PIGD real or unreal?: Here are contrasting... - Cure Parkinson's

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PIGD real or unreal?

aspergerian profile image
5 Replies

Here are contrasting opinions. I side with the "PIGD is real" concept, even if PIGD and tremor-dominant are nodes in a spectrum.

ncbi.nlm.nih.gov/pmc/articl...

ncbi.nlm.nih.gov/pmc/articl...

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.

See also:

mdsabstracts.org/abstract/l...

bebrainfit.com/acetylcholin...

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aspergerian profile image
aspergerian
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silvestrov profile image
silvestrov

"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."

medscape.com/viewarticle/84...

aspergerian profile image
aspergerian in reply to silvestrov

Silvestrov,

Thanks for the link. The article also states:

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.

aspergerian profile image
aspergerian

See also:

Cholinesterase inhibitors from botanicals.

Pharmacogn Rev 2013 Jul-Dec; 7(14): 121–130.

ncbi.nlm.nih.gov/pmc/articl...

aspergerian profile image
aspergerian

See also:

Clinical Markers for Identifying Cholinergic Deficits in Parkinson's Disease.

Mov Disord 2015 Feb; 30(2): 269–273.

ncbi.nlm.nih.gov/pmc/articl...

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.

J Cereb Blood Flow Metab 2012 Aug; 32(8): 1609–1617.

ncbi.nlm.nih.gov/pmc/articl...

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.

aspergerian profile image
aspergerian

See:

Functional connectivity alterations in the motor and fronto-parietal network relate to behavioral heterogeneity in Parkinson's disease.

March 2016 Volume 24, Pages 48–55.

prd-journal.com/article/S13...

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.

[subtypes].

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