Neurodegenerative Disorders, Parkinson’s & Alzheimer’s Disease

Neurodegenerative diseases progressively alter the neurons, brain regions, neural pathways, and interconnected networks responsible for movement, cognition, memory, balance, autonomic regulation, behavior, vision, speech, and other essential neurological functions. Parkinson’s disease, Alzheimer’s disease, Lewy body disease, and other neurodegenerative disorders require more than simply assigning a diagnosis and monitoring progression. They require understanding which neurological systems are degenerating, why the patient presents the way they do, and which aspects of their neurological function may still be protected, strengthened, rehabilitated, or modified.

Dr. Funk diagnoses and treats complex neurodegenerative disorders including Parkinson’s disease, Alzheimer’s disease, mild cognitive impairment (MCI), Lewy body dementia and dementia with Lewy bodies, Parkinson’s disease dementia, vascular dementia and mixed dementia, frontotemporal dementia (FTD), progressive supranuclear palsy (PSP), multiple system atrophy (MSA), corticobasal syndrome and corticobasal degeneration, and other forms of progressive cognitive, movement, and neurological degeneration.

Neurodegenerative diseases do not affect every neuron equally. Different diseases preferentially involve different anatomical structures, neurotransmitter systems, proteins, pathways, and neural networks. Dr. Funk uses the neurological examination to identify these patterns and localize dysfunction across cortical and subcortical regions, the hippocampus and medial temporal structures, basal ganglia and dopaminergic systems, thalamus, cerebellum, brainstem, autonomic networks, sensory and motor pathways, oculomotor systems, and the distributed neural networks connecting these regions.

In Parkinson’s disease and parkinsonian disorders, Dr. Funk evaluates far more than tremor. The neurological examination investigates bradykinesia, rigidity, postural instability, gait dysfunction, freezing, balance and coordination, eye movements, vestibular function, sensory integration, autonomic dysfunction, cognition, sleep-related symptoms, and other motor and non-motor manifestations. These findings help distinguish idiopathic Parkinson’s disease from atypical parkinsonian syndromes and identify the specific neurological systems contributing to each patient's disability.

In Alzheimer’s disease and other dementias, Dr. Funk evaluates the pattern of cognitive impairment rather than treating “memory loss” as a single neurological problem. Memory encoding, consolidation and retrieval, attention, working memory, executive function, language, visuospatial processing, processing speed, behavior, and other higher cortical functions may be affected differently depending on the underlying disease and stage of degeneration. These patterns are integrated with neurological examination findings, neuroimaging, laboratory diagnostics, medical history, and other objective information to clarify the diagnosis and characterize the neurological systems involved.

Advanced neuroimaging is an important component of this process. Dr. Funk personally reviews relevant MRI and other brain imaging and correlates structural findings with the patient's neurological examination and clinical presentation. Depending on the condition, this may include evaluation of hippocampal and temporal-lobe atrophy, cortical and subcortical patterns of degeneration, basal ganglia and brainstem abnormalities, white-matter disease, cerebral small-vessel disease, previous infarction or vascular injury, and other structural findings that may help distinguish neurodegenerative, vascular, traumatic, or mixed neurological processes.

Dr. Funk also investigates potentially modifiable contributors that may influence neurological function, disease burden, or the patient's ability to compensate for neurodegeneration. When clinically appropriate, advanced laboratory testing and other diagnostics may evaluate metabolic and glucose regulation, vascular and cerebrovascular risk, endocrine and thyroid function, nutritional deficiencies, neuroimmune and inflammatory abnormalities, infectious and post-infectious mechanisms, autonomic dysfunction, sleep, medication effects, mitochondrial and cellular-energy physiology, and other factors relevant to neuronal health.

A polysubspecialty approach is particularly important in neurodegenerative disease because these disorders rarely remain confined to a single neurological system. Dr. Funk integrates Neurodegenerative Neurology with Movement Disorders, Cognitive and Memory Neurology, Dysautonomia, Vestibular Neurology, Neuro-Ophthalmology and Oculomotor Neurology, Vascular Neurology, Neuroimmunology, Neuroendocrinology, Neuroimaging, and other relevant neurological subspecialties to understand the patient's disease as a whole rather than as a collection of unrelated symptoms.

Treatment follows the diagnosis, disease process, and neurological localization. Neurodegeneration cannot simply be rehabilitated away, and treatment is not presented as reversing diseases such as Parkinson’s or Alzheimer’s. Instead, Dr. Funk identifies the neurological systems that remain capable of adaptation and develops individualized strategies designed to improve function, strengthen compensatory neural networks, address modifiable contributors, and maximize the patient's neurological reserve and quality of life.

Depending on the neurological localization and the patient's clinical status, treatment may incorporate individualized movement and gait rehabilitation, balance and coordination training, vestibular and oculomotor rehabilitation, neuro-optometric rehabilitation, cognitive rehabilitation, sensory and motor rehabilitation, peripheral nerve stimulation, transcutaneous auricular vagus nerve stimulation (taVNS), transcranial photobiomodulation, vestibular caloric stimulation, pulsed electromagnetic field therapy (PEMF), and other targeted neurological rehabilitation and neuromodulation strategies.

Neuroplasticity remains critically important even in a nervous system affected by progressive neurodegeneration. Precisely targeted and repeated neurological activation is designed to strengthen surviving neural connections, reinforce functional networks, promote adaptive synaptic, dendritic, and axonal remodeling, and recruit compensatory circuitry where possible. The objective is to use the nervous system's remaining capacity for neuroplasticity to preserve and improve neurological function for as long as possible.

Dr. Funk may also incorporate individualized nutraceutical and over-the-counter medication strategies based on the patient's neurological, metabolic, vascular, inflammatory, nutritional, and biochemical findings. When prescription medications—including dopaminergic therapy, cognitive medications, disease-specific therapies, or other medical treatment—are indicated, Dr. Funk coordinates and co-manages care with the patient's prescribing clinicians and other appropriate specialists.

The objective is not simply to name a neurodegenerative disease and watch it progress. Dr. Funk works to establish the neurological diagnosis, determine the pattern and localization of degeneration, distinguish overlapping and potentially reversible contributors, identify modifiable mechanisms affecting neurological function, and target the surviving nervous system as precisely as possible. Through comprehensive polysubspecialty neurological evaluation, individualized rehabilitation, neuromodulation, neuroplasticity, and coordinated medical care, the goal is to preserve function, strengthen neurological resilience, and help each patient maintain the greatest possible independence and quality of life.