that time I would lose balance while standing and conversing. I think I've had postural instability from my first awareness of having PD. Little tremor then, only slightly more now.
However, in recent weeks: more drooling, lower lip droops, postural instability has increased dramatically, and I've begun to experience FOG.
Cholinergic herbs help (Bacopa, Ashwagandha, Gingko), but their effect on PIGD/FOG only seems to last ~2 hours, then off time sets in rapidly.
"The study showed that another type of intestinal bacteria ― Enterobacteriaceae ― was linked to the severity of postural instability and gait difficulty (PIGD). These bacteria were significantly more abundant in patients with a PIGD phenotype than in patients with tremor dominant (TD) phenotype."
The study showed that another type of intestinal bacteria ― Enterobacteriaceae ― was linked to the severity of postural instability and gait difficulty (PIGD). These bacteria were significantly more abundant in patients with a PIGD phenotype than in patients with tremor dominant (TD) phenotype.
There is a wide variation in clinical manifestations in PD patients ― with some having mostly tremor, and others, rigidity ― and the question is whether these phenotypes represent the same disease. Itis possible, said Dr Scheperjans, that different PD subtypes are linked to different bacteria.
There were 49 (35.8%) hypocholinergic PD subjects. The combination of RBD symptoms and fall history showed highest diagnostic accuracy (81.1%) for predicting combined thalamic and cortical cholinergic deficits. A combined assessment of 8.5 meter walk time and lower score on the Montreal cognitive assessment scale provided diagnostic accuracy of 80.7 % for predicting isolated cortical cholinergic denervation.
Heterogeneity of cholinergic denervation in Parkinson's disease without dementia.
Cholinergic denervation is heterogeneous with reduced neocortical and/or thalamic acetylcholinesterase activity in 36% of nondemented PD subjects with corresponding clinical phenotypic variation. Results also show independent cognitive effects for both cholinergic and dopaminergic system changes in nondemented PD subjects.
This multilevel analysis showed differential connectivity alterations in large scale neural networks and between motor and cognitive control areas that related to behavioral heterogeneity in PD, underscoring the classic TD-PIGD phenotypical classification.
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