What is Parkinson’s disease?
How you get Parkinson's disease is not known, though scientists believe it's a combination of genetic and environmental factors.
Parkinson’s disease is a brain disorder that affects a person’s physical and mental abilities. As the disease slowly progresses, people begin to develop difficulties walking and talking. They will also experience behavioral changes, depression, loss of memory, sleep problems, and fatigue.
The exact cause of Parkinson’s disease is not known, though scientists believe it’s a combination of genetic and environmental factors. The common thread between all people who have Parkinson’s disease is a loss of neurons that create dopamine in the area of the brain known as the substantia nigra.
While there is no known cure, there are several treatment options that include lifestyle changes, medications, physical therapy, and surgery to help a person cope with Parkinson’s.
Symptoms of Parkinson’s disease?
The symptoms and rate of progression of Parkinson’s are different among individuals. Effects of normal aging are sometimes confused for Parkinson’s. It is difficult to accurately diagnose this disease because there is not a test that can accurately do it.
There are physical and non-physical symptoms that could indicate someone has Parkinson’s disease:
Physical symptoms
- Impaired balance and coordination, sometimes leading to falls
- Moving slowly
- Stiffness of the limbs and torso
- Trembling in the hands, arms, legs, jaw, or head
Non-physical symptoms
- Cognitive changes: Problems with attention, planning, language, memory or even dementia
- Constipation
- Early satiety: A feeling of fullness after eating small amounts
- Excessive sweating: Especially when wearing off medications
- Dandruff
- Fatigue
- Hallucinations and delusions
- Lightheadedness
- Loss of sense of smell or taste
- Mood disorders: Depression, anxiety, apathy and irritability
- Pain
- Sexual problems like erectile dysfunction
- Sleep disorders like insomnia, excessive daytime sleepiness (EDS), REM sleep behavior disorder (RBD), vivid dreams, Restless Legs Syndrome (RLS)
- Urinary urgency, frequency, and incontinence
- Vision problems, especially when attempting to read items up close
- Weight loss
Early stage symptoms
Parkinson's disease occurs gradually. At first, the symptoms might not even be noticeable. Early symptoms can include feeling mild tremors or having difficulty getting out of bed or a chair. The person might start to notice that they are speaking softer than usual, or that their handwriting looks different.
Usually, it is friends or family members who are the first to notice changes in someone with early Parkinson's. For example, they may notice that the person's face lacks expression and animation, or that the person does not move an arm or leg normally.
Causes of Parkinson’s disease
Parkinson’s occurs when neurons in the part of the brain that control body movement become impaired or die. These neurons are responsible for creating dopamine, an important brain chemical that is vital for normal body function.
With fewer of these neurons in the brain, insufficient dopamine is created. Scientists are still not sure what exactly causes these neurons to become impaired or die.
People with Parkinson’s also lose nerve endings that produce norepinephrine, the chemical messenger of the sympathetic nervous system that controls heart rate and blood pressure. This could be why fatigue and a decrease in blood pressure regularly occur with people who have Parkinson’s.
While there have been cases of the disease that appear to be hereditary and can be traced to specific genetic mutations, there isn’t enough evidence yet to conclusively prove it is passed down from parents to their children.
Most cases of Parkinson’s occur randomly, and researchers believe a combination of genetic and environmental factors are responsible.
Diagnosis of Parkinson’s disease
To diagnose Parkinson’s, doctors will use a combination of diagnostic tests, physical exams, and a review of family and health history. In general, two of the four main physical symptoms must be present over a period of time for a Parkinson’s diagnosis to be given.
If your primary care doctor believes you might have early onset of Parkinson’s, they will refer you to a specialist like a neurologist or a movement disorder specialist for further tests.
Treatments for Parkinson’s disease
There is currently no known cure for Parkinson’s and most treatments are aimed at limiting its effects and symptoms.
Medication
The main medical therapy used for Parkinson’s is levodopa, also known as L-dopa. This drug will help nerve cells make dopamine to replenish the brain’s decreasing supply. L-dopa is usually taken with carbidopa, a medicine that helps to reduce the negative side effects of levodopa. It also reduces the total amount of levodopa needed to improve symptoms.
Deep brain stimulation
A surgical procedure known as Deep Brain Stimulation, or DBS, is performed on people who aren’t responding or are responding negatively to the medication. This surgery involves implanting electrodes into the affected part of the brain and connects it to a small electrical device implanted in the chest.
The device stimulates the brain in a way that helps to stop the movement-related symptoms of Parkinson’s, like tremors and rigidity.
Physical therapy
Parkinson’s disease can be delayed and its symptoms reduced through regular, safe exercise like aerobics, light to moderate strength training, and balance training. Physiotherapeutic treatment should start as soon as a diagnosis is confirmed.
Additional therapies that have been shown to be effective in reducing the symptoms of Parkinson’s include occupational and speech therapies to assist with gait and voice disorders and decline in mental functions.