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Parkinson’s Disease

Parkinson’s disease is progressive nervous system disorder that affects movements. In Parkinson’s, certain nerve cells in the brain gradually break down or die. The loss of neurons leads to a decrease in a chemical neurotransmitter, dopamine, levels leading to abnormal brain activity causing impaired movement and other symptoms associated with the disease. 


The exact cause of Parkinson’s is not known but several factors such as gene mutations, toxins, or other environmental factors are believed to play a role. Researchers have observed changes in brain of the people with this disease although it is not clear why these changes occur. There are clumps of specific substances found in the brain cells called Lewy bodies. The most common substance in these Lewy bodies is a protein called alpha-synuclein which is the focus of research currently. 


Symptoms have an insidious onset and usually start with an extremely mild tremor in one hand. There is also an accompanying stiffness or slowing of movement. In early stages of Parkinson’s disease, the face shows little or no expression, the arms might now swing on walking, and the speech becomes soft and slurred. These symptoms worsen as the condition progresses. Symptoms include impaired posture and balance, loss of autonomic movements, speech change, and writing change. 


Common complications due to the disease include thinking difficulties, depression and emotional changes, swallowing problems, chewing and eating problems, sleep problems and sleep disorders, bladder problems, and constipation. Some individuals affected by Parkinson’s may also experience blood pressure changes, smell dysfunction, fatigue, pain, and sexual dysfunction. 


There is no specific test to diagnose Parkinson’s disease, but it starts with a medical history, physical, and neurological examination. Physician may suggest a dopamine transporter scan (DaTscan). The physicians order blood test, MRI, ultrasound of the brain, and PET scans to rule out other conditions. Physicians may prescribe carbidopa-levodopa 


Although the disease cannot be cured, the symptoms can improve with medication. In more advanced cases, surgery may be advised. Lifestyle changes such as ongoing aerobic exercise and healthy eating might be recommended. Physical therapy focusing on balance and stretching is important and a speech language pathologist would be helpful with speech problems. 


Information about current clinical trials can be found at www.clinicaltrials.gov. Supporting organizations include The Michael J Fox Foundation, Parkinson’s Foundation, Parkinson Foundation for Parkinson’s, and American Parkinson Disease Association.

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