What is Parkinson’s disease?
Parkinson’s disease is a type of progressive movement disorder of the nervous system. It causes the neurons (nerve cells) in parts of the brain to weaken and damage, leading to symptoms that include problems with movement, impaired balance, stiffness and tremor. As the symptoms of Parkinson’s disease progress, one may experience difficulty talking, walking and completing everyday tasks.
Parkinson’s Disease Symptoms
Parkinson’s disease affects people in different ways. The symptoms and rate of progression differ for every individual with Parkinson’s disease. Parkinson’s disease symptoms mostly begin on one side of the body. Even though the condition eventually affects both sides of the body, the symptoms are often less severe on one side of the body as compared to the other.
The primary symptoms of PD are:
Tremor: Tremor or shaking often begins in an individual’s hands, although in a few cases the person’s jaw or foot is affected first. The tremor associated with Parkinson’s disease has a rhythmic back and forth motion.
Rigidity: Stiffness in the muscles or resistance in movement often affects most people with PD.
Bradykinesia: It is the slowing down of some automatic or spontaneous movement. It makes simple, everyday tasks more difficult and a person’s face less expressive (also known as “masked face”).
Postural instability: This includes changes in posture and balance problems, which can increase the risk of falls.
Note: Individuals with Parkinson’s disease often develop “Parkinson’s gait”. It includes the tendency to lean forward and take small or quick steps as if hurrying (known as festination), along with reduced swinging in one or both arms. They may also experience trouble initiating movement, also referred to as “start hesitation”.
In addition to characteristic symptoms of Parkinson’s disease, an individual with PD may also experience:
Emotional and mental health issues such as anxiety or depression
Difficulty in chewing or swallowing
Changes in speech or speech difficulties
Constipation or urinary problems
Skin problems such as increased facial oils, particularly in the T-zone of the face. The scalp may also become oily. In some cases, a person may experience dry skin or excessive sweating.
Sleep problems such as restless sleep, difficulty staying asleep, nightmares and REM sleep behaviour disorder are common in individuals with Parkinson’s disease.
Dementia: Some individuals with PD may experience slowed thinking and memory problems. In addition, cognitive problems become severe in the late stages of Parkinson’s disease and some people may be diagnosed with dementia.
Orthostatic hypotension: It is a sudden drop in blood pressure, for instance, when a person stands up from a seated position.
Muscle cramps: Lack of normal movement and rigidity in people with Parkinson’s disease may cause muscle cramps. PD may also be associated with dystonia- strained contractions in the muscles causing twisted or forced positions.
Lack of energy and fatigue: People with Parkinson’s disease often experience fatigue, especially during later in the day. This can be associated with sleep disorders or depression.
Sexual dysfunction: Due to the impact of Parkinson’s disease on nerve signals from the brain, it may cause sexual dysfunction.
Parkinson’s Disease Risk Factors
The risk factors for Parkinson’s disease may include:
Age: The average of PD onset in an individual is during early mid-60s. The incidence of Parkinson’s disease rises with old age. A small percentage of people are also diagnosed with early-onset Parkinson’s disease, which starts before the age of 50.
Gender: Parkinson’s disease is more common in men than women.
Genetics: People who have one or more close relatives with Parkinson’s disease are at a greater risk of developing PD themselves.
Environmental exposure: People who live in areas where exposure to pesticides is high are known to be at a greater risk of Parkinson’s disease.
Parkinson ’s Disease Causes
Even though the exact cause of Parkinson’s disease is not known, some cases of PD can be traced back to gene mutations.
A majority of cases of Parkinson’s disease are sporadic, which means with no known cause.
Genetic mutations associated with PD include the alpha-synuclein gene and many others have also been linked to the disorder.
Oxidative stress is known to be another potential cause of Parkinson’s disease, which refers to damage caused by free radicals.
Other possible causes can be categorised as:
Familial Parkinson’s Disease
PD can have a familial cause, which means that it can be inherited from one or both parents.
Idiopathic Parkinson’s Disease
Idiopathic Parkinson’s Disease happens because of issues with how the body utilises a protein known as a-synuclein.
