What is Parkinson’s Disease?
Parkinson’s disease (PD) is a long-term degenerative disorder of the central nervous system that mainly affects the motor system.
It is a progressive disease of the nervous system marked by tremor, muscular rigidity, and slow, imprecise movement, chiefly affecting middle-aged and elderly people. It is associated with degeneration of the basal ganglia of the brain and a deficiency of the neurotransmitter dopamine.
Normally, dopamine sends signals to the part of your brain that controls movement. It lets your muscles move smoothly and do what you want them to do. But when you have parkinson’s, these nerve cells break down. Then you no longer have enough dopamine, and you have trouble moving the way you want to.
Parkinson’s gets worse over time, though this happens slowly, over many years. The good news is that there are good treatments that can help you live a full life.
Parkinson’s disease itself is not fatal. However, complications from the disease are serious. It will interest you to know that the Centers for Disease Control And Prevention (CDC) rated complications from PD as the 14th top cause of death in the United States.
Statistics on Parkinson’s Disease
As many as one million Americans live with Parkinson’s disease, which is more than the combined number of people diagnosed with multiple sclerosis, muscular dystrophy and Lou Gehrig’s disease.
Approximately 60,000 Americans are diagnosed with Parkinson’s disease each year, and this number does not reflet the thousands of cases that go undetected.
The average age of onset is 60
15-25 percent of people with Parkinson’s disease have a relative with the disease.
More than 10 million people worldwide are living with Parkinson’s disease.
Incidence of Parkinson’s disease increases with age but an estimated four percent of people with PD are diagnosed before the age of 50.
Men are one and a half times more likely to have Parkinson’s than women.
Symptoms of Parkinson’s may progress over a period longer than 20 years.
Symptoms and Signs of Parkinson’s Disease (PD)
Symptoms that define this disorder are four in number. These include:
- Shaking commonly in the hands but may also occur in the feet or head.
- Slow movement.
- Rigid muscles caused by a loss of the normal contraction-relaxation between opposite muscles at the same joint.
- Weakened posture and balance characterized by bend over stance or drooping shoulders and a tendency to fall easily
Usually, early signs of Parkinson’s can be subtle and take a long period of time before they become obvious. Those signs may even be simply interpreted as the result of aging. Family members or close friends of affected people may observe irregular movement, a lack facial expression, a loss of reflexes, such as the ability to initiate walking, and speech changes.
The shaking of hands typical of Parkinson’s make holding utensils difficult, result in changes in hand writing and hinder other delicate movements.
Symptoms of Parkinson’s usually start on one side of the body, eventually spreading to both sides, although not equally. Also what symptoms appear and their intensity varies with each individual.
In addition to movement problems, a number of non-motor signs of Parkinson’s may arise. Among these are:
- Difficulty in swallowing and chewing
- Skin becomes too oily or too dry due to damage of the autonomic nervous system
- Inability to sleep
- Cramping of the muscle
- Easily gets tired
- Terrible pains in the muscles and joints
- Sudden drop in blood pressure
- Experience difficulty in urinating and constipation
- Inability to perform sexually
- Mood swings
Because these symptoms also appear in other diseases, diagnosing Parkinson’s accurately can be difficult, but is imperative to developing the correct treatment strategy.
Causes of Parkinson’s Disease (PD)
Nobody really knows the specific causes of Parkinson’s disease. What we have realized so far is that PD develops from several risk factors including aging, genetic tendency, and environmental pollutants. These risk factors is understood to lead to damage to nerve cells that produce dopamine and norepinephrine to control muscle movement. Patients with Parkinson’s retain less than 40 percent the normal number of cells that produce dopamine. Norepinephrine operates in a similar way as dopamine to control autonomic functions such as heartbeat and blood pressure.
Age is widely considered as the most important risk factor in PD. This is because most cases of PD begin in people at an average age of 60. Cases where they are observed earlier than the commonly accepted age are as a result of the Parkinson’s associated with heredity, and have been linked to mutations in several genes. Study also indicates contact with toxins and other environmental factors may be causes of Parkinson’s.
Also, men are more prone to Parkinson’s than the females, as seen in various researches, although the reason is not known. Known gene mutations related to PD include those affecting the parkin, PINK1 and DJ-1 genes.
Other likely source of Parkinson’s include viruses such as influenza (post-encephalitic parkinsonism), overproduction of free radicals that damage cells, build-ups of proteins that kill nerve cells, and neurotoxins such as MPTP (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine).
Stages of Parkinson’s Disease (PD)
In nearly all cases, the stages of Parkinson’s disease (PD) develop gradually, sometimes over a period of 20 years or longer. For others, it develops quickly. Doctors commonly use the Hoehn and Yahr scale and the Unified Parkinson’s Disease Rating Scale (UPDRS) to define how PD progresses.
