What Medications Are Used To Treat Parkinsons Disease
Medications are the main treatment method for patients with Parkinsons disease. Your doctor will work closely with you to develop a treatment plan best suited for you based on the severity of your disease at the time of diagnosis, side effects of the drug class and success or failure of symptom control of the medications you try.
Medications combat Parkinsons disease by:
- Helping nerve cells in the brain make dopamine.
- Mimicking the effects of dopamine in the brain.
- Blocking an enzyme that breaks down dopamine in the brain.
- Reducing some specific symptoms of Parkinsons disease.
Levodopa: Levodopa is a main treatment for the slowness of movement, tremor, and stiffness symptoms of Parkinsons disease. Nerve cells use levodopa to make dopamine, which replenishes the low amount found in the brain of persons with Parkinsons disease. Levodopa is usually taken with carbidopa to allow more levodopa to reach the brain and to prevent or reduce the nausea and vomiting, low blood pressure and other side effects of levodopa. Sinemet® is available in an immediate release formula and a long-acting, controlled release formula. Rytary® is a newer version of levodopa/carbidopa that is a longer-acting capsule. The newest addition is Inbrija®, which is inhaled levodopa. It is used by people already taking regular carbidopa/levodopa for when they have off episodes .
Causes Of Parkinsons Disease
Parkinsons disease is caused by ongoing loss of dopamine-secreting neurons and the associated deficiency of dopamine in the brains striatum, which is responsible for coordinating movement and balance. Parkinsons is the second most common neurodegenerative disease, behind Alzheimers disease. PD affects 1% of those above 55 years old, and more than 3% of those over 75 years old. Some studies seem to indicate that PD occurs less often in African Americans and Asian Americans than in Caucasians.
On histopathology tissue slides at autopsy, PD is characterized by aggregation of the protein alpha-synuclein into clumps in the neurons. This correlates with a loss of dopamine production in the neurons of the substantia nigra within the midbrain. The basal ganglia, innervated by the dopaminergic system, are the most seriously affected brain areas in PD. Cell death in the substantia nigra and the ventral part of the pars compacta can affect almost all of the neurons by the time of patient death.
This was evidenced quite starkly in the 1982 California incident when heroin addicts in their twenties and thirties were affected by a batch of a synthetic opiate contaminated with MPTP that unfortunately led to acquired symptoms of irreversible parkinsonism within days for all who took the drug.
What Role Do Genes Play
Your genes are like your body’s instruction book. So if you get a change in one of them, it can make your body work in a slightly different way. Sometimes, that means you’re more likely to get a certain disease.
There are several genetic mutations that can raise your risk for Parkinson’s, each by a little bit. They have a part in about 1 in 10 cases.
If you have one or more of these changes, it doesn’t mean you’ll get Parkinson’s. Some people will, but many won’t, and doctors don’t know why. It may have to do with other genes or something in your environment.
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In The Loop: Staying Ahead Of Parkinsons Disease One Ping Pong Game At A Time
Since being diagnosed with Parkinson’s disease, Steve Grinnell has worked hard to stay active, stepping up his table tennis game and, thanks to co-workers, testing his skills outside his home.
Four years ago, Steve Grinnell’s life was forever changed when doctors at Mayo Clinic in Rochester diagnosed him with early-onset Parkinson’s disease. Since that time, the progressive nervous system disorder has begun to take a toll on Steve and his family, just as it does on the millions of other Americans living with the disease. “It has greatly diminished his quality of life, leaving him with tremors, physical exhaustion, impaired balance, troubled grasping things with his right hand, slow right-arm movement and problems sleeping,” the Rochester Post-Bulletin recently reported. “That’s to name just a few of his symptoms.”
Reading that, one might assume the disorder is winning. And to Steve, sometimes it feels like it is. But much of the time, he tells us he also feels like he’s staying one step ahead of the disease by staying as physically active as possible. “Parkinson’s presents such a conundrum because it wears you down physically, and yet exercise is so valuable,” Steve says. “My legs, feet and right arm are always cramping, so it takes mental effort to get moving.”
Accidental Discovery Leads To Parkinsons Disease Cure In Mice
SAN DIEGO Sometimes, scientific breakthroughs occur when researchers arent exactly looking for them. While attempting to better understand the function of a protein in connective tissue cells, UC San Diego School of Medicine scientists found a way to transform multiple types of cells into neurons. This discovery has led to the development of a treatment that eliminates symptoms of Parkinsons disease in mice.
The protein researchers were studying, called PTB, is known for its general role in activating or deactivating genes within a cell. In an attempt to better understand how PTB contributes to cell function, researchers silenced the PTB gene using a technique called siRNA in a type of connective tissue cell, known as a fibroblast. The researchers grew the fibroblasts in petri dishes, silenced PTB, and waited a couple of weeks to check on the fibroblasts and observe any changes.
