In a landmark investment to accelerate the path to a Parkinson’s disease (PD) cure, in 2019, the Parkinson’s Foundation awarded $8 million to establish four elite Parkinson’s Foundation Research Centers: Yale School of Medicine, University of Michigan, University of Florida, and Columbia University. Each one received $2 million over four years.

In this series of articles, we will share the story of each center — their goals, successes, surprises and the future of their PD research. In this article, we check in with the Parkinson’s Foundation Research Center at the University of Michigan.

The Thalamus and Parkinson’s Disease 

Most research on how Parkinson’s affects the brain has focused on the substantia nigra. This brain region — slightly smaller than a piece of popcorn — plays key roles in regulating movement and healthy cognition.

In PD, the dopamine brain cells in the substantia nigra break down over time, leading to the progressive movement and cognitive symptoms of the disease. However, not all symptoms of PD can be explained by the loss of these substantia nigra neurons. For example, issues with gait and balance or visual dysfunction in PD do not seem to respond to dopamine therapies.  This biological puzzle led the Michigan researchers to explore how PD impacts another part of the brain – the thalamus – and how dysfunction in this part of the brain may contribute to PD symptoms, and importantly, how targeting this area for therapies could improve the lives of people living with PD. 

The thalamus is made of a pair of small, egg-shaped structures of grey matter that straddle the middle of the brain – one on the right side and one on the left. The most well-understood function of the thalamus is that it acts as a sensory “hub,” relaying signals of sight, sound, touch, and taste from the body to various regions of the cerebral cortex, the wrinkled, outer layer of the brain that provides functions like awareness, memory, and consciousness. 

However, recent research on the thalamus has hinted that it may do more than just relay sensory information. In fact, new evidence suggests that the thalamus actively modifies the signals that it sends along, playing an active role in the process connecting sensation to thought and to action.  

Looking to unravel the role of the thalamus in PD, the researchers at the Parkinson’s Foundation Research Center at the University of Michigan, led by Roger Albin, MD, Nicolaas Bohnen, MD, PhD, and Daniel Leventhal, MD, PhD, each investigated the thalamus in a different way. By taking a cross-sectional approach, this Parkinson’s Foundation funded research team developed a new, thorough and detailed way to look at how thalamic disruption impacts PD — and how to address it. 

“The Parkinson's Foundation Research Center was a chance to bring our more basic science researchers into pursuing something in an integrated topic. It was also the chance to explore something that hasn't been explored very much in Parkinson's research — the thalamus — but it's clearly an important area in neuroscience.” Dr. Albin.

Utilizing PET Scanning to Map Dopamine Neurons in the Thalamus 

The University of Michigan is home to some of the most advanced brain imaging technologies available, including Positron Emission Tomography (PET) scanning. Neuroscientists can use this technology to visualize neurons in the brain.

For Dr. Bohnen and Dr. Albin, the Research Center funding combined with PET scanning technology created a rare opportunity to map and measure neurons in the human thalamus. They sought to understand how the thalamus directs vision, balance and movement, and how its disruption could contribute to PD.

Dr. Bohnen focused on how PD affects the dopamine neurons in the thalamus. Early findings from his team found that loss of dopamine neurons in the thalamus was strongly linked to PD-like symptoms and was a better predictor of symptom severity than assessing similar changes in the substantia nigra.

“Thanks to the Parkinson’s Foundation, we have been able to use novel brain imaging tools to study chemical messenger molecules in the thalamic complex in the living brain in people with Parkinson’s and how this relates to more complex gait functions.”

For his Research Center project, Dr. Bohnen designed a larger trial to dive deeper into how thalamic dopamine neuron loss contributes to PD symptoms. He used PET scanning to measure the amount and health of thalamic dopamine neurons in participants in different stages of PD. Understanding how dopamine neuron breakdown in the thalamus coincides with PD movement symptoms could help researchers design new treatments that target this area of the brain.

Exploring the Impacts of Acetylcholine  

Another important signaling molecule used in the brain is acetylcholine. Neurons that communicate using acetylcholine are called cholinergic neurons and are the primary focus of Dr. Albin’s research project.

Cholinergic neurons in the thalamus play critical roles in visual attentional functioning - how the mind coordinates what it sees with how it reacts via movement. For example, entering a doorway requires high visual attentional function: arm movement to open the door must be coordinated with moving through the doorway, while also minding any step or threshold that could be tripped on.

