Introduction
Parkinson’s Disease and Spinocerebellar Ataxia are both progressive conditions that affect movement. In both cases, patients can experience a set of symptoms that include slurred speech, trouble walking, tremors, and so on. The conditions are highly different, however, and require their own unique diagnosis and treatment approaches. Let’s take a closer look.
What is Spinocerebellar Ataxia (SCA)?
Genetic Causes and Subtypes
Spinocerebellar Atrophy, or Spinocerebellar Degeneration is a genetic disease caused by either a recessive or dominant gene. It refers to a group of ataxias that are known to be hereditary and cause harm to the cerebellum, the part of the brain which maintains balance and controls movements.
There are over 40 subtypes of SCA, most of which are autosomal dominant and caused by mutations in specific genes. Common forms like SCA1, SCA2, SCA3 (Machado-Joseph Disease), SCA6, and SCA7 are linked to CAG trinucleotide repeat expansions, resulting in toxic polyglutamine proteins that damage neurons.
Impact on Coordination and Balance
Spinocerebellar Ataxia may result in non-coordinated gait, impaired hand-eye coordination, and abnormal speech. Cell therapy and physiotherapy are important components of both Parkinson’s Disease and Spinocerebellar Ataxia treatment.
What is Parkinsonism?
Defining Parkinsonism vs Parkinson’s Disease
Parkinsonism is a broad clinical term used to describe a group of neurological conditions that cause movement symptoms similar to those seen in Parkinson’s Disease (PD), such as tremor, stiffness, slowness of movement, and postural instability.
Parkinson’s Disease is the most common and well-known form of Parkinsonism, but not all cases of Parkinsonism are PD. While PD is a progressive neurodegenerative disorder characterized by the loss of dopamine-producing neurons in the substantia nigra, other forms of Parkinsonism—like multiple system atrophy (MSA), progressive supranuclear palsy (PSP), and drug-induced Parkinsonism—may have different underlying causes and progression patterns.
Core Symptoms and Neurological Impact
The core symptoms of Parkinsonism include bradykinesia (slowness of movement), rigidity (muscle stiffness), resting tremor (typically in hands or arms), and postural instability (impaired balance and coordination).
These symptoms result from a dysfunction in the basal ganglia, a group of brain structures responsible for regulating voluntary movement. In Parkinson’s Disease—the most common form of Parkinsonism—there is a progressive loss of dopaminergic neurons in the substantia nigra, leading to dopamine deficiency and impaired motor control. Over time, Parkinsonism can also affect non-motor functions, causing cognitive decline, mood disorders, sleep disturbances, autonomic dysfunction, and speech or swallowing difficulties, reflecting the broader neurological impact beyond just movement impairment.
The Overlap: Parkinson’s Disease and Ataxia
Shared Motor Symptoms
Parkinson’s Disease (PD) and Ataxia are distinct neurological disorders, but they can share several motor symptoms, making differential diagnosis challenging in some cases. The shared motor symptoms include:
Gait disturbances: Both conditions can cause an unsteady or shuffling walk. PD typically presents with a narrow-based, shuffling gait, while Ataxia causes a wide-based, staggering gait.
Impaired coordination: Although for different reasons—PD due to bradykinesia and rigidity, and Ataxia due to cerebellar dysfunction—both can lead to poor coordination of limb movements.
Postural instability: Balance problems are common in both conditions, increasing the risk of falls.
Slurred speech (dysarthria): disorders can cause slowed, unclear, or monotonous speech.
Difficulty with fine motor tasks: Writing, buttoning clothes, or other precise movements can be impaired due to tremor in PD or incoordination in Ataxia.
Subtypes of Ataxia with Parkinsonian Traits (e.g., SCA2, SCA3, SCA6)
Certain subtypes of Spinocerebellar Ataxia (SCA) can present with Parkinsonian features, leading to diagnostic overlap with Parkinson’s Disease. These subtypes often include symptoms like bradykinesia, rigidity, and tremor, in addition to cerebellar ataxia. Key examples include:
SCA2: One of the most Parkinsonian SCAs, it may present with slow eye movements, bradykinesia, tremor, and even a good initial response to levodopa, making it resemble idiopathic Parkinson’s Disease in some cases.
SCA3 (Machado-Joseph Disease): The most common SCA worldwide, it can present with both cerebellar ataxia and extrapyramidal symptoms like rigidity, dystonia, and sometimes a Parkinsonian gait.
SCA6: Typically characterized by pure cerebellar ataxia, but in some cases may show mild Parkinsonian signs such as rigidity or postural instability, especially in older individuals.
SCA17: Known for a broad spectrum of symptoms, including cognitive decline, ataxia, chorea, and Parkinsonism—often misdiagnosed as PD or Huntington’s Disease.