- Stage One
- Signs and symptoms on one side only
- Symptoms mild
- Symptoms inconvenient but not disabling
- Usually presents with tremor of one limb
- Friends have noticed changes in posture, locomotion and facial expression
- Stage Two
- Symptoms are bilateral
- Minimal disability
- Posture and gait affected
- Stage Three
- Significant slowing of body movements
- Early impairment of equilibrium on walking or standing
- Generalized dysfunction that is moderately severe
- Stage Four
- Severe symptoms
- Can still walk to a limited extent
- Rigidity and bradykinesia
- No longer able to live alone
- Tremor may be less than earlier stages
- Stage Five
- Cachectic stage
- Invalidism complete
- Cannot stand or walk
- Requires constant nursing care
Survivability of Parkinson’s Disease (PD)
Surviving Parkinson’s disease depends on the severity of complications that may occur in the final stages of the sickness. Parkinson’s itself is not fatal and patients can live a normal life span. The failure of the ability to control the muscle may result to choking and falls that could result in a life threatening injury.
Some drug therapies can produce significant side effects requiring exact adherence to the regimen prescribed by the doctor.
Screening and Tests for Parkinson’s Disease (PD)
No authoritative tests for Parkinson’s disease (PD) exist yet that reliably confirm the disorder. Diagnosing Parkinson’s relies on a medical history and neurological examination. Doctors may need to monitor a person over a long period until the signs of Parkinson’s appear consistently because symptoms develop slowly.
In checking for Parkinson’s disease, doctors may administer trial doses of levodopa, a medication known to help relieve symptoms. A positive reaction supports the diagnosis of Parkinson’s. CT (computed tomography) scans and MRI (magnetic resonance imaging) are normal in patients with PD, but help rule out other diseases.
Treatments for Parkinson’s Disease (PD)
Doctors have an array of treatments for Parkinson’s disease (PD) that often provide dramatic relief from symptoms. Therapies fall into three categories: drug treatment, surgical procedures and supportive care therapies.
Medications to Treat Parkinson’s Disease
Three categories of treatment options for Parkinson’s that employ medications include those that increase dopamine levels; drugs that manage neurotransmitters; drugs that control related conditions such as depression.
Levodopa, or L-dopa, is the primary medication for Parkinson’s. Although it is not a cure, it has shown high rates of success in controlling tremors and other symptoms. It most effectively treats Bradykinesia (slow movement) and stiff muscles. Because levodopa may generate side effects, some of which may be severe, its use must be carefully monitored. Doctors adjust dosage as needed to achieve desired results and minimize complications. Other medications
In addition to levodopa, other medications to treat Parkinson’s include:
- Dopamine agonists, which mimic the effects of dopamine
- MAO-B inhibitors that prevent the breakdown of dopamine in the brain
- COMT inhibitors that also helps slow the breakdown of dopamine
- Anticholinergics that help reduce tremors in about half of cases
Surgical Treatments for Parkinson’s Disease
The use of surgery declined for a period after the discovery of levodopa; however, recent advances in surgical techniques now help people when drug therapies do not succeed. Among the treatment options for Parkinson’s that employ surgery are:
- Deep brain stimulation, a process in which tiny electrical impulses are directed at specific areas of the brain using an electrode implanted surgically
- Pallidotomy and Thalamotomy selectively destroy parts of the brain reducing tremors and improving gait and balance
Supportive Therapies for Parkinson’s Disease
Supportive care treatment options for Parkinson’s involve physical, occupational and speech therapies that help people manage and control symptoms. Other complementary therapies involve diet and exercise. While no specific evidence support the use of dietary supplements, some studies suggest that coenzyme Q10 may help slow the progress of PD. Exercise increases flexibility and mobility, helping move muscles through a range of motion to help reduce rigidity. Exercise may help increase the brain’s production of dopamine and beneficial neurotrophic factors while it boosts strength, improves balance,
and helps with emotional well-being. Yoga, massage, tai-chi, hypnosis and acupuncture are other complementary treatments for Parkinson’s. While none of these therapies cure or prevent PD, proper nutrition and regular exercise generally contribute to overall health.
Prevention of Parkinson’s Disease (PD)
At the time of writing this report, doctors have found no way to prevent PD. While no treatment cures the disease, early intervention with proven therapies may help slow the onset of symptoms and reduce their intensity for as long as possible. Although there are no evidence to prove this, consuming coffee, green tea and other antioxidants may likely prevent the attack on nerve cells that produce dopamine.