Do you or anyone in your family is facing problems with the movement of muscles, balance problems, and incoordination amongst them? You might be suffering from Parkinson’s Disease.
Parkinson’s Disease is a neurological disorder, in which a person faces problems with movement of the body, thereby affecting the quality of life.
A substance, Dopamine is responsible for smooth and coordinated muscle movement in the body. Dopamine is found in the part of the brain, Substanita Nigra.
In this disease, the cells of the Substanitia nigra start to die, and due to this dopamine levels reduce. After reduction to 60 to 0% symptoms of Parkinson’s start to appear.
To this date, there is no cure for Parkinson’s. Moreover, it is a chronic disease and worsens over time.
Did you know ? More than 50,000 cases are reported annually in the USA, but there may be even more as this disease is often misdiagnosed.
What is Parkinson’s Disease?
Parkinson’s is a neurological disorder that affects the nerve cells in the brain the produce dopamine.
It is important to note that the symptoms of this disease develop gradually. They start with a slight tremor in one hand and a feeling of stiffness in the body or slowness of movement in an individual.
Over time, the symptoms develop in the body and people will have dementia.
As the symptoms increase, there is a significant decrease in the level of dopamine in the body.
A study in France found in 2015 suggests that men are 50 percent more likely to develop Parkinson’s than women overall.
However, with age, the risk for women developing this disease increases.
Most often, the symptoms start to appear at the age of 60 or over. However, 5 to 10 percent of cases appear earlier. If Parkinson’s develops before the age of 50, this is called Early Onset Parkinson’s Disease.
Early Signs and Symptoms of Parkinson’s Disease
The following are the early signs and symptoms include:
Movement: You might notice the tremor in your hands or slowness of movement in your body.
Coordination: Reduction in the sense of coordination and balance problems. Moreover, it can cause people to drop items they are holding and are more likely to fall.
Gait: The posture of a person may change. They might lean forward slightly, or they may develop a shuffling gait.
Facial Expressions: Due to changes in the nerves that control facial muscles, their facial expressions can become fixed.
Voice: There may be a tremor in the voice or the person may speak more softly than usual.
Handwriting: It may become crippled and smaller
Sense of Smell: Loss of sense of smell is one of the early signs.
Sleep Problems: This is one of the earlier signs and can be accompanied by restless legs.
Some other common signs are:
Mood swings like depression, difficulty chewing and swallowing, the problem with urination.
Moreover, a person may have constipation and skin problems.
REM Sleep Disorder
When a person sleeps, the brain moves through five different stages. One of which is REM (Rapid Eye Movement) sleep.
During this phase, your eyes move rapidly in various directions, however, the other four phases of sleep are referred to as Non-REM (NREM) sleep.
Most people enter REM sleep within 90 minutes of falling asleep, however, it repeats throughout the night.
REM sleep behavior develops in a person years before your doctor diagnoses Parkinson’s and it appears to be a risk factor for more severe cognitive decline.
Most often, doctors describe this condition as a powerful predictor for Parkinson’s disease.
Importance of Early Diagnosis
Most of the time, people mistake the signs of Parkinson’s for signs of aging. And for this reason, they do not seek any medical help.
However, if your doctor diagnoses you with early signs of Parkinson’s the treatment is more likely to be effective.
Moreover, if the treatment does not start until the person develops clear symptoms, it might not be as effective.
Moreover, it is important to note that the symptoms of Parkinson’s overlap with signs and symptoms of other diseases like head trauma, stroke, Encephalitis, Lewy body dementia, Multiple System Atrophy, and Progressive Supranuclear Palsy.
Because of this very reason, it makes it hard to diagnose Parkinson’s in the early stages.
Moreover, the movement may start on one side and gradually affect the whole body.
Severity in Signs and Symptoms
As Parkinson’s develop, there is more severity in signs and symptoms a person shows. These are:
Flaky or yellow scales on oily parts of the body, Seborrheic Dermatitis, risk of developing melanoma, disturbance during sleep, depression, anxiety, hallucinations, psychosis, problems with memory, and difficulty in visual-spatial relationships.
In most cases, the early signs of Parkinson’s go unnoticed however, your body may try to alert you to the movement disorder.
Nonmotor Symptoms
The progression of Parkinson’s disease is commonly evaluated by motor symptoms include muscle stiffness and tremors.
However, non-motor symptoms also develop and are present years before the motor symptoms.
Non-motor symptoms are cognitive changes, mood disorders, sleep disorders, fatigue, vision problems, etc.
These symptoms may require additional treatment in many people, however, these symptoms often advance with the progression of the disease.
Causes of Parkinson’s Disease
The causes of Parkinson’s in unknown. However, it may have both genetic and environmental factors that contribute to it.
Some scientists are of the view, that some viruses can trigger Parkinson’s as well.
Some of the causes are as follows:
Low Dopamine Levels: Most often scientists link Parkinson’s to low levels of dopamine in the brain. This happens when cells that are responsible for their production dies.
Dopamine is responsible for sending messages to the part of the brain that controls movement and coordination.
However, low dopamine levels can make it harder for people to control their movements.
The symptoms tend to become more severe with decreasing levels of Dopamine
Low Norepinephrine Levels: This is another transmitter for controlling body functions that are automatic.
The nerve endings that produce this neurotransmitter die in Parkinson’s disease.
This explains why people with this disease not only experience problems with movement but also fatigue, constipation, and orthostatic hypotension when blood pressure changes on standing up, leading to light-headedness.
Lewy Bodies: A person with this disease may have clumps of protein in their brain’s Lewy bodies.
Lewy body Dementia is a different condition however, it has links with Parkinson’s
Genetic Factors: Studies suggest that Parkinson’s disease runs in the family however it is not always heredity.
