Parkinson’s Disease

Parkinson’s disease hands

Last Updated February 20th, 2019

Overview of Parkinson’s Disease

Neurological disorders become very prominent after a certain age, mainly above 60. Usually, these diseases are not self-limiting in nature and in many cases lead to complete degeneration of the peripheral and central nervous systems, causing death. One very severe case of neurological disorder in the old age is the “Parkinson’s disease”. According to epidemiological studies by the American Neurological Association in the year 2016, nearly 60,000 Americans are diagnosed with Parkinson’s disease annually. This has a direct impact on the overall life-expectancy and calls for immediate attention from global health organizations.

 

Definition of Parkinson’s Disease

Parkinson’s disease brainParkinson’s disease is a disorder of the central nervous system that is common mainly in aged people. In this condition, severe degeneration of specific nerve cells in the deeper regions of the brain (basal ganglia) occurs in the initial stages. With slow progress of the disease, degeneration, and loss of nerve cells (neurons) in a portion of the brainstem (substantia nigra) takes place. A sharp decline in the level of dopamine (neurochemical messenger) occurs, that disrupts movements and coordination in the patient. This is manifested through certain symptoms such as constant quivering, general imbalance, body stiffness and overall disorientation. Microscopic examinations reveal that the degenerating neurons are associated with a circular structure known as Lewy body, which is one of the main contributing factors of Parkinson’s disease and associated neurological disorders.

 

Causes of Parkinson’s disease

Parkinson’s disease is an outcome of the following etiological factors-

  • Environment: Exposure to certain chemicals may occur due to environmental pollutants, chemicals present in food, or chemicals injected via intravenous drugs. These can lead to Parkinson’s disease at old age. One classic example of such a toxic chemical is – methyl-phenyl-tetraa hydropyridine (MTP), which is an accidental by-product of a legal variety of heroin.
  • Genetics: Research mediated evidence has shown that Parkinson’s disease may be an outcome of an autosomal dominant hereditary pattern that runs in the family. The genes that are primarily responsible for this condition are- Parkin, DJ-1, PINK1, UCH-L1, and synphilin-1. In such cases, Parkinson’s disease may occur in patients suffering from Huntington’s disease. Substantial loss of Dopamine producing brain cells occurs in such cases.
  • Inflammation: Few current or past diseases or external injuries may trigger an inflammatory response within the brain cells. Activation of microglia occurs in this case which triggers the release of cytokines (harmful chemicals released as a result of inflammation). These conditions collectively lead to degeneration and death of neuronal cells.
  • Excitotoxicity: In this condition, overactivation of the brain cells occurs due to oversensitization to neurotransmitter glutamate that shoots up the brain cell activities.
  • Protein degradation: This is characterized by impaired functioning of the protein disposal system of the brain, due to certain gene mutations due to environmental toxicities, that ultimately leads to Parkinson’s disease.
  • Protein Aggregation: This condition is marked by the formation of Lewy bodies that are composed of clustered alpha-synuclein fibrils and other proteins that disrupts neuronal functions and leads to cell death.

 

Symptoms of Parkinson’s Disease

Parkinson’s disease handsThe symptoms of Parkinson’s disease are categorized into two sections- Primary and Secondary symptoms. These are discussed below-

Primary symptoms

  • Tremor at rest: It is medically termed as “shaking palsy” and is characterized by slow and rhythmic tremor of the hands and feet. Occasional quivering of the head and neck is also observed. In few patients, tremor may be observed during holding up an outstretched arm (postural or sustention tremor) or during performing slight movements (action tremor). Internal tremor also occurs in a few patients.
  • Rigidity: This condition is characterized by heaviness or stiffness of muscles at complete rest or during minimal motion conditions. The stiffness may be perceived in the neck, limbs, and even trunk.
  • Bradykinesia: This is characterized by extremely slow movements in general. Few symptoms of this condition are- mask-like expression (hypomimia), reduced blinking, slowness in changing inertial state, cognitive impairment and loss of motor coordination.
  • Gait: In this case, shuffling motion with small fumbling steps occur which is called “festination”. Forward bending (propulsion) occurs when quick steps are initiated. Occasional freezing may also occur during normal movements.
  • Balance and posture: Overall body imbalance occurs that may lead to distorted postures. This happens due to loss of equilibrium. The patient tends to step backward at a stretch and this condition is termed as “retropulsion”.