“The work of our Parkinson’s Foundation Research Center project cemented our understanding of the importance of another major set of brain systems — the cholinergic systems — that are affected in Parkinson disease.”

Recent studies by Dr. Albin and his team found people with PD that fall more often, a dangerous and common risk of PD, had greater disruption in their thalamic cholinergic neurons. These results hinted that losing such neurons impaired those people’s visual attentional function, increasing their risk of falling.

Dr. Albin wanted to determine whether people with fewer healthy cholinergic neurons in the thalamus had more difficulty with visual attention tasks. Working with Dr. Bohnen, he designed a way to measure thalamic cholinergic neurons using PET scans, coordinated with Dr. Bohnen’s study of dopaminergic neurons.

By comparing PET scan results with participants’ performances on visual attention computer tests, he sought to determine if cholinergic neurons in the thalamus play a role in these tasks. Findings from this research could open new possibilities for future PD treatments addressing movement symptoms that are centered on acetylcholine neurons, in addition to dopaminergic ones.

Impacting Movement Symptoms

While the first two projects studied the thalamus in people, Dr. Leventhal used an animal model, the laboratory rat, to determine how PD-related changes in movement signals from other parts of the brain affect the “motor thalamus”.

The “motor thalamus” is a part of the thalamus responsible for regulating voluntary movement. It receives signals from two key regions of the brain:

• The basal ganglia: associated with initiating movement

• The cerebellum: connected to fine-tuning movement

In PD, disruptions in the function of the basal ganglia lead to movement symptoms – but we don’t exactly know how. Dr. Leventhal hypothesized that:

• Signals from the basal ganglia to the thalamus were more important for reaction time and speed than the signals received from the cerebellum.

• If he simulated PD-like neurodegeneration in rats, their reaction time would decrease as the signaling from the basal ganglia to the thalamus declined.

Pinpointing where the movement signal coordination occurs in the thalamus could guide new deep-brain stimulation (DBS) targets. Having new thalamic DBS treatment options could make DBS an option for more people with PD, granting them new opportunities to address their movement symptoms and improve their quality of life.

Mining Mountains of Data for Parkinson’s Breakthroughs

As with nearly all clinical research, the COVID-19 pandemic led to delays in Research Center projects. However, the Parkinson’s Foundation supported University of Michigan researchers to wait until it was safe to begin their studies.

“The Parkinson’s Foundation support was essential in maintaining our critical research infrastructure and personnel during the COVID-19 pandemic. This allowed us to compete successfully for major extramural funding, including a Udall Center grant and a major grant from the Farmer Family Foundation.” Dr. Albin.

Additionally, the Research Center grant helped Dr. Bohnen and Dr. Albin form an international collaboration with PD researchers at the University of Groningen in the Netherlands. These collaborators, led by Teus van Laar, MD, PhD, were coincidentally running a similar clinical study called the Dutch Parkinson Cohort (DUPARC), also performing imaging collection with people with PD in northern Netherlands. By combining the University of Michigan data with DUPARC data, both groups significantly expanded their datasets.

With so much data available, the researchers are still deep in analysis, but some breakthroughs have emerged and have been published in major scientific journals. In particular, the cholinergic research has revealed how acetylcholine neurons across the brain decline over normal aging as well as in PD, charting degeneration patterns that researchers had never fully mapped before. By understanding how these neurons break down both with and without the influence of PD, scientists can better understand how the disease affects or accelerates that process and how to better slow or stop it.

Some early symptomatic correlations with cholinergic neurons have been discovered as well. Dr. Bohnen and Dr. Albin identified specific brain regions —inside and outside the thalamus — that are important for gait and balance. In those regions, when cholinergic neurons were impaired, there were greater issues with posture and movement coordination. These results break ground for new treatments to be developed that target those regions to help with balance and gait symptoms.

Dr. Leventhal’s research into the motor thalamus using rats is still ongoing, with results soon to be reported. In the meantime, his project has inspired collaborations with other researchers at the University of Michigan, investigating other dopamine neuron dynamics in rats with Christian Burgess, PhD, and identifying new brain feedback signals that could guide DBS placement during surgery with Enrico Opri, PhD.

“There is so much exciting research across disciplines right now. I teach a class on PD research to undergraduates and am amazed at how much I have to update the curriculum every year.”

