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THE BRAIN AS A
SWITCHBOARD

Dr. Cherian Karuanapuzha from the Meinders Center for Movement Disorders in Oklahoma City compares the neural circuits that are damaged in Parkinson's to a switch box that codes for movement.

When the thinking part of the brain decides to do something – like reach for a coffee mug – the planning part of the brain relays the information to the switch box.

The switch box then does two things (click to flip the switch):

It switches on all the relevant programs needed to kickstart the activity It switches off the things that should not occur during the activity

Like a switchboard transmits signals to control devices, the brain transmits neural activity to control body functions.

Parkinson’s damages cells and disrupts the brain’s ability to do this smoothly, and people with Parkinson’s may start to experience motor fluctuations.

FLIPPING THE SWITCH

TIPS TO MANAGE ON-OFF FLUCTUATIONS

Living with Parkinson’s disease often means ON-OFF fluctuations can be erratic and hard to predict.¹ It can be as if someone is flipping a switch on and off.

Click below to flip the switches to learn more about how to increase ON time:

TALK ABOUT OFF WITH YOUR CARE PARTNERS AND MEDICAL TEAM

The most critical part of managing ON and OFF time is being open and honest with your care team. Care partners often notice important patterns about what might tend to happen before, during, and after an OFF time.

WORK WITH PHYSICAL AND OCCUPATIONAL THERAPISTS

Physical and occupational therapists can help you strengthen muscles, improve balance, and understand how to safely navigate your daily life at work.²

EAT WELL, EXERCISE, AND STAY HYDRATED

Your diet can affect medication absorption and influence ON and OFF fluctuations.³ Talk with your care team about whether you should modify your diet. Even light exercise like walking can have positive effects on management of Parkinson’s symptoms. Work with an exercise professional to develop the right exercise program for you.

CONSIDER ADJUNCT AND ADVANCED TREATMENTS

There are treatments for Parkinson’s that can help manage ON and OFF fluctuations. Talk to your care team about a treatment that is right for you.

  1. Parkinson’s Disease. National Institute of Neurological Disorders and Stroke. 2023. Available at:
    https://www.ninds.nih.gov/health-information/disorders/parkinsons-disease#:~:text=Parkinson's%20disease%20occurs%20when%20nerve. Accessed August 31, 2023.
  2. Radder DLM, Sturkenboom IH, van Nimwegen M, Keus SH, Bloem BR, de Vries NM. Physical therapy and occupational therapy in Parkinson's disease. International Journal of Neuroscience. 2017 Oct;127(10):930-943. doi: 10.1080/00207454.2016.1275617. Epub 2017 Jan 4. PMID: 28007002.
  3. Fighting Parkinson's Disease with Exercise and Diet. John Hopkins Medicine. 2023. Available at: https://www.hopkinsmedicine.org/health/conditions-and-diseases/parkinsons-disease/fighting-parkinson-diseasewith-
    exercise-and-diet. Accessed October 3, 2023.
  4. Stoker TB, Torsney KM, Barker RA. Emerging Treatment Approaches for Parkinson's Disease. Front Neurosci. 2018 Oct 8;12:693. doi: 10.3389/fnins.2018.00693. PMID: 30349448; PMCID: PMC6186796.

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