Parkinson’s disease is an incurable, non-fatal, slow progressing, chronic disorder. Its most notable symptom is a shaking, trembling hand or hand tremors. Parkinson disease (PD) is a progressive neurodegenerative disorder associated with a loss of dopaminergic nigrostriatal neurons. It is named after James Parkinson, the English physician who described it as ‘Shaking Palsy’ in 1817.
Causes of Parkinson’s Disease
Parkinson’s disease occurs when nerve cells, or neurons, in an area of the brain known as the substantia nigra die or become impaired. Normally, these neurons produce an important brain chemical known as dopamine. Dopamine is a chemical messenger responsible for transmitting signals between the substantia nigra and the next “relay station” of the brain, the corpus striatum, to produce smooth, purposeful movement. Loss of dopamine results in abnormal nerve firing patterns within the brain that cause impaired movement. Studies have shown that most Parkinson’s patients have lost 60 to 80 percent or more of the dopamine-producing cells in the substantia nigra by the time symptoms appear. Recent studies have shown that people with PD also have loss of the nerve endings that produce the neurotransmitter nor epinephrine.
Symptoms of Parkinson’s disease
Parkinson’s disease patients may notice that they are weaker or more tired. Symptoms include disorders of mood, behavior, thinking, and sensation. Poor balance is due to the impairment or loss of the reflexes that adjust posture in order to maintain balance. Falls are common in people with Parkinson’s. Shaking (muscle tremor). This is one of the first symptoms in three-quarters of people, and affects most people with Parkinson’s disease.
Parkinson’s disease is currently incurable. Symptoms can, however, be relieved or controlled. Among other treatments are L-Dopa – derived from broad beans or made synthetically – which has been used for over 20 years with limited results. An implant in the Thalamus – the message relay center of the brain – known as the Activa has also been successful in countering tremors.
Treatment
Parkinson’s disease is a chronic disorder that requires broad-based management including patient and family education, support group services, general wellness maintenance, physiotherapy, exercise, and nutrition.[11] At present, there is no cure for PD, but medications or surgery can provide relief from the symptoms.
The most widely used form of treatment is L-dopa in various forms. L-dopa is transformed into dopamine in the dopaminergic neurons by L-aromatic amino acid decarboxylase (often known by its former name dopa-decarboxylase). However, only 1-5% of L-DOPA enters the dopaminergic neurons. The remaining L-DOPA is often metabolised to dopamine elsewhere, causing a wide variety of side effects. Due to feedback inhibition, L-dopa results in a reduction in the endogenous formation of L-dopa, and so eventually becomes counterproductive.
Treatment for Parkinson’s disease is very individualized. The goal of therapy is to reduce symptoms and improve quality of life while minimizing side effects of medications. The decision to treat early Parkinson’s disease with pharmacological agents often depends on the particular needs of the person and careful weighing of possible benefits, cost, and adverse outcomes. Doctors try to use the lowest dose of any medications to achieve satisfactory improvement of function.
