Parkinson’s disease is caused by progressive deterioration of nerve cells in a part of the brain known as the substantia nigra. These cells produce dopamine which works as a neutrotransmitter or signaling chemical between the substantia nigra and another part of the brain called the corpus striatum. Normal communication between these two parts facilitates smooth muscle movement. Low dopamine levels on the other hand cause a loss in the ability to control body movements.
The cause of Parkinson’s disease is not known but there is some evidence that it may be inherited or passed on from one family member to another through the genes. There is also some evidence that toxins in the environment may contribute to Parkinson’s disease by destroying the nerves. These toxins include some herbicides and pesticides as well as the mineral manganese.
The symptoms of Parkinson’s disease vary from person to person and include tremor or uncontrollable shaking which usually begins with a hand, leg or the fingers and is more likely to occur at rest. Bradykinesia or slowed movement is another symptom of Parkinson’s disease which makes simple tasks difficult. It often results in a slow walk with very small steps.
Rigidity or muscle stiffness is also associated with this condition and it can affect any part of the body though it usually begins in the shoulders and hips. A stooped or slouching posture and impaired balance are other signs of Parkinson’s disease. Automatic movements like blinking or smiling are also lost and result in a blank stare or what is known as a mask face. The speech may also be affected and become soft, slurred and more of a monotone.
These symptoms usually develop gradually and are mild at first. They may even be unnoticed but as time passes, they become more severe.
There is no cure for Parkinson’s disease and treatment is aimed at controlling the symptoms and improving the quality of life. This treatment includes the use of medications which increase dopamine levels in the brain like Carbidopa-levodopa (Parcopa, Sinemet). This drug enters the brain where it is converted to dopamine to help control symptoms like bradykinesia and rigidity. Side effects of Carbidopa-levodopa include nausea and lightheadedness.
Dopamine agonists are other medications which are used to treat Parkinson’s disease. These drugs mimic the effects of dopamine in the brain by stimulating its receptors. Examples include pramipexole (Mirapex), ropinirole (Requip) and rotigotine (Neupro). Side effects of dopamine agonists include nausea, lightheadedness, confusion, drowsiness, and hallucinations.
Supportive therapies like physiotherapy and speech therapy are also prescribed for patients with movement and speech problems.
Deep brain stimulation (DBS) is a surgical procedure that is used to treat persons with advanced Parkinson’s disease. In this operation the surgeon places electrodes in the brain which are connected to a battery operated pulse generator known as a neurostimulator that is implanted in the chest. This neurostimulator sends electrical impulses to the areas in the brain that control movement and helps manage tremors, rigidity, slowed movement and walking problems.
The latest research from Duke Medicine, which was published on August 25, 2014 in JAMA Neurology, reveals that implanting deep brain stimulation devices does not have a greater risk of complications like bleeding and infections for patients who are older than 75 years when they are compared to those who are younger.
Support groups for patients with Parkinson’s disease include the American Parkinson Disease Association (APDA) Middle Tennessee Chapter whose president is Wendy Nadeau. Their address is 2300 Patterson Street, Nashville, TN, 37203. Their website is www.mtparkinsons.org and they can be reached by email at firstname.lastname@example.org They can also be contacted by phone at 800-493-2842 or 615-342-4635.