When the researchers checked the fibroblasts, they were shocked. They found that very few fibroblasts remained in the dishes. Instead, the dishes contained mostly neurons. Unintentionally, they had discovered a way to turn fibroblasts into neurons.
In subsequent experiments, the researchers found that they could also turn other cells into neurons. When they silenced PTB in a type of non-neuronal brain cell known as an astrocyte, they were also able to generate neurons.
Fu is a Distinguished Professor in the Department of Cellular and Molecular Medicine at UC San Diego School of Medicine.
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Scientifically Backed Ways To Prevent Parkinsons Disease
Dopamine plays a major role in a variety of mental and physical functions, including:
- Voluntary movement
- General behavior
Parkinsons now afflicts roughly 1.5 million people in the United States alone, with primary symptoms being body tremors, slow movement, rigid limbs, reduced memory, a shuffling gait and speech impairment. So we have to ask:
1.) What causes it?
2.) How do we prevent it?
Currently there isnt a known cure, and its not fully understood what causes the dip in dopamine however, we know that aging is the single most important risk factor for PD, with inflammation and stress contributing to cell damage. And we now know enough about the disease to understand the preventative measures that counter the aging and death of the neurons under attack.
Because there is no known cure, its critical that we prevent the disease before symptoms arise. Granted, thanks to recent advancements in modern surgical procedures, there are some safe surgeries that can mitigate some of the more severe symptoms associated with PD. The most common one now is deep brain stimulation, in which they implant an electrode into the brain that can stop some of the more severe symptoms of Parkinsons.
But this article will try to keep it from getting to that point. The less drugs and surgery we can have in our lives, the better.
What Raises Someone’s Risk For Parkinson’s
It’s a complex picture, but you may be more likely to get Parkinson’s based on:
Age. Since it mostly affects people 60 and older, your risk goes up as the years go by.
Family history. If your parent, brother, or sister has it, you’re a little more likely to get it.
Job. Some types of work, like farming or factory jobs, can cause you to have contact with chemicals linked to Parkinson’s.
Race. It shows up more often in white people than other groups.
Serious head injury. If you hit your head hard enough to lose consciousness or forget things as a result of it, you may be more likely to get Parkinson’s later in life.
Gender. Men get it more than women. Doctors aren’t sure why.
Where you live. People in rural areas seem to get it more often, which may be tied to chemicals used in farming.
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Who Are More Vulnerable
“The prevalence of Parkinson’s increases with age and only 4 per cent of Parkinson’s cases are diagnosed before the age of 50. While approximately 1 per cent of the population above 60 years suffers from Parkinson’s, its instance increases to 5 per cent among those above 86 years.”
“Parkinson’s disease is already the fastest-growing neurological disorder in the world and some international studies suggest that the number of people with Parkinson’s has increased by over 35 per cent in the last 10 years. Although Parkinson’s disease can’t be cured, it is important its victims know about the condition at an early stage which could be managed using medications. Occasionally, doctors may suggest surgery to regulate certain regions of the brain to improve the symptoms,” Ketan Chaturvedi, Senior Consultant, Neurology, Wockhardt Hospital at Nagpur.
“Mental health issues are underrated, stigmatized, and unaddressed in our society and such conditions could be linked to more serious complications like Parkinson’s disease. It is important we take a sympathetic approach to the victims of Parkinson’s disease,and the social circle around such individuals promptly identifies these symptoms and provides help in improving the overall quality of life of these individuals,” added Praveen Changala, Consultant — Neuro Physician, Aware Gleneagles Global Hospital, LBNagar.
Mitophagy: Autophagic Mitochondrial Removal
As discussed above, autophagy can be highly specific. During autophagy, the phagophore gradually expands and engulfs a portion of the cytoplasm, or specific cargos, to form the double-membrane autophagosome . The diameter of a typical autophagosome is approximately 500 nm however, the mechanism of autophagosome formation, involving the sequential expansion of the phagophore, provides autophagy with the capacity to sequester essentially any cellular components, including entire organelles, and deliver them into the lysosome for degradation.
In higher eukaryotes, autophagy also plays a critical role in degrading mitochondria. In fact, mitochondria were first detected inside an autophagosome in the 1950s however, a molecular understanding of this process is occurring only now. Studies suggest that the selective removal of mitochondria, especially damaged mitochondria, is part of an important homeostatic pathway for organelle quality control. Since mitochondria function is compromised in some PD models, a defect in mitochondria quality control may play a critical role in the pathogenesis of PD.
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Eat Fresh Raw Vegetables
If you needed more reasons to eat your vegetables, this should be the clincher. Studies show that increased amounts of the B vitamin folic acid, found primarily in vegetables, can significantly reduce the risk of Parkinsons.
The best sources of folic acid are simultaneously some of the healthiest foods on the planet, namely dark green vegetables like broccoli, spinach, collard greens, brussels sprouts, asparagus and okra all of which can be grown in your backyard! This B vitamin can also be found in avocado, legumes and lentils.
