Overview
Parkinson's Disease is a chronic, progressive movement disorder affecting the lives of at least 500,000 individuals across the United States. The disease primarily affects the nervous system and several regions of the brain, mostly in the substantia nigra region, which helps to control balance and movement.
There are about 60,000 new cases of Parkinson's Disease identified each year, averaging out to about 13 out of 100,000 people in America. Typically affecting people over the age of 50, early symptoms are often be subtle and occur at a gradual pace. In addition to the physical symptoms, which include trembling and shaking, impaired balance, slow movement, inability to move and stiffness, Parkinson's Disease also can result in changes in cognition and mood, sleep disturbances, autonomic dysfunction, depression, difficulty speaking and urinary difficulty.
Late onset Parkinson's is the most common form of the disease and the risk of developing the condition increases with age. As the condition progresses, the physical symptoms may affect everyday living more severely.
Symptoms
The symptoms of Parkinson's Disease primarily affect the nervous system. Symptoms include trembling in the hands, arms, legs, jaw and face, rigidity or stiffness of the limbs, bradykinesia or slowness of movement and postural instability or impaired balance and coordination.
Typically the initial symptom of Parkinson's Disease is the trembling or shaking of one particular limb especially when the body is at rest. This tremor often begins on one side of the body, often in one hand. These tremors can also affect the arms, legs, feet and face.
As the condition progresses and the individual ages, the symptoms become more severe and the patients may eventually have trouble walking, talking or completing simple tasks.
Other accompanying symptoms include depression and emotional changes, difficulty swallowing, chewing or speaking, urinary problems and constipation, skin problems, sleep disruption and autonomic dysfunction.
Diagnosis
Currently, there are no blood or specific laboratory tests that have been proven to help in the diagnosis of Parkinson's Disease. The diagnosis is based on medical history and a neurological examination. Because it is difficult to diagnosis, doctors and health care professionals may request brain scans or other laboratory tests in order to rule out other varying diseases, which could be causing similar symptoms.
There are gene tests available in the diagnosis of Parkinson's Disease as well although the most obvious indicator may be the onset of symptoms.
Knowing your medical history may help significantly in the diagnosis of Parkinson's. Heredity and Parkinson's are closely linked although it is still unconfirmed if each case is directly connected by family genetics. When three or more individuals within a family are affected with Parkinson's, it is suspected that there is a specific gene making this family more likely than others to develop the condition.
Dominant inheritance and recessive inheritance (when siblings have the condition but the parents do not) are both known to have occurred in cases of Parkinson's. If you know Parkinson's is present in your family tree, it is essential to be tested early.
Treatments
Parkinson's Disease is chronic and progressive meaning that as it persists over a long period, it steadily grows worse, affecting the body more severely. However, the condition differs with each individual. While some patients may become seriously disabled, others may experience only minor motor disruptions.
Certain pharmacological and surgical treatments aid in providing relief from certain motor disruptions but are not able to slow or stop the overall progression of the condition. Your doctor may prescribe a variety of medications for your specific treatment plan that include muscle relaxants, which may aid in providing relief from stiffness and tremors.
- Levodopa: A common pharmaceutical for Parkinson's treatment, Levodopa is used to build up the brain's dwindling supply of dopamine. Brain cells convert the drug into the hormone and replenish the need for it inside the body.
- Glutamte: A drug which targets the body's neurotransmitters, Glutamate helps to overlap the electrical signals that trigger certain Parkinson's symptoms.
Another option for those with symptoms severe enough that medication alone cannot control the condition, is Deep Brain Stimulation or DBS. DBS is a surgical procedure, currently available for those with extensively significant symptoms. The surgery is meant to treat symptoms commonly associated with Parkinson's such as tremor, rigidity, stiffness, slowed movement and walking problems. DBS uses a surgically implanted device called a neurostimulator, which delivers electrical stimulation to certain areas within the brain blocking abnormal and damaged nerve signals that cause Parkinson's symptoms. Implanted beneath the skin typically near the collarbone, the neurostimulator device is similar to the concept of a pacemaker and is about the size of a stopwatch. While the majority of patients who undergo the procedure still require medication, many find significant relief from symptoms and a drop in need for so many medications.
