Understanding Parkinson’s Disease and Its Repercussions
Parkinson’s disease is a progressive ailment that affects the neurological system and the nerve-controlled areas of the body. The symptoms appear gradually. The initial sign might be a little tremor in just one hand. Although tremors are prevalent, the disease may also induce stiffness or slowness of movement.
In the early stages of Parkinson’s, your face may be expressionless. When you walk, your arms may not swing. Your speech may become slurred or soft. Parkinson’s disease symptoms grow as the illness advances.
Although Parkinson’s disease cannot be cured, drugs may help you feel better. Occasionally, your doctor may recommend surgery to control particular areas of your brain and alleviate your problems.
Parkinson’s disease indications and symptoms might vary from person to person. Early symptoms may be subtle and go unrecognized. Symptoms often begin on one side of the body and worsen on that side, even after symptoms begin to affect limbs on both sides. (Read about Dopamine Agonists: Common Uses, Negative Consequences, and More).
Parkinson’s symptoms and indicators may include:
A tremor, also known as rhythmic shaking, generally originates in a limb, most often your hand or fingers. You may rub your thumb and fingers together. This is referred to as a pill-rolling tremor. When your hand is at rest, it may shake. When you are undertaking chores, the shaking may subside.
- Slowing of movement (bradykinesia).
Parkinson’s disease may impair your mobility over time, making routine activities complex and time-consuming. When you walk, your steps may become shorter. Getting out of a chair may be tough. As you attempt to walk, your feet may drag or shuffle.
- Muscles that are rigid.
Muscle stiffness may happen anywhere in your body. Muscle stiffness may be uncomfortable and restrict your range of motion.
- Poor posture and balance.
Your posture might become hunched. You may also fall or have balance issues as a consequence of Parkinson’s disease.
- Automatic motions are lost.
You may have a reduced capacity to conduct unconscious motions while walking, such as blinking, smiling, or swinging your arms.
- Speech evolves.
You may speak quietly, fast, slur, or pause before speaking. Your speech may be monotonous rather than having typical speech patterns.
- Writing evolves.
Writing may become difficult, and your writing may seem little.
- When should you visit a doctor?
Consult your doctor if you have any of the symptoms of Parkinson’s disease, not only to be diagnosed but also to rule out other possible causes of your symptoms.
Parkinson’s disease causes particular nerve cells (neurons) in the brain to progressively degrade or die. Many of the symptoms are caused by a loss of neurons that generate dopamine, a chemical messenger in the brain. When dopamine levels fall, aberrant brain activity occurs, resulting in poorer mobility and other Parkinson’s disease symptoms. (Read about Dysentery from Cryptosporidiosis: Causes, Symptoms, and Treatment).
Parkinson’s disease has no established etiology, however various variables seem to have a role, including:
Specific genetic alterations that may cause Parkinson’s disease have been found by researchers. However, except in rare circumstances when many family members have Parkinson’s disease, they are unusual.
Certain gene variants, on the other hand, seem to enhance the chance of Parkinson’s disease, but with a relatively low risk of Parkinson’s disease for each of these genetic markers.
- Triggers in the environment
Toxins or environmental factors may raise the likelihood of developing Parkinson’s disease later in life, although the risk is minimal.
Researchers have also discovered that various changes occur in the brains of persons suffering from Parkinson’s disease, yet it is unknown why these changes occur. These modifications include:
- Lewy bodies are present.
Microscopic signs of Parkinson’s disease include clumps of particular chemicals inside brain cells. These are known as Lewy bodies, and scientists think they offer a vital clue to the etiology of Parkinson’s disease. (Read Cholecystitis – Symptoms and causes).
- Alpha-synuclein is a protein present in Lewy bodies.
Although several compounds are detected in Lewy bodies, scientists think alpha-synuclein, a naturally occurring and widely distributed protein, is a key one (a-synuclein). It is present clumped in all Lewy bodies and cannot be broken down by cells. This is a major topic for Parkinson’s disease researchers right now.