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.
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Basic Science Research And Clinical Treatment
Based on the significant roles of mitochondria and autophagy in PD, maintaining and stabilizing mitochondrial function or promoting the degradation of damaged mitochondria might benefit the protection of dopaminergic neurons. Data on the possible connection between defects in mitophagy and PD suggest that modulation of autophagy might be one avenue for treating some types of this disease. However, autophagy is described as a double-edged sword, because both reduced and excessive autophagy can be detrimental therefore, simply upregulating autophagy is not a practical course of action, and the application of autophagy-inducing drugs must be undertaken with extreme caution.
Is Rls More Common In Pd
But what about the other possibility? Do patients with PD have an increased risk of RLS over the general population? Is it the same RLS as the person without PD has, or is it different? These questions have been difficult to answer. Of course, since PD affects about 1.5% of the elderly, and RLS in about 4-10% of the population, there will be some coincidental overlap. In addition to this however, patients with PD can have sensations that feel like RLS when their dose of dopamine medication is wearing off. These sensations are not truly RLS since they do not have the key features of RLS described above and fluctuate with medication timing, but they can be easily confused with RLS by the person with PD.
Studies of people with PD that assess for RLS and compare to a control group are hindered by the fact that the majority of patients with significant PD are under treatment with medications that affect RLS. Over the years, there have been multiple studies investigating whether RLS is more common in PD than in the general population. Different studies come to different conclusions. Studies conducted in which a group of people with PD are directly compared to a group of people without PD typically show that RLS is more common in PD than the general population.
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What Are The Symptoms Of Parkinson Disease
Parkinson disease symptoms usually start out mild, and then progressively get much worse. The first signs are often so subtle that many people don’t seek medical attention at first. These are common symptoms of Parkinson disease:
- Tremors that affect the face and jaw, legs, arms, and hands
- Slow, stiff walking
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Diagnosis And Management Of Parkinsons Disease
There are no diagnostic tests for Parkinsons. X-rays, scans and blood tests may be used to rule out other conditions. For this reason, getting a diagnosis of Parkinsons may take some time.
No two people with Parkinsons disease will have exactly the same symptoms or treatment. Your doctor or neurologist can help you decide which treatments to use.
People can manage their Parkinsons disease symptoms through:
- seeing a Doctor who specialises in Parkinsons
- multidisciplinary therapy provided for example, by nurses, allied health professionals and counsellors
- deep brain stimulation surgery .
What Is The Outlook For Persons With Parkinsons Disease
Although there is no cure or absolute evidence of ways to prevent Parkinsons disease, scientists are working hard to learn more about the disease and find innovative ways to better manage it, prevent it from progressing and ultimately curing it.
Currently, you and your healthcare teams efforts are focused on medical management of your symptoms along with general health and lifestyle improvement recommendations . By identifying individual symptoms and adjusting the course of action based on changes in symptoms, most people with Parkinsons disease can live fulfilling lives.
The future is hopeful. Some of the research underway includes:
- Using stem cells to produce new neurons, which would produce dopamine.
- Producing a dopamine-producing enzyme that is delivered to a gene in the brain that controls movement.
- Using a naturally occurring human protein glial cell-line derived neurotrophic factor, GDNF to protect dopamine-releasing nerve cells.
Many other investigations are underway too. Much has been learned, much progress has been made and additional discoveries are likely to come.
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In Summary Reduce Your Stress
The most important thing we can do for our long-term health, both physical and cognitive, is to reduce the stress in our bodies. All stress physical, emotional and chemical causes inflammation and long-term damage throughout the body.
Whether youre seeking Parkinsons prevention techniques or ways to alleviate symptoms, any of the above dietary and lifestyle practices can have long-term health benefits. Drinking green tea, eating organic, local vegetables, and regular aerobic exercise all significantly reduce the long-term cumulative damage done by stress.
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Does Having Rls Increase The Risk Of Developing Pd
Since RLS affects as much as 4-10% of the US adult population, it is clear that the vast majority of those with RLS do not ever develop PD.
Despite this, it still might be the case that RLS increases the risk of subsequently developing PD. There have been many studies trying to figure this out with conflicting results. Some studies show that there is no increased risk and others show that having RLS confers about a two-fold increased risk of developing PD over the general population.
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What Causes Parkinsons Disease
Parkinsons disease is a chronic, progressive neurological disease that currently affects about 1 million Americans. Parkinsons disease involves a small, dark-tinged portion of the brain called the substantia nigra. This is where you produce most of the dopamine your brain uses. Dopamine is the chemical messenger that transmits messages between nerves that control muscle movements as well as those involved in the brains pleasure and reward centers. As we age, its normal for cells in the substantia nigra to die. This process happens in most people at a very slow rate.
But for some people, the loss happens rapidly, which is the start of Parkinsons disease. When 50 to 60 percent of the cells are gone, you begin to see the symptoms of Parkinsons.