An overview of Parkinson's Disease

Parkinson’s disease is a brain disorder that causes unintended or uncontrollable movements, such as shaking, stiffness, and difficulty with balance and coordination.

In the early stages of Parkinson's disease, your face may show little or no expression. Your arms may not swing when you walk. Your speech may become soft or slurred. Parkinson's disease symptoms worsen as your condition progresses over time.

The most prominent signs and symptoms of Parkinson’s disease occur when nerve cells in the basal ganglia, an area of the brain that controls movement, become impaired and/or die. Normally, these nerve cells, or neurons, produce an important brain chemical known as dopamine. When the neurons die or become impaired, they produce less dopamine, which causes the movement problems associated with the disease. Scientists still do not know what causes the neurons to die.

People with Parkinson’s disease also lose the nerve endings that produce norepinephrine, the main chemical messenger of the sympathetic nervous system, which controls many functions of the body, such as heart rate and blood pressure. The loss of norepinephrine might help explain some of the non-movement features of Parkinson’s, such as fatigue, irregular blood pressure, decreased movement of food through the digestive tract, and sudden drop in blood pressure when a person stands up from a sitting or lying position.

Many brain cells of people with Parkinson’s disease contain Lewy bodies, unusual clumps of the protein alpha-synuclein. Scientists are trying to better understand the normal and abnormal functions of alpha-synuclein and its relationship to genetic mutations that impact Parkinson’s and Lewy body dementia.

Some cases of Parkinson’s disease appear to be hereditary, and a few cases can be traced to specific genetic mutations. While genetics is thought to play a role in Parkinson’s, in most cases the disease does not seem to run in families. Many researchers now believe that Parkinson’s results from a combination of genetic and environmental factors, such as exposure to toxins.

Parkinson's disease signs and symptoms can be different for everyone. Early signs may be mild and go unnoticed. Symptoms often begin on one side of the body and usually remain worse on that side, even after symptoms begin to affect the limbs on both sides.

Parkinson's signs and symptoms may include:

Slowed movement (bradykinesia) : Over time, Parkinson's disease may slow your movement, making simple tasks difficult and time-consuming. Your steps may become shorter when you walk. It may be difficult to get out of a chair. You may drag or shuffle your feet as you try to walk.

Tremor : A tremor, or rhythmic shaking, usually begins in a limb, often your hand or fingers. You may rub your thumb and forefinger back and forth. This is known as a pill-rolling tremor. Your hand may tremble when it's at rest. The shaking may decrease when you are performing tasks.

Rigid muscles : Muscle stiffness may occur in any part of your body. The stiff muscles can be painful and limit your range of motion.

Impaired posture and balance : Your posture may become stooped. Or you may fall or have balance problems as a result of Parkinson's disease.

Loss of automatic movements : ou may have a decreased ability to perform unconscious movements, including blinking, smiling or swinging your arms when you walk.

Speech changes : You may speak softly, quickly, slur or hesitate before talking. Your speech may be more of a monotone rather than have the usual speech patterns.

Writing changes : It may become hard to write, and your writing may appear small.

Parkinson’s disease happens for either genetic reasons or unpredictably. Neither are preventable, and you also can’t reduce your risk of developing it. There are certain high-risk occupations such as farming and welding, but not everyone in these professions develops parkinsonism.

There are currently no blood or laboratory tests to diagnose non-genetic cases of Parkinson’s. Doctors usually diagnose the disease by taking a person’s medical history and performing a neurological examination. If symptoms improve after starting to take medication, it’s another indicator that the person has Parkinson’s.

A number of disorders can cause symptoms similar to those of Parkinson’s disease. People with Parkinson’s-like symptoms that result from other causes, such as multiple system atrophy and dementia with Lewy bodies, are sometimes said to have parkinsonism. While these disorders initially may be misdiagnosed as Parkinson’s, certain medical tests, as well as response to drug treatment, may help to better evaluate the cause. Many other diseases have similar features but require different treatments, so it is important to get an accurate diagnosis as soon as possible.

It's all about managing symptoms. Drugs for Parkinson's can often help with tremors, stiff muscles, and slow movements. Your doctor may also suggest physical therapy, occupational therapy, and speech therapy, based on how it affects you. And in some cases, you may need surgery.

Most people who have Parkinson’s live a normal to a nearly normal lifespan, but the disease can be life changing.

For some people, treatment keeps the symptoms at bay, and they're mostly mild. For others, the disease is much more serious and really limits what you're able to do.

As it gets worse, it makes it harder and harder to do daily activities like getting out of bed, driving, or going to work. Even writing can seem like a tough task. And in later stages, it can cause dementia.

Even though Parkinson's can have a big impact on your life, with the right treatment and help from your health care team, you can still enjoy the things you love. It's important to reach out to family and friends for support. Learning to live with Parkinson's means making sure you get the backing you need.

Risk factors for Parkinson's disease include:

Age : Young adults rarely experience Parkinson's disease. It ordinarily begins in middle or late life, and the risk increases with age. People usually develop the disease around age 60 or older. If a young person does have Parkinson's disease, genetic counseling might be helpful in making family planning decisions. Work, social situations and medication side effects are also different from those of an older person with Parkinson's disease and require special considerations.

Heredity : Having a close relative with Parkinson's disease increases the chances that you'll develop the disease. However, your risks are still small unless you have many relatives in your family with Parkinson's disease.

Sex : Men are more likely to develop Parkinson's disease than women.

Exposure to toxins : Ongoing exposure to herbicides and pesticides may slightly increase your risk of Parkinson's disease.