Parkinson’s Disease

Motor symptoms:

• Rigidity or stiffness of the muscles
• Bradykinesia (slowness of movement)
• Tremor (rhythmic shaking)
• Trouble with balance, posture, and coordination
• Trouble walking
• Difficulty in initiating movements

Non-motor symptoms:

• Sleep problems
• Depression
• Difficulty in thinking
• Constipation
• Anxiety

The disorder arises due to the destruction of a part of the brain that secretes the chemical dopamine. Dopamine helps neurons in the brain to regulate movement and communicate. The loss of dopamine causes motor and non-motor symptoms to arise in people with Parkinson’s disease.

The cause of PD is idiopathic, which means it is unknown. Researchers conjecture that environment and genetics both play a role in the cause. Mutations in the genes called LRRK2, GBA, parkin, and DJ-1 have all been linked to PD. Exposure to solvents and pesticides has also been linked to PD along with repeated head injuries.

• Aging -average age of onset is 60
• Gender – men more than women
• Family history of Parkinson’s disease
• Exposure to herbicides and pesticides
• Exposure to Agent Orange
• Industrial exposure to solvents, heavy metals, and detergents
• History of head trauma (repeated injuries)

Your doctor will first ask you your medical history, including family history, and ask for you to describe any signs or symptoms you are experiencing. No test conclusively diagnoses Parkinson’s disease. Instead, physicians use neurological and physical examinations along with other diagnostic tests to diagnose PD. These tests include:

Blood tests. These will help to rule out other causes of symptoms that mimic Parkinson’s disease.

Dopamine transporter scan (DaTscan). Also called a SPECT (specific single-photon emission computerized tomography) scan. The DaTscan measures the levels of dopamine transporters in the brain.

Imaging tests. Also used to rule out other diseases or disorders. These tests include magnetic resonance imaging (MRI), positron emission tomography scan (PET), and an ultrasound of the brain.

Medication. Sometimes, doctors will prescribe a Parkinson’s disease medication to see if it improves symptoms. Improvement signals to the physician that Parkinson’s disease is the cause of neurological dysfunction.

Treatment involves drugs that mimic the effect of dopamine in the brain. Other medications can also be used to lessen symptoms. Surgery, or deep brain stimulation, can be considered but is not usually tried until medications have failed or side effects have become too advanced. Treatments for Parkinson’s disease include the following medications:

Amantadine. This drug is prescribed in the early stages of Parkinson’s disease to treat symptoms. The medication gives relief for a short time and helps to control involuntary movements.

Anticholinergics. These drugs are prescribed to help control the tremors caused by low dopamine levels.

Carbidopa-levodopa. This drug is converted into dopamine once it reaches the brain and helps to improve symptoms caused by dopamine deficiency. It is available in pillform but also can be administered via inhalation or infusion (administered through a feeding tube).

Catechol O-methyltransferase (COMT) inhibitors. Used to extend the effects of levodopa by blocking an enzyme that breaks down dopamine.

Dopamine agonists. This type of drug lasts longer than the carbidopa-levodopa combination drug. Dopamine agonists mimic dopamine and its effects on the brain.

MAO-B (monoamine oxidase type B) inhibitors. This drug contains an enzyme that our brain uses to break down chemicals, including dopamine. They inhibit this enzyme which stops the break down of dopamine and increases levels over time.

Parkinson’s disease can make life difficult. Getting dressed, eating, bathing, walking, and sleeping are all daily activities that are affected by Parkinson’s disease and each activity becomes increasingly challenging as the disease progresses. The following suggestions can help improve your quality of life and help you manage challenging days:

Move! Incorporate a daily exercise program into your routine. Moving not only increases your confidence but improves symptoms. Dance is a wonderful moving alternative that helps with balance, builds strength and confidence, and it’s fun!

Coping with freezing. Freezing is the temporary and involuntary ability to move that occurs with the progression of Parkinson’s disease. If you are suffering from a freezing episode, try the following coping methods:

• March
• Listen to music and step to the beat
• Pretend there an imaginary line in front of you and step over it
• Shift your weight from one leg to the other

Make your home safe. Install handrails in bathtubs and shower stalls. Make sure you have stable floors with non-skid surfaces. Buy secure furniture that is sturdy, does not swivel, with adequate seat heights and armrests in chairs. Remove throw rugs and all clutter. In the bedroom, create a calm, relaxing environment with good lighting and handrails to get in and out of bed.

Emotional health. Living with Parkinson’s can cause emotional turmoil, especially when first diagnosed. The diagnosis can lead to anxiety and depression and mood swings. If you are struggling with these emotions, talk to your doctor who can recommend medications and refer you to a therapist. Counseling can provide an outlet for these tumultuous emotions and you will be guided in coping methods that can help you relax and deal with worries and concerns. Support groups allow you a safe space to share your struggles and triumphs in a community of people dealing with a similar experience. Reach out for help and understand you are not alone.

Many people who live with Parkinson’s disease will explore complementary and alternative medicine (CAM) treatment options to help them manage symptoms while improving their quality of life. Complementary medicine can typically be used in combination with traditional medicine. Talk to your doctor before you take any supplements or try a new treatment method to make sure it is safe and does not interfere with your medications. Different CAM treatment options for Parkinson’s disease include:

• Acupuncture
• Art therapy
• CBD oil
• Massage
• Medical marijuana
• Meditation
• Music therapy
• Tai chi
• Yoga

• Limit sugar intake
• Eat a healthy diet
• Exercise regularly
• Get enough sleep
• Maintain a healthy weight
• Drink alcohol in moderation
• Stay well-hydrated
• Exercise to increase hunger
• Practice excellent dental hygiene

If you are interested in finding out more about current clinical trials that are actively researching Parkinson’s disease follow this link here hosted by the U.S. National Library of Medicine.

Downward, E. (2020, November). Complementary and alternative therapies. Retrieved from Parkinson’s Disease.net: https://parkinsonsdisease.net/treatment/complementary-alternative/

Gleeson, R. (2020, March 02). Exploring alternative therapies for Parkinson’s disease. Retrieved from University of Michigan Health: https://healthblog.uofmhealth.org/brain-health/exploring-alternative-therapies-for-parkinsons-disease

Johns Hopkins Medicine. (2021). Parkinson’s disease risk factors and causes. Retrieved from Johns Hopkins Medicine: https://www.hopkinsmedicine.org/health/conditions-and-diseases/parkinsons-disease/parkinsons-disease-risk-factors-and-causes

National Institute on Aging. (2017, May 16). Parkinson’s disease. Retrieved from National Institutes of Health: https://www.nia.nih.gov/health/parkinsons-disease

Standaert, D. G., et. al. (2019). Parkinson’s disease handbook. APDA. Retrieved from American Parkinson’s Disease Association: https://www.apdaparkinson.org/wp-content/uploads/2017/02/APDA1703_Basic-Handbook-D5V4-4web.pdf

Zigmond, M. J., & Burke, R. E. (2002). Pathophysiology of Parkinson’s Disease. Neuropsychopharmacology: The fifth generation of progress, 123, 1781-1793. Retrieved from American College of Neuropsychopharmacology: https://acnp.org/wp-content/uploads/2017/11/C123_1781-1794.pdf