Breathing abnormalities in Parkinsons

Several different patterns of breathing abnormality may be found in PD:

Upper airway obstruction (UAO) has been reported in a third of people with PD. The most common manifestation of UAO is soft speech, which itself may affect up to 70% of people with PD. Two types of UAO have been described: (i) “respiratory flutter” whereby the vocal cords oscillate at a frequency similar to that seen in the peripheral tremor observed in PD and may result in a ‘shaky’ voice or in noisy breathing; (ii) less common is a delay in expiration (so it feels harder to breathe out), which can at times lead to complete airway obstruction.

Restrictive breathing abnormalities have been reported in 28% to 94% of people living with Parkinson’s (the wide variation reflecting population selection bias). The underlying mechanisms of this pattern of breathing abnormality in PD are not fully understood but are likely to include a combination of factors: increased chest wall rigidity; a reduction in lung volume secondary to stooped posture; and lung changes secondary to ergot-derived dopamine agonist drugs (no longer in common usage).

Normally, our breathing is driven by high carbon dioxide (CO2) and low oxygen (O2) levels in our blood. This is regulated by the brainstem and carotid bodies respectively. However in PD, the perception of breathing can be heightened or lowered making the individual feel more SOB than they appear. This can result in them being misdiagnosed as being depressed or anxious. A possible explanation for this altered perception of breathing may be due to the loss of dopaminergic input to the brainstem and carotid bodies leading to altered regulation of CO2 and/or O2.

Hang Tough. Cheers!

[Oceanflow]

Interesting !! What is the source of your information?

[LindaP50]

Interesting. My husband makes a throat noise sometimes when he's breathing and we aren't sure of the cause. Visited an ENT (ears, nose, throat) doctor who found no issues. Perhaps we should visit with a pulmonologist.

[Hidden in reply to LindaP50]

that sounds like stridor. Stridor in Parkinson's disease: a case of ‘dry drowning’?

E C Gan (a1), D P Lau (a1) and K L Cheah (a2)

DOI: doi.org/10.1017/S0022215109... online by Cambridge University Press: 11 December 2009

cambridge.org/core/journals...

[LindaP50 in reply to Hidden]

Haven't heard of this term. Thank you, I will investigate for sure!

[Hidden in reply to LindaP50]

i have nocturnal stridor. my lungs collapse from the bottom up.

[LindaP50 in reply to Hidden]

Read the info on link. This is fabulous - actually have a "name" to call hubby's throat noise. Its a real thing!! Not our imagination (noise didn't occur when at doctors office, of course).

States this Stridor can be associated with GERD which he's had since he was 20 years old.

I'm so excited! HealthUnlocked is SUPER. We get support, information, valid resources, share with others.

Very happy to be soon able to address this with hubby's neurologist.

[Hidden in reply to LindaP50]

im really glad this helped you, when i read what you wrote i thought it sounded familiar to my situation and ithers with resp. issues. hang tough. cheers.

[SilentEchoes in reply to LindaP50]

I think seeing a pulmonologist is a good idea, get a pulmonary function test and a sleep study.

[Hidden in reply to SilentEchoes]

i started with sleep study 10 yrs ago i have a neuro-pulmonologist, a neuro physical therapist, a neuro psycholgist, and a Dr of movement disorders, and get get spirometry on my lungs at least 1 time a year. At university colorado hospital and research center.....my last move would be Ntional Jewish as they lead the world in respiratory issues. Thank you for thinking of stuff though i appreciate that. cheers!

[SilentEchoes in reply to Hidden]

This might interest you.

ahajournals.org/doi/10.1161...

You are fortunate to have medical support for your pulmonary function. I have John Bach, MD at Rutgers on my team. Would not be as well without him.

Thanks again for giving me direction on areas to do further research.

SE

[Hidden in reply to SilentEchoes]

sweet! nice piece of info ..goodd find! cheers!

[SilentEchoes in reply to Hidden]

You seem very informed to me. Why haven't your doctors done a bullectomy on that giant CO2 bolus?! Might it be time for a second opinion?

[Hidden in reply to SilentEchoes]

wellll...im DNR no heimlich, no icu, no surgery, no hospital.....totally palliative, iven been doing this for many years now ive lost everything i was working for. im done......

