Parkinson's Disease

What Is Parkinson’s Disease?

Parkinson’s disease is a neurodegenerative disorder that is characterized by a loss of muscle control, which results in trembling of the body; stiff, slow movements; and impaired balance. According to the Parkinson’s Disease Foundation, it is estimated that as many as 1 million Americans have Parkinson’s disease. Further, more than 60,000 people are diagnosed with Parkinson’s disease every year. Worldwide, 7 to 10 million people are living with Parkinson’s disease.

Causes of Parkinson’s Disease

In Parkinson’s disease, certain nerve cells (neurons) in the brain gradually break down or die. Many of the symptoms are due to a loss of neurons that produce a chemical messenger in your brain called dopamine. When dopamine levels decrease, it causes abnormal brain activity, leading to impaired movement and other symptoms of Parkinson’s disease. The greater the loss of dopamine, the more uncontrolled the symptoms. Further, it is also believed that Parkinson’s may also cause other cells in the brain to deteriorate, as well.
Although it is clear that a lack of dopamine causes the symptoms of Parkinson’s disease, why these dopamine cells deteriorate is unclear. What is clear is that a number of irregular cellular processes are to blame, although stress has also been attributed to cell damage in Parkinson’s disease patients. Having a close relative with Parkinson’s disease increases the chances that you’ll develop the disease. However, your risks are still small unless you have many relatives in your family with Parkinson’s disease.

Signs and Symptoms of Parkinson’s Disease

Parkinson’s disease signs and symptoms can be different for everyone. Early signs may be mild and go unnoticed. Symptoms often begin on one side of your body and usually remain worse on that side, even after symptoms begin to affect both sides. A number of studies have shown that, at the time symptoms first appear, most Parkinson’s patients have lost about 20 to 40 percent of their dopamine-producing cells.

According to the Mayo Clinic Parkinson’s disease may present itself as a number of major symptoms:

• Tremor. A tremor, or shaking, usually begins in a limb, often your hand or fingers. You may rub your thumb and forefinger back and forth, known as a pill-rolling tremor. Your hand may tremble when it’s at rest.

• Slowed movement (bradykinesia). Over time, Parkinson’s disease may slow your movement, making simple tasks difficult and time-consuming. Your steps may become shorter when you walk. It may be difficult to get out of a chair. You may drag your feet as you try to walk.

• Rigid muscles. Muscle stiffness may occur in any part of your body. The stiff muscles can be painful and limit your range of motion.

• Impaired posture and balance. Your posture may become stooped, or you may have balance problems as a result of Parkinson’s disease.

• Loss of automatic movements. You may have a decreased ability to perform unconscious movements, including blinking, smiling or swinging your arms when you walk.

• Speech changes. You may speak softly, quickly, slur or hesitate before talking. Your speech may be more of a monotone rather than have the usual inflections.

• Writing changes. It may become hard to write, and your writing may appear small.

Other symptoms of Parkinson’s disease that can’t be overlooked include: depression; constipation; anxiety; stress; difficulty swallowing; loss of sense of smell; excessive salivation; increased sweating; erectile dysfunction in men; confusion and memory loss; slower speech and monotone voice; and incontinence.

Diagnosis of Parkinson’s Disease

There is currently no definitive test for Parkinson’s currently available however there have been a number of neurological guidelines created to better diagnose Parkinson’s disease. These include the Hoehn and Yahr scales as well as the Unifies Parkinson’s Disease Rating Scale.

The early stages of Parkinson’s disease may be mistaken for a host of other disorders and conditions, it becomes quite challenging to properly diagnosis it. Most of the time, a diagnosis of Parkinson’s disease is made by a neurologist who specializes in Parkinson’s disease and other movement disorders. A neurologist is often able to make an accurate diagnosis based on a patient’s medical history, neurological exam, and symptoms.

Treatment for Parkinson’s Disease

There’s currently no cure for Parkinson’s disease, but treatments are available to help relieve the symptoms and maintain your quality of life. These treatments include: supportive therapies, such as physiotherapy and medication. Levodopa is currently the most effective Parkinson’s disease medication. It is a natural chemical that passes into the brain and is converted to dopamine. All therapies and medications are focused on increasing dopamine in the brain or prolonging the effect of dopamine. It is through early therapies that many patients can delay the onset of motor symptoms.

Some patients with Parkinson’s disease may benefit from deep brain stimulation (DBS), a surgical therapy that has been FDA approved for over a decade. DBS involves implanting an electrode into a targeted area of the brain, usually the subthalamic nucleus (STN) or the globus pallidus interna (GPI). The implants can be done on one side or both sides of the brain as needed. The electrodes are stimulated through a connection to a pacemaker-like device located under the skin in the chest.

It is important to note, however, that many Parkinson’s patients find that rest, physical, occupational and speech therapies, and exercise are quite beneficial for moderating or controlling symptoms.