Parkinson's Disease

Cause

The cause of Parkinson’s disease is not known yet. Within the medical world, research is done to the potential impact of the following factors:

• Heredity. In case of a genetic cause, the disease often starts earlier and proceeds more rapidly or just slower.
• Poisoning. Another cause may be poisoning by a substance, such as PCBs and certain pesticides. However, poisoning can only be seen as a cause of Parkinson’s disease in a small percentage of the cases.
• Brain infection. Some brain infections (encephalitis) may have symptoms similar to those of Parkinson’s disease.
• Age. Parkinson’s disease is often attributed to old age, but why age would cause the death of such a large amount of nerve cells isn’t clear.

Symptoms

The most common signs and symptoms of Parkinson’s disease are:

• Trembling (tremor).
• Stiffness.
• Slower and less movements.
• Fatigue.
• Shuffled walking.
• Not able to move the arm or leg anymore.
• Difficulty with balance and coordination.
• Difficulty talking (softer and monotonous).
• Difficulty writing (cramped).
• Flat facial expression (‘mask’).

Diagnosis

The diagnosis of Parkinson’s disease cannot be made with one hundred percent certainty during life. The determination is made by a neurologist and is based on the physical symptoms during examination in the consulting room. Further examination can be done to exclude other causes, for example with a brain scan. The diagnosis is confirmed by good response to an antiparkinson drug. Diseases with partly similar symptoms respond less well to such medication.

Treatment

Parkinson’s disease is still incurable. This means that doctors are currently only able to combat the symptoms and slow down the progression of the disease. Possible treatments may be:

• Dopamine agonists. An important part of the treatment of Parkinson’s disease are the dopamine agonists. These are drugs that, for example, recreate the functioning of dopamine or make dopamine more stable. All dopamine agonists ensure one way or another that the dopamine levels in the brains are getting higher.
• Deep brain stimulation (DBS). A more often used therapy is deep brain stimulation. Here, with the aid of electrodes, specific areas in the brains are stimulated by small electrical shocks. This is done in areas known to be responsible, for example, for the tremor. The aim is to reduce these symptoms.
• Anticholinergics. Apart from dopamine, the substance acetylcholine also plays an important role in the brains. Both ensure stimulation of nerve cells. In case of a lack of dopamine, such as in Parkinson’s disease, acetylcholine prevails. Some regions might receive a wrong overstimulation, which leads to, for example, tremor. By inhibiting acetylcholine, these symptoms can be reduced.

Prognosis

Parkinson’s disease itself is not fatal. However, the body deteriorates that far, that the patient’s life is severely hampered. The further Parkinson’s disease has advanced, the higher the risk of complications.

Considerations

• Stay positive and accept help when needed.
• Move regularly and do the exercises.
• Eat healthy. Maintain a balanced diet with fruits, vegetables, high-protein nutrients, dairy and grains and drink enough water.
• Prevent or reduce stress. The more stress factors, the more a patient suffers from the physical effects of Parkinson’s: more trembling, moving slower, more pain.

Facts

• Parkinson’s disease is named after the English doctor James Parkinson, who discovered the disease in 1817.
• On the birthday of James Parkinson, April 11 every year, World Parkinson’s Day is being organized. There is worldwide extra attention to this disease then.
• The prevalence of Parkinson’s disease is 0.2%. Due to aging of the population, the prevalence will increase.
• About 80% of patients with Parkinson’s disease is over 65 years.