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Parkinson’s disease is a degenerative disorder affecting the central nervous system in human beings. It mainly affects the motor system (the nerves and structures responsible for movement), and it is a long-term and progressive condition. The symptoms experienced in Parkinson’s disease worsen as the condition progresses. With this progression, the non-motor symptoms also become more apparent. The symptoms in Parkinson’s disease appear slowly and increase in prominence and effect as the disease progresses.
Some of the symptoms include rigidity, shaking, slow movements, and difficulty walking. Because the disease affects the central nervous system, its effects are widespread and can be seen throughout the body. Parkinson’s disease currently has no cure, and its treatment is focused on managing the symptoms, improving the quality of life of the individual, and slowing down the progression of the condition.
The specific cause of Parkinson’s disease is unknown, although several hypotheses have tried to explain it. The main characteristics of the condition are cell death and the presence of Lewy bodies. The cell death is in the basal ganglia of the brain and will reach about 70% of all dopamine-secreting cells in the brain by the end of the life of the individual.
The presence of Lewy bodies also characterises the changes that happen in the brain in Parkinson’s disease. Lewy bodies are accumulations of the protein alpha-synuclein, and they are present in the dopamine-producing neurons unaffected by the cell death in the basal ganglia. Sometimes, Parkinson’s disease is referred to as synucleinopathy by scientists because of the way alpha-synuclein proteins accumulate in the brain.
The cell death in parkinsonism is important because the neurons affected are responsible for producing dopamine. Dopamine is a neurotransmitter in the brain, and its job is to transmit signals from one neuron to the other. Without dopamine, there is a “breach” in the gap and movements become difficult. This is what’s responsible for the symptoms observed in Parkinson’s disease. Dopamine is also responsible for other functions in the body, like promoting feelings of happiness as well as improving focus and memory. The functions of dopamine are why symptoms such as bradykinesia, depression and thinking difficulties are seen in individuals that have Parkinson’s disease.
As mentioned earlier, the symptoms seen in Parkinson’s disease starts slowly, and they worsen as the condition progresses. The stages of Parkinson’s disease are responsible for this progression in symptoms, and the further along the stages an individual is, the more severe the symptoms. The stages can be differentiated from each other based on the symptoms that they present
This is the initial stage of the condition, and it includes mild symptoms like tremors in the hand or the entire limb. Even though they are just tremors, they are sufficient to interfere with the normal activities of daily living. Additionally, there may be mild changes in walking posture and facial expression in individuals with parkinsonism. These changes are usually only noticed by people who are familiar with them.
In the second stage, the tremors become worse and more widespread. Here also, rigidity starts to occur in the muscles; however, it is not enough to limit movement and activity. Changes in walking and standing posture are more noticeable in the second stage of Parkinson’s disease. Additionally, they are usually noticeable by any observer. These symptoms will interfere with daily activities, but will not completely stop the individual from performing them.
Stage three marks the worsening of the motor symptoms in Parkinson’s disease. These worsened motor symptoms can often be seen in the way the individual tends to lose balance when walking. Here, the pace of walking is very slow, and the individual may fall often. Additionally, the interference with activities of daily living become more severe, and there may be a difficulty with simple tasks like eating and getting dressed. However, at this stage, the individual is still capable of living alone.
By the fourth stage of Parkinson’s disease, the symptoms are extremely limiting, and the individual is often unable to perform normal daily activities by themselves. As for movement, people with Parkinson’s disease at this stage may be able to get up themselves, but they often need assistance. People at this stage usually require assistance, as they are unable to take care of themselves.
This is the most advanced stage of the condition, and individuals at this stage will experience difficulty performing most activities, including walking, standing, and even swallowing. Most of all, the other symptoms of parkinsonism are present at this stage, and the individuals are heavily dependent on others for care.
Often, individuals who have Parkinson’s disease experience other conditions as well. The relationship between the two is not clear, but they occur in a large percentage of individuals who have Parkinson’s disease. They are
Sometimes, these two terms are used interchangeably. While they appear similar, there is a key difference between the two of them.
Parkinsonism is a syndrome, which means that it is a group of symptoms that are seen together. Often, these can be diagnosed together as they are usually caused by the same events. In parkinsonism, there are symptoms seen like tremors and slow movements. However, there are other disorders as well, which are yet to be identified. When people say parkinsonism, they refer to the symptoms seen in the disease.
Parkinson’s disease, on the other hand, exclusively refers to the death of dopamine-producing neurons in the brain. Parkinson’s disease is a cause of parkinsonism: it leads to cell death, which then leads to difficulties in motion. This difficulty in motion is then called parkinsonism.
Parkinson’s disease is present in about one to two in every 1000 people. For individuals over 60, the disease is more common, and it affects one in 100.
The risk factors of Parkinson’s disease include:
The symptoms of the disease are mostly motor related. A simple observation of the individual’s motion patterns can identify the disease. However, as their symptoms progress to other stages, other symptoms begin to surface as well.
Some of the symptoms include
At the later stages, some of the other symptoms include:
There are no specific tests that can be used to diagnose the disease. It is diagnosed based on history, symptoms and neurological examination by a neurologist. Sometimes, a Dopamine Transporter scan (DaTSCAN) may be requested. However it is not necessary.
Parkinson’s disease doesn’t have a cure. However, medications and physical therapy can help control the symptoms.
Several medications are being used to treat Parkinson’s disease. Most of them are either to increase the secretion of dopamine in the body or to substitute it. One of such drugs is carbidopa-levodopa, which substitutes the neurotransmitter.
Lifestyle adaptations are also made to make living easier for the individual living with Parkinson’s disease. These modifications may include a change of diet to include more vitamins and minerals and changes in the layout of their home to make moving around easier. Other changes like changing button shirts for zippers and Velcro are also made since buttoning becomes difficult in the condition
Physiotherapy can also help manage the condition. The focus in on exercises that engage the individual, and encourages the mastery of movement and coordination. These exercises can help keep the individual active as the disease progresses.
“Parkinson’s Disease Information Page”. NINDS. 30 June 2016. Archived from the original on 4 January 2017. Retrieved 18 July 2016.
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