What is a Neurodegenerative Disorder?
Neurodegenerative Disorders
A neurodegenerative disorder is a disease in which parts of the brain, spinal cord or nerves gradually break down over time.
These disorders typically worsen over time, and there are currently no cures.
Some of the best-known conditions with neurodegenerative features are Alzheimer’s disease, Parkinson’s disease, amyotrophic lateral sclerosis (ALS) and multiple sclerosis (MS).
How Common Are Neurodegenerative Disorders?
More than 7 million Americans are living with some form of neurodegenerative disease. By 2030, an estimated 1 in 5 Americans over age 65 will be living with a neurodegenerative disease (1).
About 1.1 million Americans are living with Parkinson’s disease, and nearly 90,000 are diagnosed each year (2).
The risk of developing a neurodegenerative disease rises with age, so as people live longer, more people are affected.
What Causes Neurodegenerative Disorders?
The exact causes of neurodegenerative disorders are still not known. Research has revealed a great deal about how these diseases develop and progress, but their causes, and treatments that can stop them, remain elusive (3).
In Alzheimer’s and Parkinson’s diseases, the body fails to properly clear certain proteins. These proteins build up and gradually disrupt communication between nerve cells, eventually leading to the death of brain tissue (4, 5).
In multiple sclerosis, the immune system attacks myelin, the protective coating around nerve fibers. This disrupts communication between nerve cells and, over time, can lead to the loss of nerve fibers and nerve cells (6).
In ALS, nerve cells in the brain’s motor areas can become overexcitable, which may damage the motor nerve cells that control muscles and cause them to degenerate (7).
In all of these conditions, researchers understand a great deal about how the diseases progress, but the exact causes and triggers are still being studied.
Once these diseases begin, they generally progress, with symptoms worsening over time. As more nerve cells are lost, people gradually lose function. These diseases can be disabling, and some can be life-threatening.
What Are the Symptoms of Neurodegenerative Disorders?
Symptoms vary widely, and each condition has its own typical pattern.
In conditions involving dementia, such as Alzheimer’s disease and some conditions related to Parkinson’s, one of the earliest signs is often a subtle change in memory. Some slowing of memory is a normal part of aging, but memory loss that is noticeable to you or others and keeps getting worse is a reason for a neurological evaluation (8).
In other conditions, early symptoms may include stiffness or pain in the shoulders and hips, or a loss of coordination. Balance may worsen, people may feel unsteady, and they may start dropping things or bumping into things (9).
As these conditions progress, people may develop personality changes and trouble regulating their mood, including apathy, depression, anxiety and mood swings (10).
Later symptoms can include walking problems, tremors and involuntary movements. Fall risk can rise significantly, and falls can cause serious injuries. Thinking problems can also worsen, affecting memory, attention, focus and planning. Automatic body functions such as heart rate and blood pressure may also be affected (11).
What Happens in the Brain With Neurodegenerative Disorders?
Many neurodegenerative conditions involve a buildup of abnormal proteins. In Alzheimer’s disease, a protein called beta-amyloid builds up into clumps called plaques between nerve cells, and a protein called tau forms tangles inside nerve cells. Both disrupt communication between nerve cells, which gradually die. Certain versions of the APOE gene, especially APOE4, raise the risk of Alzheimer’s disease (12).
Parkinson’s disease is somewhat similar. A protein called alpha-synuclein builds up in clumps inside nerve cells that produce dopamine and gradually destroys dopamine pathways. A small share of cases are directly caused by genetic changes, but most involve a mix of genetic and other factors. Because dopamine pathways are critical for movement, this leads to problems with movement control, tremor and balance (13).
In multiple sclerosis, the immune system wrongly attacks myelin, the insulation around the long fibers that nerve cells use to communicate. This disrupts communication and can lead to a gradual loss of nerve tissue (6).
ALS appears to involve a process called glutamate excitotoxicity. Glutamate is a brain chemical that stimulates nerve cells to fire. Too much glutamate can overstimulate nerve cells and damage or kill them. In ALS, nerve cells in the brain’s motor pathways may become overactive and drive the motor nerve cells in the spinal cord harder than they can sustain, which damages them and causes the motor system to break down (14).
How Are Neurodegenerative Disorders Usually Treated?
Neurodegenerative disorders are usually treated with medications once they are diagnosed (15, 16, 17, 18). These medications can help manage symptoms and, in some cases, slow the disease. Medications that can cure these diseases have not yet been developed. Physical, occupational and speech therapy, exercise and other supportive care are also important parts of treatment.
How the NeuroRescue Program Can Help
We focus on the person, not just the disorder. We do not claim to cure neurodegenerative conditions, and that is not the goal of our care. The NeuroRescue Program is about making the most of the nervous system that has not yet been affected by the disease. Our care works alongside your neurologist and other providers, never in place of them. Please don’t change any medication without talking with your prescriber.
Our focus is on preserving and supporting as much neurological function as possible. We work with the healthy pathways you still have and aim to improve how well they function, how long they can keep working, and how well they connect. In doing so, we may be able to help you function better in daily life.
Depending on your needs, your program may include computerized cognitive exercises (19); eye movement exercises to engage specific parts of the brain (20); electrical stimulation, applied through the skin, which has been studied for supporting brainstem function (21); laser and LED light therapy, which has been studied for supporting energy production in nerve cells (22); exercises that coordinate the eyes, neck and inner ear to support sensory integration (23); and virtual reality exercises that engage specific pathways in a safe environment (24). Transcranial magnetic stimulation, which has been studied for activating frontal lobe pathways (25), is provided at our clinic by our psychiatric mental health nurse practitioner.
Our goals include helping you improve your balance, lower your fall risk, maintain movement control and support your thinking. We cannot guarantee results, but we can guarantee our best effort. Results always depend on the condition and the individual.
How the NeuroRescue Program Works
Your NeuroRescue Program begins with your Discovery Day. We start with a detailed history of your condition and your life on a timeline. This helps us understand the factors that may have contributed to where you are now, and identify related conditions that may be making it harder to move forward. When appropriate, we may also look at metabolic factors such as gut health, oxidative stress and mitochondrial function.
We measure how your visual, vestibular and balance systems are working through computerized analysis of your eye movements, inner ear reflexes and balance under different conditions. Our testing includes videonystagmography and saccadometry to measure several types of eye movements, the video head impulse test to measure inner ear reflexes, and CAPS computerized posturography to assess your balance under different sensory conditions. We also use NeuroSensoryMotor Integration testing to evaluate hand-eye coordination and cognition, and Virtualis testing to assess dynamic eye tracking and your perception of vertical in a virtual reality environment.
We combine this with a thorough physical and neurological exam of your sensory, motor, autonomic and cognitive systems. We also review any relevant lab work, imaging and prior testing, and integrate it with our findings.
Together, this helps us understand which parts of your nervous system are working well, which are struggling, and how quickly they tire. We use that information to design your personal NeuroRescue Program, aimed at supporting function and endurance in the systems that need it. Our testing also helps us decide when to push and when to let you rest.
We can’t bring back nerve cells that have been lost. What we can do is work with the pathways that remain, helping them work as efficiently as possible and work better together. Our goal is to help you stay as active, safe and independent as possible, for as long as possible.
Your Next Step
Living with any neurodegenerative condition is challenging. While we cannot cure these disorders, many symptoms can be managed, and function and quality of life can often be supported. To find out if the NeuroRescue Program is right for you, contact one of our patient care coordinators to schedule your Discovery Day.
It’s never too late to take the next step.
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