Introduction:
Parkinson’s disease is a progressive neurodegenerative disorder. The prevalence of the disease is 30 to 200 in 1 lakh individuals. Some personality traits start to develop in Parkinson’s disease patients long before the physical symptoms appear. Some personality traits include ambition and rigidity. People with Parkinson’s disease experience variable personality traits. Parkinson’s disease is a neurodegenerative disorder where the personality traits are risk factors or symptoms of Parkinson’s disease. Parkinson’s disease is due to damage in the dopmerginic neurons in the substantia nigra of the brain. The substantia nigra is a part of the basal ganglia. The neurons of the basal ganglia connect different areas of the brain to transmit information. The basal ganglia deals with the body's motor functions, such as walking, talking, swimming, climbing, etc. The neurotransmitters like dopamine transmit the information from the neurons to the peripheral tissues. When the nerve cells in the substantia nigra are damaged, dopamine production is deficient. So the motor functions are compromised in the patients.
What Are Personality Traits?
Character traits are a part of the personality that has differences in concepts about goals and values. Parkinson’s disease personality changes are characterized as introverted, rigid, conservative, and cautious. They are the pre-motor features of the disease. They are more introverted and cautious compared to healthy individuals. The specific personality traits precede the onset of the physical symptoms. Low novelty, anxiety, cautiousness, and rigidity precede the onset of the physical symptoms. Many studies are done to analyze the trait pattern and personality assessment, which varies in different studies. The patients exhibited high levels of neuroticism (trait deposition to experience anxiety, irritability, and anger) and low levels of extraversion and openness It is a chronic maladaptive pattern of preoccupation characterized by perfectionism, orderliness, and interpersonal control for flexibility, efficiency, and openness. It has clinical features of obsessive-compulsive personality disorder (OCPeD), as mentioned in the statistical manual for mental disorders (DSM). An obsessive-compulsive personality disorder is significantly higher in Parkinson’s patients and quite common in the elderly and patients aged 60 years and above. The difference in personality is an early sign of Parkinson’s disease. progressive supranuclear palsy (PSP) is an atypical Parkinson’s characterized by rigid perfectionism and executive function deficit. The early stages of the disease have a mental condition between dementia and normal cognition where there is an abnormality in attention and executive function impairment. There is a relationship between executive functioning and personality traits. Patients with severe motor function symptoms have a high risk of developing cognitive symptoms. They exhibit lower novelty-seeking traits and higher harm-avoidance traits.
What Are the Personality Changes in Parkinson’s?
Parkinson’s disease personality changes are inflexibility, introversion, and rigidity. The Parkinson’s disease is associated with specific personality types described as dynamic, introverted, compulsive, punctual, serious, and morally rigid. The individuals are less novelty-seeking because the normally pleasurable reward is impossible in these patients because of less dopamine. The changes in personality traits are rigidity, seriousness, single-mindedness, and perseverance. Introverted, slow-tempered, and ambitious. These personality traits appear long before the occurrence of motor symptoms. Because there is a deficiency of dopamine which is responsible for both emotional responses and helps regulate physical movements.
What Is the Role of Dopamine in Personality Traits?
Since in Parkinson’s, there is a decrease in dopamine levels. The fall of dopamine starts years before the symptoms begin, so there are changes and subtle effects on the personality long before. Since dopamine is pleasure rewarding hormone, less production can make someone more introverted and less willing to take risks in life for a thrill.
How Can Parkinson’s Medication Change Traits and Personalities?
People with Parkinson’s do not engage in risky health behaviors. However, the consumption of dopamine agonist medications that mimic the effects of dopamine in the brain leads to other changes in the personality, like taking a massive risk by engaging in unusual activities and gambling. This behavior can threaten the well-being of the patient and their family.
What Are the Cognitive Changes in Parkinson’s Disease?
There are cognitive changes associated with Parkinson’s disease. Cognitive and behavioral symptoms occur in the early stages of Parkinson’s disease. The patients have feelings of distraction or disorganization, and difficulty planning and accomplishing tasks accompanies cognitive impairment. It's harder to focus and pay attention, and it becomes hard to make choices. Trouble concentrating and choosing words for speaking. The changes can disturb the household affairs. There will be a diminished quality of life. It interferes with daily independent living and can develop mild dementia. The cause would be a drop in dopamine levels. Not only dopamine, but the changes are also due to two other chemical messengers- norepinephrine and acetylcholine. The areas affected are memory, language, visuospatial, problem-solving capacity, and mental processing speed. Other factors harm cognitive skills, such as anxiety, mood, and s, because they worsen memory and thinking, affecting the quality of life.
What Is the Treatment for Personality Changes in Parkinson’s Disease?
There are two types of systems involved in the pathology of the disease. One is the involvement of the cholinergic and adrenergic systems, and the other is the dopaminergic system. The treatment of the disease is complex and requires a multidisciplinary approach. Patients are susceptible to psychiatric conditions such as depression and anxiety. Dopamine agonists stimulate the brain parts that are influenced by dopamine. Medication-related hallucinations are seen in patients. Deep brain stimulation is done for recovery. Deep brain stimulation is done to stimulate motor symptoms. The implant is placed in the brain that delivers an electrical current directly to the areas of the brain. A mild electric current is supplied to a specific brain area to stimulate the brain cells to produce neurons. The current passes through the wire attached to a device implanted beneath the skin near the collarbone. It is done when the medications are not effective. Anticholinergic drugs treat tremors and muscle rigidity.
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Enzyme inhibitors increase the amount of dopamine by reducing the enzymes that break down dopamine in the brain. They include MAO-B inhibitors and COMT inhibitors.
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A healthy diet supports overall wellness.
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Exercise strengthens muscles and improves balance, flexibility, and coordination.
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Massage therapy to reduce tension.
Conclusion:
Addressing depression and anxiety feelings can help a great deal. Occupational therapists help treat disabled patients through the therapeutic use of daily activities. Occupational therapy provides relief and a sense of independence by teaching individuals how to care for themselves and function based on their symptoms to the best of their ability. Parkinson’s disease is more common in older patients. There is no permanent cure for the condition, but advanced treatment can help increase the situation and make life easy for cooperative patients as long as possible.
