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What is Parkinson’s?
Parkinson’s disease is a brain disorder that causes movement problems like shaking, slow movements, muscle stiffness, and loss of balance and coordination. The most effective treatment for Parkinson's is levodopa, but there are other medications and treatments available.
Parkinson’s disease is a brain disorder that causes movement problems like shaking, slow movements, muscle stiffness, and loss of balance and coordination. The disease worsens over time and can eventually lead to memory loss, behavior and mental changes, tiredness, and sleep problems.
Parkinson’s disease can happen to anyone, but it’s more likely to happen to older people and men. The average age of onset is 55 years.
Why do people get Parkinson’s?
The exact cause of Parkinson’s is unknown. Some cases are hereditary and run in families, and some happen without a clear reason. But Parkinson’s happens because of changes in your brain.
Loss of brain chemicals
Parkinson’s is caused by nerve cell breakdown in a part of the brain called the basal ganglia. Cells in this area release dopamine and control movement by sending signals down your spinal cord to your muscles. As these cells die, your body makes less dopamine, and you start to have movement problems.
The brain also loses nerve endings that make norepinephrine, which controls blood pressure, heart rate, and many other things. The lack of norepinephrine causes tiredness, constipation, and sudden blood pressure drop when you change positions.
Genetic factors
People with Parkinson’s also have irregular clumps of a protein called alpha-synuclein in the brain. These clumps are called Lewy bodies and can lead to dementia: memory loss and difficulty thinking and making decisions. Some studies suggest that a gene change causes alpha-synuclein to form Lewy bodies, leading to cell breakdown and loss of dopamine. These gene changes can cause a rare inherited form of Parkinson’s.
Environmental factors
Other studies suggest that air pollution, head injuries, and exposure to toxins like pesticides, herbicides, and Agent Orange might be risk factors. Overall, the cause isn’t clear, and it may even be a combination of factors that leads to Parkinson’s.
What is the best treatment for Parkinson’s disease?
There is no cure for Parkinson’s disease, but treatments that can improve symptoms. Medications are the main treatment, but other supportive and lifestyle therapies are often also used.
Your doctor will consider your symptoms and the stage of your disease. During the early stages, you might not need treatment as the symptoms are usually mild.
Medications
The main medication for Parkinson’s is an amino acid precursor to dopamine called levodopa. Your cells absorb this medication and turn it into dopamine. Since Parkinson’s causes a lack of dopamine, raising your dopamine levels can help ease your symptoms.
Levodopa is often combined with another medication called carbidopa, which stops levodopa from being converted into dopamine too early. This gets more dopamine to the brain and also helps prevent some side effects of levodopa like feeling sick and throwing up.
People with Parkinson’s often take levodopa for a long time. Years of the medication can lead to side effects like uncontrollable and jerky movements called dyskinesia and an “on-off” phenomenon. This is where you quickly switch from being able to move to immobility. The drug can also lose its effectiveness over time, and you might need higher doses.
Other common medications include:
- Dopamine agonists, which act as a dopamine substitute
- Monoamine oxidase-B inhibitors, used in the early stage to block an enzyme that breaks down dopamine
- Catechol-O-methyltransferase inhibitors, used in late-stage Parkinson’s to block enzymes that break down levodopa
- Duopa, a type of levodopa for severe off periods
Therapy
Physical, speech, and occupational therapy are all helpful for Parkinson’s. Physical therapy helps stretch and strengthen muscles, ease muscle tightness and weakness, and help you gain flexibility. All of this helps with movement.
Speech therapy can help with speech and swallowing problems. Occupational therapy helps you learn how to adapt your daily tasks and self-care according to your abilities and promotes independence. An occupational therapist also makes sure your home is safe and adapted.
Other treatments
You might also need to make changes to your diet to help symptoms like low blood pressure, dehydration, and constipation.
If Parkinson’s doesn’t respond to medications, your doctor might recommend deep brain stimulation surgery. During this procedure, a type of pacemaker is placed on your brain and stimulates areas affected by Parkinson’s.
Outlook
While there is no cure for Parkinson’s disease, treatment can help ease your symptoms and improve your quality of life. You might not need medications in the early stages of the disease as symptoms are often mild, but your doctor will prescribe treatment based on your needs. If you think you have symptoms of Parkinson’s, talk to your doctor.