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PARKISON’S DISEASE (PD)         

Nervous System Diseases / By

PARKISON’S DISEASE (PD)         

Parkinson’s disease is a progressive central nervous system disorder that mainly affects the motor system.

  • The motor system is the part of the central nervous system that is involved with the movement.
  • The condition affected 6.2 million people globally in 2015 resulting in about 117,400 deaths.
  • The condition is more common in people over the age of 60, of which about one percent are affected.
  • It is more common in male than in the female.
  • When the condition is seen in people before the age of 50, it is termed young-onset Parkinson’s disease
  • Following diagnosis, the average life expectancy is between 7 and 14 years.
  • The disorder is chronic and worsens over time

CAUSES

In Parkinson’s disease, nerve cells of the substantia nigra gradually break down and die. The substantia nigra is the part of the brain where a chemical messenger in the brain called dopamine is produced.

The dopamine is responsible for the smooth and coordinated muscle movement of the body.

In Parkinson’s disease, dopamine levels are reduced. When this happens, it results in an abnormal brain activity leading to symptoms associated with the condition.

The exact cause of the condition is unknown, but several factors seem to play a role, including

  • Genetics
  • Environmental factors such as exposure to certain toxins and a history of head injury
  • The presence of Lewy bodies. Lewy bodies are an abnormal aggregate of proteins found in the brain of people with PD. Researchers believe that Lewy bodies hold an important clue to the cause of PD.

Risk factors for Parkinson’s disease are:

  • Age – is around 60 years or older
  • A family history of the condition
  • Sex- men are one and half times more likely to develop the condition than women

SYMPTOMS

The four major motor problems associated with Parkinson’s disease are:

  • Tremor – shaking that occurs at rest
  • Slow movements (bradykinesia)
  • Muscle stiffness, which may occur in any part of the body
  • Impaired posture and balance leading to frequent falls

Other symptoms may include

  • Speech changes
  • Writing changes
  • Decreased blinking and swallowing
  • Reduced arm swinging when walking
  • Blank facial expression
  • Depression
  • Anxiety
  • Hallucinations or delusions
  • Cognitive disturbance such as problems with planning, inhibiting inappropriate actions, slowed cognitive processing speed.
  • Impulse control disorders including pathological gambling, compulsive sexual behavior, binge eating.
  • Hallucination or delusion
  • Oily skin and excessive sweating
  • Urinary incontinence
  • Constipation
  • Sexual dysfunction

DIAGNOSIS AND TREATMENT

There is no specific test for Parkinson’s disease. Diagnosis is made based on health history, symptoms, a physical exam, and a neurological exam.

The doctor may suggest Photo Emission Tomography (PET) scan or Single Photon Emission Computerized Tomography scan (SPECT) scan measure dopamine-related activity in the brain.

Tests such as CT scan or MRI may be used to rule out other conditions.

The finding of Lewy bodies in the midbrain is usually considered final proof that a person has Parkinson’s disease.

TREATMENT

There is no cure for this condition, treatment options can help to control symptoms.

Medications may help to manage the problem with walking, movement, and tremor. These medication serves as a substitute or increases dopamine concentration in the brain. Medications such as:

  • Carbidopa-levodopa that passes into the brain and is converted to dopamine. This is the most common treatment
  • Dopamine agonists such as pramipexole (Mirapex), ropinirole (Requip), and rotigotine (Neupro) that mimic dopamine effects in the brain
  • Anticholinergics such as Benztropine (Cogentin) or trihexyphenidyl that helps control tremor associated with the condition.
  • Amantadine that may be taken alone for short-term relief of symptoms of mild, early-stage PD or combined with carbidopa-levodopa during the later stages of the condition to control involuntary movements that may be induced by carbidopa-levodopa
  • Catechol O-methyltransferase (COMT) inhibitors that prolong the effect of levodopa. Such as Entacapone (Comtan).
  • MAO B inhibitors that help to inhibit the enzyme monoamine oxidase B.

A surgical procedure such as deep brain stimulation may also help. In this procedure, surgeons implant a device called neurostimulator, which sends electrical impulses to specific parts of your brain reducing symptoms. This procedure is usually offered to people with advanced Parkinson’s disease who are not responding well to medications.

Lifestyle changes such as healthy eating, exercising may help with your condition