Parkinson’s Disease
What is Parkinson’s disease?
Parkinson’s disease is a progressive neurological disorder caused by loss of dopamine-producing neurons in the substantia nigra, a region of the brain that controls movement. As dopamine levels fall, movement and coordination become impaired.
What causes Parkinson’s disease?
The exact cause is unknown but involves a mix of factors:
- Genetic mutations in a minority of cases
- Environmental exposures such as pesticides or heavy metals
- Advancing age—the greatest risk factor
- Male gender (men are affected more often than women)
- History of severe head injury
What are the symptoms?
Motor symptoms
- Tremor at rest, often starting in a hand or fingers
- Bradykinesia: slowness of movement and difficulty initiating tasks
- Rigidity: muscle stiffness that limits range of motion
- Postural instability: balance and coordination problems
Non-motor symptoms
- Cognitive changes, including memory and attention issues
- Mood disorders such as depression and anxiety
- Sleep disturbances and daytime sleepiness
- Autonomic dysfunction: constipation, bladder problems, orthostatic hypotension
- Loss of smell, pain, and fatigue
- Voice changes and weight loss in later stages
How is Parkinson’s disease diagnosed?
Diagnosis is clinical, based on history and exam:
- Medical and family history
- Neurological exam assessing tremor, rigidity, bradykinesia, and balance
- Trial of dopaminergic medication—improvement supports the diagnosis
- Imaging (MRI or CT) and lab tests to rule out other causes
- Referral to a movement-disorder specialist for confirmation
How is Parkinson’s disease treated?
While there is no cure, treatments aim to manage symptoms:
Medications
- Levodopa + carbidopa (e.g., Sinemet, Rytary)
- Dopamine agonists (e.g., pramipexole, ropinirole)
- MAO-B inhibitors (e.g., selegiline, rasagiline)
- COMT inhibitors (e.g., entacapone)
- Anticholinergics (for tremor in younger patients)
Surgical and procedural
- Deep brain stimulation, targeting motor-control circuits
- Focused ultrasound to ablate overactive regions
Therapies and lifestyle
- Physical therapy for mobility and balance
- Occupational therapy for daily living skills
- Speech therapy for voice and swallowing
- Regular exercise, healthy diet, and home safety modifications
- Counseling or support groups for patients and caregivers
Sources
- National Institute of Neurological Disorders and Stroke. Parkinson’s disease: Hope through research. Accessed Apr. 30, 2024.
- Michael J. Fox Foundation. Parkinson’s 101. Accessed Apr. 30, 2024.
- American Parkinson’s Disease Association. Parkinson’s Disease overview. Accessed Apr. 30, 2024.
- Parkinson’s Foundation. What is Parkinson’s? Accessed Apr. 30, 2024.