Transcript music as therapy - Foundation for Parkinson`s and Neurological

Walking with Parkinson’s with the
aid of Music 2010
John Yonushonis
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MY ENTIRE RIGHT SIDE IS SLOWER THAN
LEFT
I CANNOT SEQUENCE MY RT THUMB TO
MY RT FINGER
MY NIGHTTIME TREMORS ARE SUCH THAT
I CAN NOT DRINK A CUP OF COFFEE
I CAN NOT FLIP MY WRIST
I HAVE COMPLETELY LOST MY ABILITY TO
WRITE AND CAN NO LONGER READ
BOOKS
BUT I CAN PLAY THE NATIVE AMERICAN
FLUTE
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RAISE THE AWARENES OF PARKINSONS
AND UNDERSTAND WHAT IT DOES TO
THE HUMAN BODY
TALK ABOUT MUSIC THERAPY AND
NATIVE AMERICAN FLUTE AS
ALTERNATIVE THERAPY
SPEAK PERSONALLY ABOUT MY WALK
WITH THE DISEASE
OPEN THE DISCUSSION TO ANY
QUESTION
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PARKINSON’S IS A CHRONIC,
PROGRESSIVE, NEURODEGENERATIVE
DISORDER WHOSE SYMPTOMS INCREASE
OVER TIME AND HAS NO CURE
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1 in 100 over 60 years of age
Average age of onset 60 years of age
15% diagnosed before 50 years of age
Slightly more men than women
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Chronic progressive neurological disorder
Certain brain cells or neurons in the substantia
nigra (SN) die or are impaired
Those neurons produce dopamine
Responsible for coordinated movement and
balance
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Circuits formed by living cells called neurons
100 billion neurons
A transmitter called an axon
Receptors called dendrites
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Neurons not directly connected to one
another
Tiny gap between the transmitter end of one
cell and the receptor end of another cell
Gap is called a synapse
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Neurons act as a communication network
Neurotransmitters carry the message across
synapses from one neuron to another
This allows the nervous system to
communicate with muscles and translate
thought into motion
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There is a defect in dopamine producing
neurons
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They do not properly produce and transmit
dopamine
The Messages about balance, coordination and
movement are impaired
Decreased stimulation of the motor cortex also
occurs
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Planning, control and execution of voluntary motor
functions are impacted
Due to insufficient formation and action of
dopamine
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PD is all about brain circuits
When one part is disrupted then the circuit
malfunctions causing too much or too little
movement.
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Normally we don’t think about how it is
possible for our bodies to move
It just happens when we want it to!
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Travels from the SN to the striatum
Initiates movement
Controls movement and balance
Makes sure:
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Muscles work smoothly,
Under control and
Without extra or unwanted movements
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Transmitter end of SN neurons release dopamine into
the synapse
Fits into special receptors on receiving neuron
Message is passed along
After receiving cell is stimulated , excess dopamine is
released back into synapse
To fine tune movement the excess dopamine us broken
down in the synapse by an enzyme MAO-B
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Important step in precise control of movement as too much or
too little disrupts balance between dopamine and another
neurotransmitter system - acetylcholine
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SN degenerates 
decreased dopamine production
 Causes lack of regulation of the movement in the
control centers in the brain 
 loss of control of movements 
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Cardinal signs become apparent at 70-80%
dopamine loss
LETS LOOK AT THE SIGNS
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Present in 70% of people
Involuntary movement
“Pill-rolling” movement
Most obvious at rest or when under stress
Lessens with intentional movement
Disappears with sleep
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Slowness of movement
Incomplete movement, difficulty initiating
movements and sudden stopping of
ongoing movement.
Loss of spontaneous or automatic
movement
Slowness may interfere with daily routines;
getting dressed, shaving or showering may
take much of the day.
“Freezing”, small steps or shuffling gait
Significant problem and the most disabling
symptom.
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Stiffness or inflexibility of the limbs and/or
trunk
Muscle tone is always stiff and does not relax –
leads to decreased range of motion
Felt as “tightness” in limbs
Can cause pain and cramping
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Abnormal postural reflexes make balance and
coordination difficult
Seen as a forward lean
Fall backwards – trouble keeping upright
Leads to falls
Stooped posture
Walk with series of quick small steps
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Small handwriting
Changes in posture – stooped and lack of arm swing
Decreased facial expression
Speech changes
Difficulty swallowing and drooling
Depression/anxiety
Pain
Sleep disturbances
Constipation
Loss of sense of smell
Urinary frequency
Sexual dysfunction
Low blood pressure
Fatigue/loss of energy
Changes in mental function over time
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No definitive blood test or x-ray
Medical history
Neurological exam
Rule out other conditions
Should see a Movement Disorder Specialist
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neurologist who specializes in PD
Positive response to PD medication
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Cause unknown - lots of theories
Environmental factors
 rural living, well water, herbicide use and
exposure to pesticides
Genetic factors
 15-20% have close relative with PD symptoms
Aging
 wearing away of dopamine accelerated
Probably result of genetic predisposition coupled
with a yet unknown environmental factor
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Quality of life
Best way to live with PD
Know about PD
 Know about drugs and how they work
 Willing to make life style changes
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Good working relationship between person
with PD, their doctor and their family
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When I was in elementary school, I will never forget
a story I read, and for the life of me, I hope someday to
remember its title. It was about a dog and it’s VISION
OF A ROOM with one door and what it felt like when
the door closed and it was alone. It could not open the
door, could not see through the door, could not see
around the door and, most of all, could not do
anything to change its destiny until the door opened
again. All the little dog could do was hope. All it could
do was work to overcome the fear that no one would
ever open the door again. All the little dog could do
was wait.
