Rewiring the Parkinson’s Brain: Working Around Midbrain Damage

Columnist Dr. C shares insight into his Parkinson's brain rehab research

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by Dr. C |

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I visualize my Parkinson’s disease as a form of brain injury — specifically to small portions of the midbrain. I imagine the total volume of damaged area to be about the size of a golf ball. This means I have the rest of my brain to use for developing workarounds.

For the last eight years, this has been the focus of my research, writing, and personal development of a brain rehab program I call the Parkinson’s self-management toolkit.

I was gifted with just the right training to do this work, with foundations in the multiple disciplines needed to be a researcher, writer, clinician, and teacher. Mrs. Dr. C suggests I’m just the “right guy at the right time” to get Parkinson’s. Designing brain rehab is not a simple task, but with the right training, as well as by having the disease, I’m on the inside looking out.

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Before I can implement a brain rewiring process to address Parkinson’s, I need a full description of this midbrain damage. Here’s what I know:

  • Parkinson’s is due to dopamine neuron malfunction. There are two primary dopamine brain areas: the basal ganglia and the insular cortex. These are midbrain structures.
  • Parkinson’s is both progressive and transient, exemplified by having “good” and “bad” days.
  • There are two major sources of Parkinson’s malfunction: the damaged neurons and the malfunctions that happen when neural circuits use the distorted information coming from these damaged neurons. I call this the “Parkinson’s developmental syndrome.”

With this information, I can now construct a rehab model of the affected areas defined in my upcoming book, “Possibilities with Parkinson’s: Developing a Self-Management Toolkit.” That model is used to develop the workaround.

New neural pathways

The component of this workaround brain rewiring focuses on teaching the brain to think differently. The brain is taught to make new neural pathways that go around the damaged regions of the brain.

One function of the midbrain is to monitor and regulate autonomic body functions. Body temperature regulation is one of these functions.

The midbrain is like the thermostat in my home. When the temperature in the house drops, the thermostat registers this change. It tells the furnace to kick on and send heat throughout the rooms. When the temperature gets to the setting on the thermostat, the thermostat sends a signal to the furnace to turn off. If it’s summer, then the same process applies if the thermostat is set to “cool.” It then turns on the air conditioning when it gets too hot.

Thermal dysregulation is a frequent problem with Parkinson’s patients. It is something I experience multiple times a day. My “thermostat” kicks in, but instead of sending appropriate commands, it sends exaggerated ones. This results in my body sweating to meet the demands of the exaggerated input. I need just a little cooling, not profuse, full-body drenching and sweat pouring off my skin.

The exaggeration also happens if I feel even a hint of being cold. My “thermostat” says “shiver and warm up.” But I’m shivering beyond what I need to gain body warmth.

Sometimes both events happen consecutively — 30 minutes of alternating body heat sensation followed by 30 minutes of feeling frigid.

My body is trying to achieve homeostasis, but it is fighting against the exaggerated signals from the damaged midbrain. I “flicker” on and off while my Parkinson’s brain struggles to achieve a balance of body temperature.

If I’m aware — mindful — that this is happening, then I can try to be calm. I can do deep breathing to activate the parasympathetic nervous system, or PSNS.

The PSNS is one of the two functionally distinct divisions of the autonomic nervous system. The PSNS predominates in quiet “rest and digest” conditions, while the sympathetic nervous system drives the “fight or flight” response in stressful situations.

To quiet down the exaggerated signals, I can do one of three things: get quiet, meditate, or wait for it to pass.

The Hospital for Special Surgery notes that, “There are many ways to practice using your parasympathetic nervous system. These include mild exercise, meditation, yoga, deep breathing from your diaphragm, even nature walks.” These strategies are well known as effective treatments for Parkinson’s patients.

The individualized presentation of the disease means that no single rehab program will fit everyone. But the basic science should be useful for anyone trying to live better with Parkinson’s.

A reviewer of my first book, “Possibilities with Parkinson’s: A Fresh Look,” commented that rewiring is “mindfulness on steroids.” It’s the core idea of the rewiring strategy. The more I work with it, the more successful it gets.

Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, BioNews, and are intended to spark discussion about issues pertaining to Parkinson’s disease.


Mike Onley avatar

Mike Onley

Really useful article on aspects of PD such as temperature control. I sometimes experience violent shivering after coming out of the sea, even with a wetsuit. On the hot end of the scale I sometimes find that I overheat and have to shed layers quickly while others in the room feel cold. I’ll try the mindfulness breathing technique next time it happens.