- Risk elements
Parkinson’s disease risk factors include:
Parkinson’s disease is uncommon among young people. It usually starts in middle or late life, and the risk rises with age. People who are 60 or older are more likely to get the condition.
If a young individual is diagnosed with Parkinson’s disease, genetic counseling may aid with family planning options. Work, social settings, and pharmaceutical side effects vary from those of an older individual with Parkinson’s disease and must be addressed differently.
Having a close family who has Parkinson’s disease raises your chances of developing the condition. However, unless you have a large number of Parkinson’s disease relatives in your family, your chances remain low.
Men are more prone than women to getting Parkinson’s disease.
- Toxins exposure.
Continuous exposure to herbicides and pesticides may raise your risk of Parkinson’s disease somewhat.
Parkinson’s disease is often accompanied by the following additional issues, which may be treatable:
- Problems with thinking.
You may develop cognitive issues (dementia) and difficulty thinking. These are more common in the advanced stages of Parkinson’s disease. Medications seldom assist with such cognitive issues.
- Depression and emotional upheaval
You may suffer depression, even in its early stages. Receiving depression therapy may make it simpler to deal with the additional complications of Parkinson’s disease.
Other emotional changes, such as dread, worry, or lack of motivation, may occur. To alleviate these symptoms, your doctor may prescribe medicine.
- Swallowing issues
As your illness worsens, you may have difficulty swallowing. Due to slower swallowing, saliva may collect in your mouth, resulting in drooling. (Read Why Vitamin B is important).
- Chewing and eating issues
Parkinson’s disease in its late stages affects the muscles of the mouth, making chewing difficult. Choking and poor nutrition might result from this.
- Sleep disorders and sleep difficulties
People with Parkinson’s disease typically have sleep issues, such as waking up repeatedly throughout the night, getting up early, or falling asleep during the day.
Rapid eye movement sleep behavior disorder, which includes acting out your dreams, may also occur. Medications may help you sleep better.
- Bladder issues
Parkinson’s disease may produce bladder difficulties, such as the inability to regulate pee or trouble urinating.
Constipation is common in persons with Parkinson’s disease, owing to a sluggish digestive system.
You may also encounter:
- Blood pressure fluctuates.
A quick decrease in blood pressure may cause you to feel dizzy or lightheaded when you stand (orthostatic hypotension).
- Dysfunction is detectable.
You may have issues with your sense of smell. You may have difficulties detecting certain scents or distinguishing between odors.
Many patients with Parkinson’s disease report exhaustion and loss of energy, particularly later in the day. The reason is not always clear.
Pain. Some Parkinson’s disease patients suffer pain in particular places of their bodies or throughout their bodies.
- Dysfunction in sexual relationships.
Some Parkinson’s disease patients report a decline in sexual desire or performance.
There are no established strategies to prevent Parkinson’s since the cause is unknown. According to certain studies, regular aerobic exercise may lessen the risk of Parkinson’s disease.
Other studies have shown that persons who eat caffeine which is present in coffee, tea, and cola are less likely to develop Parkinson’s disease than those who do not. Green tea consumption has also been linked to a lower chance of acquiring Parkinson’s disease.
However, it is still unknown if caffeine prevents Parkinson’s disease or is associated in some other manner. There is currently insufficient data to show that consuming caffeinated drinks protects against Parkinson’s disease. (Read Why You Shouldn’t Pop Your Pimples – Acne Myths Debunked).
There is no particular test for Parkinson’s disease. A neurologist a doctor who specializes in nervous system disorders will diagnose Parkinson’s disease based on your medical history, a review of your signs and symptoms, and a neurological and physical examination.
Your doctor may recommend a dopamine transporter (DAT) scan, which is a kind of single-photon emission computed tomography (SPECT). Although this might add to your suspicions that you have Parkinson’s disease, it is ultimately your symptoms and neurological examination that will decide the exact diagnosis. The majority of individuals do not need a DAT scan.
