How Is Parkinson Disease Treated
Parkinson disease can’t be cured. But there are different therapies that can help control symptoms. Many of the medicines used to treat Parkinson disease help to offset the loss of the chemical dopamine in the brain. Most of these medicines help manage symptoms quite successfully.
A procedure called deep brain stimulation may also be used to treat Parkinson disease. It sends electrical impulses into the brain to help control tremors and twitching movements. Some people may need surgery to manage Parkinson disease symptoms. Surgery may involve destroying small areas of brain tissue responsible for the symptoms. However, these surgeries are rarely done since deep brain stimulation is now available.
Pesticide And Herbicide Exposure
A strong link has been shown between PD and exposure to pesticides and herbicides. We need more Parkinsons-specific research to better understand what causes PD and to work to prevent it and help eliminate the risk of getting the disease, when it comes to all environmental risk factors and whether genetics can cause an increased risk in developing Parkinsons.
One herbicide that has been linked to Parkinsons is paraquat, a widely used commercial herbicide in the U.S. that is banned in 32 countries, including the European Union and China. The Parkinsons Foundation, along with the Unified Parkinsons Advocacy Council, signed two letters to the U.S. Environmental Protection Agency encouraging them to cancel the registration of paraquat based on strong scientific research linking the herbicide to Parkinsons disease. In October 2020, the EPA re-approved paraquat for use in the U.S. Without additional action, paraquat will remain legal for sale and use in the U.S. for the next 15 years.
Referral To A Specialist
If your GP suspects Parkinson’s disease, you’ll be referred to a specialist.
This will usually be:
- a neurologist, a specialist in conditions affecting the brain and nervous system
- a geriatrician, a specialist in problems affecting elderly people
The specialist will most likely ask you to perform a number of physical exercises so they can assess whether you have any problems with movement.
A diagnosis of Parkinson’s disease is likely if you have at least 2 of the 3 following symptoms:
- shaking or tremor in a part of your body that usually only occurs at rest
- slowness of movement
- muscle stiffness
If your symptoms improve after taking a medication called levodopa, it’s more likely you have Parkinson’s disease.
Special brain scans, such as a single photon emission computed tomography scan, may also be carried out in some cases to try to rule out other causes of your symptoms.
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What Else Do We Know
As scientists try to learn what’s at the root of Parkinson’s, they’re looking far and wide to pick up clues where they can.
They’ve found that people with Parkinson’s tend to have something called Lewy bodies in their brain. These are unusual clumps of a protein called alpha-synuclein. The protein itself is normal, but the clumps are not. And they’re found in parts of the brain that affect sleep and sense of smell, which could explain some symptoms of Parkinson’s not related to movement.
Your gut may also have a part in it, as some of its cells make dopamine, too. Some doctors think that this might be where the earliest signs of Parkinson’s show up, but that idea needs more research.
Action Vs Resting Tremors
Almost all tremors are either considered action tremors or resting tremors. Action tremors are tremors that happen the most when you contract a muscle or try to hold a certain position.
Resting tremors, on the other hand, happen when a body part is at rest. Resting tremors are frequently related to Parkinsons, but action tremors are more likely to suggest other conditions.
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How Environmental Factors Could Cause Parkinsons Disease
Scientists differ about the extent that brain cells are impacted by environmental factors. However, the statistics associated with the disease show that the environment can play a very large role in whether parkinsons disease develops.
Most often, it is exposure to toxic chemicals that could play a role in the development of Parkinsons disease. Usually, these combine with genetic factors to produce the conditions that cause Parkinsons.
Increasing scientific evidence suggests that Parkinsons may be caused by environmental factors such as exposure to herbicides such as Paraquat.
Can Parkinson’s Disease Be Cured
No, Parkinson’s disease is not curable. However, it is treatable, and many treatments are highly effective. It might also be possible to delay the progress and more severe symptoms of the disease.
A note from Cleveland Clinic
Parkinson’s disease is a very common condition, and it is more likely to happen to people as they get older. While Parkinson’s isn’t curable, there are many different ways to treat this condition. They include several different classes of medications, surgery to implant brain-stimulation devices and more. Thanks to advances in treatment and care, many can live for years or even decades with this condition and can adapt to or receive treatment for the effects and symptoms.
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How Is Parkinson’s Disease Managed
Your doctors will tailor your treatment based on your individual circumstances. You will manage your condition best if you have the support of a team, which may include a general practitioner, neurologist, physiotherapist, occupational therapist, psychologist, specialist nurse and dietitian.
While there is no cure for Parkinson’s disease, symptoms can be treated with a combination of the following.
More Than Just Dopamine
While it may seem that the whole problem of tremors in PD is completely caused by deficient dopamine production in the substantia nigra, that is not the case. There are several reasons that we know there is more to a resting tremor than just a dopamine deficiency.
- The most effective treatment for symptoms of PD are medications that increase dopamine or prolong the action of dopamine in the brain. Even when dopamine is adequately replaced, a person with advanced PD may still experience tremors.
- The regions of the brain that are involved in PD, including the thalamus, globus pallidus, cerebral cortex, and the cerebellum, often show structural and metabolic deficits in PD, suggesting that deficits in these structures are involved in causing the condition.