A Research Center Becomes a Launchpad for PD Research 

Research projects, especially clinical studies involving complex imaging, require significant time and funding. The Parkinson’s Foundation Research Center designation and its stable and long-term support allowed researchers to embark on this ambitious PD research effort.

The early results from these studies, and the many breakthroughs still to come from the analysis of the collected data, show how critical this support is in driving PD research toward new treatments. Their projects have revealed new insights about how PD affects neurons in the thalamus and the brain overall, guiding future treatment design to improve symptoms.

“We are on the cusp of understanding at a deep computational level how the brain regions affected by PD normally interact with each other, and how that changes in PD. Armed with that understanding, I am hopeful that we can more efficiently restore motor and nonmotor function with fewer side-effects to people with PD.”

University of Michigan researchers have developed a launchpad of PD research that spans not just their institution, but across the world. As their scientific work continues, their findings will propel the university and the greater PD research community toward new treatments and, someday, a cure.

Learn More

The Parkinson’s Foundation works to improve care for people with PD and advance research toward a cure. Learn more with these resources:

• Read the first article in this series: From Parkinson’s Foundation Research Center to Powerhouse: How Yale Became a Leader in Parkinson’s Science.

• Discover how we are working to close gaps in knowledge about PD: Advancing Research.

• Learn about and enroll in PD GENEration — a global genetics study that provides genetic testing and counseling at no cost for people with Parkinson’s.

• Explore ways to get involved in the Parkinson’s Foundation — from becoming a research advocate to joining a research study.

Integrative medicine combines evidence-based medicine with proven complementary therapies and functional medicine, treatment that seeks to treat the whole person, to manage Parkinson’s disease (PD) symptoms. Explore how non-drug treatments — such as massage, acupuncture, red light therapy and CBD — are sometimes used to support well-being alongside traditional Parkinson’s care. 

The following article is based on a Parkinson’s Foundation Expert Briefing exploring complementary therapies and holistic medicine in Parkinson's care, hosted by Britt Stone, MD, assistant clinical professor, Movement Disorders division, Department of Neurology at Vanderbilt University Medical Center (VUMC), a Parkinson's Foundation Center of Excellence, and clinical operations director for VUMC’s main campus neurology clinics. 

Bridging Modern Medicine and Complementary Care 

Traditional Western-medicine therapies include care your neurologist might prescribe, whether levodopa or other prescription medications, physical or occupational therapy or psychiatry referrals or a home health aide recommendation. 

Integrative medicine blends medicine with proven complementary therapies to encourage optimal well-being.  

• Functional medicine falls under the umbrella of integrative medicine; it seeks to identify the root cause of illness and treat the entire person through a personalized care plan.  

• Complementary therapies are a component of functional medicine — these can include mindfulness, art or dance therapy or other treatments. 

Taking a Deeper Look at Functional Medicine 

Living well with Parkinson’s requires ongoing management — the right medications, dedicated exercise, a balanced diet and the ability to adapt to changing needs. Functional medicine also takes whole-body approach to care, with an emphasis on sustained nutrition, gut health and lifestyle factors. 

At its core, functional medicine incorporates habits, routines and rhythms into daily living that contribute to overall health. From there, specific therapies to target individual needs are integrated into a care plan. These might include tailored exercise, supplements or herbal remedies or other complementary therapies.  

Functional medicine can also include laboratory or diagnostic testing to uncover whether factors such as genetics or environmental exposures, including allergens, are impacting body function. Lab testing, which is not always covered by insurance, could include screening for environmental mold or other toxins in the body or assessments of:  

• Vitamin and mineral levels 

• Gut health 

• Inflammatory markers 

• Food sensitivities 

To some extent, genetics, environment, previous illnesses, social and behavioral factors influence the health outcomes of every person. Functional medicine considers all these aspects and aims to slow disease progression and optimize quality of life. 

Complementary Therapies 

Parkinson’s can cause various non-movement symptoms — including stiffness, pain, anxiety, sleep and mood changes — and medications might not relieve them all. Non-drug complementary therapies have been moving into mainstream use for Parkinson’s symptom management, particularly for symptoms that don’t respond as well to prescription medications. 

Certain complementary therapies that foster social connections and creativity while promoting purpose and play have been shown to improve quality of life. A 2020 meta-analysis showed that dance improved movement and non-movement symptoms and quality of life in people with Parkinson’s. A 2013 six-week clay art therapy program for Parkinson’s showed a decrease in depression, stress and obsessive-compulsive thinking among participants.  

