Dan Rothschild is a Fairport, NY, resident along with being a Parkinson’s Foundation New York Chapter Board member, a Parkinson’s Foundation Ambassador and a Research Advocate. He has found his passion for ping pong improves his Parkinson’s symptoms and enables him to travel and share his game and PD experiences with amazing and inspiring people. Check out his story “How Parkinson’s and ping pong help me to see the world” below:
Six years ago, when I was diagnosed with Parkinson’s disease (PD), I never contemplated that the diagnosis would result in opportunities to see the world. Nevertheless, in one of my life’s great ironies, my diagnosis has resulted in travels to far flung and interesting destinations and encounters with inspiring and wonderful people, all because of the disease and a love for one of America’s least followed sports: ping pong.
Like many Americans I played ping pong as a kid, in the basements of friends’ houses, at camp, and in dorms. Most of my “training” occurred in the 1970s during my sophomore year at the University of Rochester.
Adjacent to the laundry room located in one of the dorms was a single ping pong table. My roommate, Steve, and I, would carry our laundry to the dorm, strip to our skivvies, and play for hours while the machines did their work. The larger the loads the longer we played and, despite both of us being hackers without formal coaching, we developed some pretty good ping pong skills in the process.
Fast forward to 2020 and my PD diagnosis. After absorbing the somewhat earth-shattering news, I asked my doctor how I could best help myself deal with the disease. His answer was exercise.
So, I set about filling my exercise dance card with activities that I had always enjoyed and was already engaged in such as tennis, paddle tennis, cycling, hiking, cross-country skiing and ping pong.
Why ping pong? Ping pong is a "whole-brain activity" that not only engages motor activity (e.g., agility, balance, stamina, hand-eye coordination) but also requires the brain to engage in motor planning, visual attention, visuospatial processing, strategy formation, and executive functioning.
The game also fosters social connections among players. PingPongParkinson® (PPP), founded by Nenad Bach, helps promote ping pong as a PD therapy, and now operates more than 400 chapters in 31 countries. PPP also holds an annual World Championship, six of which have been held to date.
Together with my wife, I was fortunate to attend the two most recent World Championships, in Lasko, Slovenia in 2024 and Lignano Sabbiadoro, Italy in 2025. The 2025 tournament hosted approximately 1,700 matches between more than 300 players. While play was vigorous and often intense as even players with PD want to win, players socialized and bonded with others from 26 countries, supported and encouraged one another, and were inspired and awed by one another’s abilities, heart and perseverance. Each player gained new partners to support them on their PD journey.
The magic of the World Championship experience was perhaps best expressed by Steve Welling, a participant in the 2019 and first PPP World Championship held in Westchester County, who wrote: “The ping-pong center was a place where persons with even highly visible symptoms were not judged; where persons with hidden, secret pain were finally understood; where we conversed openly, without shame, about our conditions. But mostly, where we were free to follow two of the simplest human instincts: to make new friends and play with them.”
Steve’s sentiments were embodied in each of the World Championships that I attended, and I also experience them weekly at my local PPP chapter sessions. Together with the physical, cognitive and social benefits of the game, they motivate my play and my desire to attend future World Championships, as long as health and resources permit.
Never in my wildest dreams did I think that my PD journey would include smacking a little white ball all over the world with wonderful and inspiring people!
Dan is a co-founder of the Rochester (Fairport), NY chapter of PingPongParkinson®. For more information visit www.pingpongparkinson.org. Players with PD at all skill levels are welcome. The Parkinson’s Foundation is a past sponsor of PingPongParkinson® through its Community Grants program.
Exploring Complementary Therapies and Functional Medicine in Parkinson’s Care
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:
Explorando las terapias complementarias y la medicina funcional en el cuidado del Parkinson
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:
Hi. I’m Reka Janisse, and I live with young-onset Parkinson’s disease (YOPD). My symptoms began at 39, and I was officially diagnosed at 42. I’ve learned that Parkinson’s isn’t just about tremors — it’s an unpredictable mix of over 40 possible symptoms, from bradykinesia (slowness of movement) to dyskinesia (involuntary movement of face, arms or legs) and every day can feel different. Some mornings I’m dancing on TikTok, and others I’m moving in slow motion. The key? I never let two bad days stack up.
I approach Parkinson’s like I do my fitness training: with discipline, curiosity, and a lot of humor. Alongside medication, I lean on what I call “frosting therapy” — the lifestyle habits that make the whole journey more manageable. That means prioritizing exercise and focusing on muscle building as a way to fight back against symptoms.
I’m currently training to compete in my second HYROX, a high-intensity fitness competition, because mobility, strength and resilience are my best long-term strategies. Every PR (personal record) in the gym feels like a personal win over Parkinson’s.
I chose to tackle HYROX Dallas as a Parkinson's Champion, where I could design my own event. Not only will it challenge me physically, but the fundraising will help everyone living with PD. I’m interested in spreading awareness and inspiring others to take on a challenge. It’s you against you and it’s such a fulfilling and rewarding challenge especially if you do it year after year and get to work on improving your time. Considering this is a degenerative disease that is a thrilling goal to achieve!
