What is Parkinson’s Disease?
Parkinson’s disease is a chronic degenerative condition that affects your brain.
This disorder can impact your ability to move and cause various other debilitating symptoms as it progresses.
Although it can affect individuals under age 50, parkinson’s disease is more common in people above 60 years old. It is also more prevalent in men than women. (1)
Symptoms
The risk factors and causes of parkinson’s disease are not fully understood. Most cases appear to occur at random without clear identified risks. However, research suggests certain genetic traits may be related to the disease.
The condition occurs when nerve cells (neurons) in your brain begin to lose function or die. The affected neurons are located in the part of your brain that manages movement.
These neurons produce dopamine, an essential chemical in the brain. When dopamine levels decrease, the movement-related symptoms begin to appear. (2)
Dopamine plays a key role in controlling and maintaining movements. Countless studies have confirmed a lack of dopamine can impact motor skills. (3)
The disease also attacks norepinephrine production. Norepinephrine is the primary chemical that relays messages throughout your sympathetic nervous system.
This system regulates various automatic functions of the body, such as your heart rate.
Decreased norepinephrine production is believed to be linked to non-movement symptoms of the disease. (4)
Symptoms of parkinson’s disease can be described as follows: (5)
Tremors
A typical early warning sign of parkinson’s disease is shaking, or tremors. Shaking is common if you are under a lot of stress or after hard physical activity.
Tremors related to the disease can occur without these circumstances. You might notice your hand or fingers trembling slightly, even if you are not moving or at rest.
Difficulty Moving
Stiffness and rigid muscles can be a symptom of parkinson’s disease. Your mobility can be affected as a result.
For example, you might realize you can no longer swing your arms while walking. Some parkinson’s patients report difficulty lifting their feet when they want to move.
These symptoms can also contribute to an increased loss of balance over time. (6)
Loss of Smell
Loss of smell can happen due to a stuffy nose and in this case it will eventually return to normal. Parkinson’s disease however, can make you lose this sense but it won’t get better with time.
Cognitive Issues
Parkinson’s disease can impair your ability to think clearly. It can manifest as difficulty concentrating or remembering things.
You might also develop issues with speech. Some patients eventually develop dementia, a severe decline in cognitive skills.
Urination Changes
The disease can impact upon bathroom habits. Parkinson’s disease patients can experience an increase in frequency of urination or urinary urgency.
As the disease progresses, it may also result in urinary incontinence. (7)
Stages
Parkinson’s disease is a degenerative condition. The progression of the disease can vary from person to person.
Some individuals may experience slow changes taking place over years. Others can progress through stages at a faster rate.
The stages of parkinson’s disease are as follows: (8)
Stage #0
At this stage, you have nothing to worry about. Dopamine neurons and norephrine production are functioning normally.
Stage #1
You will begin to experience symptoms, but they are mild enough not to interfere with your usual activities.
Movement-related symptoms such as tremors will affect only one side of your body. However, you might notice some changes in your walk and posture.
Stage #2
At this point, existing symptoms will start to appear on the unaffected side of your body. Muscle stiffness, tremors and other signs of the disease will intensify.
A poor posture and difficulty in walking may grow more noticeable. Daily activities can be managed, but take more time.
Stage #3
Parkinson’s disease at this stage is considered moderate. Slowness of movement and increasing loss of balance are more frequent and severe.
You may fall over more often. You are still able to live an independent life, but basic tasks like getting dressed can be significantly harder to manage.
Stage #4
The symptoms of the disease have progressed to severely limiting. You might require an assistive device like a walker to move around.
Daily tasks are extremely difficult if not impossible to manage on your own. By now it’s highly unlikely you can live by yourself at this stage.
Stage #5
This is the final progression of parkinson’s disease. Symptoms related and unrelated to movement are extreme and debilitating.
Rigid, stiff legs and other symptoms may confine you to a wheelchair or bed. You will require a full time carer to help manage all daily tasks and activities.
Treatment
There is no particular test or process to diagnose parkinson’s disease. Your doctor will likely perform blood and imaging tests to rule out other conditions.