Your doctor may request lab tests, such as blood testing, to rule out other possible causes of your symptoms. (Read Are kiwi fruit good for you?).
Imaging tests, including an MRI, brain ultrasonography, and PET scans, may also be done to rule out other illnesses. Imaging tests aren’t very useful in diagnosing Parkinson’s disease.
In addition to your evaluation, your doctor may prescribe carbidopa-levodopa (Rytary, Sinemet, and other Parkinson’s disease medications). Low dosages for a day or two are not dependable, thus you must be given a large amount to prove the benefit. Significant improvement with this medicine will almost always confirm your Parkinson’s disease diagnosis.
It might take some time to diagnose Parkinson’s disease. Regular follow-up meetings with neurologists skilled in movement disorders may be recommended by your health care provider to review your condition and symptoms over time and diagnose Parkinson’s disease.
Parkinson’s disease cannot be cured, although treatments may significantly reduce symptoms. Surgery may be recommended in certain more severe situations.
Your doctor may also advise you to make modifications to your lifestyle, including regular aerobic activity. Physical therapy that focuses on balance and flexibility is beneficial in certain circumstances. A speech-language pathologist may be able to assist with speech issues.
Medications may help you manage walking, movement, and tremor issues. These drugs either boost or replace dopamine.
Parkinson’s disease patients have reduced dopamine levels in their brains. Dopamine, on the other hand, cannot be administered directly since it cannot reach the brain.
After starting Parkinson’s disease medication, you may see a dramatic improvement in your symptoms. However, the advantages of medications typically fade or become less consistent with time. You can typically still keep your symptoms under control.
Medications that your doctor may prescribe include:
Carbidopa-levodopa (Rytary, Sinemet, Duopa, and others), Levodopa is a natural substance that enters your brain and is converted to dopamine.
Levodopa is coupled with carbidopa (Lodosyn) to prevent early conversion to dopamine outside the brain. This avoids or reduces adverse effects like nausea.
When you stand, you may experience nausea or lightheadedness (orthostatic hypotension).
As your illness advances over time, the effectiveness of levodopa may diminish, with a propensity to wax and wane (“wearing off”).
In addition, greater dosages of levodopa may cause uncontrollable movements (dyskinesia). To manage these side effects, your doctor may reduce your dosage or change the timing of your doses.
If you have advanced Parkinson’s disease, you should take carbidopa-levodopa on an empty stomach unless your doctor tells you otherwise.
Carbidopa-levodopa was inhaled.
Inbrija is a brand-name medication that delivers carbidopa-levodopa by inhalation. It might assist with symptoms that occur when oral drugs abruptly cease functioning throughout the day.
Carbidopa with levodopa infusion
Duopa is a brand-name drug that contains the active ingredients carbidopa and levodopa. However, it is supplied through a feeding tube, which distributes the drug in the form of a gel straight to the small intestine.
Duopa is prescribed for people with advanced Parkinson’s disease who react to carbidopa-levodopa but have a lot of variability in their response. Because Duopa is administered continuously, the blood levels of both medications stay consistent.
The tube must be placed via a minor surgical procedure. The risks of having the tube include the tube falling out and infections at the infusion site.
Agonists of dopamine.
Dopamine agonists, unlike levodopa, do not convert to dopamine. They instead imitate dopamine actions in your brain.
In terms of symptom relief, dopamine agonists are not as effective as levodopa. They do, however, persist longer and may be used with levodopa to smooth out the occasionally off-and-on impact of levodopa.
Pramipexole (Mirapex ER) and rotigotine are dopamine agonists (Neupro, given as a patch). Apomorphine (Apokyn) is a short-acting injectable dopamine agonist that is used to provide immediate comfort.
