What is Parkinson's Disease?

Symptoms, Treatments, and Living with Parkinson's Disease

page with Parkinson disease written with other words such as dopamine
What is Parkinson's disease?. Istockphoto.com/Stock Photo©tupunsato

What is Parkinson's disease and what are the symptoms? How is the diagnosis made and what treatments are available? What should you know about living day to day with the disease?

What is Parkinson's Disease? - Definition

Parkinson's disease is a brain disorder named after the British physician, James Parkinson, who first accurately described its symptoms in 1817. Its three major symptoms are tremor (trembling which usually starts in one hand), rigidity in the trunk or limbs, and slowness of movement.

It is a progressive disorder, meaning that it typically gets worse over the years. But new treatments are emerging for PD that promise to reduce the most disabling symptoms of the disease.

How Common Is Parkinson's Disease (PD)?

Parkinson's disease (PD) affects approximately one million people in the United States and Canada. Men are slightly more likely to get PD than women.

What Causes Parkinson's Disease?

We learned in the 1950's that PD is related to a lack of the chemical messenger dopamine in the movement centers of the brain, though we are learning that the cause of Parkinson's disease is more complex and involves processes unrelated to dopamine (non-dopaminergic processes) as well. 

Though we know of risk factors that raise the risk of developing the disease, it's not known exactly how these factors work together to cause the disease.

Risk Factors for Parkinson's Disease

Though nearly anyone may get Parkinson's disease, some people are at an increased risk of developing the disease.Risk factors do not mean that someone will get Parkinson's disease, only that they are at an increased risk.

It's important to note that most often Parkinson's disease is multifactorial in origin, meaning that it's likely that several different factors work together to create the brain changes responsible for PD. Risk factors for Parkinson's disease include:

  • Age - Parkinson's disease is more common (with 75 percent of people developing the disease after age 60) up to the age of 80, when it then becomes less common again
  • Sex - Men are slightly more likely to develop Parkinson's disease than women
  • Race - Caucasians are more likely to develop PD than African Americans
  • Genetics - Having a family history of PD increases your risk somewhat, and one gene in particular is associated with early onset Parkinson's disease
  • Exposures to some toxic chemicals
  • Illegal drug use (especially use of stimulants which have an effect on dopamine in the brain)
  • People who have had a traumatic brain injury

Symptoms of Parkinson’s Disease

Since dopamine normally controls muscle activity, Parkinson's disease primarily affects movement. Yet there are other non-motor (non movement related) symptoms as well, such as problems with mood, sleep, thinking and speech.

The classic motor symptoms of Parkinson's disease include:

  • Slowness of movement - The term bradykinesia is used to describe these slow movements
  • Resting tremors - These resting tremors are also called "pill-rolling" tremors as they have the appearance of a person rolling a pill in their hands
  • Rigidity

In recent years it's been found that the first symptoms of Parkinson's disease are often non-motor symptoms, and that these may occur up to five years before the movement disorders of Parkinson's disease become evident. These earliest non-motor symptoms of Parkinson's disease include:

  • Loss of the sense of smell (oflactory dysfunction)
  • Constipation
  • Sleep problems including one type of sleep abnormality known as REM sleep behavior disorder. This sleep disorder involves people with PD essentially acting out their dreams; hitting or kicking themselves or a bed partner in response to what is happening in their dreams

In addition to sleep problems, other non-motor symptoms of Parkinson's disease may include:

Speech problems with Parkinson's disease are many faceted, but are very significant socially, because when combined with the "masked faces" of Parkinson's disease it can be difficult to understand what someone with PD is saying. Other common symptoms include visual disturbances, urinary problems, and sexual dysfunction.

How Is Parkinson's Disease Diagnosed?

There are no unequivocal tests for diagnosing Parkinson's disease. There is not a blood test or brain scan which can conclusively determine whether someone has Parkinson's disease or not, and it is diagnosed on the basis of the history of the symptoms and after a careful and detailed neurological examination. If your motor symptoms (tremors, rigidity and slow movements) get better after taking a trial of the drug levodopa, then it is more likely that you have PD.

Treatments for Parkinson's Disease

There is, at present, no cure for PD, but there are some very effective treatments. In addition, clinical trials are actively looking at new treatment and new approaches are becoming available each year.

Treatment options for Parkinson's disease usually include a combination of different modalities.Medications for Parkinson's disease include dopamine replacement therapy and dopamine agonists in addition to other medications which work in a different way. Deep brain stimulation has been looked at increasingly in recent years and has its own list of pros and cons.

It's important to consider treatment for the symptoms related to Parkinson's disease as well, since some of these can be very bothersome. For example, many people with the disease will want to consider treatment options for depression. In addition, alternative treatments, though they can't reverse the process of the disease, may help people cope with many of the problems related to the disease.

Living With Parkinson's Disease

It is possible to live an active life with PD. If you take advantage of the best treatment options for you, maintain an exercise regimen as best you can, and create and use a support network you will increase your ability to remain independent and to live a pretty normal life. Remember you are not your disease. Learn as much as you can about PD and allow yourself to accept help from others when you need it.

If you've been recently diagnosed with PD, take a look at these first steps for people diagnosed with Parkinson's disease.

If Your Loved One Has Been Diagnosed with Parkinson's Disease

If your loved one has recently been diagnosed with Parkinson's disease, we don't need to tell that PD is a family disease. PD can have a tremendous impact on relationships. That said, if you and your loved one work together and maintain open communication, a diagnosis of PD can be a time for families to draw closer together and work as a team in coping with the day to day frustrations of the disease.

Sources:

Kasper, Dennis, Anthony Fauci, Stephen Hauser, Dan Longo, and J. Jameson. Harrison's Principles of Internal Medicine. New York: McGraw-Hill Education, 2015. Print.

U.S. National Library of Medicine. Medline Plus. Updated 10/13/16. https://medlineplus.gov/parkinsonsdisease.html

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