Some complementary therapies are rooted in Chinese philosophy and medicine and the concept of chi, or qi — the energy or life force that animates a person. Sluggish or deficient chi is thought to cause illness. Mind-body breathwork, such as Tai Chi and qigong, used to improve balance, function and mood in Parkinson’s, aims to improve energy flow. 

Other therapies include: 

Acupuncture: One study showed acupuncture, which also aims to balance energy flow, could possibly relieve musculoskeletal pain in Parkinson’s. Other case reports and clinical studies show that acupuncture may improve activities of daily living for people with Parkinson’s. Dry needling, a physical therapy technique used to ease pain, speed healing and improve movement, also uses small thin needles, but the technique is different and the goal is targeted muscle treatment, rather than improved energy flow. 

Massage: It is used to boost relaxation and ease muscle spasms and cramps. A 2020 review looking at 12 studies of massage therapy and its benefits in Parkinson's found that:  

• Multiple types of massage induced relaxation. 

• Participants reported improvements in mood, fatigue, sleep and pain.  

• Some research shows neuromuscular types of massage, including shiatsu, tuina and Thai neuromuscular massage, might improve motor symptoms.   

A 2020 review of 12 massage therapy studies and its benefit on Parkinson's symptoms, found that:  

• Multiple types of massage induced relaxation  

• Participants reported improvements in mood, fatigue, sleep and pain.  

• Some research shows neuromuscular types of massage, including shiatsu, tuina and Thai neuromuscular massage, might improve movement symptoms.   

Red-light therapy: Emerging research shows low-level red-light therapy, also called photobiomodulation, may hold neuroprotective potential for Parkinson’s. However, more studies are needed. The potential health benefits of red-light therapy were discovered by NASA scientists who, when experimenting with light-emitting diodes to boost plant growth, noticed the lights also sped up wound healing.  

Red-light therapy is currently used as part of photodynamic therapy in dermatology to treat certain types of skin cancer (the red light activates a photosensitizing drug). It is also used to treat psoriasis and acne. Red-light therapy is thought to work by stimulating the mitochondria in the cells being treated, leading to more efficient cellular activity and new cell growth. It is important to protect the eyes when using any sort of red-light therapy. 

Cannabidiol (CBD): This compound is found in hemp and marijuana cannabis plants and interacts with the body's endocannabinoid system. CB1 and CB2 receptors, key components of this system, are involved in communication between brain cells and gut and immune system health. 

There are higher concentrations in marijuana of THC, the compound that gets people high. Hemp is typically rich in CBD, a compound that may be helpful for sleep, anxiety or pain, though more research is needed. Epidiolex is a prescription form of CBD, approved by the Food and Drug Administration to treat certain types of seizures.  

Medical and recreational marijuana legalization varies by state. There can be safety considerations, depending on your symptoms or medications you may be taking.  

Working Complementary Therapy into Your Routine  

Creating a personalized, balanced plan to manage Parkinson’s can help you maintain independence. Complementary therapies, therapeutic touch, a practitioner who listens to you, downtime and mindfulness can all benefit quality of life and improve sense of wellness.  

When deciding what therapies might benefit you, think about your goals and what symptoms bother you the most. Have an open conversation with your healthcare team and discuss what treatment options are available. Talking about potential therapies with your doctor can help you avoid potential interactions and ensure the best outcomes. Connecting online or in person with people in the Parkinson’s community can also give you an opportunity to talk about what has worked for others and share your own experiences.   

Consider therapies that align with your needs that are also accessible, affordable and manageable. Add in one new thing, observe the effects or benefits and adjust or change plans, with input from your healthcare team, as needed. 

Learn More  

Explore our resources about complementary therapies and symptom management in Parkinson’s:   

• Top Takeaways About Complementary Therapies and PD 

• A Beginner's Guide to Managing Pain Through Mindfulness 

• Over the Counter & Complementary Therapies 

La medicina integrativa combina la medicina basada en la evidencia con terapias complementarias de eficacia comprobada y la medicina funcional; tratamiento que pretende atender a la persona en su totalidad, para controlar los síntomas de la enfermedad de Parkinson (EP). Explore cómo los tratamientos no farmacológicos, como los masajes, la acupuntura, la terapia con luz roja y el CBD, se utilizan a veces para favorecer el bienestar junto con los cuidados tradicionales del Parkinson. 

