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Stress Response

March 21, 2011

Although often unrecognized by Medicine, Parkinson’s patients struggle with a poorly regulated stress response. As a disruption of the endocrine system’s “fight or flight” circuitry, it becomes more and more evident as the disorder progresses. It seems more common as a problem associated with Young Onset and is generally seen as a dysregulation of the hypothalamus – pituitary – adrenal complex (the HPA axis).

When it is recognized it is often dismissed as another symptom to be papered over with anti-depressants. It is seldom accepted for what it is – one of the primary processes leading to YOPD.

In the later stages of the disorder, this disrupted stress response can become more of a problem than the motor symptoms generally thought to be the hallmarks of PD. When one looks at the broader picture presented here, several points become more and more evident-

  • Dysfunctional stress response is a defining feature of YOPD and differentiates it from Senior Onset.
  • Many of the non-motor symptoms arise from the dysregulation of the HPA.
  • The same chain of events that lead to the immune/inflammatory aspects of PD also produce this endocrine/HPA disfunction.
  • The two systems, immune and endocrine, at some point begin to interact in an amplifying feedback loop and the disorder spins out of control. This can be triggered by challenge to either system. It is common for PWP to report an immune challenge such as influenza or an endocrine challenge such as the loss of a loved one in the months just before diagnosis.

It is only by addressing this paired degenerative force that we can understand PD.

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