Article By Sucharita Desu
April is Parkinson’s Awareness Month. On average, approximately 60,000 Americans are diagnosed with Parkinson’s Disease (PD) each year. Increasing awareness about the disease helps improve care for people with Parkinson’s disease. One of the ways to do this is simply by learning more about the disease, sharing what you know with others and applying what you know if/when you help people with Parkinson’s disease. So, what is Parkinson’s disease?
Parkinson’s disease is a brain disorder, specifically it is a progressive nervous system disorder that affects a person’s movements. It can lead to shaking, stiffness and difficulty with walking, balance, and coordination. It may also cause mental and behavioural changes, sleep problems, depression, memory difficulties and fatigue. Some other complications of the disease include thinking difficulties or cognitive problems like dementia, bladder problems, smell dysfunction (difficulty identifying certain odours), problems chewing and eating, and more.
Parkinson’s disease occurs when certain neurons (nerve cells) in the brain gradually become impaired (break down) or die. These neurons are specifically in the basal ganglia, the area of the brain that controls movement. These neurons are responsible for producing a brain chemical called dopamine. Less dopamine is produced if these neurons die or become impaired, which causes movement problems seen in Parkinson’s disease. Some people with Parkinson’s disease also lose nerve endings that produce norepinephrine. Norepinephrine is the chemical messenger of the sympathetic nervous system and controls many functions of the body, such as heart rate and blood pressure. Losing these nerve endings causes things like fatigue, irregular blood pressure, decreased movement of food through the digestive tract and more.
Another change in the brain caused by Parkinson's disease is the presence of Lewy bodies in the brain. Lewy bodies are clumps of specific substances, including alpha-synuclein (a natural and widespread protein), within brain cells. They are microscopic indicators of Parkinson’s disease and are believed to have an important clue to the cause of the disease, which is still being studied.
The symptoms of this disease are gradual and worsen as the condition progresses. The symptoms vary from person to person and can sometimes go unnoticed at the start because they are very mild. The symptoms start to affect one side of the body before they start on both sides. Even after symptoms start on both sides, they are worse on the first side. Symptoms of Parkinson’s disease include tremors (usually in hands or fingers), bradykinesia (slowed movement), rigid muscles, impaired posture and balance, changes in speech, loss of automatic/unconscious movements (i.e., blinking, smiling, facial expressions, swinging arms when walking), and changes or difficulties in writing.
Currently, the exact cause of Parkinson’s disease is still unknown. Some cases are hereditary, others are traced to specific genetic mutations, and most seem to occur randomly. In general, studies show that several factors play a role in the cause of the disease, including genes and environmental factors. There are certain genetic variations/mutations that appear to increase the risk of Parkinson’s disease. In addition, exposure to toxins can increase the risk of getting Parkinson's. However, these risks are still relatively small and the link between them and Parkinson’s disease is still being researched.
One risk factor for getting Parkinson’s disease is age as the disease begins in middle or late life, meaning the risk increases as a person ages. Usually, the disease develops at around 60 or more years old. Heredity is also a risk factor of Parkinson’s disease, especially if a person has many relatives within their family with the disease. Lastly, gender is a risk factor as men are more likely to develop Parkinson’s disease than women.
Although there are not any blood or laboratory tests to diagnose nongenetic cases of the disease, doctors base their diagnosis of Parkinson’s disease on symptoms, medical history, and neurological examination. After a diagnosis, treatments are available to help relieve the symptoms of Parkinson’s disease, but there is no cure for this disease.
One option is using medications, specifically drugs that increase dopamine levels, affect other brain chemicals in the body and help control nonmotor symptoms. Some examples include levodopa which can be used by neurons to make dopamine and replenish the brain’s reducing supply. Others include dopamine agonists that mimic the role of dopamine, and anticholinergic drugs to reduce tremors and muscle rigidity. Another treatment is surgery, specifically something known as Deep Brain Stimulation, where they implant electrodes and a small electric device into the brain and chest to help stop movement-related symptoms. Other therapies, like physical, occupational and speech therapies, healthy diets, and exercises, may also be recommended to help with many of the symptoms (e.g., tremors, decreased mental functions, muscle strength and balance).
There is still much research being done on prevention of the disease as well. In fact, some studies show regular aerobic exercise might reduce the risk of Parkinson’s disease. Furthermore, a few studies even show a link between consuming caffeine and a reduced risk of developing the disease. However, there still is not enough information to fully understand how and why these things protect against Parkinson’s disease.
As always, it’s encouraged to find out more about the disease. Check out these links for a place to start learning:
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