Parkinson’s Disease affects up to 1 million people in the United States. As many as 60,000 new cases are diagnosed each year and strikes 50% more men than women.
Parkinson’s disease (PD) is a neurodegenerative brain disorder that progresses slowly in most people. The average age of onset is 60 years; and for most people, the symptoms take years to develop.
So what causes Parkinson’s disease?
Parkinson’s is caused when the brain slowly stops producing dopamine which is a chemical that relays messages in the brain. Dopamine helps people to have smooth, coordinated muscle movements. The reduction of dopamine causes a person to have less ability to regulate their body movements and emotions. When 60-80% of the dopamine-producing cells are damaged, the motor symptoms of PD appear.
Though Parkinson’s is not fatal, complications from the disease can be. According to the CDC, complications from PD is the 14th top cause of death in the U.S.
Early symptoms of PD can be difficult to detect. Loss of sense of smell, sleep disorders and constipation may precede the loss of motor function of the disease for several years. For this reason, researchers are focusing in on these non-motor symptoms to detect PD earlier as well as look for ways to stop its progression. At present, there is no cure for Parkinson’s.
Not everyone experiences all of the same symptoms of Parkinson’s. However, for the most part, the stages are the same.
In the initial stage, mild symptoms will appear, but daily activities will not be impacted. Tremors will be present, but usually only affected movement on one side of the body. Friends and family may notice changes in posture, walking and facial expressions.
Symptoms will start to get worse in stage two of Parkinson’s. Tremors, rigidity and other movement will affect both sides of the body. Walking is more difficult and poor posture may be more noticeable. A person can still live alone, but normal routines and tasks will be more difficult and take longer.
Stage Three is noted when loss of balance occurs and movements further slow down. Falls are more common at this point, too. A person can still be independent in this stage, but daily tasks such as getting dressed and eating are significantly impaired.
During the fourth stage of the disease, symptoms are more severe. While a person may be able to stand alone, movement may require a walker. Daily routines are much more difficult rendering a person unable to live alone.
The most advanced and debilitating phase is stage five. The stiffness in a person’s legs makes it impossible for them to stand or walk and a wheelchair is required. For some, they become bedridden. 24-hour nursing care is required for all activities. Some people may also experience hallucinations and delusions.
Other symptoms can include:
- Depression, anxiety and irritability
- Slow thought, language and memory difficulty
- Hallucinations and delusions
- Sleep disorders
- Vision problems
- Excessive sweating, especially of hands and feet (with little or no exercise)
- Oily skin
- Increase in urinary frequency and incontinence
- Loss of sense of smell
- Sexual problems
- Weight loss or gain
Treatment and Medications
At present, there is no cure for PD, but a variety of medications provide dramatic relief from the symptoms. Usually, affected individuals are given levodopa combined with carbidopa.
Carbidopa delays the conversion of levodopa into dopamine until it reaches the brain. Nerve cells can use levodopa to make dopamine and replenish the brain’s dwindling supply. Although levodopa helps at least three-quarters of parkinsonian cases, not all symptoms respond equally to the drug. Movement and rigidity respond best, while tremors may be only marginally reduced. Problems with balance and other symptoms may not be alleviated at all.
Anticholinergics may help control tremor and rigidity. Other drugs, such as bromocriptine, pramipexole, and ropinirole, mimic the role of dopamine in the brain, causing the neurons to react as they would to dopamine.
An antiviral drug, amantadine, also appears to reduce symptoms. In May 2006, the FDA approved rasagiline to be used along with levodopa for patients with advanced PD or as a single-drug treatment for early PD.
A therapy called deep brain stimulation (DBS) has now been approved by the U.S. Food and Drug Administration. In DBS, electrodes are implanted into the brain and connected to a small electrical device called a pulse generator that can be externally programmed. DBS can reduce the need for levodopa and related drugs, which in turn decreases the involuntary movements called dyskinesias that are a common side effect of levodopa. It also helps to alleviate fluctuations of symptoms and to reduce tremors, slowness of movements, and gait problems. DBS requires careful programming of the stimulator device in order to work correctly.
If you are showing signs or symptoms associated with Parkinson’s disease, make an appointment with your doctor. Early treatment can help slow the progression of the disease.
Sources: National Parkinson’s Foundation and the National Institute of Health