What is Parkinson’s Disease?

Parkinson’s Disease is a neurodegenerative disease that attacks your brain and nervous system. An estimated one million people across the nation suffer from this chronic degenerative disease with about 60,000 new cases being diagnosed annually. Many patients go undiagnosed until they have progressed to one of the advanced stages of the disease, leaving some difficulty with pinpointing more accurate statistics of the condition.

Parkinson’s Disease progresses slowly, and although the condition isn’t terminal, it causes complications that can be life threatening. Parkinson’s Disease affects the neurons in a part of the brain called the substantia nigra. The neurons affected in this area are our dopamine producers and over time the condition causes them to either malfunction and/or eventually die.

Dopamine regulates the body’s ability to control body movements and emotions and as the production of dopamine decreases involuntary movements like tremors alert Parkinson’s sufferers to the growing neurological condition.

At this time there is no cure for this disease however, medical advancements and research focused on offering Parkinson’s patients life quality and longevity are creating treatments to improve the outlook of the condition.

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Parkinson’s Disease Causes and Risk Factors

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Much is still unknown about the causes of Parkinson’s Disease. A few factors have been identified so far to give doctors an idea for the best course of action to stop the degeneration, but researchers are still hard at work searching for a way to prevent the disease.

One of the known factors of Parkinson’s Disease is genetic predisposition. Although these links are uncommon, if any of your close relatives have a history of Parkinson’s Disease, you are more likely to contract the condition yourself. Nevertheless, heredity only accounts for about 20% of reported cases of Parkinson’s.

Other causes include environmental influencers. Exposure to toxins like pesticides and herbicides have been identified as possible causes of the disease. Prolonged exposure or long term consumption of well water could raise your risks of contracting the condition. Veterans who have been diagnosed with Parkinson’s have also created a link between the Agent Orange used in the Vietnam War and the disease.

There are some demographics affected with Parkinson’s at higher rates than others. The condition is majorly diagnosed at about 50 or 60 years of age and the risk continues to increase as we age. Men are also at higher risk for the disease than women and are diagnosed at a rate of 2 to 1 over women.

Parkinson’s Symptoms

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Parkinson’s disease is categorized in stages called Hoehn and Yahr stages or more commonly the Unified Parkinson’s Disease Rating Scale (UPDRS). Because each experience with this disease is largely unique, this rating system is an attempt to describe and generalize symptoms for study and treatment. Remember, Parkinson’s progresses slowly so movement through these stages can sometimes take up to 20 years until a patient reaches the most severe.

Stage one: These symptoms commonly appear around age 40 or 50. Only 4% of cases report symptoms earlier than 40 years old. Stage one symptoms are mild and easily to overlook. In fact, many patients go undiagnosed during this stage because the symptoms are ignored. During stage one, patients experience slight to moderate tremors on one side of the body. There are changes to posture, gait and facial appearance as well but usually only close family and friends who observe the affected person on a regular basis are able to notice the differences. Some patients also report minor changes in speech and handwriting during this stage.

Stage two: In this stage symptoms become severe enough for the patient as well as others to notice the indication of a neurological issue. Tremors begin to appear on both sides of the body and although patients are still able to stand and walk unassisted, impact to mobility is noticeable. Many report stiff, painful muscles during this stage as well.

Stage three: Patients begin to experience loss of balance and instability during this stage. Movements begin to slow because of a condition called bradykinesia. Patients are mostly still able to live unassisted but normal personal care activities like dressing, bathing and eating become more challenging.

Stage Four: In stage four the symptoms become more severe and most patients are no longer able to live unassisted. Many are able to still stand but need mobility assistance to get around. Loss of movement control on both sides of the body is prevalent.

Stage Five: Stage five shows a drastic drop in cognitive function and is characterized by hallucinations and delusions. Complete immobility sets in at this stage and patients need assistance with all tasks.

Parkinson’s Treatments

The current focus of Parkinson’s treatment is largely centered around improving quality of life for Parkinson’s sufferers and slowing the symptoms and progression of the disease. The first approach is to focus on lifestyle habits such as exercise, proper nutrition and the reduction of any toxin exposure that could be intensifying symptoms. Studies have shown that regular exercise in Parkinson’s patients helps the brain use limited dopamine more efficiently. Stronger bones and muscles also improve balance, motor function and strength.

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There are regenerative therapies available, centered around autologous stem cells from the patient’s bone marrow and adipose (fat) tissue. These treatments are highly favored because they offer regenerative properties to repair damaged cells and reduce the progression of the condition. Stem cells in the stem cell therapy treatment target dopamine producing neurons to either repair or replace the malfunctioning cells.

The increase of cytokines and growth factors in the brain promotes the differentiation of the stem cells and transforms them into replacement dopamine producing neurons. Clinical trials for this revolutionary treatment have produced successful reduction in symptoms and slowed progression of the condition.

Medication for the treatment include drugs that temporarily increase dopamine production or drugs that mirror the action of dopamine. The medicine protocol helps to reduce mobility issues and the severity of tremors.

Surgery is usually reserved for Parkinson’s cases that remain resistant to medicinal treatment. The most common of these surgeries is deep brain stimulation (DBS). During the DBS procedure an electrode is implanted into the brain and connected to a neurostimulator located under the skin near the collarbone. The electrode stimulation helps to reduce bradykinesia, tremors and stiffening muscles. There are other surgeries such as Pallidotomy and Thalamotomy which involves destroying minuscule areas of the brain with scarring to reduce the progression of tremors and mobility issues but the risk for cognitive issues after surgery becomes more likely.

Specialist treatment in the form of cognitive, physical and speech therapies help to maintain normal function for a greater period and assists with the transition between stages of the disease. This therapy is vital when learning to cope with new limitations and could help patients live unassisted longer.

Living with Parkinson’s

Coping with a chronic disease diagnosis like Parkinson’s Disease is a lengthy road full of peaks and valleys. Living with Parkinson’s in the early stages can be a deep mental struggle for most of the newly diagnosed. Warning signs for depression should be closely monitored as well as sleep disorders and erratic behavior.

As the disease progresses many non-motor symptoms become as equally challenging as motor symptoms. Thinks like fatigue, sexual dysfunction, loss of smell, excessive sweating, incontinence and unpredictable mood changes are non-motor symptoms of Parkinson’s that have a major impact on you life and relationships.

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Impulsive control disorders are also serious non-motor symptoms of Parkinson’s. Patients may find themselves obsessively eating, gambling or indulging in other vices with no control. Anyone struggling with addictions or obsessive compulsive behavior prior to contracting the disease may be at an even higher risk for this symptom.

Although a cure has yet to be identified, people living with Parkinson’s benefit from a strong support system and comprehensive care. There is life after the diagnosis and learning more about the condition may help to position the newly diagnosed for longevity.

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Mesenchymal stem cell therapy in Parkinson's disease animal models
A. Gugliandolo, P. Bramanti, E. Mazzon

Stem Cell Technology for (Epi)genetic Brain Disorders
Renzo J. M. Riemens, Edilene S. Soares, Manel Esteller, Raul Delgado-Morales