Nutrition is another cornerstone. I’ve made it a non-negotiable to measure my meals and keep my diet steady, not out of obsession but because I know how much it impacts my energy, my gut health and even dopamine production. Food is fuel — and in my case, it’s therapy, too.
I also stay tuned into innovative approaches — like red light therapy, sauna and cold plunge therapy, and supplements — because supporting my body at the cellular level helps me manage symptoms and maintain quality of life. My main focus is to reduce oxidative stress and inflammation and improve cellular health.
Most importantly, I share this journey publicly on Instagram, Facebook, and TikTok to build awareness, reduce the stigma surrounding Parkinson’s, and bring some laughter into a space that often feels heavy. Humor is my superpower. By mixing honest education with moments of levity, I aim to show that living with Parkinson’s doesn’t mean losing joy.
I mostly rely on social media for my updates and news about Parkinson’s. I love the Parkinson’s Foundation Instagram page! Follow them on Instagram now.
My mission is to inspire and empower others, especially those diagnosed at a younger age, to take ownership of their health. Parkinson’s is part of my story, but it’s not my whole story. With movement, nutrition, community, and a little sass, I’m proving every day that you can live strong, laugh loud, and push back against this disease.
La medicación desempeña un papel fundamental en el tratamiento de la enfermedad de Parkinson (EP), pero es sólo una parte de un plan de cuidados más amplio.
El siguiente artículo se basa en una Charla con Expertos - Expert Briefing de la Parkinson's Foundation donde el Dr. Danny Bega explora cómo encajan los medicamentos en el cuidado integral y holístico del Parkinson. El Dr. Bega tiene una maestría en Ciencias, es profesor adjunto de Neurología, director médico y director del programa de residencia en Neurología del Centro de la Enfermedad de Parkinson y Trastornos del Movimiento de la Northwestern University Feinberg School of Medicine, un Centro de Excelencia de la Parkinson’s Foundation. También es director de los programas de las enfermedades de Huntington y Wilson en Northwestern.
Comprender la conexión entre la dopamina y el Parkinson
El Parkinson es un trastorno progresivo relacionado con la disminución de los niveles de dopamina, una sustancia química cerebral que influye en el movimiento, la memoria y muchos otros procesos vitales del organismo. Otras sustancias químicas del cerebro, como la norepinefrina y la serotonina, también pueden verse afectadas en la enfermedad de Parkinson e influir en los síntomas.
A medida que avanza el Parkinson, el número de células cerebrales que producen dopamina sigue disminuyendo y las células restantes luchan por almacenar y liberarla. Esto provoca lentitud de movimientos, temblores, rigidez y otros síntomas motores. También puede causar diversos síntomas no motores, como estreñimiento, pérdida del olfato y cambios en el pensamiento.
Manejo del Parkinson’s
El Parkinson es una enfermedad compleja. No existe un tratamiento estándar. Sin embargo, los medicamentos —junto con el ejercicio, la atención integral, una dieta nutritiva y prácticas de atención plena— pueden controlar los síntomas del Parkinson y ayudarle a vivir bien.
Establecer una rutina de ejercicio poco después del diagnóstico puede ayudar a ralentizar la progresión de la enfermedad y mejorar el movimiento, la fuerza, el equilibrio y el estado de ánimo. También puede ayudarle a dormir mejor. Mantenerse social e interactuar puede reducir la sensación de soledad.
Su equipo de atención es igualmente importante. Busque profesionales médicos expertos en Parkinson, incluyendo un neurólogo, un terapeuta del habla y el lenguaje, un fisioterapeuta y un terapeuta ocupacional, un trabajador social y otros profesionales de la salud, para que le ayuden a controlar los síntomas de la EP. No deje de acudir a las revisiones periódicas.
El papel de los medicamentos
La mayoría de los medicamentos para el Parkinson mejoran los síntomas aumentando la dopamina en el cerebro o actuando como la dopamina. La levodopa es el fármaco más eficaz para tratar los síntomas del Parkinson. En el transcurso del Parkinson, la mayoría de las personas tomarán levodopa en algún momento.
La ansiedad y la depresión también pueden ser frecuentes en el Parkinson y afectar al bienestar incluso más que los síntomas motores. Tratar estos síntomas mediante una combinación de medicamentos, como un ISRS, un IRSN o la mirtazapina, —un antidepresivo tricíclico—, junto con terapia, control del estrés y mantener la actividad física, puede reducir la discapacidad significativamente.
Las personas recién diagnosticadas de Parkinson a menudo se preguntan cuándo deben empezar a tomar la medicación. Los estudios demuestran que esperar no tiene beneficios. La mayoría de los médicos concuerdan en que debe empezar a tomar la medicación cuando los síntomas se vuelvan molestos.
