Demystifying Parkinson's: must-knows of the disease

In his essay "An Essay on the Shaking Palsy," a British physician named James Parkinson first gave a comprehensive account of the symptoms, course, and progression of Parkinson's disease, which helped establish it as a distinct medical condition. In recognition of James Parkinson's groundbreaking research, a French neurologist named Jean-Martin Charcot coined the term "Parkinson's disease" in the late 1800s.

The number of people affected by Parkinson's disease varies across different sources and estimates, but it is generally believed that around 10 million people worldwide are living with this neurological disorder. Parkinson's disease is more common as people age, and most people develop the illness at around age 60 or older. However, early-onset Parkinson's, which affects people before age 50, accounts for approximately 5-10% of cases. It is important to note that the number of people living with Parkinson's may be higher, as some cases may remain undiagnosed, especially in the early stages.

The exact underlying cause is not known for sure. However, the disease result from nerve cells in the basal ganglia, an area of the brain that controls movement, becoming impaired and/or dying. These cells produce dopamine, a neurotransmitter that regulates movement, equilibrium, and coordination. So, neurons produce less dopamine when they die or become impaired. Those with Parkinson’s also lose the nerve endings that produce norepinephrine, which regulates the sympathetic nervous system. However, what is not known is what causes the cells to become affected in the first place.

Even though the exact cause of Parkinson's disease is still unknown, it is thought to be a mix of genetic and environmental factors. Genetics may play a significant role in some cases, while toxins or other environmental factors may play a role in others. Also, oxidative stress, inflammation, and an abnormal buildup of proteins are being looked into as possible causes of the illness.

What is the life expectancy of someone with Parkinson's disease?

While it can significantly impact a person's quality of life, Parkinson's generally does not directly cause death. People with Parkinson's can have very different life expectancies, depending on how old they were when they first got sick, how bad their symptoms are, and how well individual treatments work.

On average, individuals with Parkinson's disease may have a slightly shorter life expectancy compared to those without the condition. It can make some people more vulnerable to severe and life-threatening infections. However, many people with Parkinson's can live for 10–20 years or more after the initial diagnosis with the help of proper treatment and management of symptoms.

At the moment, there is no known cure for Parkinson's disease, but there are several treatments that can help manage the symptoms and improve the quality of life for those who have it. Levodopa and other drugs that raise dopamine levels in the brain are frequently used to address motor symptoms. Medications that mimic dopamine's effects or prevent its breakdown may also be prescribed. When medication is ineffective or has significant side effects, deep brain stimulation (DBS) surgery may be an option to relieve symptoms.

Physical therapy, occupational therapy, and speech therapy are additional therapies that can help maintain mobility and muscular strength and aid in speech and swallowing issues. Support from family, friends, and medical professionals is essential for managing Parkinson's disease and maintaining a good quality of life.

What are some of the first signs of Parkinson's?

The initial signs of Parkinson's disease can be subtle and vary from person to person. Symptoms often begin on one side of the body and may go unnoticed, particularly in the early stages. Some of the first signs of Parkinson's disease include:

• Tremor: One of the most common early symptoms is a resting tremor, which manifests as a slight shaking or twitching in the hands, fingers, or other parts of the body when they are relaxed. The tremor usually begins on one side and may spread to both sides as the disease progresses.
• Bradykinesia: Slow movement and a reduction in spontaneous movement can be early signs of Parkinson's. This may manifest as difficulty initiating movement or taking longer to complete daily tasks.
• Rigidity: Stiffness in the muscles and resistance to movement, particularly in the limbs or neck, can be early symptoms. This may result in a decreased range of motion and discomfort during movement.

• Changes in gait: Individuals may notice a shuffling walk, a reduced arm swing when walking, or difficulty in starting or stopping movement.
• Changes in facial expression: Reduced facial expressions or a "mask-like" appearance due to decreased movement of facial muscles may be observed.
• Changes in handwriting: Some people may notice a difference in their handwriting, with the writing becoming smaller and more cramped. This is known as micrographia.
• Loss of sense of smell: A reduced or lost sense of smell (hyposmia or anosmia) can be an early indicator of Parkinson's disease, often occurring years before motor symptoms appear.
• Postural changes: Stooped posture or a tendency to lean forward while standing or walking can be early signs of Parkinson's.

It is important to note that many early signs are not specific to Parkinson's disease and can occur due to other conditions or to normal aging processes. If you or someone you know has these symptoms, seeing a doctor for a thorough exam and a correct diagnosis is essential. People with Parkinson's can better deal with their symptoms and have a better quality of life if diagnosed and treated early.