Moreover, researchers are trying to identify specific genetic factors that may lead to this disease.
Alpha-synuclein is a protein in our brain that is present at the tip of neurons. The dysfunction of this gene in the brain causes this disease and in some cases can cause seeding of aggregation.
Environmental Factors: Researchers also suggest that along with genetic factors environmental factors also lead to Parkinson’s.
Environmental factors that could lead to Parkinson’s our exposure to toxins, such as pesticides, solvents metals, or other pollutants.
Autoimmune Disease: Scientists found evidence of a possible genetic link between Parkinson’s and autoimmune diseases such as Rheumatoid Arthritis.
Stages of This Disease
Parkinson’s is a progressive disease, which means that with time it worsens. Many doctors use Hoehn and Yahr scale to classify the stages of Parkinson’s.
Moreover, this scale divides it into 5 stages and it helps the doctors and healthcare providers to understand how advanced the disease signs and symptoms are.
Stage 1
This the mildest form of Parkinson’s, however, there may be symptoms but not severe enough to interfere with the daily routine.
moreover, the symptoms are so minimal that they often are not diagnosed. However, your family and friends might notice slight changes in your posture, walk, or facial expressions.
One of the distinct features of this stage is tremors and other difficulties in the movement of the body.
These are generally present on one side of the body. Prescription medications can help effectively minimize and reduce the signs and symptoms at this stage.
Stage 2
This is the moderate stage of Parkinson’s and the symptoms are more noticeable than in stage 1.
Stiffness, tremors, and trembling of the body are more noticeable and there may be changes in the facial expressions.
Stage 2 does not impair the balance of a person while muscle stiffness prolongs task completion. A person might face difficulty in walking and the posture may also change.
People at this stage tend to live alone though they might find some tasks take longer to complete.
The progression from stages 1 to 2 can take months or even years however, there is no way to predict the progression as it varies from person to person.
Stage 3
This is the mid-stage of Parkinson’s and is the major turning point in the progression of this disease.
Most of the signs and symptoms are the same as that of stage 2, however, you are more likely to experience loss of balance and a decrease in your reflexes.
The movement becomes slower hence it makes it common in stage 3.
Parkinson’s at this stage significantly affects the daily routine of a person however, people are still able to complete them.
A person might need occupational and medical therapy in combination to help decrease the symptoms.
Stage 4
In this stage, people are more dependent on others. During this stage, It is possible to stand without assistance. However, movement may require a walker or another assistive device for a person.
In most cases, people are unable to live alone as there is a decrease in movement and reaction time of a person.
Daily normal tasks become impossible at this stage and living alone can be very dangerous.
Stage 5
This is an advanced stage, of Parkinson’s disease, and there is excessive stiffness in the legs that can also cause freezing upon standing.
People in this stage require a wheelchair and they are often unable to stand on their own. Moreover, they need assistance around the clock.
30% of people during stages 4 and 5 experience hallucinations, confusion, and delusion. Moreover, Dementia is also common during this stage.
This affects up to 75% of people with Parkinson’s. Moreover, in this stage, the side effects of medications can outweigh the benefits.
Diagnosis
To this date, there is no specific diagnosis of Parkinson’s, however, doctors make diagnoses based on health, physical and neurological disorders.
They will also review the signs and symptoms you are presently showing of this disease. Your doctor can use image testing to rule out other conditions.
Moreover, a DAT (Dopamine Transporter) scan can be used.
Most of the time it cannot diagnose Parkinson’s but it helps to rule out other conditions.
Treatment for Parkinson’s Disease
Treatment options for Parkinson’s include lifestyle changes, medications, and therapies.
Enough rest, exercise, and a balanced diet are important as well as various therapies like speech therapy, occupational therapy, and physical therapy.
Your doctor will prescribe medications to control various physical and health signs and symptoms. These are:
Levodopa: This medication is the most common one and replenishes dopamine. About 75 percent of the people respond to this medication however not all of the symptoms improve.
Anticholinergics: This medication blocks the parasympathetic nervous system and can help with rigidity.
Amantadine (Symmetrel): This medication can be used with carbidopa-levodopa and is a glutamate blocking drug (NMDA).
COMT Inhibitors: This medication prolongs the effects of levodopa, however, it can cause liver damage.
MAO B inhibitors: This medication inhibits an enzyme monoamine oxide that breaks down dopamine in the brain.
Consult your doctor before taking this medication as it can interact with other drugs like antidepressants, ciprofloxacin, St. John’s wort, etc.
Surgery
In case a person does not respond to medications, therapy, or lifestyle changes, doctors recommend two primary surgeries:
- Deep Brain Stimulation: The surgeon implants electrodes in specific parts of the brain that are connected with a generator that sends pulses to help reduce symptoms.
- Pump-Delivered Therapy: In this procedure, a pump delivers a combination of medications, i.e. levodopa and carbidopa and is placed near the small intestine.
Parkinson’s Life Expectancy
This disease is not fatal, however, Parkinson-related complications can affect the quality of life and shorten it.
It increases the risk of developing potentially life-threatening complications such as a fall, blood clots, lung infections, etc.
One study found that at 6-year survival rates of nearly 140,000 people who had been diagnosed with Parkinson’s. About 64% of the people in this study died.
Conclusion
As of 2017, there is no definite cure for Parkinson’s, moreover, there is no definite cause also.
It is likely due to a person’s susceptibility and environmental factors. However, research is going on to find possible cures for this disease.
Understanding motor and non-motor symptoms can help diagnose Parkinson’s at an earlier stage and therefore earlier treatment. Knowing the potential risk factors can help you detect symptoms in the early stages however it is important to keep in that not all people progress to later stages.