Secondary symptoms

These usually develop at a much later stage and are described below-

  • Speech: With the gradual progress of the disease, the person may start talking in a monotone or develop a peculiar form of stammering called “palilalia”. Freezing and complete loss of speech may occur at a critical stage.
  • Swallowing: Problems in swallowing (dysphagia) occurs due to uncoordinated movements of the tongue and throat muscles.
  • Drooling: Uncontrolled drooling (sialorrhea) occurs due to the accumulation of excess saliva at the back of the throat resulting from loss of coordination of tongue and throat muscles.
  • Seborrheic dermatitis: Skin of the forehead and scalp becomes extremely oily.
  • Swollen feet and ankles
  • Sweating
  • Urinary problems
  • Dizziness
  • Sexual dysfunctions
  • Impaired vision

 

Stages of Parkinson’s Disease

Parkinson’s disease manParkinson’s disease typically progresses through the following five stages-

  • Stage I: Slight tremor and occasional distortion of facial expressions are observed. This stage is marked by unilateral defects only with no functional impairment as such.
  • Stage II: This stage is characterized by bilateral loss of facial expressions, reduced blinking, speech impairment and stooping posture.
  • Stage III: It is marked by significant loss of equilibrium, unsteadiness, and loss of involuntary movements.
  • Stage IV: In this stage, the patient becomes completely dependent on other people even during performing day to day activities.
  • Stage V: The patient loses the ability to maintain a standing or sitting postures and resorts to a wheelchair or walking stick.

 

Diagnosis

The following tests are normally carried out-

  • Structural and functional imaging
  • Acute Dopaminergic testing
  • Olfactory testing

 

Treatment and prevention

Treatment 

Medications 

  • Carbidopa-levodopa – This is the most common medication that is given to those diagnosed with Parkinson’s. Here, the chemical passes through the brain and passes dopamine.
  • Carbidopa-levodopa infusion – This medication is given via a tube and it enters directly into the small intestine. This goes into the body and passes dopamine.
  • Dopamine agonists – This medication does not release dopamine in the brain, instead, it mimics the effects of dopamine in the body.
  • MAO B inhibitors – This medication helps in restricting the breaking down of the dopamine present in the brain by inhibiting a brain enzyme called monoamine oxidase B (MAO B)
  • Catechol O-methyltransferase (COMT) inhibitors – These medications tend to prolong the effect of levodopa in the brain, thereby blocking the enzymes that break down the dopamine in the brain.
  • Anticholinergics – These medications help in controlling the tremors felt by Parkinson’s patients.
  • Amantadine – This medication is used to treat the mild and early symptoms of Parkinson’s.

Surgical procedure 

  • Deep brain surgery (DBS) – Here surgeons implant a small electrode in the brain and the generator is implanted near the collarbone. The electric currents pass through the generator and into the electrode. This help in reducing the symptoms of Parkinson.

Prevention – There are no sure shot prevention methods for Parkinson’s disease. There are certain risk factors that help in reducing the symptoms.

  • If you have a family history of Parkinson’s Disease, pay special attention to the risk factors that could make you more vulnerable to the condition. ( For eg: protection from environmental toxins and keeping a track of dopamine levels as you age).
  • Those who are 60 years and above need to get regular neurological check-ups done, as they are at a higher risk of developing Parkinson’s.
  • Statistics indicate that men are more susceptible to this condition than women. So, as they age, men need to be extra cautious with the initial symptoms of Parkinson’s ( if any).
  • Limit your exposure to environmental toxins and chemicals such as pesticides, solvents, and heavy metals toxicity.

Facts

  • Parkinson’s disease has been known since the ancient times, it is called as ‘Kampavata’ in Ayurveda. ‘Kampa’ is the Sanskrit word for ‘tremor.’
  • Parkinson’s disease is named after a London doctor, James Parkinson, who wrote a long and detailed essay on this disease in 1817. The essay was titled “An Essay on the Shaking Palsy.”

Facts

  • In the 1940s and 1950s, surgeons started performing surgeries on the basal ganglia ( present in the brain). This showed an improvement in the symptoms of Parkinson’s disease.

Facts

  • The expenditure associated with this disease is almost $ 25 billion / year in the USA alone.
  • 50% of PD patients suffer from depression and around 40% of them show symptoms of anxiety.

Related Conditions

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Dos and Don'ts

Dos
  • Exercise regularly it helps in strengthening the muscles and bones.
  • Maintain a healthy diet; eat foods that will help strengthen your bones.
  • Use a walking cane if required; it helps by providing you support.
Don'ts
  • Isolate yourself. Parkinson’s is known to be closely related to depression.
  • Ignore your weight. Maintain a healthy weight.
  • Wear complex shoes and clothes, they tend to hinder your movement.