[SilentEchoes in reply to Hidden]

I'm sorry. I'm not there yet emotionally. Please know that your presence and contribution here are valuable.

God bless,

SE

[Hidden in reply to SilentEchoes]

oh.............neither am i............thats the point of a suppport group.......ummmm............Confucius bless you with many flowers.......cheers.

[SilentEchoes in reply to LindaP50]

Does the throat noise happen when he's falling asleep? It could be his airway collapsing.

[LindaP50 in reply to SilentEchoes]

Sitting mostly and sitting in bed to read. We bought an adjustable bed so we can sleep in a slight head upright position. Reduced the throat issue with the adjustable bed. Now we are working on the rest.

He does have a new neurologist, appt first of June. Now I have more info if Dr doesn't mention Stridor I can inquire.

[SilentEchoes in reply to LindaP50]

A sleep study could be helpful. He might need bipap therapy, watch for central apnea - this is loss of respiratory drive.

[Hidden in reply to SilentEchoes]

I looooove my bi-pap.......

[SilentEchoes in reply to Hidden]

I failed bipap therapy, trilogy ventilator now, when therapy works it's a life changer.

[Hidden in reply to SilentEchoes]

did it help your stridor?

[SilentEchoes in reply to Hidden]

Don't have stridor, it's a choking sound. Terrified my son the first time it happened. I NEVER sleep laying flat.

[Hidden in reply to SilentEchoes]

i call it my nightly waterboarding.

[SilentEchoes]

My history is that my mom had PD and I have ALS. I belive the two disorders are related.

It's interesting that restrictive lung disease is present in a large percentage of Parkinson's patients. This is a hallmark of ALS and leads to respiratory failure. My mom complained of "trouble breathing" but didn't get respiratory support.

I had my serum levels of catecholamines tested and dopamine was below the detection limit. Dopamine is neuroprotective in ALS. I had a DaTScan and there was no defect in the substantia nigra.

I know that I have hypothalamic injury from being poisoned with Roundup, who knew there are dopamine neurons in the hypothalamus? I'm now trying to discover why my dopamine neurons have been wiped out and if I can replace them or need to replace dopamine with mucuna pruriens.

enzolifesciences.com/scienc...

You other interesting point is the role of dopamine in the brainstem and regulation of O2/CO2 gas exchange, this is the central respiratory drive that is lost during sleep due to autonomic dysfunction, which is controlled by the hypothalamus.

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

Annual Reviews › doi › pdf › annur...

Central Regulation of Respiration by Endogenous ... - Annual Reviews

The effect of supplemental dopamine on the respiratory system has been studied, it can be both helpful and harmful. Dopamine may improve respiratory muscle function. This is a big deal to me.

sciencedirect.com/science/a...

People on this forum like us to cite our sources, not sure if they ever read them though 😉

Great area to investigate. Thanks

SE

[Hidden in reply to SilentEchoes]

everyone likes a cite i just sometimes forget i also dont fix typos because its too hard to....my chest wall muscles are dopamine responsive but barely i still stay at FEV1 = 48%........the flu or a cold even and im done for....dopamine is everywhere in the body, even the rods and cones of the eye. some dr say that its overkill to blame so much on PD i stay with dr's that know it effects almost every system in the body in one way or another......cheers!

[Hidden in reply to Hidden]

when you pass into REM sleep you begin to breathe more with the diaphragms than the chest wall but pwp often have trouble with rem sleep and thus dont expel co2 due to diaphragmatic rigidity thats why o2 supplentation can be contraindicated i hsave a bolus the size of a grapefruit in my right lung all built up co2......fun! cheers!

[SilentEchoes in reply to Hidden]

Do you have other dx besides PD? Are you on a ventilator? At 48% VC you're in big trouble. If you're not on a ventilator you need to be. Follow Dr. Bach's protocol to get your oxygen up. My FVC improved 10%.

Dr. Bach is doing telemedicine, but you need a referral to see him.

SE

[Hidden in reply to SilentEchoes]

my o2 stats stay at 98%...iknow im in troublw my last pulmo said "theres nothing we can do"........thats what he said...that was fun....