Dado que no cada persona experimenta la EP de forma única, los tratamientos varían de una persona a otra, al igual que el ritmo de progresión. Sin embargo, conocer los estadios típicos del Parkinson puede ayudarle a anticiparse a los cambios:
En los primeros cinco años después del diagnóstico, es posible que los síntomas no afecten su vida diaria significativamente. Su médico podría recomendarle un ensayo clínico. La participación en la investigación del Parkinson podría darle acceso temprano a nuevos tratamientos, mejorar la atención y sentar las bases para una cura.
En un plazo de uno a diez años, conforme los síntomas empiezan a interferir con las actividades, la mayoría de las personas con Parkinson pueden esperar una respuesta duradera y constante a la medicación.
Entre cinco y 20 años después del diagnóstico, al cerebro le resulta cada vez más difícil conservar dopamina. La respuesta de su cuerpo a la levodopa puede volverse más corta y menos eficaz. Esto puede provocar fluctuaciones motoras: periodos en "on", cuando la medicación funciona bien, y periodos en "off", cuando la medicación deja de hacer efecto y los síntomas reaparecen. Es importante trabajar de cerca con su médico para ajustar el tratamiento y encontrar lo que mejor se adapte a usted.
Después de 10 o más años de vivir con Parkinson, las personas pueden experimentar problemas más importantes. Algunas personas pueden desarrollar importantes problemas de memoria y pensamiento. Problemas de equilibrio, caídas y congelamiento (la incapacidad temporal para moverse) también puede volverse un problema. Su médico puede hablarle de ajustes de la medicación o terapias farmacológicas o mandarlo a ver a un profesional médico adecuado para sus necesidades, que puede ser un neuropsicólogo, un psiquiatra, un terapeuta del habla y el lenguaje o un terapeuta ocupacional.
Tipos de medicamentos utilizados en el Parkinson
Es frecuente que las personas con Parkinson tomen una variedad de medicamentos, en distintas dosis y momentos del día, para manejar los síntomas. Esto puede incluir:
Agonistas de la dopamina: al principio, los fármacos que estimulan la dopamina en el cerebro, como el pramipexol, el ropinirol y la rotigotina, a menudo pueden tratar los síntomas motores del Parkinson. Los agonistas de la dopamina presentan menos riesgo de discinesias, movimientos erráticos involuntarios que suelen comenzar tras unos años de tratamiento con levodopa.
Los efectos secundarios pueden incluir náuseas, mareos, somnolencia, confusión y trastornos del control de los impulsos, como compras compulsivas, juegos de azar, comer en exceso y los impulsos sexuales. Los estudios muestran que un 28% de las personas con Parkinson dejan de tomar agonistas de la dopamina debido a los efectos secundarios, mientras que un 40% necesita añadir otra medicación en un plazo de dos años.
Levodopa: la levodopa, el fármaco más eficaz para los síntomas motores del Parkinson, sustituye a la dopamina en el cerebro. Suele administrarse en combinación con el fármaco carbidopa para reducir las náuseas, un efecto secundario frecuente. Tomar levodopa con las comidas también puede reducir las náuseas, pero las proteínas pueden interferir en la eficacia del fármaco. Alrededor de un 2% de las personas dejan de tomar levodopa debido a los efectos secundarios, mientras que un 15% necesita añadir otra medicación a los dos años.
Las discinesias, también relacionadas con la levodopa, pueden controlarse a menudo mediante un ajuste de la dosis o mediante tratamiento directo, utilizando un medicamento llamado amantadina. Funciona bloqueando el NMDA, una sustancia química que provoca movimientos extras. La amantadina de liberación inmediata también se utiliza a veces sola para los síntomas motores del Parkinson. Existe un mayor riesgo de confusión y alucinaciones con el uso de amantadina en personas de más de 75 años. También puede asociarse a hinchazón de piernas, alteraciones de la piel y otros efectos secundarios.
Anticolinérgicos:Los medicamentos trihexifenidilo y benztropina se utilizan a veces para mejorar el temblor o las distonías (calambres dolorosos y sostenidos). Actúan bloqueando la acetilcolina, una sustancia química del cerebro relacionada con el movimiento. Sin embargo, su uso debe evitarse en personas de 70 años o más debido al riesgo de confusión y alucinaciones. Los anticolinérgicos también pueden asociarse a visión borrosa, sequedad de boca, estreñimiento y retención urinaria.
Algunos de los medicamentos que su médico podría considerar para mejorar los efectos de la levodopa son:
Inhibidores de la MAO-B: los inhibidores de la monoaminooxidasa B rasagilina, selegilina y safinamida ponen más dopamina a disposición del cerebro. Estos medicamentos pueden utilizarse solos o en combinación con la levodopa para aumentar su eficacia. Los inhibidores de la MAO-B suelen tolerarse bien, pero un 70% de las personas que los toman solos para el Parkinson necesitarán añadir otra medicación a los dosaños.
Inhibidores de la COMT: medicamentos como la entacapona y la opicapona aumentan la levodopa disponible en el cerebro al bloquear la enzima catecol-O-metil transferasa.
