Parkinson’s disease (PD) is a progressive brain disorder that occurs because of damage to neurons (nerve cells) in the substantia nigra (SN), a part of the midbrain that controls body movements, among other functions. This disorder causes unintended or uncontrolled movements in individuals, along with difficulty in co-ordination and balance. The symptoms usually show up after the age of 50, with men more likely to be affected than women.
Symptoms of Parkinson’s disease
PD begins with mild symptoms which gradually become worse, with individuals finding it difficult to even walk and talk in the later stages. Sometimes people lose their sense of smell years before any other symptom develops. There is cauSse for concern when people experience mild tremors and start having difficulty in getting up from a chair. Some people may speak too softly, and their writing becomes very slow.
There are four characteristic symptoms of Parkinson’s Disease:
- Tremors – These tremors occur in the hands or legs when they are at rest, or even the jaw or the head.
- Movements – Individuals find it difficult to do normal tasks, and they start walking slower with smaller steps.
- Muscle rigidity – There is rigidity and stiffness of muscles, difficulty in making facial expressions, and painful cramps.
- Balance – A loss of balance and co-ordination can increase risk of falls and injury. Individuals with PD develop a Parkinsonian gait in which they lean forward and walk without swinging the arms.
Most of the physical symptoms tend to start on one side of the body and worsen with both sides getting affected. However, there are a lot of variations in the symptoms and the rate of progress among people with PD.
- Difficulty in chewing and swallowing, and even in speaking. This is accompanied with an increased production of saliva and drooling.
- Increase in the frequency of urination, and difficulty in holding back urine.
- Excessive sweating, burning, numbness, and constipation.
- Sexual dysfunction is observed in both men and women.
- Episodes of anxiety, hallucinations and delusions.
Along with these physical changes, individuals may show mental or emotional changes, and problems with memory and cognition.
Causes of Parkinson’s disease
When they are healthy, neurons in the substantia nigra (SN) produce dopamine, a chemical that transmits messages from the brain to the rest of the body. A certain amount of dopamine is required to regulate and coordinate body movements. Due to damage or death of these neurons, there is a decrease in the production of dopamine. Consequently, the SN is not able to function normally, and movements become slow or abnormal. This damage is believed to be a result of genetics, through gene mutations, and environmental factors like head injury and increased exposure to chemicals and pesticides. However, a cause of why Parkinson’s disease occurs is not known yet.
Diagnosing Parkinson’s disease
There are no tests to conclusively diagnose PD in an individual. A detailed physical examination and medical history, along with a proper description of the symptoms is usually enough to arrive at a diagnosis.
Individuals may be asked to move, walk, and perform other simple tasks to help a medical practitioner observe typical symptoms. When two out of the following three symptoms are seen, a PD diagnosis is made:
- Tremors which occur at rest
- Very slow movement
- Stiffness of muscles
A diagnosis of Parkinson’s disease can be confirmed, especially if the symptoms improve with the use of dopamine precursor medications. Special scans of the brain may be done to rule out other causes of these symptoms.
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Treating Parkinson’s disease
There is no known cure for PD. Medications along with other holistic treatment approaches work well in managing symptoms and increasing the quality of life of the affected individual. However, some people who do not respond well to treatments can become severely disabled, so surgery can be used to relieve symptoms of the neurological disorder.
A wholesome treatment for PD will include physiotherapy that helps in relieving pain and muscle stiffness and improves movement.
Occupational therapists can work with individuals to ensure their safety at home, helping to perform routine tasks like getting dressed and going out.
Speech therapists can help in performing exercises to improve speech and swallowing.
If seen through the view of an imbalance in brain chemicals, PD is a dopamine-deficient illness. Medications can be helpful in countering this.
- As directed by doctors, lost dopamine can be compensated with dopamine precursors, which pass through the blood-brain-barrier and gets converted into dopamine in the brain.
- Though levodopa is the primary medication used in PD, its long-term use comes with a side effect – Dyskinesia. It is characterised by uncontrolled shaking and tremors. Therefore, it is important for those with PD and their caretakers to support holistic ways to reduce the dose and frequency of levodopa.
- Your doctor may advise surgical procedures to control extreme tremors and the on-off effects of dyskinesia. Deep Brain Stimulation (DBS) is a surgical option where an impulse generator is implanted under the collarbone or the abdomen that fires electric current in specific areas of the brain. While DBS is effective in controlling movement symptoms, non-movement symptoms like difficulty in speech and cognition tends to get worse after it.
For those who have been diagnosed with PD, it is important to ensure regular exercise and a healthy diet. Individuals and their families (or support groups) should be encouraged to perform activities to stay physically and mentally fit and indulge in hobbies which help to improve their mood and relieve stress.
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