[Hidden in reply to Hidden]

i also have a tumor over the medula of my left adrenal gland but by now most folks realize sinemet is asssocited with cancer.....especially skin......i get screened every year......

Privacy tips

[SilentEchoes in reply to Hidden]

I think most people don't know sinemet is associated with cancer. Doesn't surprise me though.

[Hidden in reply to SilentEchoes]

COPD...parkinsons induced.....RLD, restrictive lung disease parkinsons induced, asthma...pd induced thats the package. all dopamine responsive. cheers.

[Hidden in reply to SilentEchoes]

im also on bipap to breathe .........pd is relentless , do all the alchemy you want but at a certain point .......you know its time...im 52...........im done .....i always say "im on dog time" my 2 chi hua huas go....i go........we have assisted suicide in colorado..i sure as helll aint going to slowly suffocate over the next 5 years.....REALITY BITES ......cheers

[Hidden in reply to Hidden]

my granfater had pd my uncle and my cousin all maternal side......ive lived with it my whole life...52 yrs.....cheers! oh and my first symptom was right foot drag at age 26.....i have used roundup been a welder annd welding on glavanized steel that produces zinc oxide, worked in the oilfield and drank wellwater ...i tick all the big boxes ......not to mention masssive trauma during chilhood , my dad used to drug me with dextromathorpin to put me out and i now have olney's lesions on the brain which result from high dose DM dosing.........

[SilentEchoes in reply to Hidden]

💔

[rideabike in reply to Hidden]

Some father be was!....You're endurance levels have been incredible and when we hear this makes us want to cheer each other on even more. We're ALL survivors and a gift to someone.

[Hidden in reply to rideabike]

Thank you for saying that.

[rideabike in reply to Hidden]

I have developed SOB and await a pulmonary function test. Sometimes it's worse than others. This thread is interesting and I agree with your statement that PD, atypical types, dystonia, and I'll add MS, are all part of the same thing. So many symptoms are very similar and some of us fall between too many cracks for a definite diagnosis. It would be even more baffling if it weren't for HU and posts like yours and many others. Had too much exposure to poisons over a lifetime but lots in my younger years especially and I'm the only one in my family with celiac and food allergies.

[Hidden in reply to rideabike]

yes MS for sure....

[LindaP50 in reply to SilentEchoes]

I glance at and sometimes read the information provided by links for sources.

[Rhyothemis]

I am interested in this topic for a few reasons. I'm on this forum since my father had Multiple System Atrophy and I have dysautonomia symptoms (there is a lot more research on PD than MSA).

Last summer my daughter was hospitalized for intractable vomiting. She was put on Reglan and unfortunately she had an adverse reaction - neuroleptic malignant syndrome which results from a massive drop in dopamine . During the episode she experienced shortness of breath and her lips turned blue; she continued to be able to talk and was not confused, however. Ever since I was curious to know what happened and began researching hypoxia; I had also studied metabolic dormancy (estivation/hibernation) for my master's thesis years ago and was familiar with some aspects of hypoxia in other animals. I learned about altitude sickness and 'happy hypoxia' sometime in December and now there is increased interest in the topic due to the pandemic.

There is a lot of interaction between dopamine and hypoxia and I am just starting read up on it (I had been spending much of my time researching Celiac and Oral Allergy Syndrome and how to deal with them as they were the cause of my daughter's illness).

[SilentEchoes in reply to Rhyothemis]

I'd love to pick your brain!

I don't carry Mendelian Parkinson's genes, this is environmental. I found out I'm heterogeneous for the Park9 gene, it's a missense mutation "of unknown significance" it's an ALS vulnerability gene, benign by itself, but when triggered by hypoxia....I had a brain SPECT, the radiology report said "toxic, hypoxic encephalopathic process" this is a blind read, they don't know the history of the person.

I was able to equate organophosphate poisoning to cyanide poisoning, same biological process. Cyanide (and OP) is an asphyxiant. That's why acutely poisoned people (and animals) die of respiratory failure. My poisoning was subacute, the neighbors cattle died. They threatened to sue me if I make this information public. Oops.

