Bradykinesia: what it is, and disorders associated with this symptom.

This symptom appears in pathologies associated with abnormal functioning of the nervous system.

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 to react to it. And such a reaction requires adjusting to certain tempos: if we don't run, we will be eaten.

While most people today no longer run the risk of being eaten by a predator, the fact remains that we have to cope with a large number of environmental demands that require complex sequences of movements. But some people have the difficulty of not being able to move at a normative pace. This is what happens to people with bradykinesia..

Bradykinesia: what is it?

It is known as bradykinesia to the condition characterized by the slowing down of the movementwithout the need for this slowing to also occur at the cognitive level. Bradykinesia is not considered a disorder per se, but rather a symptom of the existence of some other type of problem or alteration.

Generally, and unless we are facing a neurological problem, the subject may be aware of his motor slowness, which in turn can generate discomfort, stress and frustration. There is usually a reduction in movements and in the initiative to carry them out, with the sequencing of movements being more complex and less functional. This may be due both to bradykinesia and to the loss of motivation to do them when observing their slowness. Although not technically it does not have to be, bradykinesia is often accompanied by hypotonia, or decreased muscle tone, which can further hamperThis can further hinder functionality by making movement not only slower but also less powerful.

It should be borne in mind that bradykinesia involves a slowing of movement, but that the specific speed of movement will depend mainly on the premorbid levels of the subject. A person whose movements are already slow in themselves does not have bradykinesia unless a decrease in their normal speed is detected.

This problem, although it may seem minor, can have serious repercussions in the sufferer's life. For example, in the workplace many jobs require a certain pace in order to be carried out efficiently (especially if they are jobs that require a slowing of speed). (especially if they are jobs that require manual manipulation), which can lead to a motor slowing that can disqualify the person from professional practice. It should also be taken into account that certain activities can become dangerous, such as driving.

Although mentally there is no such slowing, if we are not able to react with sufficient speed we can cause to suffer different types of accidents. On a social level, bradykinesia is usually seen as clumsiness and in some cases in which the subject's condition is not known, it can provoke certain rejection or mockery. It is important to keep in mind that the experience of this symptom and the reaction of others towards it can provoke alterations in the self-esteem and sense of self-efficacy and competence of the subject. and competence of the subject, and may alter his or her 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, and there is no single possible cause for it. In fact, it should be noted that motor slowing can have both a medical-physiological and a psychogenic cause.

At the psychogenic level, it is possible to find alterations such as bradykinesia during the suffering of depressive episodes, lack of sleep and energy or the continuous experience of stress or anxiety, as well as in other mental disorders.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 observe 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. As for neurotransmitters, it has generally been found associated with bradykinesia the existence of low levels of dopamineor a reduction of the usual ones. Likewise, it may be the result of demyelination of motor neurons, losing much of its speed in the transmission of information.

Although in both cases a great variety of symptoms are usually present, 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 is caused by the effects (temporary or not) of substance abuse or even some medications.

Last but not least, it is not necessary for there to be a problem for bradykinesia to appear: the appearance of a certain motor slowing is frequent and normal during aging. is frequent and normal during agingIt is common as we get older.

Disorders in which it occurs

As we have said, bracinesia can occur in a large number of situations and disorders, both medical and psychiatric.

Traditionally, it has been considered as a symptom deeply linked (and in fact it is part of the diagnostic criteria) to Parkinson's disease. In this disorder, in which progressive degeneration of neurons of the nigrostriatal pathway occurs, movement disorders and alterations such as Parkinsonian tremors or slowing of movement and gait appear.

It is also a common element in many dementias, especially in subcortical dementias (such as those associated with Parkinson's disease, where bradykinesia is more characteristic) but also in cortical dementias. For example, we may find bradykinesia in Alzheimer's disease as it progresses.

In addition, other neurological problems can also generate 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. There are also diseases such as diabetes can also cause a loss of psychomotor efficiency and speed over the long term 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 depressed mood generate a lower reaction capacity, decreased movement and thinking, and lower energy levels. The same occurs in schizophrenia, in those patients with negative symptomsand in catatonia. Substance abuse and dependence can also generate bradykinesia.

Can bradykinesia be treated?

Bradykinesia, as we have mentioned, is not a disorder but rather a symptom, is not a disorder but rather a symptom.. That is why its treatment is actually based on overcoming the disorder or element that has generated it.

The treatment of depression, stress or exhaustion can contribute to eliminate the problem if we are facing a psychogenic cause. For this purpose, different types of strategies are recommended, such as the performance of 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). The establishment of adequate sleep schedules, the practice of physical exercise and nutrition can also play a role. In schizophrenia, pharmacological treatment may help to 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, since many of the problems that cause bradykinesia are caused by dopaminergic problems, the use of drugs that stimulate its synthesis, increase dopamine levels or generate dopamine agonist effects can be very efficient in the reduction or temporary elimination of symptoms (for example, L-dopa given to patients with Parkinson's disease). The practice of physiotherapy, stimulation and rehabilitation can also improve the motor performance of patients, as well as occupational therapy.

In any case, psychoeducation to learn to understand what is happening, why it is happening and ways to deal with it may be essential. It is also advisable to have a space where the subject can express his or her doubts, concerns and thoughts.