Some dopamine agonist adverse effects are similar to carbidopa-levodopa side effects. They may, however, include hallucinations, drowsiness, and compulsive behaviors including hypersexuality, gambling, and eating. If you’re taking these drugs and acting in ways that are out of character for you, speak to your doctor.
Inhibitors of MAO B.
Selegiline (Zelapar), rasagiline (Azilect), and safinamide are examples of these drugs (Xadago). They assist prevent the breakdown of dopamine in the brain by blocking the enzyme monoamine oxidase B. (MAO B). This enzyme metabolizes dopamine in the brain. Selegiline in combination with levodopa may assist avoid wear-off.
MAO B inhibitors may cause headaches, nausea, or sleeplessness as side effects. These drugs, when combined with carbidopa-levodopa, enhance the risk of hallucinations.
Because of the possibility of dangerous but infrequent interactions, these drugs are seldom used in conjunction with most antidepressants or certain opioids. Before using any additional drugs with an MAO B inhibitor, consult with your doctor.
Inhibitors of catechol O-methyltransferase (COMT).
The principal drugs in this family are entacapone (Comtan) and opicapone (Ongentys). By inhibiting an enzyme that breaks down dopamine, this medicine modestly prolongs the efficacy of levodopa treatment.
Side effects, such as an increased risk of uncontrollable movements (dyskinesia), are mostly caused by an improved levodopa action. Other potential adverse effects include diarrhea, nausea, and vomiting.
Tolcapone (Tasmar) is another COMT inhibitor that is seldom used owing to the danger of severe liver damage and failure.
For many years, these drugs were used to help control the tremors associated with Parkinson’s disease. There are many anticholinergic medicines available, such as benztropine (Cogentin) or trihexyphenidyl.
However, their little advantages are often outweighed by negative side effects such as poor memory, disorientation, hallucinations, constipation, dry mouth, and impaired urine.
Amantadine (Gocovri) alone may be prescribed by a doctor to relieve the symptoms of mild, early-stage Parkinson’s disease. It may also be used in conjunction with carbidopa-levodopa treatment to suppress involuntary movements (dyskinesia) caused by carbidopa-levodopa.
Skin mottling, ankle swelling, and hallucinations are possible side effects.
Antagonists of the adenosine receptor (A2A receptor antagonist).
These medications target brain locations that govern dopamine response and enable more dopamine to be released. One of the A2A antagonist medications is istradefylline (Nourianz).
This medication is used to treat hallucinations and delusions caused by Parkinson’s disease. Experts are baffled as to how it works.
Deep neural stimulation
Deep brain stimulation (DBS) involves the placement of electrodes in a particular area of the brain by surgeons. The electrodes are linked to a generator implanted at your collarbone in your chest, which transmits electrical pulses to your brain and may alleviate your Parkinson’s disease symptoms.
Your health care professional may change your settings to address your issue. Infections, strokes, and brain bleeding are all dangers of surgery. Some patients encounter issues with the DBS system or difficulties as a result of the stimulation. Some pieces of the system may need to be adjusted or replaced by your doctor.
People with severe Parkinson’s disease who have unpredictable drug (levodopa) reactions are the most likely candidates for deep brain stimulation.
DBS may help to normalize medication fluctuations, minimize or stop involuntary movements (dyskinesia), reduce tremors, and stiffness, and enhance mobility.
DBS is beneficial in regulating shifting levodopa responses or dyskinesia that does not improve with drug changes.
Apart from tremors, DBS is ineffective for issues that do not respond to levodopa medication. Even if a tremor is not sensitive to levodopa, DBS may be used to control it.
Although DBS may give long-term relief from Parkinson’s symptoms, treatment does not prevent the illness from developing.
MRI-guided focused ultrasound (MRgFUS) is a minimally invasive therapy that has helped some Parkinson’s disease patients regulate their tremors. An MRI directs the ultrasound to the part of the brain where the tremors begin. The ultrasound waves are very hot and burn regions, which contribute to the tremors.