Parkinson’s Disease

Parkinson’s Disease is a progressive neurological disorder that primarily affects movement. It is caused when our nerve cells known as the substantia nigra in our brain die out. It leads to a decrease in dopamine production—a key neurotransmitter responsible for controlling movement.

A person with Parkinson’s Disease typically experiences tremors, stiffness, and difficulty with balance and coordination. The symptoms develop slowly over the years which makes it more difficult to prevent. With time, the symptoms can worsen, impacting daily activities and quality of life. Therefore, understanding Parkinson’s Disease is crucial for early diagnosis, effective management, and improving the lives of those affected.

It was first described by Dr. James Parkinson in 1817, and since then, it has become one of the most recognized neurodegenerative conditions globally. As per multiple reports, more than 10 million people worldwide are affected by Parkinson’s Disease, more than one million in the United States alone.

Parkinson’s Disease is known for its diverse range of symptoms, meaning the symptoms may vary from person to person and can develop gradually over time. They are typically classified into two categories: motor and non-motor symptoms.

Motor symptoms are the most common type of symptoms. They are typically related to movements and coordination. They are also usually visible and widely recognized aspects of Parkinson’s Disease. Let’s take a look at some of the most common motor symptoms:

• Tremor: Often starting in the hand or fingers, most noticeable at rest and may lessen with movement.
• Bradykinesia: Slowness of movement, making tasks like buttoning a shirt or walking difficult and time-consuming
• Rigidity: Stiffness in limbs and trunk, making movements difficult and sometimes painful
• Postural Instability: Trouble with balance, increasing the risk of falls and causing a hunched posture.
• Gait and Movement Problems: Trouble with balance, increasing the risk of falls and causing a hunched posture.

Non-motor symptoms may not be as apparent as motor symptoms, but they can significantly impact the quality of life for those with Parkinson’s Disease:

• Sleep Disturbances: Difficulty falling asleep, and staying asleep, and REM sleep behavior disorder, where they act out dreams.
• Cognitive Impairment: Difficulties with attention, planning, and memory. In advanced stages, some individuals may develop Parkinson’s Disease dementia.
• Mood Disorders: Depression and anxiety. They can be related to both the psychological burden of living with a chronic illness and the changes in brain chemistry.
• Autonomic Dysfunction: Problems such as constipation, urinary incontinence, and orthostatic hypotension.

It’s always challenging to Diagnose Parkinson’s Disease can be challenging, especially in the early stages given how the symptoms are typically mild at that stage. It’s not like any regular disease that can be identified with a single test. Instead, the diagnosis is based on medical history, symptoms, and neurological examination.

• Clinical Evaluation: A neurologist will perform a thorough examination, focusing on both motor symptoms and non-motor symptoms, and ask about the patient’s medical history and family history.
• Response to Medication: Your doctor will also check your response to levodopa, a medication that increases dopamine levels in the brain. If symptoms improve with levodopa, it supports the diagnosis of Parkinson’s Disease.
• Imaging Tests: Certain scans like MRI or DAT-SPECT (dopamine transporter scan) can help rule out other conditions that are identical to Parkinson’s symptoms.

Unfortunately, there is no cure for Parkinson’s Disease at this moment. However, a variety of treatments can help manage symptoms and improve quality of life. Treatment often involves a combination of medication, lifestyle changes, and, in some cases, surgical interventions. Let’s take a look.

Medications prescribed for Parkinson’s Disease treatment aim to restore dopamine in the brain. Below are the medications your doctor may prescribe for Parkinson’s Disease treatment.

• Levodopa/Carbidopa: Levodopa turns into dopamine to ease symptoms; Carbidopa prevents it from breaking down too soon.
• Dopamine Agonists: Mimic dopamine’s effects, used early or with levodopa later on.
• MAO-B Inhibitors: Stop dopamine breakdown to keep more available in the brain.
• COMT Inhibitors: Work with levodopa to extend its effects by blocking dopamine breakdown.
• Anticholinergics: Help with tremors and stiffness but can cause memory issues.
• Amantadine: Reduces involuntary movements from long-term levodopa use

Individuals with advanced Parkinson’s Disease may require surgery, particularly if medications are no longer effective.

Deep Brain Stimulation (DBS): DBS is the most common surgical treatment for Parkinson’s Disease. It implants electrodes in specific areas of the brain, which are connected to a small device implanted in the chest. The key role of this device is to send electrical impulses to the brain to help control motor symptoms.

Lesioning Surgery: This older surgical approach’s role is to create a small lesion in the brain to disrupt abnormal signals. Although this approach is not that common nowadays due to the success of DBS, doctors still prefer to do it in certain cases.

In addition to medication and surgery, lifestyle changes and supportive therapies play a crucial role in managing Parkinson’s Disease.

• Physical Therapy: Helps maintain movement, flexibility, and balance through exercise.
• Occupational Therapy: Supports independence by suggesting tools and strategies for daily tasks.
• Speech Therapy: Assists with speech and swallowing difficulties.
• Diet and Nutrition: A balanced diet aids overall health and symptom management.
• Mental Health Support: Essential for managing depression and anxiety, with options like counseling and support groups.

When Should You Consult a Doctor for Parkinson’s Disease?
As we already know, the symptoms of Parkinson’s Disease are very mild in the early stages which makes it difficult to go for treatment. Following are the symptoms that tell you to see a doctor.

• Persistent tremors or shaking in the hands, fingers, or limbs.
• Slowness in movement or difficulty starting movements.
• Stiffness in the arms, legs, or trunk that doesn’t go away.
• Problems with balance or frequent falls.
• A noticeable change in handwriting, making it smaller or more cramped.
• Trouble with coordination, such as shuffling when walking or reduced arm swing.
• Speech changes, like a softer or slurred voice.
• Loss of smell that isn’t related to a cold or allergies.

Early consultation with a doctor is crucial for a proper diagnosis and timely treatment. Book an appointment at My Consultant Corner now!