FYI, John's Hopkins calls Sarin, cyanide and Sarin causes lymphoma. If anyone is on the fence about the extreme hazard of Roundup, maybe this will change your mind. Maybe this is why Sharon Crayn unceremoniously said I'm fkd. It would be a mistake to bet against me 🙂

Researchers seem more willing to link Parkinsons with pesticides than ALS. My job is to link ALS with PD.

I'm so grateful to have an online home to share what I know 💕

SE

[Hidden in reply to SilentEchoes]

ive used organophosphates for mosquito control....i used a respirator but thats not perfect in the field. i think ALS and PD and PD + syndromes etc will eventually be apart of a spectrum as opposed to individual diseases..............

[Rhyothemis in reply to SilentEchoes]

Pick away (slim pickins at the moment)

rhyobrain.blogspot.com/

~

Do you know what happened to the OP 'Hidden'? I am sad to see them go so soon after I first encountered them on here; I can't remember their screen name ...

[SilentEchoes in reply to Rhyothemis]

BrerTerrapin replied to you in Breathing abnormalities in Parkinsons

No idea why he left, checked and his account is indeed deleted.

I'm in Minnesota, we're under siege. When I get my head back in the game, I'll reach out to you. Keep safe.

[shakymum]

what do you mean by "perception of breathing can be heightened or lowered making the individual feel more SOB than they appear. " ? do you mean my body is actually not lacking oxygen when i feel SOB?

thanks,

jackie

[Hidden in reply to shakymum]

thats what my neuro says....you reatain some CO2 and it sends signals to the brain "we need more o2" and even though your o2 stats are good you feeling sob or short of breath.....

[SilentEchoes in reply to Hidden]

Methemoglobin prevents oxygen from being used by the RBCs. Oxygen levels look normal. This is the method of toxicity for cyanide.

Hydrogen cyanide is manufactured by oxidation of ammonia-methane mixtures.

atsdr.cdc.gov/MMG/MMG.asp?i...

How can Roundup/Glyphosate biologically act like cyanide?

The active ingredient in Roundup is N-(Phosphonomethyl)glycine isopropylamine.

I'm not a chemist, but the first thing I see is nitrogen (N).

Phosphono is a prefix indicating the presence of the group –P(=O)(OH)2, an organophosphorus containing compound - which are nerve agents and insecticides ☠

Organophosphates are inhibitors (prevent the activity) of the enzyme acetylcholinesterase that breaks down acetylcholine and other cholinergic neurotransmitters causing neuromuscular disorders like ALS.

Methyl (methyl group; Me): A molecular structure equivalent to methane minus one hydrogen atom. We've all heard of methane gas and methyl alcohol. ☠

Glycine is an amino acid; as a neurotransmitter, glycine both stimulates and inhibits cells in the brain and central nervous system, affecting cognition, mood, appetite and digestion, immune function, pain perception, and sleep. Glycine is also involved in the production of other biochemicals that influence these body functions.

It has been asserted that Glyphosate (N-(Phosphonomethyl)glycine) the so called active ingredient in Roundup, substitutes for glycine in polypeptide chains leading to protein misfolding and toxicity.

Formaldehyde, classified as a known human carcinogen and and N-nitrosoglyphosate, have been identified as toxicologically relevant impurities in glyphosate. N-Nitrosoglyphosate, "belonging to a group of impurities of particular concern as they can be activated to genotoxic carcinogens."

Glyphosate is always attached to a carrier for solubility, Monsato exclusively uses isopropylamine (also used to make Sarin).

Isoproplyamine (MIPA) is created by chemically reacting isopropyl alcohol (isopropyl) and ammonia (amine).

Earlier we saw that hydrogen cyanide (HCN) is manufactured by oxidation of ammonia-methane mixtures.

The methane (methyl group) comes from glyphosate and the ammonia comes from the carrier isoproplyamine.

New research (5/15/20) suggests that exposure to glyphosate, the active ingredient in the most commonly used pesticide worldwide (Roundup), may be a risk factor in the development of Parkinson’s Disease.

beyondpesticides.org/dailyn...

beyondpesticides.org/resour...

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

So what can we do? I found a supplement that might be a game changer now that the biological process is understood.

ijpsonline.com/articles/can...

SE

[Hidden in reply to SilentEchoes]

nice!