SCA8 and SCA10: Though less commonly, these can also exhibit extrapyramidal features including tremor and rigidity.
How is Parkinsonism Diagnosed in SCA Patients?
Key steps in diagnosis include:
Imaging and Neurological Assessments
Clinical examination: Identifying hallmark Parkinsonian signs such as bradykinesia, resting tremor, rigidity, and a positive response to levodopa. The presence of cerebellar signs (like dysmetria and nystagmus) alongside Parkinsonian features suggests a mixed phenotype.
Imaging studies: Dopamine transporter (DaT) SPECT scans can show reduced striatal uptake, supporting a Parkinsonian diagnosis, while MRI may reveal cerebellar atrophy characteristic of SCA.
Symptom progression and medication response: A good response to dopaminergic therapy (like levodopa) may further support the presence of Parkinsonism in SCA patients.
Role of Genetic Testing
Genetic testing is essential for confirming a specific SCA subtype, especially those known to have Parkinsonian presentations (e.g., SCA2, SCA3, SCA17).
Differentiating Pure Parkinson’s from Overlap Syndromes
Differentiating pure Parkinson’s Disease from overlap syndromes like MSA, PSP, or SCAs is key, as these conditions may share motor symptoms but differ in progression, response to medication, and underlying cause. Unlike classic PD, overlap syndromes often show poor levodopa response and include features like ataxia or autonomic issues. At Plexus, we use advanced diagnostics and personalized care plans to accurately identify and manage these complex cases.
Cell Therapy for Parkinson’s
Healthy Cells are introduced into the brain to replace damaged or lost neurons, and restore normal functioning in the brain. The procedure holds immense promise for slowing or even halting the progression of Parkinson’s disease. At Plexus, we use MSCs as part of our customized regenerative rehabilitation program for Parkinson’s. The regenerative, anti-inflammatory, and immunomodulatory properties of MSCs make them a compelling candidate for addressing the complex pathology of Parkinson’s.
Our Parkinson’s rehabilitation program comprises –
- Cell therapy
- Occupational therapy
- Physical therapy
- Speech and language therapy
- Cognitive rehabilitation therapy
- Bradykinesia management
- Rigidity management
- Agility training
- Functional training
- Hand function training and more
- Counseling and psychological support
Treatment can slow disease progression and manage the symptoms. Physiotherapy, Cell therapy, occupational therapy, and speech and language therapy are all highly beneficial for improving the patient’s independence and mobility. There are also various exercises that specifically target tremors and help to reduce their frequency.
Plexus offers customised rehabilitation programs for Parkinson’s and Spinocerebellar Ataxia at our centres in Bangalore and Hyderabad.
Cell Therapy for Spinocerebellar Ataxia
Injected mesenchymal cells (MSCs) differentiate into various cell types and possess anti-inflammatory and immunomodulatory properties, making them the ideal choice for ataxia regenerative treatment.
The advantages of mesenchymal Cell therapy at Plexus include:
- Reduces inflammation and neuroinflammation
- Promotes neuroprotection and neuronal survival
- Supports neurogenesis and neurorepair
- Minimally-invasive and painless procedure
- Autologous Cells minimize risk immune rejection
If you wish to know more about our rehabilitation programs for Parkinson’s and Ataxia, reach out to our teams in Bangalore and Hyderabad today.
WhatsApp +91 89048 42087
Call +91 78159 64668 (Hyderabad) | +91 82299 99888 (Bangalore)
FAQs
What is Parkinsonism in Spinocerebellar Ataxia?
Parkinsonism in SCA refers to the presence of Parkinson-like symptoms, such as bradykinesia, rigidity, and tremor, in addition to cerebellar ataxia due to specific genetic mutations.
How is Parkinsonism diagnosed in patients with SCA?
Parkinsonism in SCA is diagnosed through clinical evaluation, genetic testing, imaging (e.g., MRI, DaTscan), and response to dopaminergic treatment.
What is the difference between Parkinson’s Disease and Ataxia?
Parkinson’s Disease is primarily a motor disorder characterized by bradykinesia, tremor, and rigidity, while Ataxia involves lack of coordination, balance issues, and cerebellar dysfunction.
Can someone have both Parkinson’s Disease and Ataxia?
Yes, some individuals can have both Parkinson’s Disease and Ataxia, particularly in cases of overlap syndromes or genetic conditions like certain SCAs.
How effective is cell therapy for Parkinsonism in SCA?
Cell therapy for Parkinsonism in SCA shows promising potential and is being actively researched at Plexus, with ongoing clinical advancements aimed at improving patient outcomes.
