What Is Cogwheeling?
Cogwheel phenomenon, also known as cogwheel rigidity or cogwheeling, is a type of rigidity seen in people with Parkinson’s disease. It’s often an early symptom of Parkinson’s, and it can be used to make a diagnosis.
What does cogwheeling look like?
In cogwheel rigidity, your muscles will be stiff, like in other forms of rigidity. But you might also have tremors in the same muscle when it’s at rest.
Cogwheel rigidity can affect any limb, but it’s most common in the arms. It can affect one or both arms.
With any type of muscle rigidity, your muscles might feel “tight.” You might not be able to move the muscle fully. This can be painful and uncomfortable.
The rigidity of any kind is one of the three main types of symptoms of Parkinson’s disease. The other two are tremors and slowed movement called bradykinesia. Therefore, cogwheel rigidity can help doctors diagnose Parkinson’s disease.
How do you get tested for cogwheeling?
To test you for cogwheel rigidity, your doctor will have you relax the muscles in your limb. They’ll then flex and extend your limb. They’re looking to see if:
- your muscle is stiff and inflexible when they try to move it
- your limb moves with small, “jerky” motions (ratcheting motions)
Ratcheting motions are the hallmark of cogwheel rigidity. For you, this might feel like a click or catch in your muscles as you move your arm.
Another hallmark of cogwheel rigidity is that the jerky movements happen even when the doctor moves your limb slowly. This distinguishes it from spasticity, another potential symptom of Parkinson’s disease.
What causes cogwheeling?
The basal ganglia are parts of the brain that help control your body movements and keep them smooth. To do this, the neurons in the basal ganglia use dopamine to connect and communicate with one another.
People with Parkinson’s disease have less dopamine, a type of neurotransmitter (a chemical in the brain). When there’s less dopamine, the cells in the basal ganglia can’t connect or communicate as well. This means they can’t keep your motions as smooth as they would otherwise be, which causes rigidity and the other body movement issues common to Parkinson’s disease, like tremors.
Cogwheel rigidity can be found in other Parkinsonian conditions. These include:
- progressive supranuclear palsy
- multiple system atrophy
- corticobasal degeneration
These conditions have similar symptoms but different causes. However, cogwheel rigidity is most common in Parkinson’s disease.
How is cogwheeling treated?
You can help treat cogwheel rigidity by treating the underlying condition. The most common and effective treatment for Parkinson’s disease is levodopa (l-dopa). It can help all symptoms, not just cogwheel rigidity. It’s often combined with carbidopa, which helps lessen side effects.
Dopamine agonists and MAO-B inhibitors are other medications that treat Parkinson’s disease.
If no other medication has worked, some people with advanced Parkinson’s disease are candidates for deep brain stimulation. In this procedure, electrodes are positioned in the basal ganglia, where they send small electrical signals into the brain. This can help lessen cogwheel rigidity.
There are also things you can do at home to help manage your cogwheel rigidity. These include:
- Bouncing a ball — like dribbling a basketball — to keep your arms moving.
- Exercising. This can help strengthen your muscles and relieve pain. Aerobic exercise where you do large movements (like certain types of dancing) is best for reducing rigidity. Just be sure not to push yourself beyond your physical limitations.
- Stretching, to keep your muscles flexible.
- Practicing tai chi or yoga.
- Reducing stress. While stress doesn’t cause Parkinson’s disease, it can make your symptoms worse.
When you do any type of exercise, make sure you cool down properly. This helps keep your muscles from getting stiff again. A physical therapist can help you find the best exercise and stretching routine for you.
Parkinson’s disease isn’t curable at the current time, but the symptoms can be treated with medication and lifestyle changes like exercise and stress reduction.
Research on Parkinson’s treatment and potential cures is progressing as the pace of brain research in general is getting faster. While Parkinson’s is a complicated disease, researchers have learned a lot about its underlying biology and are working on targeted treatments.
Early diagnosis is particularly important for effective treatment. Cogwheel rigidity is often an early sign of Parkinson’s disease, so talk to a doctor if you have this symptom. This will help ensure you get a proper diagnosis and treatment.
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