Your ‘wildest’ dreams could offer an early clue to Parkinson’s disease

October 2, 2018

In July, 82-year-old actor Alan Alda revealed that he has Parkinson’s disease—a progressive nervous system disorder that affects movement—and in an interview with CBS This Morning, he revealed that an unusual dream helped lead him to his diagnosis. 

Alda, best-known for his portrayal of Army Captain “Hawkeye” Pierce in the TV series M*A*S*H (1972-1983), said he asked his doctor to test him for the disease after reading an article about how physically acting out your dreams can be one of the earliest precursors of the neurological disorder.

“I asked for a scan because I thought I might have it,” Alda said. “I read an article by Jane Brody in The New York Times that indicated that if you have — if you act out your dreams, there’s a good chance that might be a very early symptom, where nothing else shows,” Alda told CBS News.He recognized that what the story described had happened to him.

“By acting out your dreams, I mean I was having a dream where someone was attacking me and I threw a sack of potatoes at them, and what I was really doing was throwing a pillow at my wife,” Alda explained.

At that point, he had no other sign of illness. “The doctor said, ‘Why do you want a scan? You don’t have any symptoms,'” Alda recalled. “And I said, I want to know if there’s anything I can do—I want to do it.”

About 60,000 Americans are diagnosed with Parkinson’s disease each year, and this number does not reflect the thousands of cases that go undetected. An estimated 7 million to 10 million people worldwide—and about 1 million in the United States—are living with Parkinson’s disease, according to the Parkinson Association of the Carolinas..

Catching the disease in its early stages can be beneficial for a number of reasons, Dr. Claire Henchcliffe, director of the Parkinson’s Disease & Movement Disorders Institute at Weill Cornell Medicine and New York-Presbyterian told the network news outlet.

“There are modifiable lifestyle factors that could make a difference, for example exercising and diet. While these are not proven to delay onset of Parkinson’s there is considerable optimism about their role,” she told CBS News. “Making the diagnosis also means that if a person wants to get involved in clinical studies then they can make a real contribution to developing better understanding of and treatments for Parkinson’s.”

Henchcliffe notes that it’s been well documented that sleep disturbances, including having problems falling asleep or staying asleep, and restless legs syndrome, are common in people with Parkinson’s. Over the years there’s been some debate over whether sleep trouble is a complication of Parkinson’s or a precursor of the disease — an early warning sign that surfaces well  before other symptoms set it.

“What’s really turned out to be a critical link is the recognition that certain specific sleep disorders [such as REM sleep behavior disorder, or RBD], not only affect people with Parkinson’s but in fact show up in some cases many years earlier than the movement symptoms that lead to diagnosis,” Henchcliffe said. “So while for some types of sleep disturbances we might still debate whether they are precursors or complications, for RBD there is now extremely strong evidence that it can be a harbinger of Parkinson’s disease that will manifest some years down the line.”

Carlos L. Rodriguez, MD, a sleep medicine doctor at Cleveland Clinic Sleep Disorders Center, told CBS News that he saw a patient with RBD several years ago who was dreaming that he was playing high school football again in the defensive end position. “He had a clear avenue of attack straight to the quarterback and was rushing aggressively to tackle him when he awoke to find that his head had rammed through the drywall of his room,” Rodriguez told CBS News.

Rodriguez explains that RBD is usually caused by neurodegeneration within the brainstem, which disables the mechanisms responsible for immobilizing muscles during REM sleep—the cycle of of sleep in which we dream. This is what enables someone to literally act out what’s happening in their dreams.

The sleep disorder has been connected to other neurodegenerative diseases, including multiple system atrophy, and dementia, including Alzheimer’s disease and Lewy body disease. In one small study of 26 patients with RBD, fully 80% went on to develop Parkinson’s or another one of these diseases.

Henchcliffe emphasizes that not everyone with RBD is destined to develop Parkinson’s.

“But I do think that acting out dreams in RBD warrants a visit to a doctor to figure out what the cause may be,” she said. ”

Alda told CBS This Morning that one of the reasons he decided to speak out about his medical condition was to send a message of hope to others who might be facing the disease. The actor is still extremely active, taking boxing lessons three times a week, and he recently launched a podcast called Clear+Vivid that explores all the ways people communicate with each other.

“In the very beginning, to be immobilized by fear and think the worst thing has happened to you — it hasn’t happened to you. You still have things you can do,” he said.

Research contact: @Ashley_LizWelch

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