The Last Straw: How Stress Can Unmask Parkinson’s Disease 2024 van der Heide et al

[Andy]

Abstract

We discuss two people with Parkinson’s disease (PD), in whom tremor manifested directly following a severely stressful event. Both were initially misdiagnosed with a functional neurological disorder. These stories highlight that stress can trigger the onset of clinical manifestations of PD, by unveiling an underlying disease that had been unfolding for many years. Thus, the sudden symptom onset after a stressful event is not unique to functional disorders, and may lead to avoidable feelings of guilt if people wrongly attribute PD to this event. It remains unclear what mechanism explains this phenomenon, and why symptoms persist after the stressful event has passed.

Open access, https://content.iospress.com/articles/journal-of-parkinsons-disease/jpd230400

 

[rvallee]

All of this makes a lot of sense when stress is used with its common meaning, typically an external force making a demand and requiring energy to return to its previous state, rather than the modern woo-woo definition misused in psychosocial ideology.

Physicians have long advised ill people to take it easy. This isn't just about avoiding conflict or unpleasant situations, you're also usually expected not to go on a cross-country expedition or work long hours in a regular job, because the body is unable to handle it.

It will make every illness worse, not because of the nature of the illness, but because of the nature of the event: a demand in energy, exertion from a system that is not working optimally, and can tip out of balance in a way that is very hard to reverse.

It doesn't even make sense to pretend that this is unique to imagined psychosomatic processes. It simply ignores centuries of history that have been chucked out the window when convalescence was replaced with an obsession with active rehabilitation, unable to find a balance between both and instead going all the way on the opposite side.

Here they focus on tremors, and I don't see how it should be much difference than tremors people have when pushing muscles past their limits. It's clearly about energy and in biology, energy is energy, there isn't a different reserve for physical energy as there is for cognitive, attentive or emotional exertion. But even though they use a general definition of stress that should respect this, they deviate from the implications anyway, because psychological exertion is still somehow considered to have its own independent psychic energy, or whatever. Not in so many words, but this is how it's always misused, in creating this separation from other types of exertion.

Here they claim a different 'sign' from the fashionable one, forget its name, as positive evidence, combined with distractibility, which is quite arbitrary:

Examples of these inconsistencies are disappearance of tremor during cognitive or motor co-activation (distractibility), or a change in tremor frequency when the patient makes a voluntary movement with another limb (entrainment). Furthermore, a brief cessation of the tremor during a ballistic movement of the contralateral limb (pointing test) is a sign of a functional tremor

They simply attribute psychological response to the event, rather than the event, which is really the same thing as blaming LC on lockdowns during the pandemic, rather than the virus most of the population got several times since.

 

[Jonathan Edwards]

There are about 4,000 new diagnoses of Parkinson's in the Netherlands each year. Radboud is a big medical centre so might see several thousand cases over 5 years. We all probably meet serious stress once every 5 years. If you narrow down the time period to a week then one or two over a few years can be expected to have experienced serious stress the week their Parkinson's started, I would think.

The striking thing is that this was only seen in two people. If it was 200 then it might be of some interest.

 

[Sean]

These stories highlight that stress can trigger the onset of clinical manifestations of PD, by unveiling an underlying disease that had been unfolding for many years.

Reveal, not trigger.

 

[EndME]

Last straw: How to cling on to ideas by misunderstanding basic mathematics and confusing correlation with causation.

 

[NelliePledge]

Major stress episodes such as problems with finances, housing, relationship, relatives illness can last weeks months,years even.

 

[rvallee]

confusing correlation with causation

I don't think there's much confusion here. Rather it's preferring to think that a correlation must be causative because reasons.

 

[Arnie Pye]

The Last Straw: How Stress Can Unmask Parkinson’s Disease

It occurs to me that someone suffering from stress may have higher than normal levels of cortisol and/or adrenaline. And yet neither of these are given a single mention in the paper linked in the first post in the thread.

 

[Evergreen]

The Last Straw: How Stress Can Unmask Parkinson’s Disease

It occurs to me that someone suffering from stress may have higher than normal levels of cortisol and/or adrenaline. And yet neither of these are given a single mention in the paper linked in the first post in the thread.

They do say this:

The mechanisms linking stress and tremor are complex and multifaceted, but a potential underlying reason is that the noradrenergic system, which is activated during stress, is thought to influence the cerebello-thalamo-cortical tremor circuitry [3, 7, 8].[my bold]