Antagonista del receptor A2A: la istradefilina, un antagonista de la adenosina A2A, bloquea la adenosina en los receptores A2A del cerebro para reducir el tiempo en "off" de la levodopa.
La levodopa inhaladase utiliza a menudo con la levodopa, según sea necesario, para el tiempo en "off" repentino. La apomorfina inyectable también puede utilizarse a demanda, para el alivio en tiempos en "off". Ambos medicamentos pueden aumentar el riesgo de discinesias.
Es importante trabajar con su médico para encontrar el equilibrio adecuado para usted. Su médico puede aumentar o disminuir su dosis de levodopa con base en sus síntomas. Por ejemplo, el temblor, la rigidez o los problemas de movilidad podrían beneficiarse de un aumento de la levodopa. Sin embargo, las alucinaciones, la confusión y la baja presión arterial podrían mejorar con una disminución de la levodopa.
También existen estrategias y medicamentos para controlar el babeo, el goteo nasal, los problemas de sueño, los problemas intestinales, los cambios en el pensamiento y otros desafíos del Parkinson.
¿Qué pasa si no funciona la levodopa?
Si está tomando levodopa pero no obtiene beneficios, hable con su médico. Estas son algunas preguntas que puede hacer:
¿El síntoma que le molesta no responde bien a la levodopa? ¿Podría estar relacionado con otro problema de salud?
¿Puede haber algo que esté interfiriendo en la absorción de la medicación? Algunas personas experimentan menos beneficios cuando toman levodopa con una comida alta en proteínas.
También es importante discutir si es necesario ajustar la dosis. Por ejemplo, los efectos del Sinemet, una forma de levodopa, sólo duran poco tiempo: a los 90 minutos, la mitad ha desaparecido. Su médico puede ajustar el horario y la dosis de levodopa, utilizar una formulación de acción más prolongada o recomendar tomar la medicación 30 minutos antes o 60 minutos después de comer.
Terapias avanzadas
Si se vuelve difícil controlar las fluctuaciones motoras ajustando la medicación oral, existen otras opciones para mejorar la absorción de la medicación y reducir el tiempo en "off":
La terapia con Duopa suministra carbidopa-levodopa en gel directamente al intestino a través de un tubo colocado quirúrgicamente.
La terapia con foscarbidopa y foslevodopa (Vyalev) utiliza una bomba para administrar de forma constante una forma de levodopa bajo la piel a través de un pequeño tubo llamado cánula. Se utiliza una aguja para colocar la cánula.
La terapia continua con apomorfina (Onapgo) utiliza una bomba para administrar apomorfina de forma continua a través de una fina aguja colocada bajo la piel.
Estos medicamentos requieren ajustes en el estilo de vida, instrucción para su uso y un compromiso con el buen cuidado de la piel para reducir el riesgo de irritación e infecciones.
Otras opciones además de la medicación
En ocasiones, los síntomas de Parkinson más avanzados pueden beneficiarse de otras estrategias de tratamiento, como la estimulación cerebral profunda (ECP, o DBS, por sus siglas en inglés), que consiste en implantar quirúrgicamente un generador de impulsos eléctricos conectado a electrodos colocados en el cerebro para tratar los síntomas motores del Parkinson y algunos síntomas no motores.
La ECP podría ser considerada para alguien que:
vive con la enfermedad de Parkinson clásica
tiene síntomas que responden a la levodopa
experimenta frecuentes fluctuaciones motoras y temblores, a pesar de una dosificación constante de la medicación
tiene discinesias molestas
Tras la ECP, muchas personas pueden reducir su medicación y seguir experimentando una reducción de los síntomas de la EP. La reducción de la dosis de medicamento puede llevar a menos discinesias.
El ultrasonido focalizado, una terapia no invasiva, no requiere una incisión quirúrgica. Durante el procedimiento, se dirigen ondas sonoras de alta frecuencia a una zona específica del cerebro relacionada con el temblor para aliviar el temblor de la enfermedad de Parkinson. A diferencia de la terapia de ECP, que es ajustable y reversible, los cambios por ultrasonido focalizado son permanentes.
Si tiene preguntas acerca de las opciones de tratamiento de la EP, comuníquese con nuestra Línea de Ayuda al 1-800-4PD-INFO (473-4636) opción 3 para español o en Helpline@Parkinson.org.
Aprenda más
Explore nuestros recursos acerca de medicamentos para tratar los síntomas del Parkinson:
Medication plays a key role in managing Parkinson’s disease (PD), but it’s only one part of a broader care plan.
The following article is based on a Parkinson’s Foundation Expert Briefing exploring how medications fit into integrated, holistic Parkinson’s care, hosted by Danny Bega, MD, MSCI, associate professor of neurology, medical director and director of the Parkinson's Disease & Movement Disorders Center neurology residency program at Northwestern University Feinberg School of Medicine, a Parkinson's Foundation Center of Excellence. Dr. Bega is also the director of the Huntington's and Wilson’s diseases programs at Northwestern.
