Parkinson’s disease or primary parkinsonism is a progressive deteriorating disorder of the central nervous system which affects the brain cells (neurons) of the substantia nigra region that produce dopamine thus, giving rise to motor symptoms such as tremors and shaking, rigidity and slowness of movement that can eventually lead to dementia and Alzheimer’s disease. Parkinson’s disease is more common in older adults and most of the cases are observed in people over the age of 50 years. The cause of this disease is unidentified and no cure has still been discovered, but the condition can be treated effectively and kept under control with medication and surgery.
Symptoms of Parkinson’s Disease
Although, the symptoms that are experienced vary from person to person, yet some of the early signs of Parkinson’s are as follows:
Early Signs:
- Shaking and Tremors in Arms, Face and Legs
- Difficulty in Walking
- Slowness of Movement
- Stiffness of Limbs
- Problem with Balance and Co-ordination
At advanced stage, the Parkinson’s disease symptoms include:
Advanced Signs:
- Dementia
- Sensory and Emotional Problems
- Chronic Depression
- Sleep Related Problems
Causes of Parkinson’s Disease
Although the precise cause of Parkinson’s disease is not known yet, it is caused due to the degeneration and death of brain and nerve cells named neurons and the motor movement is diminished as a result of the death of these cells that work as chemical messengers of the brain. The reduced level of Dopamine in the brain lead to abnormal brain functions.
- Genes: Researches found that the genetic mutation in an individual can lead to Parkinson’s disease. Although, this is an exceptional case, but it can also be caused in an individual who has a family history of this disease with several family members affected by Parkinson’s. Specific gene variations have also been shown to increase the risk of Parkinson’s.
- Environmental Factors: Overexposure to certain toxins present in the environment can trigger the risk of Parkinson’s disease at a later stage in life, but more research is needed to sustain this theory.
- Presence of Lewy bodies: Clumps of particular substances in the brain cells is known as Lewy bodies. The presence of these microscopic knots has a close relation to Parkinson’s disease.
- A-synuclein found Lewy bodies: Although, various substances are found within Lewy bodies, it is the presence of natural protein alpha-synuclein that researchers believe is one of the reasons of Parkinson’s disease.
Risk Factors for Parkinson’s disease
Although, there is no fixed measures or tests to know who can develop Parkinson’s disease in future but there are certain risk factors that put specific groups at high risk of this disease.
- Age: The risk of developing Parkinson’s disease increases with age. Young people are most unlikely to be affected by Parkinson’s but the risk increases in people above the age of 50 years.
- Sex: Men are at higher risk of developing Parkinson’s disease compared to women.
- Heredity: This is a rare case, but having close relations affected by Parkinson’s or a family history of the disease increase the risk of developing it.
- Toxin Exposure: prolonged exposure to toxic pesticides and herbicides increases the risk of Parkinson’s disease.
Diagnosis of Parkinson’s disease
In many cases, the early symptoms of Parkinson’s disease mimic that of Alzheimer’s and therefore, it becomes difficult to diagnose even for an experienced neurologist. Most of the tests for Parkinson’s disease diagnosis are physical ones as there are no standard diagnostic tests such as accurate image scanning or blood tests.
- The Doctor observes the patient’s expressions and movement and look for tremors, stiffness, co-ordination and balance.
- The physician also takes into account the past medical history and a neurological examination of the patient.
- Tests are done to confirm the presence of Lewy bodies in the midbrain.
- PET scan is done to access the brain functions of the regions related to movement.
- CT scan of the body and brain is done to identify signs of Parkinson’s in the body.
- MRI is done to get a precise and clear image of the whole body.
- The Doctor can administer Parkinson’s medication carbidopa-levodopa, and significant relief of motor impairment will confirm the diagnosis of Parkinson’s disease.
Treatment and Management of Parkinson’s disease
Although, there is no cure for this disease, the symptoms can be kept under control with Parkinson’s disease treatment that includes medications and surgery in some cases.
Carbidopa-levodopa: The Carbidopa-levodopa is one of the most important Parkinson’s disease medications that the Doctor is most likely to prescribe. Levodopa is a natural chemical that is converted into dopamine as it enters the brain. It is combined with carbidopa in order to prevent premature conversion outside the brain. But with prolonged use, the effects of levodopa may wear off and effectiveness may be diminished.
Dopamine agonists: The dopamine agonists that combine with dopaminergic post-synaptic receptors have similar effects like levodopa on the brain, but unlike levodopa, it does not transform in to dopamine, but mimic the effects of dopamine instead. Although, it is not as powerful as levodopa, but its effects are long lasting and can be used along with levodopa to power up its reduced effect. Dopamine agonists is a combination of pramipexole, ropinirole and rotigotine. The side effects of dopamine agonists include sleepiness, hallucinations and compulsive behaviors.
MAO-B inhibitors: The MAO-B inhibitors include selegiline and rasagiline that prevents dopamine metabolism and increases dopamine level in brain. They block the monoamine oxidase B (MAO-B) from breaking down dopamine produced by neurons. MAO-B inhibitors are usually not taken with any antidepressants because of risks of serious reactions. The side effects of taking MAO-B inhibitors include headaches and nausea.
Surgery
Deep brain stimulation: It is a surgical method by which electrodes are implanted in specific parts of the brain in order to send artificial impulses to the brain. This surgery is usually administered for patients who are suffering from an advanced stage of the disease and are not responding to medicinal treatment. Deep brain stimulation can improve movement, reduce tremors and rigidity and stabilize a medication fluctuation that is often seen in case of levodopa therapy.
Tips to Cope with Parkinson’s disease
Following a healthy life style can help a lot in dealing with the symptoms of this disease.
- Eating a balanced diet rich in fiber such as fruits, vegetables and whole grains, omega 3 fatty acids and lots of fluid can help in controlling the effects of Parkinson’s disease.
- Low intensity exercises such as walking, stretching, etc. can improve flexibility, balance and muscle strength and also help in mobility. It can also help in relieving depression.
- During the later stage of Parkinson’s the patient might lose balance and fall more easily. Being careful about your movement and avoiding falls can also help in minimizing the risk of injuries.
- Massage therapy, acupuncture sessions, meditation and yoga can help in improving well-being and reducing muscle tension, stress and pains.
- Research shows that daily intake of Coenzyme Q10 at early stages of Parkinson’s disease can be extremely beneficial for better controlling of the symptoms.
Living with a chronic disease is very difficult and it is extremely important for family members and friends to support and understand the person and his requirements and extend their helping hand in order to give him a better and more comfortable life.
Image Sources: parkinsondisease.in, bocahomecareservices.com, slideshare.net, medindia.net, fpnotebook.com.