Parkinson’s disease is suspected if you present typical symptoms which you’ve been experiencing long term. These include shaking (tremors), slowness of movement, stiff muscles and balance issues. (9)
There is no cure for parkinson’s disease. However, there are the following available treatments to help manage the disease:
Exercise
Exercise has been shown to benefit parkinson’s disease patients. It can help you maintain mobility, flexibility and balance for longer.
Ideally, you should try to work out regularly for at least 2.5 hours weekly. The type of exercise you choose depends on your preference. (10)
Amantadine
Amantadine is a drug for people in the early stages of parkinson’s disease. It can help to reduce tremors.
It may also help to reduce the side effect of involuntary movement from other medications used to treat the condition. (11)
Levodopa
Levodopa helps to restore depleted dopamine levels to combat movement issues. It travels through the blood then to your brain, which converts it into dopamine.
This medication comes in various strengths and forms, such as tablets and powders. This drug is typically mixed with carbidopa, another medication, to boost its potency.
Carbidopa also decreases vomiting and nausea typically caused by levodopa. You may receive COMT inhibitors alongside levodopa.
These drugs help to prevent levodopa being metabolized by your body. In turn, this helps to prolong its effects. (12,13)
Dopamine Agonists
Dopamine agonists stimulate areas of your brain that require dopamine to function. Your brain is tricked into believing dopamine levels are being replenished.
Although these drugs can relieve severe parkinson’s disease symptoms, the effects are not permanent. They are usually prescribed with levodopa. (14)
MAO-B Inhibitors
MAO-B inhibitors consist of selegiline and rasagiline. This medication works to block monoamine oxidase type B.
This is a type of enzyme that contributes to breaking down certain chemicals in your brain, including dopamine.
By blocking this enzyme, these drugs increase available dopamine in the brain and reduce symptoms.
MAO-B inhibitors are usually prescribed to patients with early stages of the disease. (15)
Deep Brain Stimulation (DBS)
Deep brain stimulation (DBS) involves implanting electrodes into certain areas of your brain.
These electrodes provide electrical pulses that disrupt abnormal brain activity that cause parkinson’s symptoms.
The doses and frequency of the electricity are controlled by a device in your chest. The device settings may be changed by your doctor over time. (16)
You may still have to take medication, but your symptoms may be dramatically reduced. Unfortunately, DBS does not stop the progression of the disease.
Not everyone is a candidate for DBS either. It is not an option in individuals with dementia as it can worsen the condition. (17)
FAQ
What is parkinson’s disease? Parkinson’s disease is a chronic disorder that affects the neurons (nerve cells) and chemical production in your brain.
What are the signs of parkinson’s disease? Typical signs of the disease include shaking and difficulty moving due to stiff, rigid muscles. You can also experience urination changes such as incontinence, cognitive issues and a loss of smell.
How do you develop parkinson’s disease? The disease develops when dopamine-producing neurons in your brain start to die. It also affects the production of norepinephrine, an important chemical in your brain. The underlying cause of parkinson’s disease is not known.
What is the best treatment for parkinson’s disease? The best treatment for parkinson’s disease depends on your specific symptoms and what stage you are at. Treatments include: increased exercise, medications and surgery. The drugs used to manage the condition are amantadine, levodopa, dopamine agonists, and monoamine oxidase-b inhibitors.
What are the long term complications of parkinson’s disease? As the disease progresses, it can cause a debilitating loss of movement. At more advanced stages of the disease, you will likely require a carer to help with your daily activities.
Is parkinson’s disease considered a disability? If the disease has progressed far enough, you might qualify for disability. Criteria include inability to walk or stand and difficulty performing basic movements such as typing. (18)
Is there any cure for parkinson’s disease? No, there is no cure for parkinson’s disease. However, there are treatment options to manage symptoms.
Is parkinson’s disease life threatening? Parkinson’s disease is chronic, but generally not life threatening. However, it can seriously impair your quality of life. (19)
Summary
Parkinson’s disease affects every individual differently. This means symptoms of the condition and how it progresses also varies from person to person.
It is important to consult with your doctor to determine the best treatment plan for you. Although parkinson’s disease cannot be cured, it can be managed.
There is a wealth of resources for parkinson’s disease patients such as websites, foundations and support groups.
These will enable you to receive advice, guidance and share information about living and coping with the disease. (20)