At birth we already have a few billion years

In this course we will analyze, from an evolutionary perspective, some important characteristics of Homo Sapiens Sapiens infants, the result of millions of years of evolution, which affect adult development and psychic life.

Migraine: what to do?

Migraine is a primary episodic headache. Symptoms typically last from 4 to 72 h and can be severe. The pain is often unilateral, throbbing, worsens during physical exertion, and is

Sexual Habits: Outercourse, non-penetrative sex

Sexual partners may move toward outcourse for a variety of reasons of a practical, ideological, moral, or religious nature, to limit the risk of pregnancy, as a matter of sexual preference , as an alternative to menstruation, or for medical impediments that advise against penetration at a given time.

Eating well, a weapon against depression too?

A comprehensive article published in The Lancet’s journal, EbioMedicine, analyzes current knowledge on the relationship between nutrition and some psychiatric disorders, particularly depression. What are the key messages of the

Sexual desire in the various ages of life

It may seem easy to define it, but despite the many studies conducted, the composition of the structure of sexual desire, what elements make it up and to what extent they may influence it, is still unclear.

Parkinson’s disease: Symptoms, causes and treatment


Parkinson’s disease is a chronic progressive disease; it was first described by James Parkinson in 1817. After dementias, it is the most common neurodegenerative disease.


The condition is equally prevalent worldwide; the average age of onset is between
55 and 60 years of age
and affects
1-2% of the entire population over 65 years of age
; 5% of those affected are under 40 years of age.

In Italy there are about
220 thousand
people affected.


Various risk factors for Parkinson’s disease have been identified, including age, family history, male gender, environmental exposure to herbicides, pesticides, metals (manganese, iron), well water, residence rural, mental and physical trauma, emotional stresses.

A protective factor, on the other hand, is cigarette smoking.

The cause of the disease is unknown, but it is probably the result of an interaction between environmental toxins, genetic susceptibility, and senescence.
Mitochondrial dysfunction and oxidative stress
are now considered among the main mechanisms underlying the disease.

In a .small percentage
of the cases a genetic cause
. Major mutations include those affecting genes coding for
and for

is related to the
degeneration of most of the dopaminergic neurons in the black substance
(nerve structure located at the level of the midbrain). This results in the reduced production of
, a key neurotransmitter in the
regulation of movement
. Symptoms of the disease become apparent
When more than 70 percent
of dopaminergic neurons were lost.

The main alterations involve the
black substance
which appears paler than normal; within it there is a reduction in the number of neurons and in surviving neurons inclusions of a substance called
are the so-called
Lewy bodies
, which are not specific to Parkinson’s disease, as they can also be found in
Lewy body dementia
and in
Alzheimer’s dementia.


The onset is sneaky
with tremor in one hand
, but also often with
joint pain
, depression of mood, easy fatigability.

The cardinal symptoms are
resting tremor
, the
slowness of movement
, also called bradykinesia,

and the
. To these symptoms must be added postural instability. PD is a
asymmetric pathology
in that, especially in the early stages, it affects one half of the body more than the other .

Let us go on to illustrate the basic symptoms.

The resting tremor, present in about 70% of cases, has a frequency of 4-6 shocks per second and at onset affects only one hand and, in particular, the first three fingers, giving the impression of “count coins“; tremor is accentuated under conditions of emotional tension, fatigue, o When the subject feels observed, while it is absent during sleep.

is characterized by an
increased muscle tone
constant resistance
to mobilization. There may be the so-called
cogwheel phenomenon
, in that the presence of resistance to passive mobilization is alternated with
sudden failures
, brings to mind the
clicks of a gear

slowness of movement
(bradykinesia) is the third cardinal sign of the disease, also accompanied by reduced motility. During the march, the subject with PD gives the impression of having the
upper limbs attached
to the body
without the characteristic
pendular movements

Also observed are
difficulties such as using a knife or fork
, buttoning up or
, shave. The writing becomes trembling and uncertain and you shrinks (microgra phy), the facial expressions is reduced (amimia) (Figure 8). The subject, over time, assumes a prone posture with
Head flexed forward and knees and elbows flexed

Postural instability
is the difficulty in maintaining upright station in response to external thrusts; it can be the cause of disastrous falls and is present in about 40% of cases.