Stem cell research is a large factor in the continued search for Parkinson's treatment and many continue to advocate for its further research. Embryonic stem cells, cells able to differentiate into any type of cell within the human body, are thought to be possibly used to derive dopamine-producing neurons which might alleviate symptoms in Parkinson's patients. The ability these stem cells have to become any cell necessary, including brain cells, mean they have the potential to overlap damaged cells within the brain, which trigger Parkinson's symptoms. This could provide significant relief from symptoms and improve livelihood to those living with the condition.
Causes
Parkinson's Disease results from a complex interaction of environmental and genetic factors.
Fifteen percent of those diagnosed with Parkinson's have a family history of the condition. Gene mutations and alterations have been thought to play a role in developing risk for the disorder but not in the inheriting of the condition itself.
Many of the symptoms associated with Parkinson's Disease occur when neurons or nerve cells die or become greatly impaired. These cells regularly produce dopamine, which is responsible for the transmission of signals within the brain to create smooth and successful movement. When these dopamine-producing neurons die, the necessary communication between the brain and muscles weaken, eventually reaching the point when the brain can no longer control the limbs' movements.
Getting Help
Getting help is essential in the management and treatment of Parkinson's Disease. As a condition that typically affects those over the age of 50, debilitating symptoms that greatly affect motor skills could signify the need to be near or live with others who may assist you.
Depending on the severity of the symptoms, you may be interested in pursuing surgical options in addition to a medication treatment plan mapped out with your doctor or health care professional. While there is no cure or stable and universal treatment for Parkinson's, there are options available and speaking with your doctor about your eligibility is essential.
Besides medication options which may include a variety of prescriptions including muscle relaxants to improve body tremors and rigidity, you should ask your doctor about Deep Brain Stimulation or DBS. DBS is a surgical option for those who are unable to control their symptoms through medication alone. DBS provides patients with a neurostimulator that blocks the electrical signals which can cause Parkinson's symptoms. Although the majority of patients who undergo the procedure still require medication to regulate their condition, many experience a significant reduction of their symptoms.
Related Information
Research and Potential
What research initiatives are being conducted for Parkinson's?
- At the National Institutes of Health (NIH), the National Institute of Neurological Disorders and Stroke is the primary institute supporting Parkinson's Disease research. In 2011 alone, they funded $96 million out of $151 million in NIH supported Parkinson's research. Scientists and researchers are not only looking for treatment but also environmental factors that may act as triggers for the condition.
Are there any known possible treatments on the horizon for those with Parkinson's?
- While there is currently no cure or stable and universal treatment for those with Parkinson's, there are treatments currently in the testing process which could provide aid to those in the future suffering from the condition. Coenzyme Q10, a compound used in a placebo-controlled multicenter clinical trial in 2002, has been shown to slow disease progression in patients with early-stage Parkinson's. In 2004, an experimental vaccine tested on mice, showed it is possible to reduce the amount of neurodegeneration for Parkinson's and provided hope that medication which slows the condition will one day be available for humans. Deep Brain Stimulation (DBS), is a surgical option for patients with Parkinson's whose condition is not able to be controlled with medication and alternative therapy alone. The procedure, which is currently available, provides patients with a neurostimulator that blocks the electrical signals which can cause Parkinson's symptoms. Although the majority of patients who undergo the procedure still require medication to regulate their condition, many experience a significant reduction of their symptoms.
What is GWAS and how can it aid in Parkinson's research and diagnosis?
- Genome-Wide Association Studies (GWAS) or new research studies, is a particular approach that involves rapidly scanning markers across completed sets of DNA from many people in order to find genetic variations associated with a specific disease or condition. So far, GWAS has been able to identify genetic variations that contribute to diseases such as Parkinson's. Locating and studying these specific genes, may help doctors understand how the disease is inherited and why.
Living With
While living with Parkinson's Disease is a difficult burden, it is possible with the necessary assistance, support and vigilance. Consult your doctor or health care professional about treatment and symptom management. What doesn't work for one patient, may work for another.
Health management depends on symptoms experienced and medication combinations or surgical options can be prescribed by your doctor depending on your physical needs.
If your symptoms are severe and unable to be properly controlled by prescribed medication, you may be eligible for Deep Brain Stimulation (DBS), which is a surgical option for those who suffer significant symptoms and have been unable to find relief through more mild and conventional outlets.
