Bradykinesia: What It Is, And Disorders Associated With This Symptom
The human being is movement. As with most animals, our survival depends on it: eating, finding shelter, reproducing or fleeing from possible dangers are actions that require both the ability to detect external stimulation and react to it. And this reaction requires adjusting to certain tempos: if we don’t run, we will be devoured.
Although most people are no longer at risk of being eaten by a predator, the truth is that we have to face a large number of environmental demands that require sequences of complex movements. But some people have the difficulty of not being able to move at a normative pace. This is what happens to people who have bradykinesia
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It is known as bradykinesia. the condition characterized by slowing of movement, without the need for said slowing to also occur at a cognitive level. Bradykinesia is not considered a disorder per se, but rather is a symptom of the existence of some other type of problem or disorder.
Generally, unless we are dealing with a neurological problem, the subject may be aware of his or her motor slowness, something that in turn can generate discomfort, stress and frustration. There is usually a reduction in movements and the initiative to carry them out, with the sequencing of movements being more complex and less functional. This may be due to both bradykinesia and the loss of motivation to do them when observing his slowness. Although it doesn’t technically have a reason, bradykinesia It is usually accompanied by hypotonia or decreased muscle tone something that can make functionality even more difficult by making the movement not only slower but less strong.
It must be taken into account that bradykinesia involves a slowing of movement, but that the specific speed of this movement will fundamentally depend on the premorbid levels of the subject. A person whose movements are already slow in themselves does not present bradykinesia unless a decrease in their normal speed is detected.
This problem, although it may seem minor, can have serious repercussions on the life of those who suffer from it. For example, at work level Many jobs require a certain pace to be carried out efficiently (especially if they are jobs that require manual handling), which can lead to motor slowing that disqualifies one from professional practice. It must also be taken into account that certain activities can become dangerous, such as driving.
Although mentally there is no such slowing down, if we are not able to react quickly enough we can cause different types of accidents. At a social level, bradykinesia is usually seen as clumsiness and in some cases where the subject’s condition is not known, it can cause certain rejection or ridicule. It is important to keep in mind that the experience of this symptom and the reaction of others towards it can cause alterations in self-esteem and a feeling of self-efficacy and competence of the subject, which may alter their emotional state.
Some possible causes of this symptom
The appearance of motor slowing or bradykinesia can be a consequence of a large number of factors, there being no single possible cause for it. In fact, it must be taken into account that motor slowing can have both a medical-physiological and a psychogenic cause.
At a psychogenic level, it is possible to find alterations such as bradykinesia during depressive episodes, due to lack of sleep and energy. or the continued experience of stress or anxiety as well as in other mental disorders such as schizophrenia (although in this case the reason may be more neurological).
At a more biological level, it is possible to see how bradykinesia can be a consequence of an alteration of the nervous system, being a possible cause of hyper or hypoactivity of the basal ganglia and its connection with the motor cortex and muscles. Regarding neurotransmitters, it has generally been found associated with bradykinesia. the existence of low levels of dopamine, or a reduction of the usual ones. Likewise, it may be a product of the demyelination of motor neurons, losing the transmission of information much of its speed.
Although a wide variety of symptoms usually occur in both cases, bradykinesia is among them. Thus, the existence of neurological problems is one of the possible causes of this symptom. It is also possible that it occurs due to the effects (temporary or not) of substance use or even some medications.
Last but not least, we must comment that it is not necessary for a problem to exist for bradykinesia to appear: the appearance of a certain motor slowing. It is common and normal during aging becoming common as we get older.
Disorders in which it occurs
Brakinesia, as we have said, can occur in a large number of situations and disorders, both medical and psychiatric.
Traditionally, it has been considered a symptom deeply linked (and in fact is part of the diagnostic criteria) to Parkinson’s disease. In this disorder, in which progressive degeneration of the neurons of the nigrostriatal pathway occurs, movement disorders and alterations such as parkinsonian tremors or slowing of movement and walking appear.
It is also a common element in many dementias, especially in subcortical dementias (such as that associated with Parkinson’s, where bradykinesia is most characteristic) but also in cortical dementias. For example, we can find bradykinesia in Alzheimer’s as it progresses.
In addition, other neurological problems can also cause bradykinesia. An example is found in neuropathies and disorders such as multiple sclerosis and amyotrophic lateral sclerosis, as well as other diseases of the neuromuscular junction. Also exist Diseases such as diabetes can also cause a loss of psychomotor efficiency and speed in the long term (although the alteration is usually minor except in those with severe neuropathy).
On the other hand, as we have already mentioned, we can also find bradykinesia in mental problems such as depression, in which anhedonia and a depressed mood generate a lower capacity to react, decreased movement and also thinking, and lower energy levels. The same thing happens in schizophrenia, in those patients with negative symptoms, and in catatonia. Substance abuse and dependence can also lead to bradykinesia.
Bradykinesia, as we have mentioned, It is not a disorder but rather a symptom That is why its treatment will actually be based on overcoming the disorder or element that has generated it.
Treatment of depression, stress or exhaustion can help eliminate the problem if we are dealing with a psychogenic cause. For this, different types of strategies are recommended, such as carrying out pleasant activities, cognitive restructuring in case of dysfunctional beliefs and other types of psychotherapy useful for the subject’s problem in question (for example, expressive ones). Establishing adequate sleep schedules, practicing physical exercise and nutrition can also play a role. Regarding schizophrenia, pharmacological treatment can help keep the patient stabilized and reduce bradykinesia if it is not caused by neuronal degeneration and death.
If the cause is neurological, there may be no curative treatment However, given that a large number of the problems that cause it are caused by dopaminergic problems, the use of drugs that stimulate its synthesis, increase dopamine levels or that generate agonist effects to its dopamine can be very efficient in reducing or temporary elimination of symptoms (for example, L-dopa given to Parkinson’s patients). The practice of physiotherapy, stimulation and rehabilitation is also recommended, it can improve the motor performance of patients, as well as occupational therapy.
In any case, psychoeducation to learn to understand what happens, why, or ways to deal with it may become essential. It is also advisable to have a space in which the subject can express their doubts, concerns and thoughts.