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I have now talked to hundreds of people with
NEUROLOGICAL DISORDERS and their story
is the same: We all became the little dog in the
room with no way to open the door. We only
had fear to begin with, but with the help of our
friends, our fear turned to hope. FOR ME IT,
AND MY WIFE ANN that taught me that the
room I was in was no longer small. The room I
was in became a room with a window and then
it became ROOM WITH AN OPEN DOOR. The
flute brought me back into society.
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RELAXATION
COORDINATION
BREATHING EXERCISE
SOCIAL STIMULATION
FUN
FOCUS ON NOW, TODAY
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A BRAIN THAT ENGAGES IN MUSIC IS
CHANGED BY ENGAGING IN MUSIC
Dr Michael Thaut
Began after World War I and World War II
when community musicians of all types, both
amateur and professional, went to Veterans
Hospitals around the country to play for the
thousands of veterans suffering both physical
and emotional trauma from the wars. The
patients' notable physical and emotional
responses to music led the doctors and nurses
to request the hiring of musicians by the
hospitals.
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The Biochemical Theory
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The Entrainment Theory
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Music stimulates the cerebral cortex and
Autonomic Nervous System, which sends
vibrations and impulses through the body
Sounds are received through the human energy
field and entrain the body’s rhythms
The Metaphysical Theory
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Music is a gift from God and connects people
together (For example…)
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ADJUSTS THE INTERNAL RHYTHM OF AN
ORGANISM TO EXTERNAL FREQUENCIES
TO CREATE HARMONY
OUR BRAIN ENTRAINS THE FREQUENCY
AND RHYTHM OF SOUND TO ENHANCE
OUR NATURAL RHYTHM
IN PARKINSON’S THE ENTRAINMENT
ALLOWS PEOPLE TO DANCE WHO CAN
NOT WALK
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the “ability to experience an altered state of
physical arousal and subsequent mood
by processing a progression of musical notes
of
varying tone,
 rhythm, and
 instrumentation
 for a pleasing effect.”
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In the Mysteries the lyre was regarded as the secret
symbol of the human constitution, the body of the
instrument representing the physical form, the
strings the nerves, and the musician the spirit.
Playing upon the nerves, the spirit thus created the
harmonies of normal functioning
PYTHAGORAS set HARMONY to a mathematical
scale Pythagoras cured many ailments of the
spirit, soul, and body by having certain specially
prepared musical compositions played in the
presence of the sufferer
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PROMOTES WELLNESS
ALEVIATES PAIN
MANAGE STRESS
OUTLET TO EXPRESS FEELINGS
IMPROVE COMMUNICATION
IMPROVE PHYSICAL COORDINATION
FORCES FOCUS ON TODAY
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INCREASES THE ABILITY TO OVERCOME THE
DIFFICULTY GENERATING SEQUENCE
GIVES BACK RHYTHM
GIVES BACK TEMPO
GIVES BACK TIMING
John Phillips Sousa
Parkinson’s patients that cannot walk but can
dance
The loss of dopamine creates a lack of
synchronization of movement that music may be
able to somehow reorganize
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My personal opinion: there is a rhythm in the
soul of mankind and is manifested internally,
universally similar but distinctively different in
everyone and can be touched by the Native
American Flute (remember Tony and his
Grandfather)
Next: a healthy mind creating a healthier brain
Music helps depression you can help those
with Parkinson’s
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“It is the stagnation of our personal story,
maintaining a rigid definition of our own
meaningfulness and worth, coupled with a loss
of imagination, a lack of courage to face our
imperfections that defines depression, not just
a particular chemical change.
Left unattended (in Parkinson’s) this molecular
backdrop transmogrifies into a self fulfilling
paradigm
Those actively engaged…….have a slower
progression of the disease (Parkinson’s)”
MY PROMISE:
I WOULD NOT BE EMBARASSED BY THE
DISEASE
I WOULD TELL EVERY ONE ABOUT IT TO
INCREASE AWARENESS
I WOULD HELP MY BROTHERS AND SISTERS
WITH PARKINSON’S FFPNR
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A
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ALI
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ALI
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KLAGETOH
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KLAGETOH HOGAN
FOUNDATION FOR PARKINSON’S AND
NEUROLOGICAL RESEARCH MISSION
A WORLD WITHOUT PARKINSON’S