Understanding Parkinson's Disease

BY JAMES S. BURKHARDT, D.O.

Many people have heard of Parkinson’s disease, but most know very little about the condition and how it affects a person and their friends and family. While there are no official statistics, Parkinson’s disease is thought to affect over one million people in the United States.

Parkinson’s disease is a neurodegenerative condition and after Alzheimer’s is the second most common disease in the United States. Neurodegenerative is a term which refers to a progressive loss of nerve cells (neurons) and/or their function. Neurodegeneration from Parkinson’s disease can give rise to a wide spectrum of symptoms which can vary widely between people in terms of type and severity.

Parkinson’s disease is a movement disorder that progresses slowly. Some people will first notice a sense of weakness, difficulty walking, and stiff muscles. Others may notice a tremor of the head or hands. Parkinson’s is a progressive disorder and the symptoms gradually worsen. The general symptoms of Parkinson’s disease include:

· Slowness of voluntary movements, especially in the initiation of such movements as walking or rolling over in bed.

· Decreased facial expression, monotonous speech, and decreased eye blinking.

· A shuffling gait with poor arm swing and stooped posture.

· Unsteady balance: difficulty rising from a sitting position.

· Continuous “pill-rolling” motion of the thumb and forefinger.

· Abnormal tone or stiffness in the trunk and extremities.

· Swallowing problems in later stages.

Early symptoms of Parkinson’s disease are usually mild and generally occur gradually. You may have fatigue or a general sense of uneasiness. You may feel a slight tremor or have difficulty standing. Some may notice that their speech has become softer or that their handwriting has changed. You may forget a word or thought and have feelings of depression or anxiety. Generally, friends and family begin to notice the changes before you do. They often notice the stiffening or lack of movement, or the absence of facial expression (“masked face”) seen in Parkinson’s disease.

As the disease progresses, it begins to interrupt daily activities. It is important to note that not all people with Parkinson’s disease experience the full range of symptoms; in fact, most people with Parkinson’s have mild, non-intrusive symptoms.

The cause of Parkinson’s disease is not known, but there is progressive deterioration of nerve cells called neurons. When functioning normally these cells produce a brain chemical or neurotransmitter called dopamine. Dopamine is a chemical messenger to communicate with different areas of the brain. This communication coordinates smooth and balanced muscle movement. In Parkinson’s disease, there is damage to these nerves, resulting in abnormal levels of dopamine, and this in turn causes a decrease in the ability of the body to control movements.