- Surgical treatment that is effective for PD symptoms is targeted toward a number of regions in the brain, including the globus pallidus and subthalamic nucleus.
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How You Lose Dopamine Production
Damaged nerve cells can be what results in a decreased ability of the brain to create dopamine. Generally, some kind of degradation of the brain cells will reduce dopamine production.
There is some genetic link to parkinsons disease. For example, specific genetic mutations can impact the dopamine production. Far more common is that exposure to something in the environment can impact the brain.
Causes Of Parkinson Disease
In Parkinson disease, synuclein forms clumps called Lewy bodies in nerve cells. Lewy bodies consist of misfolded synuclein. Synuclein can accumulate in several regions of the brain, particularly in the substantia nigra and interfere with brain function. Lewy bodies often accumulate in other parts of the brain and nervous system, suggesting that they may be involved in other disorders. In Lewy body dementia Dementia With Lewy Bodies and Parkinson Disease Dementia Dementia with Lewy bodies is progressive loss of mental function characterized by the development of Lewy bodies in nerve cells. Parkinson disease dementia is loss of mental function characterized… read more , Lewy bodies form throughout the outer layer of the brain . Lewy bodies may also be involved in Alzheimer disease Alzheimer Disease Alzheimer disease is a progressive loss of mental function, characterized by degeneration of brain tissue, including loss of nerve cells, the accumulation of an abnormal protein called beta-amyloid… read more , possibly explaining why about one third of people with Parkinson disease have symptoms of Alzheimer disease and why some people with Alzheimer disease develop parkinsonian symptoms.
About 10% of people with Parkinson disease have relatives who have or have had the disease. Also, several gene mutations that can cause Parkinson disease have been identified.
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Causes Of Parkinsons Disease
At present, we do not know the cause of Parkinsons disease. In most people there is no family history of Parkinsons Researchers worldwide are investigating possible causes, including:
- environmental triggers, pesticides, toxins, chemicals
- genetic factors
- combinations of environment and genetic factors
Symptoms Of Parkinson Disease
Usually, Parkinson disease begins subtly and progresses gradually.
The first symptom is
Tremors in about two thirds of people
Problems with movement or a reduced sense of smell in most of the others
Tremors typically have the following characteristics:
Are coarse and rhythmic
Usually occur in one hand while the hand is at rest
Often involve the hand moving as if it is rolling small objects around
May be worsened by emotional stress or fatigue
May eventually progress to the other hand, the arms, and the legs
May also affect the jaws, tongue, forehead, and eyelids and, to a lesser degree, the voice
In some people, a tremor never develops. Sometimes the tremor becomes less obvious as the disease progresses and muscles become stiffer.
Parkinson disease typically also causes the following symptoms:
Walking becomes difficult, especially taking the first step. Once started, people often shuffle, taking short steps, keeping their arms bent at the waist, and swinging their arms little or not at all. While walking, some people have difficulty stopping or turning. When the disease is advanced, some people suddenly stop walking because they feel as if their feet are glued to the ground . Other people unintentionally and gradually quicken their steps, breaking into a stumbling run to avoid falling. This symptom is called festination.
Parkinson disease also causes other symptoms:
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How Is Parkinsons Disease Diagnosed
There is not a test that can confirm you have Parkinsons. You must experience at least 2 of the 4 main motor symptoms before your doctor will consider it. They will ask about your medical history and do a physical exam. If your doctor thinks you have Parkinsons disease, they may refer you to a neurologist. The neurologist will have you complete tasks that use your nervous system. These are intended to test your balance, muscles, gait, and agility. They may also do imaging tests, such as a CT or MRI scan, to rule out other conditions.
Can Parkinsons Disease Be Prevented
It is not possible to prevent Parkinsons disease, but some believe that lifelong healthy habits may reduce ones risk of developing the condition. Some medications may also relieve some of its symptoms.
In some PD patients, particularly those who are at the late stage of the disease, surgery may be an option to help improve symptoms.
Some experts also advise doing rpeventive measures such as wearing gloves and other protectvie equipment when applying pesticides as it may help protect you against the disease.
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What Causes Parkinson’s Disease
Parkinson’s disease is a neurological condition that mainly affects your body’s movement. The disease is progressive and has symptoms like tremors, slow movement, stiffness, and speech difficulty. Most people develop the disease around or after the age of 60. But 10% to 20% of people with Parkinson’s develop it at age 50 or younger. Men are more likely to develop this condition than women.
Parkinson’s symptoms are caused by a decrease in the cells in your brain that produce dopamine. It’s the lower dopamine levels that cause the movement-based symptoms of this disease.
Experts are not 100% sure what exactly causes this disease. They believe most cases of Parkinson’s don’t have one single cause but may have multiple components interacting with each other.
Genetics. Between 10% and 15% of all Parkinson’s cases are caused or influenced by at least 1 of 12 genetic mutations that can be passed down from a parent to a child.