Understanding the Dopamine-Parkinson’s Connection
Parkinson’s is a progressive disorder linked to declining levels of dopamine, a brain chemical that influences movement, memory and many other vital body processes. Other brain chemicals, including norepinephrine and serotonin, can also be impacted in Parkinson's disease and influence symptoms.
As Parkinson’s advances, the number of brain cells making dopamine continues to decrease, and remaining cells struggle to store and release it. This leads to slowness of movement, tremor, rigidity and other motor symptoms. It can also cause various non-motor symptoms, such as constipation, loss of smell and thinking changes.
Managing Parkinson’s
Parkinson’s is a complex disease. There is no standard treatment. However, medications — along with exercise, comprehensive care, a nutritious diet and mindfulness practices — can manage Parkinson’s symptoms and help you live well.
Establishing a regular exercise routine soon after diagnosis may help slow disease progression and can improve movement, strength, balance and mood. It can also help you sleep better. Staying social and engaged can reduce feelings of loneliness.
Your care team is equally important. Look for healthcare professionals with expertise in Parkinson’s, including a neurologist, speech-language pathologist, physical and occupational therapist, social worker and other healthcare professionals, to help manage your PD symptoms. Be sure to attend regular checkups.
The Role of Medication
Most Parkinson’s medications work to improve symptoms by either increasing dopamine in the brain or acting like dopamine. Levodopa is the most effective drug for managing Parkinson’s symptoms. During the course of Parkinson’s, most people will take levodopa at some point.
Anxiety and depression can also be common in Parkinson’s and can impact well-being even more than motor symptoms. Treating these symptoms using a combination of medication, such as an SSRI, SNRI or mirtazapine — a tricyclic antidepressant drug — along with therapy, stress management and staying active, can significantly decrease disability.
People newly diagnosed with Parkinson’s often wonder when to begin prescription medication. Studies show there is no benefit in holding off. Most doctors agree you should start medication when symptoms begin to bother you.
Because no two people experience PD in exactly the same way, treatments vary from person to person, as does the rate of progression. However, knowing the typical stages of Parkinson’s can help you anticipate changes:
In the first five years following diagnosis, you may find symptoms don’t significantly impact your daily life. Your doctor might recommend a clinical trial. Participation in Parkinson’s research can potentially give you early access to new treatments, improve care and lay the foundation for a cure.
Within one to 10 years, as symptoms begin to interfere with activities, most people with Parkinson’s can expect a long-lasting, steady response to medication.
Between five and 20 years after diagnosis, it becomes increasingly harder for the brain to store dopamine. Your body’s response to levodopa can become shorter and less efficient. This can lead to motor fluctuations — "on" periods, when medication works well, and "off" periods, when medication wears off and symptoms return. It is important to work closely with your doctor to adjust your treatment and find what works best for you.
After 10 or more years of living with Parkinson’s, a person can experience more significant issues. Some people can develop significant memory and thinking problems. Trouble with balance, falls and freezing, a temporary inability to move, can also become an issue. Your doctor can discuss medication adjustments or drug therapies or provide a referral to the right healthcare professional for your needs, which might include a neuropsychologist, psychiatrist, or a speech or occupational therapist.
Types of Medications Used in Parkinson’s
It can be common for people with Parkinson’s to take a variety of medications, at different doses and different times of day, to manage symptoms. This can include:
Dopamine agonists: Early on, drugs that stimulate dopamine in the brain, such as pramipexole, ropinirole and rotigotine, can usually treat Parkinson’s movement symptoms. Dopamine agonists pose less risk for dyskinesia — involuntary erratic movements that usually begin after a few years of levodopa treatment.
Side effects can include nausea, dizziness, sleepiness, confusion and impulse control disorders, such as uncontrolled shopping, gambling, eating and sexual urges. Studies show 28% of people with Parkinson’s stop taking dopamine agonists due to side effects, while 40% need to add another medication within two years.
Levodopa: Levodopa, the most effective drug for Parkinson’s movement symptoms, replaces dopamine in the brain. It is usually given in combination with the drug carbidopa to reduce nausea, a common side effect. Taking levodopa with meals can also reduce nausea, but protein may interfere with the drug’s effectiveness. About 2% of people taking levodopa stop due to side effects, while 15% need to add another medication within two years.
Dyskinesia, also linked to levodopa, can often be managed by a dose adjustment or through direct treatment, using a medication called amantadine. It works by blocking NMDA, a chemical that causes extra movement. Immediate-release amantadine is also sometimes used alone for Parkinson’s movement symptoms. There is an increased risk of confusion and hallucinations with amantadine use in people over 75. It can also be associated with leg swelling, skin changes and other side effects.
Anticholinergics:The medications trihexyphenidyl and benztropine are sometimes used to improve tremor or dystonia — painful, sustained cramping . They work by blocking acetylcholine, a brain chemical tied to movement. However, their use should be avoided in people 70 and older due to the risk of confusion and hallucinations. Anticholinergics can also be associated with blurred vision, dry mouth, constipation and urinary retention.
