Parkinson’s Disease, also known as PD, is a progressive neurodegenerative disorder that affects predominately dopamine-producing (“dopaminergic”) neurons in a specific area of the brain called substantia nigra. In simple terms, Parkinson’s Disease is a nervous system disorder that affects movement. PD is considered a diverse disorder that develops slowly over time and is different for everyone – no two people experience PD in the same way. Approximately 60,000 Americans are diagnosed with PD each year and over 10 million people worldwide are living with it.
Although the cause of Parkinson’s Disease is unknown, it is believed to be a combination of genetics, environmental factors and lifestyle choices that collectively determine whether someone will develop PD or not. With PD, certain nerve cells, known as neurons, in the brain gradually break down or die. Many of the symptoms of PD are due to a loss of neurons that produce dopamine, a chemical messenger in your brain. When dopamine levels decrease, it causes abnormal brain activity, leading to impaired movement and other symptoms of PD.
According to experts, genetics cause roughly 10 to 15 percent of all PD. Researchers have found over the years specific genetic mutations that can cause PD. These mutations are uncommon except in the few cases where multiple family members are affected by PD and therefore carry the same genetic mutation. These genetic mutations are inherited or passed down from generation to generation.
Over the years, scientists have discovered dozens of gene mutations that are linked to Parkinson’s Disease; however, if someone has one of these gene mutations the probability of developing PD is low.
Environmental causes of Parkinson’s Disease include such things as:
Through years of research, scientists have also found that there are certain factors that may reduce the risk of developing Parkinson’s Disease such as:
There are both movement and non-movement symptoms of Parkinson’s Disease to be aware of. PD symptoms usually begin gradually and get worse over time. The rate at which the symptoms progress differs among everyone diagnosed with PD.
Parkinson’s Disease movement symptoms include:
Of the movement symptoms listed above, there are three (3) that are significant symptoms that help doctors make a PD diagnosis. The three (3) symptoms are Bradykinesia, tremor and rigidity.
Bradykinesia is defined as slowness of movement and is one of the symptoms that must be present to be diagnosed with Parkinson’s Disease. There are various ways in which individuals will experience slowness of movement. Someone diagnosed with PD may experience a reduction of automatic movements which are things like blinking. They may have trouble initiating movements like getting up out of a chair. They may experience general slowness in physical actions, or they could have abnormal stillness or a decrease in facial expression.
A tremor, also defined as shaking, usually begins in a limb, often your hand or fingers. Those diagnosed with Parkinson’s Disease typically experience a resting tremor which means the shaking occurs mostly at rest and lessens during sleep and when the body part is actively in use. In most cases, PD patients experience the tremor in their hands, but tremors can also appear in other parts of their body, including their lower lip, jaw or leg. As the disease progresses the tremor, that typically only affects one side of the body, can progress to both sides.
Rigidity is defined as stiffness or tightness in limbs. Rigidity can occur on one or both sides of the body and can contribute to a decreased range of motion. This decrease in motion can lead to problems with achiness or pain in the muscles or joints affected.
To be diagnosed with Parkinson’s Disease, Bradykinesia plus either tremor or rigidity must be present.
Although Parkinson’s Disease is a neurological movement disorder, most individuals diagnosed with PD will also experience other health problems not related to movement. Some of these “other health” problems also labeled as non-movement symptoms include:
There are various ways in which doctors describe the stages of Parkinson’s Disease. The Parkinson’s Foundation separates PD into five (5) stages. These stages correspond to both the severity of the movement symptoms and how much PD is affecting a person’s daily activities.
In Stage 1 of PD, symptoms are mild and typically do not interfere with daily activities. During this stage tremors and other movement symptoms begin on only one side of the body.
In Stage 2 of PD, symptoms start to get worse and tremors and other movement symptoms such as rigidity start affecting both sides of the body. Daily tasks take longer and are more challenging to complete.
In Stage 3 of PD, also known as the mid-stage, loss of balance and slowness of movements are the most common symptoms. Individuals with PD that advance to this stage fall more often, and dressing and eating become very difficult. They are still independent, but daily life is progressively getting more challenging.
In Stage 4 of PD the symptoms are severe and very limiting. Individuals with PD at this stage can stand on their own, but most likely require a walker to move anywhere. At this stage individuals with PD are no longer able to live alone.
In Stage 5 of PD the disease is the most advanced and the symptoms are debilitating. Individuals with PD who have advanced to this final stage are unable to walk and require a wheelchair or are bedridden. In addition, they require 24/7 care.
There is no cure for Parkinson’s Disease; however, there are a variety of things that can assist with relieving symptoms. Treatment includes such things as
It is important to note that there is no standard treatment for Parkinson’s Disease and treatment is different for everyone based on their symptoms.
At Roseman Medical Group (RMG), we have expert neurologist, Eric Farbman M.D., dedicated to treating Parkinson’s Disease and a variety of other neurological disorders. Roseman University is a site for the Parkinson Study Group and currently has studies for patients with many different degrees of Parkinson’s Disease, from newly diagnosed to advanced. The University is waiting to start a study for multiple system atrophy, an atypical Parkinson-plus disorder with no current treatments, as well as an essential tremor study.
RMG also performs more aggressive treatments for Parkinson’s Disease. Dr. Farbman currently manages over 200 deep brain stimulator (DBS) patients for a variety of medical conditions including Parkinson’s disease, essential tremor, and dystonia. For those who are unaware of this treatment, it is essentially a pacemaker for the brain. This treatment can be particularly helpful for involuntary movements and dystonia, especially when maximal oral medical treatment has been provided. There is now a levodopa pump that can be prescribed for Parkinson’s Disease patients as well, and botulinum toxin injection has been a longstanding therapy for dystonia.
Our neurologists provide empathic, patient-centered, evidence-based care. If you have a friend or family member who suffers from Parkinson’s Disease, let RMG’s expert neurologists help! Contact us today!
This article was originally posted on Roseman University of Health Sciences’ blog, as well as published in the May/June edition of Roseman University’s print edition