Some of these gene mutations are more common in specific cultural groups. For example, Ashkenazi Jews and North African Berbers are more likely to have the G2019S mutation on the LRRK2 gene, which can cause Parkinson’s. However, even having a genetic tendency for Parkinson’s doesn’t mean you will get it. Studies show that only between 25% and 35% of people with the G2019S mutation will get Parkinson’s disease.
Medications For People With Parkinsons Disease
Symptoms of Parkinsons disease result from the progressive degeneration of nerve cells in the brain and other organs such as the gut, which produce a neurotransmitter called dopamine. This causes a deficiency in the availability of dopamine, which is necessary for smooth and controlled movements. Medication therapy focuses on maximising the availability of dopamine in the brain. Medication regimes are individually tailored to your specific need. Parkinsons medications fit into one of the following broad categories:
- levodopa dopamine replacement therapy
- dopamine agonists mimic the action of dopamine
- COMT inhibitors used along with levodopa. This medication blocks an enzyme known as COMT to prevent levodopa breaking down in the intestine, allowing more of it to reach the brain
- anticholinergics block the effect of another brain chemical to rebalance its levels with dopamine
- amantadine has anticholinergic properties and improves dopamine transmission
- MAO type B inhibitors prevent the metabolism of dopamine within the brain.
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Genetic And Environmental Interactions
Although several genetic mutations have been identified to be associated with a higher risk of developing Parkinson’s disease most people do not have these genetic variations.
On the other hand, even though pesticides and head traumas are associated with PD, most people do not have any obvious exposure to these environmental factors.
Parkinson’s is caused by a combination of genes, environmental and lifestyle influences. The interaction of all three components determines if someone will develop Parkinson’s. Parkinsons-specific research is critical to better understanding how these components interact to cause PD and how to prevent it.
Page reviewed by Dr. Lauren Fanty, Movement Disorders Fellow at the University of Florida, a Parkinsons Foundation Center of Excellence.
Is There A Cure For Parkinsons
Theres currently no cure for Parkinsons, a disease that is chronic and worsens over time. More than 50,000 new cases are reported in the United States each year. But there may be even more, since Parkinsons is often misdiagnosed.
Its reported that Parkinsons complications was the
Complications from Parkinsons can greatly reduce quality of life and prognosis. For example, individuals with Parkinsons can experience dangerous falls, as well as blood clots in the lungs and legs. These complications can be fatal.
Proper treatment improves your prognosis, and it increases life expectancy.
It may not be possible to slow the progression of Parkinsons, but you can work to overcome the obstacles and complications to have a better quality of life for as long as possible.
Parkinsons disease is not fatal. However, Parkinsons-related complications can shorten the lifespan of people diagnosed with the disease.
Having Parkinsons increases a persons risk for potentially life threatening complications, like experiencing:
Parkinsons often causes problems with daily activities. But very simple exercises and stretches may help you move around and walk more safely.
Coping With A Parkinsons Diagnosis
A diagnosis of Parkinsons can be a frightening experience for both you and your loved ones. While there is currently no cure, there are treatments available for Parkinsons symptoms and lifestyle changes you can make to slow the progression of the disease and delay the onset of more debilitating symptoms, including Parkinsons disease dementia. Early diagnosis can prolong independence and help you to live life fully for much longer.
If youve been diagnosed with Parkinsons you may feel anger, deep sadness, or fear about what the future will bring. These feelings are all normal. Its also normal to grieve as you deal with this enormous adjustment.
Give yourself some time to adjust. As with any major change in life, dont expect that you will smoothly snap into this new transition. You may feel alright for a while, and then suddenly feel stressed and overwhelmed again. Take time to adjust to this new transition.
Learn all you can about Parkinsons disease and Parkinsons disease dementia. Educating yourself and making important decisions early can help you feel more in control during this difficult time.
Reach out for support. Living with Parkinsons presents many challenges, but there is help available for this journey. The more you reach out to others and get support, the more youll be able to cope with symptoms while continuing to enrich and find meaning in your life.
Foods Containing Nutrients That People May Be Deficient In
Some research suggests that people with Parkinsons often have certain nutrient deficiencies, including deficiencies in iron, vitamin B1, vitamin C, zinc, and vitamin D.
The above study points out that some of these deficiencies may be associated with neuroinflammation and neurodegeneration, which are key factors in Parkinsons.
Therefore, people with Parkinsons may wish to consume more of the following foods.
Foods containing iron
The following foods are good sources of iron:
- certain fortified foods
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Support Groups For Parkinsons With Or Without Dementia
Parkinsons disease is tough to live with, both for the person affected and their family. Support groups are filled with people who are going through very similar experiences. Theyre a great place to safely vent frustrations, get new ideas for how to cope or solve problems, and learn about helpful resources.
Check with these organizations to find a support group in your area:
Foods High In Saturated Fat
Although the specific role of saturated fat in Parkinsons is still being studied, research suggests that a high dietary fat intake may increase your risk of this disease .
Generally speaking, diets high in saturated fat have been linked to chronic conditions like heart disease. As such, you may wish to keep these foods in moderation (
- some baked and fried foods
Conversely, a very small study notes that the keto diet which is high in fat is beneficial for some people with Parkinsons. However, a low fat diet also showed benefits. Overall, more research is needed .
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