Medications your doctor might consider to improve the effects of levodopa include:
MAO-B inhibitors: Monoamine oxidase-B inhibitors rasagiline, selegiline and safinamide make more dopamine available to the brain. These medications can be used alone or in combination with levodopa to extend effectiveness. MAO-B inhibitors are generally well tolerated, but 70% of people taking them alone for Parkinson’s will need to add another medication within twoyears.
COMT inhibitors: Medications such as entacapone and opicapone increase available levodopa in the brain by blocking the catechol-O-methyl transferase enzyme.
A2A receptor antagonist: Istradefylline, an adenosine A2A antagonist, blocks adenosine at A2A receptors in the brain to reduce levodopa “off “time.
Inhaled levodopais often used with levodopa, as needed, for sudden “off” time. Injectable apomorphine can also be used on demand, for “off” time relief. Both medications can increase the risk of dyskinesia.
It is important to work with your doctor to find the right balance for you. Your doctor might increase or decrease your levodopa based on your symptoms. For example, tremor, stiffness or mobility issues might benefit from an increase in levodopa. However, hallucinations, confusion and low blood pressure might improve with a decrease in levodopa.
There are also strategies and medications to manage drooling, runny nose, sleep issues, gut issues, thinking changes and other Parkinson’s challenges.
What if levodopa doesn’t seem to be working?
If you are taking levodopa but aren’t seeing benefits, talk to your doctor. Here are some questions to ask:
Is the symptom troubling you one that doesn’t respond well to levodopa? Could it be related to another health issue?
Could something be interfering with how your body is absorbing medication? Some people experience less benefit when taking levodopa with a high-protein meal.
It is also important to discuss whether your dose needs to be adjusted. For example, the effects of Sinemet, a form of levodopa, only last a short time — after 90 minutes half of it is gone. Your doctor might adjust the timing and dose of levodopa, use a longer-acting formulation or recommend taking your medications 30 minutes before or 60 minutes after eating a meal.
Advanced Therapies
If it becomes difficult to control motor fluctuations by adjusting oral medications, there are other options to improve medication absorption and reduce “off” time:
Duopa therapy delivers carbidopa-levodopa gel directly to your intestine through a surgically placed tube.
Foscarbidopa and foslevodopa (Vyalev) therapy uses a pump to steadily deliver a form of levodopa under the skin through a small tube called a cannula. A needle is used to place the cannula.
Continuous apomorphine therapy (Onapgo) uses a pump to deliver continuous apomorphine through a fine needle placed under the skin.
These medications require lifestyle adjustments, training to use and a commitment to good skin care to reduce the risk of irritation and infections.
Options Beyond Medication
More advanced Parkinson’s symptoms can sometimes benefit from other treatment strategies, such as deep brain stimulation (DBS) — which involves surgically implanting an electrical pulse generator connected to electrodes placed in the brain to address Parkindeep-brainson’s movement symptoms and some non-movement symptoms.
DBS might be considered for someone who:
lives with classic Parkinson’s disease
has symptoms that respond to levodopa
experiences frequent motor fluctuations and tremor, despite consistent medication dosing
has bothersome dyskinesia
Following DBS, many people can reduce their medications and still experience a reduction of their PD symptoms. The reduction in dose of medication can lead to decreased dyskinesia.
Focused ultrasound, a non-invasive therapy, does not require a surgical incision. During the procedure, high-frequency sound waves are aimed at a specific area of the brain connected to tremor to relieve Parkinson’s tremor. Unlike DBS therapy, which is adjustable and reversible, focused ultrasound changes are permanent.
If you have questions about PD treatment options, contact our Helpline at 1-800-4PD-INFO (473-4636) or Helpline@Parkinson.org.
Learn More
Explore our resources about medications to treat symptoms of Parkinson’s:
2026 will be my second time running the Marine Corps Marathon as a Parkinson’s Champion, in memory of my dad. He lived with Parkinson’s disease (PD) before passing away in 2023, and not a day goes by that I don’t feel his influence guiding my steps.
I speak often of his love of his daily walks; I joke that long before I became a run streaker, he was a “walk streaker.” Three miles a day, no matter the weather, until his health no longer allowed it. Those walks were steady and intentional, just like he was.
Through his consistency, he showed me what it means to show up 100% — for those you love, for the life you’re given. He truly “walked the walk” in so many ways, and I still learn from his example.
I’ve come to genuinely appreciate the role of exercise in managing Parkinson’s symptoms. Research shows that just 2.5 hours of physical activity per week — when combined with medication — can significantly improve mobility, mood, and overall quality of life. My dad lived that research before it had a name. Long before Parkinson’s truly took its toll, he found strength, clarity and dignity in his daily walks.
For me, running is a way to process loss and carry love forward; running for the Parkinson’s Foundation has become one way that I stay connected to my dad. It’s how I honor the lessons he left behind. Every mile of training reminds me of the path he walked, both literally and figuratively.
