Focus - Parkinsons Disease

Focus – Parkinsons Disease (PD)

In 1817 James Parkinson, an English physician, was first to recognized, described, and write about a group of progressive symptoms he called Shaking Palsy disease. His contributions to medical knowledge resulted in Shaking Palsy being coined Parkinson’s Disease (PD) in the 1860’s. ¹

PD is classified as a progressive disorder of the central nervous system that occurs when dopamine-producing neurons are damaged, or die, in a part of the brain called the substantia nigra (see figure 1). Dopamine is a chemical messenger in the brain that is responsible for the coordinated functioning of the body’s muscles.

Fig. 1: A color photo of a cross section of the brain with the substantia nigra area highlighted in the center.
Fig. 1: Cross section of the brain with the substantia nigra area highlighted in the center.

There are four primary symptoms associated with PD: tremors, slow movements, stiffness, and balance problems. People are affected differently by the disease and may exhibit other signs or symptoms, such as small, cramped handwriting, stiff facial expressions, raspy or soft speech, depressive symptoms, pain or loss of smell. ²

In the United States, it is estimated that 60,000 new cases are diagnosed each year, adding to the 1.5 million Americans who currently have Parkinson’s Disease. The average age at which Parkinson’s Disease is diagnosed is 60; however, 10 to 20 percent of those diagnosed with Parkinson’s Disease are under age 50, and are referred to as “young-onset” Parkinson’s Disease. Both men and women can develop Parkinson’s and there is currently no cure for the disease. ³

Causes of PD are unknown and researchers believe there may be several possible contributing causes, including a complex interaction between environmental and genetic factors. Increased risk for acquiring PD has been associated with demographic or intrinsic factors, environmental exposures and infectious diseases. ⁴ Since no diagnostic tool currently exists, a final diagnosis of PD is made through clinical observations and a rather lengthy process of eliminating other possible disorders.

Treatment for PD symptoms include: medication, surgery, and restorative or experimental therapy.

Several medications are available which affect the production of dopamine in the brain. The most commonly prescribed is Levodopa. Long-term use of levodopa-containing medication can lead to “off” episodes where symptoms return. At this point, other medications may be used in combination with Levodopa.

For persistent or severe symptoms surgery may be an option for some individuals. The most commonly performed surgeries are Pallidotomy and Deep Brain Stimulation (DBS). Pallidotomy uses a small electric probe to create a lesion to correct abnormally discharging nerve cells located in the part of the brain called the globus pallius. DBS provides small electrical impulses to the brain in order to block the impulses that produce PD symptoms. Because many people with PD may have extreme fluctuations in motor control, the main benefit of DBS surgery is that it smoothes out these fluctuations. DBS has also been helpful in reducing tremors, slowness, stiffness, and involuntary movements. Restorative therapy, which is experimental and highly regulated, tries to increase the dopamine produced in the brain through stem cell transplants. For more information about common medications and surgical procedures currently used for PD, the National Parkinson’s Foundation offers a summary of treatment options. ⁵

Living with PD

A chronic, progressive disease produces an unknown sense of the future. The level of control over the course of the disease may be limited, but the person’s attitude, how they adapt to the disease and how they manage the symptoms and limitations will affect the quality of their life.

Living with PD will gradually require adjustments to normal home and work routines. Eating a balanced diet high in fiber and fluids, taking calcium and avoiding excessive amounts of protein will help manage the symptoms and the side effects of treatment. 6 Daily exercise will help keep bones and muscles strong and flexible and will improve overall functioning.

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In This Issue
Section 1: Client Story – Bill Putnam: Determination and flexibility describe this New Hampshire farmer Section 2: Focus – Parkinsons Disease Section 3: Assistive Technology Notes – Parkinsons Disease	Section 4: State Project Feature – Northern New England AgrAbility Project Section 5: References Section 6: Contacts

Focus – Parkinsons Disease (PD)

Living with PD

Focus – Parkinsons Disease (PD)