Alzheimer’s disease, Parkinson’s disease, Lewy body disease… These well-known pathologies are called “neurodegenerative”: they are the cause ofprogressive deterioration of cells in the brain and spinal cord. “Due to the progressive aging of the population and the absence of curative treatments, the number of people who suffer from it has increased considerably over the last decades and is expected to grow steadily in the coming years“, Public Health France alert. Update on the warning signs, the causes of these diseases and the treatments that preserve the quality of life of patients.
Definition: what is a neurodegenerative disease?
Neurodegenerative diseases (MND) set in gradually and their incidence increases with age. They are the origin of cognitive-behavioral, sensory and/or motor disorders disabling, and unfortunately irremediable: loss of memory, loss of motor skills, loss of balance, loss of speech, etc. These are all factors that have a major impact on the quality of life and the autonomy of patients.
Concretely, the cells of the central nervous system (the cells of the brain and the spinal cord) cease to function and eventually die. We therefore speak of degeneracy or programmed death of certain neurons, involved in vital – or at least essential – functions such as breathing, sleep, motor skills, language or decision-making.
Alzheimer’s disease, Parkinson’s disease, Huntington’s disease… What are the different neurodegenerative diseases (list)?
There are a number of neurodegenerative disorders, which sometimes affect different groups of neurons:
- Alzheimer’s disease ;
- spinocerebellar ataxia;
- multiple system atrophy;
- posterior cortical atrophy;
- fatal familial insomnia;
- Alexander’s disease;
- Alpers disease;
- Lewy body dementia;
- Creutzfeldt-Jakob disease;
- Huntington’s disease;
- Parkinson’s disease ;
- Pick’s disease;
- macrophagic myofasciitis;
- progressive supranuclear palsy;
- amyotrophic lateral sclerosis (ALS);
- and Wolfram syndrome.
What is the most common neurodegenerative disease?
The most common neurodegenerative diseases are:
- Alzheimer’s disease, the most common form of dementia (more than a million cases in France, according to Public Health France);
- Parkinson’s disease (167,000 cases in France, according to Inserm);
- et ALS, or Charcot’s disease(2,300 new cases in France each year, according to Public Health France).
Causes and risk factors: where do these neurodegenerative pathologies come from?
Scientists have not yet managed to identify specific causes at the origin of the various neurodegenerative diseases. Research continues. On the other hand, age and genetic and/or environmental risk factors (exposure to chemicals such as pesticides, or heavy metals) can promote their appearance.
These pathologies can also be linked to a medical condition, such as an autoimmune inflammatory disease, tumor or stroke. In other cases, they may be due to viruses.
Either way, it is important to note that this is a complex process usually involving several factors that can vary from person to person.
Are only the elderly affected?
Aging is indeed the main risk factor for degenerative disorders. Most pathologies appear late, without being able to clearly identify their cause. In some cases, however, the first signs of degeneration appear in young subjects.
In video: Michel’s testimony: Living with Charcot’s disease
Symptoms: how do you know if you have a degenerative neurological disease?
The warning signs are very heterogeneous. For good reason, the symptoms of degenerative diseases depend on the type of neurons affected. Patients may present:
- of the memory and reasoning problems ;
- of the difficulty speaking and swallowing ;
- a confusion in time and space ;
- of the behavioral problems and mood swings ;
- of the motor function disorders : muscle rigidity (hypertonia), slowness in the execution of movements (akinesia), tremors at rest, etc.;
- of the balance and movement coordination disorders ;
- of the visual disturbances (blindness or visual agnosia);
- of the hearing, ENT and respiratory muscle disorders ;
- etc.
What are the consequences for the daily lives of patients?
Neurodegenerative diseases have an immensely significant impact on the quality of life of patients. They cause neurological symptoms, but also affect motor functions, preventing patients from carrying out many daily actions themselves – including vital actions. The main difficulties for patients are:
- inability to hold conversations or remember important biographical information;
- the inability to find one’s bearings or to move regarding at home;
- inability to participate in certain activities;
- difficulty sleeping (sleep disorders);
- difficulty urinating (incontinence);
- difficulty eating (which may lead to eating disorders);
- difficulties in washing, dressing, doing their hair, applying make-up, etc.;
- etc.
So many factors that may have a significant impact on the family, social and professional life of patients. Their loss of autonomy and their great dependence often lead to stress, anxiety, and even depressive symptoms.
do not forget the psychological and financial consequences that weigh on the family caregivers and all familiesas evidenced below by Guy, who accompanied his dependent wife for many years.
In video: Guy, former helper of his wife, now volunteer in an association
Diagnosis: how to detect a degenerative brain disease?
The good instinct is to consult your doctor at the first warning signs (memory loss, tremors, muscle stiffness, etc.). If left untreated, the symptoms will only get worse. Depending on the case, the professional may referral to a medical specialist (neurologist, psychiatrist, etc.).
The diagnosis of neurodegenerative disease will take some time. First of all, because the symptoms remain invisible for a long time and vary according to the type of neurodegenerative pathology concerned and according to the patients.
To establish a certain diagnosis, the medical specialist relies on:
- interviews with the patient, which details his medical history, his symptoms, their context of appearance, their speed of evolution, their incidence, etc. Note: the expert also often questions those around him;
- a clinical examinationwhich makes it possible to estimate the general state of the patient and his possible sensory or motor deficits;
- neuro-psychological tests, memory tests, identification tests, impact on daily lifeetc ;
- a blood test, a thyroid test and / or any test to detect a genetic abnormality;
- a lumbar puncturewhich makes it possible to measure several specific biological markers in the cerebrospinal fluid;
- and medical imaging examinationssuch as a brain CT scan or a brain MRI.
Once the diagnosis has been made, the management of the patient is required a multidisciplinary follow-up. Depending on the severity and impact of the symptoms, this follow-up is provided by a general practitioner, a neurologist, a psychologist, a psychomotor therapist, a physiotherapist, an occupational therapist, a speech therapist, etc.
Treatment: how to treat a neurodegenerative disease?
Currently, neurodegenerative disorders cannot be “cured”. The goal of support is to halt disease progression and relieve symptoms to prolong patient independence and improve quality of life. The solutions are specific to each type of neurodegenerative disease. It is therefore essential that patients and their families work closely with their doctor to develop a treatment plan tailored to their needs.
Several lifestyle advice help limit risk factors as soon as the first warning signs appear:
- manage cardiovascular risk factors as soon as they appear (smoking, diabetes, cholesterol, hypertension);
- adopting good sleep hygiene and managing disorders such as sleep apnea;
- favor a diet rich in antioxidants and hunt free radicals. The ideal is to opt for a so-called “Mediterranean” diet, consisting mainly of fresh fruits and vegetables, bread, cereals, fish, olive oil;
- maintain intellectual and physical activity and a social network as much as possible.
THE medications only relieve symptoms.
A intervention chirurgicale can be considered when a tumor compresses part of the brain, for example.
As indicated above, the care pathway may include speech therapy sessions, psychomotricityphysiotherapy, physiotherapyof light therapyetc.
Finally, psychological support is essential to support patients, enable them to maintain good self-esteem and a certain autonomy. Certain support and stimulation techniques, such as music therapy, museotherapyart therapy, animal-assisted therapy (equitherapy, for example), etc. can also improve the psychological well-being of patients.
Furthermore, the psychoeducation will allow the patient and his relatives to better understand the disease, to better apprehend it. Family members and caregivers are strongly encouraged to join support and guidance groups or to benefit from individual or family psychological follow-up.
