Parkinson’s Disease

What is Parkinson's Disease?

Parkinson's disease (PD) is a neurodegenerative disorder that affects both motor and non-motor systems. Motor symptoms include tremors, slowed movement, rigidity, and difficulty maintaining balance. Non-motor symptoms may appear at any stage of the disease, including autonomic nervous system dysfunction, sleep abnormalities, decreased ability to smell, and behavioral or neuropsychiatric problems, such as cognitive impairment, psychosis, and anxiety. Symptoms typically develop gradually, and non-motor issues become more prevalent as the disease progresses.

Risk Factors

While Parkinson's disease has no single cause, some common risk factors for developing Parkinson's Disease include:

• Age: Older adults are more at risk, and the average age for onset is 60.
• Gender: Men are more likely than women to develop Parkinson's disease.
• Genetics: If you have a parent or sibling with Parkinson's disease, you are also more likely to develop it.
• Environmental factors: Exposure to some chemicals, including pesticides, herbicides, Agent Orange, solvents, and detergents, could all contribute to the development of Parkinson's disease.
• Head trauma: Repeated blows to the head can lead to Parkinson's

Symptoms

Parkinson's disease has four main symptoms:

• Tremor in hands, arms, legs, jaw, or head
• Muscle stiffness, where muscle remains contracted for a long time
• Slowness of movement
• Impaired balance and coordination, sometimes leading to falls

Other symptoms may include:

• Depression and other emotional changes
• Difficulty swallowing, chewing, and speaking
• Urinary problems or constipation
• Skin problems

The symptoms of Parkinson's disease and the rate of progression differ among individuals. For example:

• People may feel mild tremors, have difficulty getting out of a chair, notice that they speak too softly, or that their handwriting is slow and looks cramped or small.
• Friends or family members may be the first to see that the person's face lacks expression and animation, or that the person does not move an arm or leg normally.
• People with Parkinson's disease often develop a Parkinsonian gait that includes a tendency to lean forward; take small, quick steps; and reduce swinging their arms. They also may have trouble initiating or continuing movement.
• Symptoms often begin on one side of the body or even in one limb on one side of the body.
• Many people with Parkinson's disease note that prior to experiencing stiffness and tremor, they had sleep problems, constipation, loss of smell, and restless legs.

Diagnosis

There are currently no blood or laboratory tests to diagnose non-genetic cases of Parkinson's disease. Doctors usually diagnose the disease by reviewing a person's medical history and performing a neurological examination. If symptoms improve after starting medication, it's another indicator that the person has Parkinson's disease.

Treatments

Although there is no cure for Parkinson's disease, medications, surgical treatment, and other therapies can often relieve some symptoms.

Medication

Medication can help treat the symptoms of Parkinson's disease by:

• Increasing the level of dopamine in the brain.
• Having an effect on other brain chemicals, such as neurotransmitters, which transfer information between brain cells.
• Helping control non-movement symptoms.

The main therapy for Parkinson's disease is levodopa. Nerve cells use levodopa to make dopamine, replenishing the brain's dwindling supply. Usually, people take levodopa with another medication called carbidopa. Carbidopa helps prevent or reduce some side effects of levodopa therapy - such as nausea, vomiting, low blood pressure, and restlessness - and reduces the amount of levodopa required to improve symptoms.

People living with Parkinson's disease should never stop taking levodopa without consulting their doctor. Suddenly stopping the drug can have serious side effects, such as being unable to move or having difficulty breathing.

The doctor may prescribe additional medications to treat Parkinson's symptoms, including:

• Dopamine agonists to stimulate the production of dopamine in the brain.
• Enzyme inhibitors (e.g., MAO-B inhibitors, COMT inhibitors) to increase the amount of dopamine or by slowing down the enzymes that break down dopamine in the brain.
• Amantadine to help reduce involuntary movements.
• Anticholinergic drugs to reduce tremors and muscle rigidity.

Deep Brain Stimulation

For people with Parkinson's disease who do not respond well to medications, the doctor may recommend deep brain stimulation. During a surgical procedure, the doctor implants electrodes into a part of the brain and connects them to a small electrical device implanted in the chest. The device and electrodes painlessly stimulate specific brain areas that control movement, potentially helping to stop many movement-related symptoms of Parkinson's, such as tremor, slowness of movement, and rigidity.

Other Therapies

Other therapies that may help manage Parkinson's symptoms include:

• Physical, occupational, and speech therapies, which may help with gait and voice disorders, tremors and rigidity, and declines in mental function.
• A healthy diet to support overall wellness.
• Exercises to strengthen muscles and improve balance, flexibility, and coordination
• Massage therapy to reduce tension
• Yoga and tai chi to increase stretching and flexibility

Support

As Parkinson's disease progresses, activities such as working, caring for a home, and participating in social activities with friends may become challenging. Support groups can help people cope by providing information, advice, and connections to resources for those living with Parkinson's disease, their families, and caregivers.