Parkinson’s disease is a progressive neurodegenerative condition that affects movement. Common symptoms include resting tremors, muscle stiffness, slow movement, and problems with balance.
The exact cause of Parkinson’s disease is not fully understood. However, it develops when neurons that produce dopamine, a neurotransmitter involved in controlling movement, become damaged and die.
Parkinson’s disease has no cure, but treatment can help manage symptoms and improve quality of life. Treatment may include medications that affect dopamine levels or activity in the brain, physical therapy, and surgery.
Parkinson’s disease symptoms
The main symptoms of Parkinson’s disease include:
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Tremors while at rest;
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Slow movement;
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Muscle stiffness;
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Difficulty moving and walking;
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A stooped posture;
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Loss of balance and reflexes.
As Parkinson’s disease progresses, other symptoms may develop, including constipation, urinary retention, reduced facial expression, speech problems, difficulty swallowing, frequent choking, sexual dysfunction, and depression.
Symptoms usually develop gradually. They may be barely noticeable at first but become more pronounced over time.
How Parkinson’s disease is diagnosed
Parkinson’s disease is diagnosed by a neurologist based on a physical examination and an assessment of the person’s symptoms, medication use, personal medical history, and family medical history.
There is no single test that can confirm Parkinson’s disease. However, the doctor may order tests such as magnetic resonance imaging, or MRI, and computed tomography, or CT, to rule out other conditions that can cause similar symptoms, such as stroke or dementia with Lewy bodies.
An appointment with a neurologist should be scheduled when Parkinson’s disease is suspected.
Possible causes
Parkinson’s disease is associated with a buildup of the protein alpha-synuclein in the brain, particularly in an area called the substantia nigra. This buildup contributes to the degeneration and death of neurons that produce dopamine, which helps control muscle tone and movement.
The reason alpha-synuclein accumulates is not fully understood. Some research suggests that it may be related to genetic changes, such as mutations in the PARK1 gene, environmental factors such as exposure to herbicides and pesticides, or changes in the microbiota-gut-brain axis.
Treatment options
Parkinson’s disease treatment should be supervised by a neurologist. Treatment is intended to manage symptoms, maintain independence, and improve quality of life.
The main Parkinson’s disease treatments include:
1. Medications for Parkinson’s disease
The main medications used to treat Parkinson’s disease are levodopa and carbidopa. This combination increases the amount of dopamine available in the brain and helps control movement.
Carbidopa also reduces the breakdown of levodopa outside the brain. This allows more levodopa to reach the brain and may reduce peripheral side effects such as nausea and vomiting. Carbidopa-levodopa combinations are FDA-approved for Parkinson’s disease.
Rivastigmine may be prescribed when a person has mild-to-moderate dementia associated with Parkinson’s disease. It increases the availability of acetylcholine, a substance involved in memory, learning, attention, and orientation. Rivastigmine is not prescribed to treat the primary movement symptoms of Parkinson’s disease.
Other medications that a doctor may prescribe to help manage Parkinson’s disease symptoms include benztropine, amantadine, selegiline, bromocriptine, and pramipexole.
Amantadine is FDA-approved for Parkinson’s disease, while some extended-release formulations are specifically approved for Parkinson’s disease or levodopa-related dyskinesia.
Selegiline is generally used as an additional treatment for people taking carbidopa-levodopa whose response to that treatment has begun to decline.
Bromocriptine and pramipexole act on dopamine receptors and may also be prescribed for Parkinson’s disease.
2. Physical therapy
Physical therapy sessions may include relaxation techniques, posture exercises, breathing exercises, balance training, and movement exercises. These sessions are an important part of Parkinson’s disease treatment.
Physical therapy can improve a person’s overall physical condition. It can also help restore or maintain independence when performing everyday activities.
3. Deep brain stimulation
Deep brain stimulation is a surgical treatment that may be considered for advanced Parkinson’s disease. It is performed by a neurosurgeon at a specialized neurology center and may improve certain symptoms and quality of life.
During the procedure, electrodes are implanted in a specific area of the brain. They are connected to a generator placed under the skin in the chest, which sends electrical impulses to the brain to reduce certain symptoms.
Is Parkinson’s disease curable?
Parkinson’s disease is a chronic condition with no cure. However, treatment prescribed by a doctor can help manage symptoms, maintain daily functioning, and improve quality of life.