A review of the most important neurodegenerative diseases and their symptoms.
Let’s think about the disease that scares us the most. Probably, some people have imagined cancer or AIDS, but many others have chosen Alzheimer’s, or another disorder in which there is a progressive loss of abilities (especially mental, but also physical). And the idea of losing our capacities (not being able to remember, not being able to move, not knowing who we are or where we are) is part of the deepest nightmares and fears of many.
Unfortunately, for some people it is more than a fear: it is something they are living or hope to live soon. It is about people who suffer from neurodegenerative diseases, a concept that we are going to talk about throughout this article.
What are neurodegenerative diseases?
Neurodegenerative diseases are understood to be the set of diseases and disorders characterized by the presence of neurodegeneration, that is, the progressive degradation until death of the neurons that are part of our nervous system.
This neuronal death is usually progressive and irreversible, causing a series of effects or repercussions of varying severity that can range from not having a symptomatic effect to causing the progressive loss of mental and / or physical faculties and even leading to death (for For example, due to cardiorespiratory arrest, one of the most frequent causes of death in these types of conditions).
Neurodegenerative diseases are one of the most frequent and relevant causes of disability, since progressive neurodegeneration will end up causing limitation of functions and the progressive inability to cope with environmental demands, requiring external support and different degrees of help.
The causes of this type of disorders or diseases can be multiple, with a large number of factors that can influence their appearance. The origin in question will largely depend on the neurodegenerative disease we are talking about. However, in most cases the specific causes of the appearance of these pathologies are unknown.
Among the many possible causes that are suspected for some of them that they do know, some causes are in viral diseases that are not yet curable that affect the nervous system, the presence of alterations in the autoimmune system that cause it to attack the cells of the body, trauma and / or cerebrovascular accidents (in the case of vascular dementia). An excess of some elements such as Lewy bodies, beta-amyloid plaques or neurofibrillary tangles is also observed in some dementias, although the reason for their appearance is not known.
Most common types of neurodegenerative diseases
There are a large number of diseases and disorders that can cause the degeneration and subsequent death of neurons in our nervous system. Dementias and neuromuscular diseases are usually the best known and most frequent. Below we can see some examples of some of the most common neurodegenerative diseases.
1. Alzheimer’s disease
One of the best known neurodegenerative diseases is Alzheimer’s disease, perhaps the most prototypical and prevalent problem of this type. This disease, which begins in the temporoparietal lobes and later spreads throughout the brain, has no clear known cause. It generates a dementia characterized by the progressive loss of mental faculties, memory being one of the most affected elements and the aphasic-apraxo-agnosic syndrome appearing in which the abilities of speech, sequencing and carrying out complex movements and recognition are lost of stimuli such as faces.
2. Parkinson’s disease
Parkinson’s is another of the best known and most frequent neurodegenerative diseases. In it , a progressive degeneration of the neurons of the substantia nigra and the nigrostriatal system occurs, affecting the production and use of dopamine in this pathway. The most recognizable symptoms are those of a motor type, with slowing down, gait disturbances and perhaps the best known symptom: parkinsonian tremors in resting situations.
It can end up generating dementia, in which, in addition to the above symptoms, mutism, loss of facial expression, mental slowing, memory disorders and other alterations can be observed.
3. Multiple Sclerosis
Chronic and currently incurable disease generated by the progressive demyelination of the nervous system due to the reaction of the immune system against the myelin that covers neurons. It occurs in the form of outbreaks between which there may be a certain level of recovery, as the body tries to repair the loss of myelin (although the new one will be less resistant and effective). Fatigue, muscle weakness, lack of coordination, visual problems and pain are some of the problems it causes, usually progressing in intensity over time. It is not considered fatal and has no great effect on life expectancy.
4. Amyotrophic Lateral Sclerosis
Amyotrophic lateral sclerosis is one of the most frequent neuromuscular disorders, being one of the neurodegenerative diseases linked to the alteration and death of motor neurons. As neurodegeneration progresses, the muscles atrophy until their voluntary movement becomes impossible. Over time it can affect the respiratory musculature, one of the causes being that the life expectancy of those who suffer from it is greatly reduced (although there are exceptions, such as Stephen Hawking).
5. Huntington’s chorea
The disease known as Huntington’s chorea is one of the best known neurodegenerative diseases of genetic origin. Hereditary disease transmitted in an autosomal dominant manner, it is characterized by the presence of motor alterations, such as choreas or movements generated by the involuntary contraction of muscles, its displacement being somewhat similar to a dance. In addition to motor symptoms, as the disease progresses, alterations appear in executive functions, memory, speech and even personality.
The presence of important brain lesions is observed throughout its development, especially in the basal ganglia. It usually has a poor prognosis, greatly reducing the life expectancy of those who suffer from it and facilitating the presence of cardiac and respiratory disorders.
6. Friedreich’s ataxia
Hereditary disease that alters the nervous system through the involvement of neurons in the spinal cord and the nerves that control the extremities. The most visible difficulty is coordinating movements, muscle weakness, speech and walking difficulties, and eye movement problems. The progression of this disease often makes those affected require assistance and the use of wheelchairs. It frequently occurs accompanied by heart problems.
Treatment of neurodegenerative diseases
Most of the neurodegenerative diseases are incurable today (although there are exceptions, since in some caused by infections the infectious agent could be eliminated). However, there are treatments that aim to slow the progression of these diseases and prolong the autonomy and functionality of the patient. Depending on the specific case, different medical-surgical procedures can be used that can alleviate the symptoms of the disorder or different medications that prolong the functionality of the subject.
In the first place, it must be taken into account that the same diagnosis will be a hard blow for the patient, generating a probable period of grief and adaptive problems derived from it. Anxiety and depression are likely to appear, and even acute or post-traumatic stress disorder depending on the case. In these cases, the use of psychotherapy may be necessary, adapting the strategy to each specific case. And not only in the case of the patient, but caregivers can also experience these types of problems and require professional care.
Psychoeducation for both the patient and the environment with regard to the disease and its consequences is essential, helping to reduce the level of uncertainty that they may have and providing adaptation mechanisms and strategies.
The use of neuropsychological rehabilitation, occupational therapy, physiotherapy and speech therapy is common as part of a multidisciplinary strategy to optimize and prolong the quality of life, the state, the capacities and autonomy of the patient. It also usually ends up requiring the use of external aids that can be used as compensation or replacement for lost skills such as pictograms, agendas (something as simple as this can be of great help for people with memory and planning problems for example), visual aids or movement mechanisms such as adapted wheelchairs.
- World Health Organization (2006) Neurological disorders. Challenges for public health. WHO. 45-188.