Some circumstances and conditions have also been linked to parkinsonism. The possible causes may include:
Medications: Some medications can potentially cause a parkinsonism-like effect. The effects are often temporary but can linger for weeks or months after the medication is stopped.
Encephalitis: Inflammation in the brain, also known as encephalitis can sometimes cause parkinsonism.
Toxins: Exposure to toxins like manganese dust, fumes from welding or pesticides and carbon monoxide can lead to parkinsonism.
Injury: Repeated head injuries, including those due to contact or high-impact sports can lead to brain damage. This is also referred to as post-traumatic parkinsonism.
Parkinson’s Disease Diagnosis
Presently, there are no specific tests to help diagnose Parkinson’s disease. Regular follow-up appointments with a neurologist is crucial to evaluate the condition and its symptoms overtime. Some of the tests and procedures a doctor may recommend includes:
Neurological examination: A neurological exam determines an individual’s senses, thinking or mental abilities, coordination, and reflexes.
Blood tests: These tests help rule out other underlying conditions that may be causing symptoms.
Imaging tests: These tests may include a brain ultrasound, MRI, and positron emission tomography (PET) scan.
Single-photon emission computerised tomography (SPECT) called dopamine transporter (DAT) scan: This type of tests helps determine different types of tremor.
Genetic tests: This test detects gene changes in case of a known family history of Parkinson’s disease.
Alpha-synuclein test: Also known as alpha-synuclein seed amplification assay, this test helps detect Parkinson’s disease before an individual experiences any symptoms.
Parkinson’s Disease Treatment
Even though Parkinson’s disease can’t be cured, medicines can help control the symptoms.
Medicines help improve problems with movement and tremor. The medicines work by increasing or substituting for the dopamine in the brain.
Medicines prescribed for Parkinson’s disease may include:
Carbidopa-levodopa: This is the most effective Parkinson’s disease medicine. Levodopa is a natural chemical that passes into the brain and turns into dopamine.
Inhaled levodopa: This medicine helps manage symptoms when oral medicines suddenly stop working during the day.
Carbidopa-levodopa: This medicine is for patients with advanced Parkinson’s disease who still respond to medicine but require a more constant levodopa level.
Dopamine agonists: Unlike levodopa, dopamine agonists do not change with dopamine. Instead, it mimics dopamine effects in the brain.
Other medicines may include monoamine oxidase B inhibitors, catechol O-methyltransferase inhibitors, anticholinergics, amantadine, adenosine receptor antagonists, pimavanserin.
Deep Brain Stimulation (DBS)
DBS involves putting electrodes in the brain. The electrodes are connected to a generator that is placed just close to the collarbone. This generator sends electrical pulses to the brain and helps reduce Parkinson’s disease symptoms. It is particularly helpful for improving severe tremor and involuntary muscle movements (dyskinesia).
MRgFUS or MRI-guided focused ultrasound is a minimally invasive treatment that helps improve tremor in some individuals with Parkinson’s disease.
FAQs
What is the main cause of Parkinson’s disease?
Parkinson’s disease is caused due to a loss of nerve cells in a part of the brain referred to as “substantia nigra”. The nerve cells or neurons in this part of the brain are responsible for producing a chemical called dopamine. A family history of Parkinson’s, genetic mutations and exposure to toxins are some of the known Parkinson’s disease causes.
What is the life expectancy of Parkinson’s disease?
PD does not directly cause death, but the condition can place a great amount of strain on the body. It can also make some people vulnerable to serious or life-threatening conditions. However, with advances in treatment, a majority of people with Parkinson’s disease have a normal or near-normal life expectancy.
Is Parkinson’s disease curable?
Currently, there is no cure for Parkinson’s disease. However, treatments are available to relieve symptoms and maintain quality of life.
How to prevent Parkinson’s?
In terms of Parkinson’s disease prevention, aerobic exercise is linked to a lower risk of Parkinson’s disease. Additionally, caffeinated beverages such as green tea and coffee has also been linked to a lower risk of Parkinson’s.
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