Does smoking/nicotine prevent Parkinson's disease?

Epidemiological studies show that people who smoke have a lower chance of getting Parkinson's disease than people who don't smoke. This has led to the idea that nicotine or other components of tobacco might have a neuroprotective effect that could help prevent or delay the start of Parkinson's disease.

But it's important to remember that the link between nicotine and Parkinson's disease is complicated and not fully understood. While some studies have shown that nicotine may have potential benefits for dopamine-producing neurons in laboratory and animal models, the exact mechanisms are still unclear. Also, these possible neuroprotective effects should be weighed against the well-known and significant harmful effects of smoking on health, such as a higher risk of lung cancer, heart disease, and other severe conditions.

What are the five stages of Parkinson's disease?

The five stages of Parkinson's disease show how symptoms and the ability to do things change over time. These stages are based on the Hoehn and Yahr scale, which Melvin Yahr and Margaret Hoehn created in 1967 to gauge the severity of the disease. Here is an overview of the five stages:

• Stage 1 (mild): In the initial stage, symptoms are usually subtle and may only affect one side of the body (unilateral involvement). Common signs include tremors, changes in posture, and mild coordination problems. These symptoms might not be noticeable to others, and daily activities are generally unaffected.
• Stage 2 (mild to moderate): At this stage, symptoms become more noticeable and can affect both sides of the body (bilateral involvement), although one side may still be more affected. There may be increased tremors, rigidity, and balance issues. Daily tasks may become more challenging, but individuals can usually still perform them independently.

• Stage 3 (Moderate): Patients' motor symptoms get much worse at this stage. They move more slowly, have trouble keeping their balance, and are likelier to fall. Daily tasks like getting dressed and eating become more complicated and help may be needed. However, most patients are still able to maintain some degree of independence.
• Stage 4 (moderate to severe): Motor symptoms are tough at this stage, and patients require help with most daily activities. Walking may still be possible, but many patients need assistive devices like a walker. Living independently becomes challenging, and daily care assistance is usually necessary.
• Stage 5 (severe): In the last stage of Parkinson's disease, when motor symptoms are advanced, patients often have to use a wheelchair or be confined to bed. They might lose their balance entirely and cannot do simple tasks independently. Assistance is required for all aspects of daily living, and around-the-clock care may be necessary. Cognitive decline, hallucinations, and delusions may also be present at this stage.

It is important to note that the progression of Parkinson's disease varies significantly among individuals, and not everyone will experience all five stages. Some patients may worsen slowly and have milder symptoms, while others may worsen quickly and more severely. Parkinson's disease should be treated to fit the needs and circumstances of each person.

What is the leading cause of Parkinson's disease?

Parkinson's disease is likely caused by a complex combination of genetic and environmental factors, but the underlying cause is still unknown.

Researchers have found specific genetic mutations that can lead to Parkinson's disease. However, these cases are rare, making up only 10–15 percent of sufferers. Other genetic differences are linked to a higher risk of getting Parkinson's, but they don't mean a person will get the disease.

Other potential causes include environmental factors. Exposure to pesticides, herbicides, and heavy metals, among other things, has been linked to a higher risk of Parkinson's disease. However, the exact mechanisms by which these factors contribute to the development of the disease are not yet fully understood.

Age also plays a part. Your chance of getting Parkinson's disease increases as you get older; most cases happen after age 60. Dopamine-producing neurons in the substantia nigra, a part of the brain affected by Parkinson's disease, may die off because of the aging process.

Another factor is cellular deterioration. Abnormal protein accumulation, oxidative stress, and inflammation have been implicated in the development and progression of Parkinson's disease. The buildup of misfolded proteins, such as alpha-synuclein, can lead to the formation of protein clumps called Lewy bodies, which are a hallmark of Parkinson's disease. Oxidative stress and inflammation can also damage neurons and contribute to their degeneration.

Even though the exact cause of Parkinson's disease is still unknown, researchers are still trying to figure out how genes, the environment, and cellular processes interact to find better treatments and, eventually, a cure.

And that is your lot for today.

Parkinson's disease is a complex neurological disorder primarily affecting movement and motor function. Even though there is no cure for the disease, new treatments and ways to deal with its symptoms have made life better for those with it. As we learn more about what causes Parkinson's disease and how it worsens, ongoing research can lead to new treatments and, eventually, a cure. Patients can only get the proper care and support if their symptoms are caught early and diagnosed correctly. This gives them the tools they need to live their whole lives despite the challenges the disease brings.