Abstract
We present the case of a 78-year-old male who, 16 years ago, was diagnosed with Parkinson’s disease (PD) by a neurologist. He initially presented with left-hand tremor, stooped posture, shuffling gait, and frequent falls, which eventually progressed to bilateral motor symptoms after 3 years. Since 2012, his symptoms and signs have almost completely remitted, and he has been off all pharmacotherapy for that time. The accuracy of the initial PD diagnosis is supported by an appropriate clinical presentation, history of positive response to Sinemet, and an abnormal SPECT DaT scan; thus this case suggests the possibility of remission of symptoms in some patients. We propose that the patient’s long history of meditation practice may have been one contributing factor of this improvement as meditation has been shown to release dopamine in the striatum.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission. This work was conducted at Boston VA Healthcare System, Jamaica Plain Campus at 150 S. Huntington Ave., Jamaica Plain, MA, 10461.
Research funding: This work was supported by The John Templeton Foundation under Grant #7733510.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
References
1. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189–98.10.1016/0022-3956(75)90026-6Search in Google Scholar
2. Marek KL, Seibyl JP, Zoghbi SS, Zea-Ponce Y, Baldwin RM, Fussell B, et al. [123I]beta-CIT/SPECT imaging demonstrates bilateral loss of dopamine transporters in hemi-Parkinson’s disease. Neurology 1996;46:231–7.10.1212/WNL.46.1.231Search in Google Scholar
3. Seibyl JP, Marek K, Sheff K, Zoghbi S, Baldwin RM, Charney DS, et al. Iodine-123-b-CIT and Iodine-123-FPCIT SPECT measurement of dopamine transporters in healthy subjects and Parkinson’s patients. J Nucl Med 1998;39:1500–8.Search in Google Scholar
4. Ravina B, Marek K, Eberly S, Oakes D, Kurlan R, Ascherio A, et al. Dopamine transporter imaging is associated with long-term outcomes in Parkinson’s disease. Mov Disord 2012;27:1392–7.10.1002/mds.25157Search in Google Scholar PubMed PubMed Central
5. Tsolaki M, Messini CZ, Siapera M, Fotiadou F, Delaporta D, Karatolias A. Depression, extrapyramidal symptoms, dementia, and an unexpected outcome: a case report. Cases J 2010;3:47–51.10.1186/1757-1626-3-47Search in Google Scholar PubMed PubMed Central
6. Lobo R, Fraser A, Kiely P, Boers P. Parkinsonism can be cured. BMJ Case Reports 2013;2013:1–3.10.1136/bcr-2012-008057Search in Google Scholar PubMed PubMed Central
7. Shprecher DR, Grossmann KF, Tward JD. Sustained remission of Parkinson disease associated melanoma with immunotherapy. Parkinsonism Relat Disord 2014;20:1027–9.10.1016/j.parkreldis.2014.05.017Search in Google Scholar PubMed
8. Purdon-Martin J. The basal ganglia and posture. London: Pitman Medical Publishing Co. Ltd., 1967.Search in Google Scholar
9. Rahman S, Griffin HJ, Quinn NP, Jahanshahi M. The factors that induce or overcome freezing of gait in Parkinson’s disease. Behav Neurol 2008;19:127–13.10.1155/2008/456298Search in Google Scholar PubMed PubMed Central
10. Critchley M. Arteriosclerotic Parkinsonism. Brain 1929;52:23–83.10.1093/brain/52.1.23Search in Google Scholar
11. Shiner T, Seymour B, Symmonds M, Dayan P, Bhatia KP, Dolan RJ. The effect of motivation on movement: a study of bradykinesia in Parkinson’s disease. PLoS ONE 2012;7:e47138.10.1371/journal.pone.0047138Search in Google Scholar PubMed PubMed Central
12. Thaut MH, McIntosh GC, Rice RR, Miller RA, Rathbun J, Brault JM. Rhythmic auditory stimulation in gait training for Parkinson’s disease Patients. Movement Disorders 1996;11:193–200.10.1002/mds.870110213Search in Google Scholar PubMed
13. McIntosh GC, Brown SH, Rice RR, Thaut MH. Rhythmic auditory-motor facilitation of gait patterns in patient’s with Parkinson’s disease. J Neurol Neurosurg Psychiatry 1997;62:22–6.10.1136/jnnp.62.1.22Search in Google Scholar
14. Sharp K, Hewitt J. Dance as an intervention for people with Parkinson’s disease: a systematic review and meta-analysis. Neurosci Biobehav Rev 2014;47:445–56.10.1016/j.neubiorev.2014.09.009Search in Google Scholar
15. Mueller K, Fritz T, Mildner T, Richter M, Schulze K, Lepsien J, et al. Investigating the dynamics of the brain response to music: a central role of the ventral striatum/nucleus accumbens. Neuroimage 2015;116:68–79.10.1016/j.neuroimage.2015.05.006Search in Google Scholar
16. Lazar SW, Bush G, Gollub RL, Fricchione GL, Khalsa G, Benson H. Functional brain mapping of the relaxation response and meditation. Neuroreport 2010;11:1581–5.10.1097/00001756-200005150-00042Search in Google Scholar
17. Haber SN. Corticostriatal circuitry. Dialogues Clin Neurosci 2016;18:7–21.10.31887/DCNS.2016.18.1/shaberSearch in Google Scholar
18. Kjaer TW, Bertelsen C, Piccini P, Brooks D, Alving J, Lou HC. Increased dopamine tone during meditation-induced change of consciousness. Brain Res Cogn Brain Res 2002;13:255–9.10.1016/S0926-6410(01)00106-9Search in Google Scholar
19. Pagnoni G, Cekic M. Age effects on gray matter volume and attentional performance in Zen meditation. Neurobiol Aging 2007;28:1623–7.10.1016/j.neurobiolaging.2007.06.008Search in Google Scholar PubMed
20. Pickut BA, Hecke WV, Kerckhofs E, Marien P, Vanneste S, Cras P, et al. Mindfulness based intervention in Parkinson’s disease leads to structural brain changes on MRI: A randomized controlled longitudinal trial. Clin Neurol Neurosurg 2013;115:2419–25.10.1016/j.clineuro.2013.10.002Search in Google Scholar PubMed
21. Newberg AB, Wintering N, Waldman MR, Amen D, Khalsa DS, Alavi A. Cerebral blood flow differences between long-term meditators and non-meditators. Conscious Cogn 2010;19:899–905.10.1016/j.concog.2010.05.003Search in Google Scholar PubMed
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