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Stunning discovery involving the brain-inspiring new questions and treatment for Parkinson’s, Alzheimer’s, dementia, and other neurological disorders: A unifying hypothesis?

Parkinson’s disease is a neurodegenerative brain disorder. Normally, there are brain cells (neurons) in the human brain that produce dopamine. These neurons concentrate in a particular area of the brain, called the substantia nigra. Dopamine is a chemical that relays messages between the substantia nigra and other parts of the brain to control movement of the human body. Dopamine helps humans to have smooth coordinated muscle movements. When dopamine-producing cells do not produce enough dopamine, the motor symptoms of Parkinson’s disease appear. This process of impairment of brain cells is called neurodegeneration [1]. Dopamine has been demonstrated to play a role in pain processing in multiple levels of the central nervous system, including the spinal cord, thalamus, and basal ganglia [2–5]. Decreased levels of dopamine have been associated with painful symptoms that frequently occur in Parkinson’s disease [6]. Abnormalities in dopaminergic neurotransmission have also been demonstrated in painful clinical conditions, including burning mouth syndrome, fibromyalgia, and restless legs syndrome [7–10]. Data supports the suggestion that the influence of substance P (SP) on the internal compensation system is, to a significant extent, mediated by dopaminergic mechanisms and provides a possible explanation for the effects of the neuropeptide seen in a conditioned place preference reflex [11]. The current theory (so-called Braak’s hypothesis) [1] is that the earliest signs of Parkinson’s are found in the enteric nervous system, the medulla, and in particular, the olfactory bulb, which controls the sense of smell. Under this theory, Parkinson’s only progresses to the substantia nigra and cortex over the years. This theory is increasingly borne out by evidence that non-motor symptoms, such as a loss of sense of smell, hyposmia, sleep disorders, constipation, and irritable bowel syndrome (IBS) may precede the motor features of the disease by several years. For this reason, researchers are increasingly focused on these “non-motor” symptoms to both detect Parkinson’s disease as early as possible and to look for ways to stop its progression. When the jaw is misaligned, the trigeminal nerve is hyper activated through the necessary accommodations that it has to perform. This affects all aspects of the trigeminal nerve: sensory, motor, and proprioceptive. Hence, any and all aspects of trigeminal neutral interactions can be affected, leading to a very broad array of disorders [12]. A major reason for the consequential medical disorders is due to the fact that jaw misalignment causes SP levels to become elevated in the body. SP is the neurotransmitter from C fibers (pain sensors) that sends all pain signals to the brain. The trigeminal nerve has an extreme high density of pain fibers, thus causing it to have a major effect on SP levels in the body. SP is released from the terminals of specific sensory nerves; it is found in the brain and spinal cord. It is associated with inflammatory process and pain perception. There is a classification of medical disorders called “neurogenic inflammatory disorders” that are associated with elevated SP levels. SP levels have been implicated in the development of Parkinson’s disease [13–15]. Fibromyalgia is a syndrome of widespread chronic pain associated with sleep disorders, depressed mood, cognitive impairment, and fatigue. Its etiology and pharmacopathology are poorly understood, but it is thought to result from dysfunction of central pain processing mechanisms, leading to a generalized pain sensitization. Pain perception is the result of a bi-directional process of ascending and descending pathways. Nociceptive input from peripheral afferent neurons is sent via the dorsal horn of the spinal cord to the higher brain centers involved in pain perception. Some descending inhibitory projections to the spinal cord attenuate the nociceptive effects. Numerous neurotransmitters, including serotonin, dopamine, noradrenalin, and SP are involved in these processes. In other neuronal pathways in the brain, the same neurotransmitters are involved in mood control, sleep regulation, and cognitive function, providing a neurochemical substrate for the wide range of symptoms seen in fibromyalgia [16]. CRANIO®: THE JOURNAL OF CRANIOMANDIBULAR & SLEEP PRACTICE 2018, VOL. 36, NO. 5, 279–282 https://doi.org/10.1080/08869634.2018.1512511