 

 

 

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Anoscopy Anoscopy is an invasive diagnostic procedure where a small device known as anoscope will be inserted in the…
ureteroscopy
Ureteroscopy Ureteroscopy is the diagnostic procedure which is used for the detection of the kidney stones in addition to…
eating disorder anorexia
Eating Disorders: Lifestyle choice or a psychological condition? Is eating disorder just a harmless bad habit? Or does it represent grim psychological disorders? Do you want…
sleep deprivation
Don’t let your sleep deficit grow into memory loss or heart attack Why is sleep important for us? How could sleep deprivation harm you? We bet you didn't know about…
Did you know drinking alkaline water could be the healthier choice for you? Ever wondered how safe is your drinking water in terms of pH? Recent studies have revealed that Alkaline…
How to correctly perform nasal irrigation using a Neti Pot? Neti pot has been a part of Ayurveda since centuries. This ancient tool is extremely effective in treating…
Oxidative Stress: Understanding the most lethal phenomenon happening in your body right now Free radicals cause damage to the body, which is known as oxidation.  The amount of oxidation caused by…
11 unbelievable health benefits of thyme you didn’t know! Thyme is a herb that has been used in alternative medicine.It is a well known seasoning in the…
Balneotherapy jacuzzi
5 things you didn’t know about balneotherapy and how you can do it at home Sauna baths have been popular since a long time. But how much more beneficial can balneotherapy be as…
Barium-enema
Barium Enema Barium enema is also known as colon x-ray. Here, the patient is asked to consume small amount of…
Tissue Transglutaminase Antibody (tTG) Test Transglutaminase is an enzyme present in our body and is involved in protein metabolism. A tTg test is…
immunoglobulin M
Immunoglobulin M Test Immunoglobulin M is the largest and the first produced antibody which helps in the prevention or fighting of…
hidden causes obesity
8 hidden causes of obesity you probably didn’t know! Did you know that around 2 billion people worldwide are either overweight or obese? Are you too a…
Find all the instant ways to get rid of blackheads Blackheads - Not only are they aesthetically unappealing but if left untreated these can cause bacterial overgrowth on…
Pescatarian Diet 101: What are the inherent health advantages of this diet? People opt to become a pescatarian in order to enrich their bodies with the essential health benefits that…
Oxalates: How healthy greens can sometimes be bad news for your kidneys Oxalates are compounds present in a majority of healthy foods. However, at times an overconsumption of these could…
SIBO Diet: The important dos and don’ts of this gut-healing diet A SIBO diet is a diet that works by eliminating certain sugars from your diet and adding fibers…
Coffee Enema: Turn your favorite morning beverage into a powerful colon cleanser The wonders of coffee are not just limited to waking you up every morning. You can now use…
GGt test
GGT – Gamma-Glutamyl Transferase Test GGT or gammaglutamyl transferase test is a liver function test that is used to detect the extent of…
lp-pla2
LP-PLA2 Test The LP-PLA2 test is a test which is carried out to assess the levels of Lipoprotein-Associated Phospholipase A2…
quinoa salad
Quinoa : A prodigious superfood you need to include in your diet today! Quinoa - what is so special about this native South American grain that has taken the world by…
L-theanine attention
L-Theanine: Better sleep, higher focus, and many other benefits Did you know that L-theanine found in green tea can make you sleep better and be focused at…
improve digestion weight loss
Power up your gut: 8 proven steps on how to improve your digestion Did you know you have a colony of bacteria in your gut that help you in digesting food?…
avocado benefits
Avocado: 15 reasons why this fruit should be a staple in your diet Did you know that the word avocado literally means "testicles". Don't get grossed out as this power-packed fruit…
bananas exercise
10 health reasons why you should go “bananas” over bananas! Bananas:The world's most popular fruit comes with a host of unbelievable health benefits. Find out how you can…
ashwagandha brain
Ashwagandha: The best-kept secret of Ayurveda now revealed! Ashwagandha literally means "smell of horse". Don't get bogged down by that one tiny detail because this ayurveduic…
Salt dangers
Sodium chloride: The wonders and dangers of the simple table salt Sodium chloride is a salt containing sodium and chlorine ions at a 1:1 ratio. It is edible and…
Coconut sugar: What is it and is it healthier than table sugar? In the long list of things that the wonderful coconut gives us, coconut sugar is another remarkable addition.…
The right way to prepare Alfalfa sprouts at home Alfalfa or lusan ghas is not just a nutritious animal fodder. This flavonoid-rich herb has some amazing health…
How to scrub away stress and fatigue with an Epsom salt bath? Epsom salt is a popular home remedy for many skin ailments. Though there is a lack of scientific…
Bubble Tea: Bubbling with nutrition or a hidden sugar mine? The tapioca pearls present in the tea looks like bubbles and hence the name bubble tea became popular.…
thyroid_scan
Thyroid Scan Thyroid scan is a diagnostic procedure that aims to view the thyroid gland and detect any growths or…
vdrl test syphilis
VDRL Test The VDRL test is a blood test that is used to diagnose sexually transmitted or venereal diseases, primarily…
complement c4 test
Anemia Profile Anemia Profile test (Basic) is a blood screening test that measures the levels of important components of the…
shoudler exercises
Keep your shoulders pain-free with these shoulder exercises Shoulder exercises are important in order to prevent chronic back and neck pain. Learn more about how you…
sugar toxic health
Sugar: 7 new shocking truths revealed about the sweet poison Can drinking soda bring you closer to death? Is sugar slowly poisoning you and your family? You would…