Akinesia: the challenge of regaining lost movement

Akinesia is a medical term that describes the inability to initiate voluntary movements. This symptom can be associated with various neurological conditions and significantly impacts patients’ quality of life. Although it is commonly linked to Parkinson’s disease, it can also appear in other disorders of the nervous system.

What is akinesia?

Akinesia is a neurological disorder characterized by:

• Voluntary immobility: The patient has difficulty initiating movements, even though there is no evident muscle weakness.
• Association with neurodegenerative diseases: It is frequently linked to conditions such as Parkinson’s disease, but it can also occur in other disorders.

Akinesia should not be confused with paralysis, as in this case the muscles retain their strength, but the brain has difficulty sending the necessary signals to initiate movement.

Main causes of akinesia

Akinesia has several causes, among which the following stand out:

1. Neurodegenerative diseases:
   • Parkinson’s disease: This is the most common cause, where the lack of dopamine in the basal ganglia affects motor coordination.
   • Atypical parkinsonism: Such as progressive supranuclear palsy or multiple system atrophy.
2. Structural brain damage:
   • Stroke: Injuries in motor areas of the brain can trigger akinesia.
   • Traumatic brain injuries: These can disrupt the motor pathways responsible for movement.
3. Psychiatric disorders:
   • In some cases, akinesia may be related to catatonia or severe depression.
4. Medications:
   • Antipsychotic drugs can induce extrapyramidal symptoms, including akinesia.

Symptoms of akinesia

Akinesia presents with the following symptoms:

• Difficulty initiating movements, even simple tasks such as walking or standing up.
• Reduced facial expression or “hypomimia”.
• Slowness in the execution of movements (bradykinesia).
• Muscle rigidity, which may accompany the lack of movement.

These symptoms affect daily activities, reducing the patient’s independence and, in some cases, increasing the risk of complications such as falls.

Diagnosis of akinesia

The diagnosis of akinesia requires a multidisciplinary approach and usually includes:

1. Clinical evaluation:
   • A neurologist evaluates the medical history, symptoms, and physical examination, with emphasis on reflexes and movement.
2. Complementary tests:
   • Brain imaging: MRI or CT scans to detect structural damage or underlying diseases.
   • Functional tests: Such as dopamine studies in Parkinson’s disease.
3. Ruling out other conditions:
   • Psychiatric causes or medications should be excluded as the origin of the problem.

Treatment of akinesia

The management of akinesia depends on the underlying cause and may include:

1. Pharmacological therapy:
   • Levodopa and dopamine agonists: These are the standard treatment in Parkinson’s disease, improving movement ability.
   • Anticholinergics: Help reduce muscle rigidity and other symptoms.
2. Physical rehabilitation:
   • Physical therapy aimed at improving mobility and preventing muscle atrophy.
3. Deep brain stimulation (DBS):
   • In advanced cases of Parkinson’s disease, this surgical procedure can restore motor function.
4. Occupational therapy:
   • Techniques and adaptations to perform daily tasks more efficiently.
5. Psychological treatment:
   • In cases of akinesia associated with depression or catatonia, cognitive-behavioral therapy and, if necessary, antidepressant medication are recommended.

Akinesia and strokes

Akinesia can be a complication of a stroke affecting the basal ganglia or the motor cortex. This connection highlights the importance of early rehabilitation in post-stroke patients to minimize mobility impairments and promote functional recovery.

Impact on quality of life and coping strategies

Akinesia can severely limit the patient’s autonomy. Some strategies to cope with this condition include:

• Regular exercise: Improves coordination and muscle strength.
• Family and psychological support: Essential for maintaining motivation and emotional well-being.
• Home adaptations: Assistive devices such as support bars or ergonomic chairs can help facilitate daily tasks.

Conclusion

Akinesia is a debilitating symptom that can have various causes, ranging from neurodegenerative diseases to psychiatric disorders or brain damage. With early diagnosis and an appropriate therapeutic approach, it is possible to improve patients’ quality of life and help them regain some of their mobility.

Advances in pharmacological and surgical treatments, along with comprehensive rehabilitation, have made it possible to address this condition more effectively, offering hope to those facing this challenge.

If you would like more information about NeuroAiD II, please fill out this contact form.