El siguiente artículo se basa en una de las Charlas con Expertos - Expert Briefings  de la Parkinson's Foundation, que explora las terapias complementarias y la medicina holística en el cuidado del Parkinson, presentada por la Dra. Britt Stone, profesora clínica adjunta, división de Trastornos del Movimiento, Departamento de Neurología en el Vanderbilt University Medical Center (VUMC, por sus siglas en inglés), un Centro de Excelencia de la Parkinson's Foundation y directora de operaciones clínicas para las clínicas de neurología del campus principal de VUMC. 

Un puente entre la medicina moderna y los cuidados complementarios 

Las terapias tradicionales de medicina occidental incluyen los cuidados que pueda recetar su neurólogo, ya sea levodopa u otros medicamentos recetados, fisioterapia o terapia ocupacional o psiquiatría o la recomendación de un asistente de salud a domicilio. 

La medicina integrativa combina la medicina con terapias complementarias de eficacia probada para fomentar un bienestar óptimo.  

• La medicina funcional se engloba dentro de la medicina integrativa; busca identificar la causa raíz de la enfermedad y tratar a la persona en su totalidad mediante un plan de atención personalizado.  

• Las terapias complementarias son un elemento de la medicina funcional: pueden incluir atención plena (mindfulness), terapia artística o de danza u otros tratamientos. 

Una mirada más profunda a la medicina funcional 

Vivir bien con Parkinson requiere un manejo continuo: los medicamentos adecuados, ejercicio estructurado, una dieta equilibrada y la capacidad de adaptarse a las necesidades cambiantes. La medicina funcional también adopta un enfoque integral de la atención, haciendo hincapié en factores constantes de nutrición, salud intestinal y estilo de vida. 

En esencia, la medicina funcional incorpora a la vida diaria hábitos, rutinas y ritmos que contribuyen a la salud general. A partir de ahí, las terapias específicas para atender las necesidades individuales se integran en un plan de cuidados. Éstos pueden incluir ejercicios adaptados, suplementos, hierbas medicinales u otras terapias complementarias.  

La medicina funcional también puede incluir pruebas de laboratorio o diagnósticas para descubrir si factores como la genética o la exposición ambiental, incluidos los alérgenos, influyen en el funcionamiento del organismo. Las pruebas de laboratorio, que no siempre cubre el seguro, podrían incluir la detección de moho ambiental u otras toxinas en el organismo o evaluaciones de:  

• Niveles de vitaminas y minerales 

• Salud intestinal 

• Marcadores inflamatorios 

• Sensibilidad alimentaria 

Hasta cierto punto, la genética, el medio ambiente, las enfermedades previas y los factores sociales y de conducta influyen en los resultados de la salud de cada persona. La medicina funcional toma en cuenta todos estos aspectos y busca ralentizar la progresión de la enfermedad y optimizar la calidad de vida. 

Terapias complementarias 

El Parkinson puede causar diversos síntomas no motores, como rigidez, dolor, ansiedad, sueño y cambios de humor, y es posible que los medicamentos no los alivien todos. Las terapias complementarias no farmacológicas se han ido generalizando para el tratamiento de los síntomas del Parkinson, sobre todo para aquellos que no responden tan bien a los medicamentos recetados. 

Ciertas terapias complementarias que fomentan las conexiones sociales y la creatividad al tiempo que promueven el propósito y el juego han demostrado mejorar la calidad de vida. Un metaanálisis de 2020 demostró que el baile mejoraba los síntomas motores y no motores y la calidad de vida en personas con Parkinson. Un programa de seis semanas de arteterapia con barro para Parkinson mostró una disminución de la depresión, el estrés y el pensamiento obsesivo-compulsivo entre los participantes.  

Algunas terapias complementarias están basadas en la filosofía y la medicina chinas y en el concepto de chi o qi, la energía o fuerza vital que anima a una persona. Se cree que un chi lento o deficiente provoca enfermedades. El trabajo de respiración mente-cuerpo, como el Tai Chi y el qigong, utilizados para mejorar el equilibrio, el funcionamiento y el estado de ánimo en el Parkinson, busca mejorar el flujo de energía. 

