Parkinson's Disease

MRI Scans

What is Parkinson’s disease? 

Parkinson’s disease is a neurological illness that results in loss of dopamine producing brain cells in an area known as the substantia nigra. 

Because dopamine is involved in the brain circuits for motor control, Parkinson’s disease sufferers often experience tremors, stiffness (rigidity) of their limbs, difficulty walking and a stooped posture.

Family and friends of sufferers may also notice reduction in facial expressions and that their voices become softer over time.

It is a neurodegenerative condition, so symptoms worsen over time.

What causes Parkinson’s disease? 

To date, scientists are still uncertain what causes the causes the loss of dopamine producing cells. Though some familial trends and dominant genes such as LRRK2 and SNCA have been found, the great majority of cases are sporadic. These are thought to be caused by a combination of genetic and environmental factors. Efforts in research are currently underway to find out these causes so we may one day slow down or prevent the disease.

An old uncle going through physiotherapy

What are the symptoms of Parkinson’s disease?

Parkinson’s disease affects everyone differently depending on the stage of the disease, but it is generally characterized by four symptoms: 

  • Tremors in hands, arms, legs, head or jaw 
  • Stiffness (Rigidity) of the limbs
  • Slowing of movement 
  • Balance and coordination problems 

Early symptoms of Parkinson’s like mild tremors and changes in posture are often dismissed as effects of ageing, but as the disease progresses, friends and family members are usually the first to detect changes. For example, they may notice that the person lacks facial expression, or the person does not move his arm or leg properly. People with Parkinson’s also often develop a characteristic shuffling gait, which includes trouble initiating movement, a tendency to lean forward and small, hurried steps. 

Lesser known symptoms may include depression, difficulty swallowing and speaking, sleep disruptions and urinary problems. 

Who is at risk for Parkinson’s disease? 

The risk factors for Parkinson’s disease include: 

Age

Parkinson disease’s is seldom seen in young people. It usually develops around age 60 or older. 

The incidence in those aged above 65 is ~3%. However, about 5-10% of people with Parkinson’s have a young onset, and develop symptoms before the age of 50. 

Genetics 

Having a first degree relative (parents or siblings) with Parkinson disease increase the odds of your having Parkinson’s Disease by ˜1.6 times.

Head trauma

Having even minor head injuries, such as concussions have been shown associated with 

Parkinson’s disease. Certain professions such as boxing where such injuries are more likely may put one at increased risk.

Sex

Men are approximately 2x as likely to have Parkinson disease as women. 

Exposure to toxins 

Epidemiological studies seem to suggest that exposure to the rural environment and herbicides in early life leads to a small increase of developing of Parkinson disease in later life.

How is Parkinson’s disease diagnosed?

There are a number of conditions that may mimic Parkinson’s disease especially in their early stages. The diagnosis is clinical, and it is usually made after a careful medical interview regarding symptoms and their onset as well as a physical examination. Blood investigations and brain imaging may be helpful in the diagnosis of some cases and would be ordered by the treating doctor.

Dr Lee of Capernaumneurology running a test for a patient

How is Parkinson’s disease treated?

While there is currently no cure for Parkinson’s disease, there are many treatment options that can help relieve many of the troubling symptoms.

As Parkinson’s is caused by low levels of dopamine in the brain, medications such as Madopar which helps replenish dopamine are commonly used to ameliorate some of the motor symptoms.

Other medications like Rasagiline, a monoamine oxidase inhibitor are also used for symptom relief and may have some potential in slowing down disease progression.

In cases where medication does not work, deep brain stimulation may be employed. Deep brain stimulation involves implanting electrodes in your brain to regulate abnormal impulses and stop movement-related symptoms of Parkinson’s, including tremor, slowness of movement and rigidity. 

Physical exercises like strength training, yoga and tai chi have been shown to improve symptoms of Parkinson’s and help patients maintain their balance and mobility. Since exercise is beneficial for most aspects of health, and there so many types, we suggest you just try one out and if you enjoy, stick with to it. If not, keep switching until you get one you like, there are so many sports around, there is bound to be one that suits you. 

If you think you may have Parkinson disease, do see a neurologist early. Early diagnosis and treatment would help preserve your quality of life and minimize complications.

Over the years, several influential individuals such as Hollywood actor Michael J. Fox, who has been living with Parkinson’s for close to 30 years, have stepped up to raise awareness about the disease. They have also shown that though there are difficulties, it is possible to carry on with an active life while still having this disorder.