Created in the early 1990s, the Movement Disorders and Neurodegenerative Diseases Clinic is the care and research unit of the International Center for Neurological Restoration (Ciren), dedicated to the study, treatment and comprehensive multidisciplinary management of patients with ailments. and lesions of the nervous system, whose main symptoms are motor and cognitive.
This is the case of Parkinson’s disease, which, fundamentally characterized by rigidity, tremor, decreased movements and the inability to control them voluntarily, along with deterioration of balance, is one of the most treated at the institution.
Described for the first time in 1817 by the British neurologist James Parkinson, who then called it paralysis agitans, its appearance seems to be largely linked to a deficit of dopamine in the nervous system, a neurotransmitter that is involved in the regulation of different functions in the human body. , such as motor behavior, emotionality, affectivity and communication.
Some studies relate it to a probable hereditary nature, that is, if there is a family history, and to exposure to contaminating compounds.
The diagnosis of Parkinson’s disease is basically clinical based on the observation of the patient’s symptoms in the neurological examination and although to date there is no cure, the earlier it is detected and can be treated immediately with drugs (the most effective used Today to improve symptoms is levodopa), physical rehabilitation and surgery, the possibilities of improving the quality of patients are really favorable.
PROMISING CREDENTIALS
Dr. Ivonne Pedroso Ibáñez, a II Degree specialist in Neurology and head of the Ciren Movement Disorders and Neurodegenerative Diseases Clinic, told Granma that when a patient arrives there referred by a health institution, they undergo a comprehensive evaluation directed to study the symptoms for which our medical attention is required.
«With this we seek to confirm the alleged initial diagnosis. On many occasions and based on the results of the tests carried out, we have changed the diagnosis by confirming that it is a different disease.
“After a collective discussion involving the Clinic’s multidisciplinary team of specialists, we began to design the personalized therapeutic program in accordance with the predominant symptoms and present disabilities.”
It is vital, of course, to communicate with patients and their families and their active participation in all stages of treatment, he indicated.
«For the management of Parkinson’s disease in particular, which is the second most frequently studied neurodegeneration linked to movement disorders and the best known pathophysiologically, we have developed effective, safe and reliable therapeutic methods, supported by a experience of more than thirty years.
According to Dr. Ivonne Pedroso, the treatment applied includes the traditional use of antiparkinsonian drugs, aimed at controlling motor symptoms in the different stages of the disease.
«Likewise, we address the management of non-motor symptoms that are largely disabling, such as those related to insomnia – we have a specialized area to treat each type of sleep disorder –, cognitive problems, depression and pain, in particular. “particularly in the joints of the shoulders and the cervical region, which often accompany the evolution of Parkinson’s disease from its beginnings.”
He stated that, in recent years, new therapeutic procedures have been incorporated, including non-invasive brain stimulation in its two variants: repetitive transcranial magnetic stimulation and transcranial direct current stimulation.
«These are therapies that have demonstrated their positive effect on the non-motor and motor symptoms caused by this condition, by modulating the neuronal circuits and neurotransmission systems, causing an increase in the release of dopamine, to mention some of the positive effects. ».
He also said that, simultaneously with what was described, an intensive and individualized comprehensive rehabilitation program is applied in the clinic, which includes training in gait, posture, balance, manipulative skills and language.
«We also do cognitive training, through learning techniques based on feedback methods, specific motor learning, strengthening, stretching and stimulation techniques of the neuroplastic capacities of the nervous system, with the aim of increasing the motor and cognitive possibilities of the children. patients, with priority in the execution of their daily tasks.
As Dr. Ivonne Pedroso pointed out, in patients who present uncontrollable motor fluctuations after being treated with the aforementioned procedures, we resort to surgical treatment using stereotactic functional lesional surgery techniques – the number of surgical interventions exceeds 1,000 in 981 patients. , focused on different targets.
The results, he stressed, show a significant improvement in the control of dyskinesias (involuntary movements) and gait alterations, providing a high degree of recovery of motor abilities and functional independence, which is enhanced by the other pillars of the treatment.