Malik de Kok avatar

Malik de Kok

Thank you for this post. I too am working on rewiring my brain, but with a bit of a different perspective. I am curious whar you think about this.

In essence, I try to stay away from micromanaging my brain parts and processes. Reasons:
- I find it too complicated to do,
- I hate being micromanaged myself, and I believe that my body knows far better what it must do to reach a certain goal than I.
- I think that we don't know half of what is going on in the brain and I don't want to interfere on basis of false information.

So I focus mostly on visualizing desired outcomes: being able to walk 10 kmm in hilly terrain, etc.

I don't rewire speciifically but I do clean up. I found this video very stimulating or my imagination: In my mind's eye, I visuallize all the processes shown there, but in the opposite direction: i.e. cleaning up, healing, and coming to liife.

Curious for your thoughts!

Michael Berry avatar

Michael Berry

I am looking forward to buying and reading your upcoming book. This is a very interesting concept. Thank you.

Gregg Daniels avatar

Gregg Daniels

Dr, C's analysis is on point. I have noticed large day to day fluctuations in my heart rate variability (sympathetic vs parasympathetic) and temperature as measured by my Fitbit overnight. I suspect some variability also occurs during waking hours but is not noticeable to me and is not measured by my Fitbit.

Wesley Isenhart avatar

Wesley Isenhart

The author makes a good point that this disease is unique to the individual and coping mechanisms that work for one patient might not work for another. His article was skimpy on techniques for 'rewiring' the brain. Hopefully he will address this concept in more detail in his book. Pre-Parkinson's, I noticed that I was overusing my dominant hand, so I took up juggling to get more balance. Post-Parkinson's, I continue to enjoy juggling to get more finger/hand/flex movement out of both hands.

Wynn McGrenera avatar

Wynn McGrenera

I’m very interested in your new book. I’ve been diagnosed with Parkinson’s since 2013. In reality I’ve had it at least 22 years. It started with extreme fatigue. It was so bad I would almost fall asleep driving to work. My students would tell me I would fall asleep mid-sentence. I took to drinking 4 energy drinks a day. That helped a little but was fairly risky health wise. Today I’m still fighting it but it’s much less pronounced. I find Balance of Nature is a big help. I can even drive cross country. So anyway please let me know when it comes out and be one of your first customers.

Patricia Castile avatar

Patricia Castile

Since my PD diagnosis in 2016 I resist reading about Parkinson’s so that I don’t scare myself with the multitude of issues that may cr may not come up. I’ve decided to let it surprise me. But a couple of curious reads online set up the algorithm for me to receive your post on meditation as a way to live with Parkinson’s.
I meditate regularly and can say that it makes a huge difference in my life experience and sets me up for a more peaceful day, which was my original goal. I have noticed that the tremors often subsist during meditation, which is a welcome relief. My other practice is to read my preferred spiritual text…A COURSE IN MIRACLES, an excellent mind training tool and way to approach life’s many issues.
My doc at Barrows in Phoenix says the Parkinson’s is moving slowly, which makes sense since years before my diagnosis in 2016 I felt like I was “falling apart”, a feeling friends with the disorder share.
Meditation has been part of my life since my 30’s and I will be 73 this week. As you indicated, it taps into the parasympathetic nervous system; the peaceful, rather than action part of the brain, quieting the chaos of the mind and for a brief period. It brings me to the quiet center. The regular, simple mental exercise of mediation is similar to physical exercise: it benefits throughout the day.
So I’m delighted to know you are promoting meditation as a regular practice in people living with Parkinson’s. The more people who meditate, the better. Finding a way to live in this ever changing world, even without Parkinson’s is challenging. Meditating helps.
Pat Parkinson Castile (ironic, I know)
Chino Valley, Arizona USA

Dr. C. avatar

Dr. C.

Hi Pat "Parkinson's" ~ How ironic as you say! Thank you for the in-depth thoughtful comment. I was specifically pleased to see your statement about how meditation decreases Parkinson's symptoms, even if just for the time spent in meditation and perhaps lessens their impact through the day. We are in the middle of a series of columns on meditation and Parkinson's. Hope you check in with our column on BioNews ("Possibilities with Parkinson's"). Would love to get your feedback on these columns as well.
Dr. C.

Stuart Mardlin avatar

Stuart Mardlin

What are any new developments as cures for Parkinson’s


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