All you want to know about Parkinson’s Disease
Parkinson’s disease is a slowly progressive neurodegenerative movement disorder that primarily affects elderly people above the age of 60 years. Approximately 7 to 10 million people worldwide and nearly 58 lakhs Indians (as estimated in 2016) live with this incapacitating disease that not only affects physical movements but also takes a toll on the social life of an individual and his family members.
What is Parkinson’s disease?
Parkinson’s disease (PD) is a chronic neurological disorder characterized by the impairment/loss of dopamine-producing neurons in the mid-brain owing to the deposition of abnormal protein, resulting in the classical triad of tremors [shaking], rigidity [stiffness], and bradykinesia [slowness of voluntary movements].Table 1: Types of Parkinson's disease based on origin
Causes of Parkinson’s Disease
Basal Ganglia is a part of our brain that is primarily responsible for organizing and coordinating movements by sending nerve impulses to muscles.
Substantia Nigra is a part of the basal ganglia which is responsible for the secretion of dopamine. Abnormal deposition of misfolded protein in substantia nigra leads to degeneration of nerve cells which causes less dopamine production. As a result, the nerve cells are not able to communicate and basal ganglia cannot regulate/control muscle movements (Figure 1)
Figure 1: Brain changes in Parkinson’s Disease
Certain non-movement related symptoms are observed in the late stage of PD owing to a decrease in another neurotransmitter (Norepinephrine) that primarily controls autonomic functions (digestion, heart rate, blood pressure, and breathing)
Who gets Parkinson’s Disease?
PD is 2nd most common neurodegenerative disorder after AD (Alzheimer’s Disease) that affects elderly males (>60 years of age). However, 10% of cases that are diagnosed before 50 years of age have a positive family history.
What are the Symptoms of Parkinson’s Disease?
Symptoms may include
- Tremors at rest (shaking)
- The first symptom that affects one side of the body (usually hands/arms) in the early stages
- Worsens with stress/fatigue
- Disappear during sleep and deliberate movements (limb being moved)
- Increased muscle tone (stiffness/rigidity)
- Uncontrolled stiffness of muscle impairs the free movement
- Pain/aches in affected muscles
- Bradykinesia (slowness of movement)
- Difficult to initiate movements(difficulty in getting out of a chair)
- Activities become slow (slow in bathing, getting dressed, etc.)
- Characteristic parkinsonian gait / Unsteady balance or coordination
- Difficulty taking the first step [feel as if feet are stuck to the floor(freezing)]
- Small quick steps as if hurrying forward to avoid a fall
- Tendency to lean forward
- Difficulty stopping or turning
- The reduced swinging of the arms
- Stooped posture
- Small muscles of the hands are affected
- Difficulty performing daily tasks [buttoning, tying shoelaces]
- Shaky/tiny handwriting (micrographia)
- Masklike- expressionless face in late-stage
- Speech Issues
- Speak softly in monotone
- Stutter (difficulty in articulating words)
- Other symptoms may include depression, anxiety, impaired thinking, hallucinations, loss of smell, swallowing problems, constipation, urinary problems, sleep disturbances, etc.
What are the stages of Parkinson’s Disease?
The disease usually progresses through stages [Table 2] from early to mid to mid-late to an advanced stage, however, no two people get the same symptoms, and the intensity may also vary from person to person.
Table 2: Stages of Parkinson's disease
Management of the Parkinson’s disease
Early symptoms mimic age-related physiological changes and symptoms of other diseases so it becomes difficult to diagnose the disease in the early stages. The medical history, family history, lab tests, exposure to toxins, and Imaging (CT, MRI) studies rule out other diseases.
There is no cure for Parkinson’s disease. Treatment includes management of symptoms through medications (Levodopa/Carbidopa), exercises, physical therapy, occupational therapy, and speech-language therapy.
Tips to improve quality of life in a patient with Parkinson’s Disease
- Regular exercises help improve balance, coordination, flexibility, tremors, and muscle strength. Keep doing the daily activities as much as possible.
- Have a fiber-rich healthy balanced diet and consume plenty of fluids
- Measures to prevent falls
- Move slowly while changing positions
- Don’t multitask. Concentrate on one task at a time.
- Install grab bars in bathrooms and railings where ever required, and use non-skid rubber mats on slippery surfaces
- Stay socially active, indulge in your hobbies, avoid stress, and practice “sleep hygiene” habits to improve sleep quality
- Take medicines regularly as prescribed
Parkinson’s disease is unpredictable, patient needs constant support, love, and care. It can become stressful for family members too. If you are too stressed out as a caregiver, talk to the expert at DocOnline for guidance.