Autonomic nervous system involvement is characterized by the presence of
orthostatic hypotension, constipation, sialorrhea, seborrhea, increased sweating
At the level of the head and neck. Urinary disorders may be present such as urinary urgency
and increased
urinary frequencyI

cognitive impairment
, usually moderate, is present in up to 60 percent of cases; there may be impairment of attention, concentration and memory and slowness in performing executive tasks. Unfortunately in some cases until the
in 20%
may be present a
frank dementia
subcortical type

depression of mood tone
is often present but under-diagnosed and under-treated. I sleep-wake rhythm disorders are very common being able to affect up to 90% of people with PD. They can consist of
excessive daytime sleepiness
or in
difficulty in initiating or maintaining sleep
, or in
poor sleep quality with frequent awakenings
and reductions in stages III and IV sleep and REM sleep.


It is mainly based on the recognition of the three main signs
, resting tremor, rigidity and bradykinesia with unilateral onset, and the response to L-DOPA.

CT or MRI scans of the brain are normal or at most can demonstrate the presence of some degree of brain atrophy, which is otherwise highly variable.

The following can be used to assess presynaptic dopaminergic pathways
the SPET-DaT SCAN, which s
erve to show alteration of dopaminergic pathways, but is not always superior to clinical diagnosis.

To assess the degree of disability, the use of Rating Scales is useful. The most widely used are the UPDRS and the Hoehn and Yahr Scale.


Initially there is a good drug response; later, as the disease worsens, the response to drugs worsens and fluctuations appear especially in the area of motor symptoms. These include the on-off phenomenon, sudden lack of response to medication with no relation to the timing of intake; wearing-off, predictable reappearance of parkinsonian symptoms after a number of years due to the shorter duration of response to medication; and freezing of gait or simply freezing, sudden motor blockage that occurs at the onset of walking, or in crossing narrow passages, or in changes of walking direction; in the latter case, the subject reports having his or her feet as if glued to the floor.



Obsessive compulsive disorder

Obsessive compulsive disorder is a psychiatric disorder characterized by recurring thoughts, accompanied by completely irrational and unfounded fears and worries, that lead the sufferer to continuously repeat, in an obsessive

Panic attack

What is meant by a panic attack? It is understood as the sudden manifestation of a strong fear accompanied by an equally intense physical symptomatology despite the absence of an

Transient ischemic attack

Transient ischemic attack (TIA) is a mild form of ischemic cerebral stroke or “mini-stroke,” which occurs when the cerebral circulation is partially impaired by the presence of narrowing or occlusion

Morton’s neuroma

Morton’s neuroma consists of a thickening of the tissue surrounding a nerve tract present in the sole of the foot at the anterior (forefoot) support area, usually at the base

Neurovegetative dystonia

If you have the patience to interview a family doctor whose outpatient clinic is always very crowded, you will find that a good portion of patients are afflicted with a

Trigeminal neuralgia

The trigeminal nerve is the fifth of the twelve pairs of cranial nerves in the head; it is the nerve responsible for providing sensation to the face. One trigeminal nerve

Major depression

Major depression (or “major depressive disorder,” as stated in the “Statistical Diagnostic Manual of Mental Disorders – DSM 5”), is a mood disorder that is characterized by the presence of

Sleep and mood disorders

Sleep disorders and mood disorders are linked by a double thread and articulately affect each other. Decades of studies and clinical-practical experience, both in the field of Sleep Medicine and

Jet lag

Jet-lag is a sleep disorder that affects those who travel by crossing at least 3-4 time zones, either westward or eastward, due mainly to the temporary failure of synchronization between

Obstructive sleep apnea

Repetitive episodes of upper airway obstruction may occur during sleep, often accompanied by reduced oxygen saturation. Such episodes are accompanied in almost all cases by snoring. Apneas often end with

your advertising
exclusively ON

complete the form and you will be contacted by one of our managers