Parkinson’s is often described as tremors or stiffness, but it’s so much more than that. It’s a relentless, unpredictable disease that affects movement, mood, sleep, speech and so much more. It reshapes daily life not only for those diagnosed, but for their caregivers and loved ones. They deserve understanding, resources, and hope, and the Parkinson’s Foundation is delivering on all three.
This marathon isn’t just about honoring Dad’s memory. It’s about supporting the millions of people still living with Parkinson’s and the families who support them daily. I often think about how different our journey might have been if we’d had access to the resources the Parkinson’s Foundation provides when my dad’s symptoms first appeared.
If this effort helps even one person feel less alone, then I’ve done well. That’s why I’ve chosen to fundraise for the Parkinson’s Foundation: because they work every day to improve care and advance research toward a cure.
My dad always showed up, day after day and step after step. Running this marathon is a way for me to do the same: for him and for everyone still traveling this road.
Run as a Parkinson’s Champion today! Help raise funds and awareness for the Parkinson’s Foundation while competing in some of the world’s most popular endurance events.
Episode 181: What to Know Before Taking Nutritional Supplements for Parkinson’s
People with Parkinson’s disease (PD) may hear, whether through word of mouth or the internet, about herbs or supplements that claim to ease PD symptoms. It’s important to recognize that nutritional supplements are not federally regulated, and there is limited research supporting their overall effectiveness. You should always speak with your healthcare provider before starting a new medication or supplement.
Nutritional supplements can include herbs, vitamins, or other drugs that are often available without a prescription. Since these products are not formally regulated, there is a high risk for potentially dangerous drug interactions when mixed with other medications, regardless of if they are prescribed by a doctor or available over the counter.
In this episode, we speak with Dr. Angela Hill, a pharmacist and professor at the University of South Florida, to better understand the precautions of taking supplements while living with PD. She discusses the potential side effects and risks of taking drugs without fully knowing what’s in their ingredients, as well as the warning signs to watch for. She shares tips for reading and evaluating labels and offers guidance on the type of questions to ask a pharmacist to help decide whether the supplement may be a good fit based on your specific health condition.
During the episode, Dr. Hill mentions additional resources for evaluating herbal medications and understanding medication timing. Click here to view the articles, along with her contact information for any follow-up questions.
Released: July 15, 2025
About Angela M. Hill, Pharm. D., CRPh
Dr. Angela M. Hill is a professor, Associate Dean of Clinical Affairs and the Project Director for WE-CARE at the Taneja College of Pharmacy at the University of South Florida. She received her doctorate in pharmacy from Florida A&M University and completed a post-graduate residency in neurology from the Neuroscience Research Foundation, Inc. of Florida. Throughout her career, she has helped patients with neurological and psychiatric disorders through her work in community and hospital pharmacy practice, specialty clinics and community boards. She has provided pharmacy services to patients being screened, treated, or involved in clinical research with Alzheimer’s disease and other dementias for the last 25+ years, and is one of the pioneering pharmacists to be involved in Memory Disorder Clinics in the State of Florida and was acknowledged by the Department of Elder Affairs and the Alzheimer’s Resource Association for her pioneering work.
Dr. Hill is the project manager for WE-CARE where she does work in clinical trial recruitment and health disparities. Dr. Hill has done research and published on a variety of topics related to her specialty areas, which include pharmacogenomic principles in psychiatric and neurological disorders. Her work and training of pharmacists, spans from the United States to other countries like Nigeria, Trinidad, Panama, and most recently Canada.
She is currently practicing at Dr. Tracy’s House, an innovative holistic health primary care practice that serves underrepresented and marginalized populations in Tampa, Florida.
Dr. Hill is the wife of Mr. Thaddeus Hill and their 10-year-old daughter, Sylvia Hill.
Exercise and staying active are essential not only for physical health but also for mental and emotional well-being, especially as a veteran living with Parkinson’s disease. This program will address how staying active can positively impact physical symptoms, mood, and overall health. Participants will learn about the benefits of exercise, discover strategies to stay active beyond traditional workouts, and explore meaningful activities that bring joy and purpose.
Hillari Olson, DPT, RYT 200
LSVT BIG®, PWR! Moves® Certified Clinician
Program Coordinator / Physical Therapist
Parkinson's Disease and Movement Disorders Program
Minneapolis VA Health Care System
Emily Hall, LCSW
Southeast PADRECC Senior Social Worker
Central Virginia VA Healthcare System
Konner Kielman, OTD, OTR/L
LSVT BIG® Certified Clinician
Occupational Therapist
Parkinson's Disease and Movement Disorders Program
Minneapolis VA Health Care System
Science News
Study Finds Potential Link Between Parkinson's and Gut Health
Inflammatory bowel disease (IBD) — conditions like Crohn's disease and ulcerative colitis — are linked to an increased risk of developing Parkinson's disease (PD), a neurodegenerative disorder affecting movement. Scientists are working to figure out why the diseases are linked, and a key player may be the community of microbes living in our gut, often referred to as the gut microbiome.
