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 to react to she. And this reaction requires adjusting to some tempos: if we do not run, we will be eaten.

Although today most people are no longer at risk of being eaten by a predator, the truth is that we have to cope with a lot of environmental demands that demand sequences of movements complex. But some people have the difficulty of not being able to move at a normative pace. This is what happens to people with bradykinesia.

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Bradykinesia - what is it?

It is known as bradykinesia a the condition characterized by slowing of movement, without the need for said slowing down to also occur at the cognitive level. Bradykinesia is not considered a disorder per se, but rather is the symptom of the existence of some other type of problem or alteration.

Generally and unless we are dealing with a neurological problem, the subject may be aware of his 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 both to bradykinesia and a loss of motivation to do them when observing its slowness. Although not technically necessary, 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 supposes a slowing down of movement, but that the specific speed of this will depend fundamentally on the subject's premorbid levels. A person whose movements are already slow does not have bradykinesia unless a decrease in 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 the labor 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 a motor slowdown disabling for professional practice. It must also be taken into account that certain activities can become dangerous, such as driving.

Although mentally there is no such slowdown, if we are not able to react with enough speed we can cause different types of accidents. On a social level, bradykinesia is usually seen as clumsiness and in some cases in which the subject's state is not known, it can cause some rejection or ridicule. It is important to bear in mind that the experience of this symptom and the reaction of others towards it can cause alterations in self-esteem and a sense of self-efficacy and competence of the subject, being able to alter his emotional state.

Some possible causes of this symptom

The appearance of motor slowdown or bradykinesia can be the consequence of a large number of factors, and there is 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 the 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 observe how bradykinesia can be the consequence of an alteration of the system nervous system, being a possible cause of the hyper or hypoactivity of the basal ganglia and its connection with the motor cortex and the muscles. Regarding neurotransmitters, it has generally been found associated with bradykinesia the existence of low levels of dopamine, or a reduction of the usual. Likewise, it can be the product of demyelination of the motor neurons, losing the transmission of information much of its speed.

Although in both cases a wide 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 occurs due to the effects (temporary or not) of using substances or even some medications.

Last but not least, we must comment that it is not necessary that there be a problem for bradykinesia to appear: the appearance of a certain motor slowdown is common and normal during aging, being habitual as we get older.

Disorders in which it occurs

Brazinesia, as we have said, 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 the neurons of the nigrostriatal pathway occurs, movement disorders and disturbances such as parkinsonian tremors or slowing of movement and March.

It is also a common element in many dementias, especially the subcortical ones (such as the associated to Parkinson's, being in this where bradykinesia is more characteristic) but also in the cortical. For instance, we can find bradykinesia in Alzheimer's as it progresses.

In addition to this, 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 efficiency and psychomotor speed long-term (although the alteration is usually minor except in those with severe neuropathy).

On the other hand, as we have already commented, we can also find bradykinesia in mental problems such as depression, in which anhedonia and depressed mood leads to a decreased ability to react, decreased movement and thinking, and lower levels of Energy. The same is true in schizophrenia, in those patients with negative symptoms, and in the catatonia. Substance abuse and dependence can also lead to bradykinesia.

Can bradykinesia be treated?

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

Treating 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, physical exercise, and nutrition can also play a role. Regarding schizophrenia, drug treatment can help to keep the patient stabilized and reduce bradykinesia if not caused by degeneration and death neuronal.

If the cause is neurological, there may be no curative treatment. However, since a large number of the problems that cause it are caused by dopaminergic problems, the use of drugs that stimulate its synthesis increases the levels of dopamine or that generate agonist effects to those of it can be very efficient in the reduction or temporary elimination of symptoms (for example, the L-dopa that is given to patients with Parkinson). 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 happens, why or ways of dealing with it can become essential. The existence of a space in which the subject can express their doubts, concerns and thoughts is also recommended.