We think of the disease that scares us the most. Some people will probably have imagined cancer or AIDS, but many others will have chosen Alzheimer’s disease, or another disorder in which there is a progressive loss of capacities (especially mental, but also physical). And it is that the thought of losing our abilities (not being able to remember, not being able to move, not knowing who we are or where we are) is one of the deepest nightmares and fears of many.
Unfortunately, for some people, it’s more than a fear – it’s something they experience or hope to experience soon. These are people who suffer from neurodegenerative diseases, A concept that we will talk about throughout this article.
What are neurodegenerative diseases?
By neurodegenerative diseases is meant all the diseases and disorders characterized by the presence of neurodegeneration, that is to say progressive degradation until the death of neurons that are part of our nervous system.
This neuronal death is generally progressive and irreversible, causing a series of effects or repercussions of varying severity which can range from the absence of symptomatic effects to the progressive loss of mental and / or physical faculties and even lead to death ( e.g. arrest, one of the most common causes of death in this type of condition).
Neurodegenerative diseases are one of the most common and relevant causes of disability, as progressive neurodegeneration will eventually lead to limitation of function and progressive inability to meet environmental demands, requiring external support and varying degrees of assistance.
The causes of this type of disorder or disease can be multiple, there are a large number of factors that can influence its occurrence. The origin in question will largely depend on the neurodegenerative disease we are talking about. However, in most cases, the specific causes of the appearance of these pathologies are unknown.
Among the many possible causes suspected by some of them who know, some are found in viral diseases not yet curable that affect the nervous system, the presence of alterations in the autoimmune system that cause it to attack the own body cells, trauma and / or stroke (in vascular dementia). An excess of certain elements is also observed as Lewy bodies, beta-amyloid plaques, or neurofibrillary tangles in some dementias, although the reason for its occurrence is not known.
The most common types of neurodegenerative diseases
There are many diseases and disorders that can cause neurons in our nervous system to degenerate and subsequently die. Dementias and neuromuscular diseases are generally the best known and most common. Here are some examples of some of the most common neurodegenerative diseases.
1. Alzheimer’s disease
One of the most well-known neurodegenerative diseases is Alzheimer’s disease, which is perhaps the most typical and prevalent problem of this type. This disease, which begins in the temporoparietal lobes and then spreads throughout the brain, has no clear known cause. Generates dementia characterized by progressive loss of mental faculties, memory being one of the most affected elements and appearing the aphasic-apraxo-agnósico syndrome in which the capacities of speech, sequencing and accomplishment of complex movements and the recognition of stimuli like the faces are lost.
2. Parkinson’s disease
Parkinson’s disease is one of the best known and most common neurodegenerative diseases. in there is a progressive degeneration of the neurons of the substantia nigra and the nigroestriado system, affecting the production and use of dopamine in this way. The most recognizable symptoms are those of the motor type, with slowing down, difficulty in walking and perhaps the most well-known symptom: Parkinson’s tremors at rest.
It can end up causing dementia, Wherein in addition to the above symptoms may observe mutism, loss of facial expression, mental retardation, memory impairment and other disorders.
3. Multiple sclerosis
Chronic and currently incurable disease caused by the progressive demyelination of the nervous system due to the immune system’s reaction to the myelin that covers neurons. This occurs in the form of outbreaks between which there may be some level of recovery, depending on the body trying to repair the loss of myelin (although the new one will be less resistant and effective). Fatigue, muscle weakness, lack of coordination, visual problems and pain are some of the problems it causes, the intensity of which usually increases over time. It is not considered fatal and has no major effect on life expectancy.
4. Amyotrophic lateral sclerosis
Amyotrophic lateral sclerosis is one of the most common neuromuscular disorders, being one of the neurodegenerative diseases linked to the damage and death of motor neurons. As neurodegeneration progresses, muscles atrophy until voluntary movement is impossible. Over time, it can affect the respiratory muscles, Being one of the causes that the life expectancy of those who suffer from it is drastically reduced (although there are exceptions, like Stephen Hawking).
5. Huntington’s Korea
The disease known as Huntington’s disease is one of the best known neurodegenerative diseases of genetic cause. The inherited disease transmitted in an autosomal dominant manner, is characterized by the presence of motor disorders, such as chorea or movements generated by an involuntary muscle contraction, its movement resembling a dance. In addition to motor symptoms, as the disease progresses, alterations in executive functions, memory, speech and even personality appear.
The presence of significant brain damage is observed throughout its development, especially in the basal ganglia. It is generally of poor prognosis, considerably reducing the life expectancy of those who suffer from it and facilitating the presence of heart and respiratory problems.
6. Friedreich’s ataxia
An inherited disease that affects the nervous system through the involvement of neurons in the spinal cord and nerves that control the limbs. The most visible difficulty is coordinating movements, muscle weakness, Difficulty speaking and walking and problems with eye movement. The progression of this disease usually requires those affected to need assistance and use wheelchairs. It is often accompanied by heart problems.
Reduction of neurodegenerative diseases
Most neurodegenerative diseases today are incurable (although there are exceptions, because in some of them generated by infections, the infectious agent could be eliminated). However, there are treatments that aim to delay the progression of these diseases and to prolong the autonomy and functionality of the patient. Depending on the particular case, they can use different medico-surgical procedures which can relieve the symptoms of the disorder or various drugs which prolong the functionality of the subject.
First of all, it should be borne in mind that the diagnosis itself will be a severe blow to the patient, generating a probable period of grief and subsequent adjustment problems. Anxiety and depression are likely to appear, even a state of acute or post-traumatic stress depending on the case. In such cases psychotherapy may be necessary, Adapt the strategy to each particular case. And not only in the case of the patient, but the caregivers can also experience these types of problems and require professional care.
Psychoeducation for the patient and the environment with regard to the disease and its consequences, it is fundamental, helping to reduce the level of uncertainty they can have and providing mechanisms and coping strategies.
The use of neuropsychological rehabilitation is common, Occupational therapy, physiotherapy and speech therapy as part of a multidisciplinary strategy to optimize and prolong the quality of life, status, capacities and autonomy of patients. It also often ends up requiring the use of external aids which can be used as compensation or to replace lost skills such as pictograms, journals (something as simple as this can be very useful for people with disabilities. memory and scheduling issues). For example), visual aids or scrolling mechanisms such as adapted wheelchairs.
- World Health Organization (2006) Neurological Disorders. Public health challenges. WHO. 45-188.