Hay otras terapias como: 

Acupuntura: Un estudio demostró que la acupuntura, que también busca equilibrar el flujo de energía, podría aliviar el dolor musculoesquelético en el Parkinson. Otros informes de casos y estudios clínicos muestran que la acupuntura puede mejorar las actividades de la vida diaria de las personas con Parkinson. La punción seca, una técnica de fisioterapia utilizada para aliviar el dolor, acelerar la curación y mejorar el movimiento, también utiliza pequeñas agujas finas, pero la técnica es diferente y el objetivo es el tratamiento del músculo específico, en lugar de mejorar el flujo de energía. 

Masaje: Se utiliza para aumentar la relajación y aliviar los espasmos y calambres musculares. Una revisión de 2020 que analizaba 12 estudios acerca de la terapia de masaje y sus beneficios en el Parkinson descubrió que:  

• Múltiples tipos de masaje inducían relajación. 

• Los participantes reportaron mejoras en el estado de ánimo, la fatiga, el sueño y el dolor.  

• Algunas investigaciones demuestran que los tipos de masaje neuromuscular, como el shiatsu, el tui na y el masaje neuromuscular tailandés, podrían mejorar los síntomas motores.   

Terapia de luz roja: Las nuevas investigaciones muestran que la terapia con luz roja de bajo nivel, también llamada fotobiomodulación, puede tener un potencial neuroprotector en el Parkinson. Sin embargo, se necesitan más estudios. Los beneficios potenciales para la salud de la terapia con luz roja fueron descubiertos por científicos de la NASA que, al experimentar con diodos emisores de luz para estimular el crecimiento de las plantas, observaron que las luces también aceleraban la cicatrización de las heridas.  

La terapia con luz roja se utiliza actualmente como parte de la terapia fotodinámica en dermatología para tratar ciertos tipos de cáncer de piel (la luz roja activa un fármaco fotosensibilizante). También se utiliza para tratar la psoriasis y el acné. Se cree que la terapia con luz roja actúa estimulando las mitocondrias de las células tratadas, lo que conduce a una actividad celular más eficaz y al crecimiento de nuevas células. Es importante proteger los ojos cuando se utiliza cualquier tipo de terapia con luz roja. 

Cannabidiol (CBD): Este compuesto se encuentra en las plantas de cannabis como cáñamo y marihuana e interactúa con el sistema endocannabinoide del organismo. Los receptores CB1 y CB2, componentes clave de este sistema, intervienen en la comunicación entre las células cerebrales y la salud intestinal e inmunitaria. 

En la marihuana, hay mayores concentraciones de THC, el compuesto que produce un efecto psicoactivo. El cáñamo suele ser rico en CBD, un compuesto que puede ser útil para el sueño, la ansiedad o el dolor, aunque se necesita más investigación. Epidiolex es una forma recetada de CBD, aprobada por la Food and Drug Administration (Administración de Alimentos y Medicamentos) para tratar ciertos tipos de convulsiones.  

La legalización  de la marihuana medicinal y recreativa varía según el estado. Puede haber consideraciones de seguridad, dependiendo de sus síntomas o de los medicamentos que esté tomando.  

Incorporación de la terapia complementaria a su rutina  

La creación de un plan personalizado y equilibrado para manejar el Parkinson puede ayudarle a mantener su independencia. Las terapias complementarias, el contacto terapéutico, un profesional que escuche, el tiempo de descanso y la atención plena pueden mejorar la calidad de vida y la sensación de bienestar.  

A la hora de decidir qué terapias podrían beneficiarle, piense en sus objetivos y en los síntomas que más le molestan. Mantenga una conversación abierta con su equipo de atención médica y analice las opciones de tratamiento disponibles. Hablar acerca de las posibles terapias con su doctor puede ayudarle a evitar posibles interacciones y garantizar los mejores resultados. Conectarse en línea o en persona con personas de la comunidad de Parkinson también puede darle la oportunidad de hablar acerca de lo que ha funcionado para otros y compartir sus propias experiencias.   

Considere terapias que se ajusten a sus necesidades y que además sean accesibles, asequibles y manejables. Añada un elemento nuevo, observe los efectos o beneficios y ajuste o cambie los planes, con la opinión de su equipo de atención médica, según sea necesario. 

Aprenda más  

Explore nuestros recursos acerca de las terapias complementarias y el manejo de los síntomas en el Parkinson:   

• Mensajes clave sobre las terapias complementarias y la EP 

• Explorando terapias complementarias para el Parkinson  

• Terapias sin receta y complementarias