The gut microbiome is a complex ecosystem of trillions of bacteria, fungi, viruses and other microorganisms that live in our digestive system. It plays a crucial role in digestion, immunity and brain health. An imbalance in this gut microbial community, known as gut dysbiosis, can contribute to various health issues.
A recent study compared the gut microbiomes of people with Parkinson’s disease, IBD and healthy individuals. It also examined larger, publicly available microbiome data from people with Parkinson’s or IBD. This research is the first to directly compare gut microbiomes across these three groups.
Parkinson’s Foundation Scientific Advisory Board member Malú Gámez Tansey, PhD, led the study, which was published in npj Parkinson's Disease; Michael S. Okun, MD, Parkinson's Foundation National Medical Advisor, was also a study contributor. The results revealed previously unknown similarities between the gut microbiomes of people with Parkinson’s and those with IBD.
The study found a reduced number of a certain type of microbe in both people with inflammatory bowel disease and Parkinson’s, suggesting that these specific microbes may influence the risk of Parkinson’s.
Study Results
The study recruited 54 people with Parkinson’s, 24 people with IBD and 16 people without these diseases. The researchers used fecal samples and special techniques to identify the microbes that make up each participant’s microbiome. When they compared the microbes, they observed clear differences as well as certain overlaps in the species of bacteria in the guts of people with IBD and Parkinson’s compared to healthy individuals.
Additionally, in large sets of data from past studies of people with IBD or Parkinson’s, they found that even though there are unique changes in each condition, there are also specific bacteria and metabolic processes that are either more or less common in both IBD and Parkinson’s.
In people with Parkinson’s or IBD, the study found that there tended to be a decrease in the levels of certain types of bacteria known for producing short-chain fatty acids (SCFAs), which are important fuel and signaling molecules for our gut and brain. The study highlighted a few specific SCFA-producing bacteria that were lower in both the Parkinson’s and IBD groups.
Furthermore, researchers also found a reduction in the biological machinery responsible for producing the bacteria in both conditions. As SCFAs play a role in maintaining gut health and may have neuroprotective effects, these findings suggest that the depletion of SCFA-producing bacteria in people with IBD might increase their susceptibility to developing Parkinson's disease. A lack of these beneficial compounds could potentially impact brain health over time.
This research underscores the connection between our gut and our brain — often referred to as the gut-brain axis. It suggests that a healthy and diverse gut microbiome may be important for brain and gut health, and a lack of these beneficial bacteria could potentially impact brain health over time. However, more studies are needed to show whether interventions to change diet or microbiome could help with IBD or Parkinson’s.
Highlights
The study recruited 54 people with Parkinson’s, 24 people with IBD and 16 people without these diseases. The researchers used special techniques to identify the microbes that make up each participant’s microbiome. They also analyzed publicly available data from past studies of people with IBD or Parkinson’s.
They found previously unknown overlap between the gut microbiomes of people with Parkinson’s and people with IBD.
They found a decrease in the amount of certain types of bacteria known for producing short-chain fatty acids (SCFAs), which are important fuel and signaling molecules for our gut and brain, in both people with Parkinson’s and IBD.
Their findings suggest that the depletion of these important bacteria in individuals with IBD might contribute to an environment that increases their susceptibility to developing Parkinson's disease.
What does this mean?
This study has identified new shared features between the microbiomes of people with PD and IBD. Because there is a link between these two conditions, improving our understanding of the specific microbes involved in both diseases may potentially lead to new therapies.
While this research provides insights into the potential link between gut dysbiosis, IBD, and Parkinson's disease, more studies with larger sample sizes are needed to fully understand the complex mechanisms at play and whether any interventions could help.
What do these findings mean to the people with PD right now?
About 80% of people with Parkinson's experience gastrointestinal (GI) issues. These issues can develop up to 10-20 years before a PD diagnosis. Therefore, the gut microbiome is a ripe target for future treatments that could potentially stop or slow PD progression at an early stage.
However, the gut microbiome is very complex and unique to each person. If you are suffering from gastrointestinal issues, try eating more fiber-rich foods and less starchy ones, drinking more fluids and increasing exercise. Speak to your doctor before trying pro- or pre-biotic supplements that alter your gut microbiome, since they may affect people differently.
PD-related gastroparesis (the impaired ability to empty the contents of the stomach) and other GI issues can impact how medications are absorbed. People with gut issues may find PD medications such as carbidopa/levodopa take longer to take effect or seem less effective. Additionally, the medications themselves can alter the structure of your gut microbiome. Bring up any GI issues to your PD doctor who might refer you to a gastroenterologist, a doctor specializing in GI issues.
Learn More
The Parkinson’s Foundation believes in empowering the Parkinson’s community through education. Learn more about PD and the topics in this article through our below resources, or by calling our free Helpline at 1-800-4PD-INFO (1-800-473-4636) for answers to your Parkinson’s questions.
