Parkinson’s disease is a progressive and, unfortunately, sometimes devastating illness. As a nervous system disorder, Parkinson’s affects movement. It begins gradually. For example, you might develop a slight tremor on just one hand. Parkinson’s can also cause slow movements and stiffness early on.
When you’re in the early stages of Parkinson’s, you might have fewer facial expressions, or your arms might not swing when you walk. Your speech could become slurred or softer, and symptoms worsen over time.
PD occurs when your brain cells responsible for making dopamine stop working or die off. Dopamine is a brain chemical that coordinates movement. Around one million people are affected by Parkinson’s in the U.S. each year and six million worldwide.
The following are some key things to know about Parkinson’s disease.
What Causes Parkinson’s?
Sometimes, there are environmental triggers that researchers believe are linked to the development of Parkinson’s. For example, exposure to toxins like Paraquat has been found to increase the risk. Paraquat is a commonly used pesticide used in the U.S. and globally. People exposed to Paraquat, particularly over the long term, may have a higher risk of Parkinson’s.
Other environmental risk factors can include having a history of head injury, where you live, and your occupation. Exposure to metals is associated with an increased risk of Parkinson’s, and so is exposure to various solvents.
Researchers have identified genetics as playing a role in the development of Parkinson’s. For example, certain genetic variations can increase the risk.
Other risk factors include age—it usually begins in middle or later life. It’s usually something a person develops around age 60 or older. Having a close relative with Parkinson’s can increase your likelihood of developing it, and men are more likely than women to have it.
Researchers have worked to identify protective factors as well. While we aren’t entirely sure, there’s some evidence these factors can reduce the risk of developing Parkinson’s:
- Consuming caffeine in tea or coffee regularly
- Higher uric acid levels in the blood
- Regularly taking anti-inflammatory drugs
- Having higher levels of vitamin D
- Getting more physical activity in early life
Everyone may experience slight differences in their Parkinson’s symptoms, and early signs tend to be very mild and go unnoticed for a period of time. Symptoms usually start on one side of the body, and they stay worse on that side, even once you have symptoms on both.
- Tremors: This is one of the most tell-tale signs of Parkinson’s. You might experience a tremor or shaking usually in your hands or fingers first. Your thumb and forefinger might rub back and forth. If your hand is at rest, you may notice a tremor.
- Bradykinesia: This is a term for slow movement. With time when you have Parkinson’s, it can reduce your ability to move. It can also make it take longer for you to do specific tasks. Your steps might get shorter or it can be hard to do things like getting out of a chair. When you walk, you might drag your feet.
- Impaired balance and posture: You could have stooped posture or balance issues when you have Parkinson’s.
- Rigidity: Stiff muscles can occur anywhere in your body, and along with causing pain, this symptom can limit your range of motion.
- Lack of automatic movements: Automatic movements are those things we do unconsciously or without thinking about it, like blinking or swinging your arms when you think about it.
- Changes in speech: You could slur, hesitate before you speak, or speak more softly. Sometimes people with Parkinson’s don’t have normal inflections when they speak and instead talk in a monotone.
- Writing: PD can make it hard to write, and your handwriting can get small.
There’s not one specific test that your doctor can use to make a definitive PD diagnosis. Instead, doctors have to make a clinical diagnosis based on physical exams, your answers to particular questions, and your medical history.
Typically if PD is suspected, your doctor will refer you to a movement disorder specialist, a type of neurologist. A movement disorder specialist can look for things like a resting tremor, stiffness or slowness, characteristic of PD.
While there aren’t lab or imaging tests to make a definitive diagnosis, your doctor may order them to make sure there aren’t other conditions that could be mimicking Parkinson’s.
Is There a Treatment?
Parkinson’s is considered a lifelong chronic disorder, and it can’t be cured as a result. Some medicines can help control symptoms, and in more advanced cases, surgery might be recommended.
Medicines that increase or replace dopamine are the first-line treatment in many cases. These medicines can help with movement and walking problems as well as tremors.
You can’t take dopamine directly, but these medicines can help your body more easily make dopamine.
For example, the most effective drug for PD is called Levodopa. This is a chemical that can pass the blood-brain barrier, and once there, it’s converted to dopamine.
Inbrija is a new brand-name version of carbidopa-levodopa, which is the same ingredient in Levodopa. This medicine is an inhaled form of the drug, and there’s also an infusion version.
Other types of medications for Parkinson’s can include:
- Dopamine agonists: These don’t change into dopamine in your brain, so they’re different from Levodopa. Rather, this replicates the effects of dopamine in the brain. They’re not as effective as Levodopa, but they tend to work for longer.
- MAO B Inhibitors: These medicines help prevent dopamine from breaking down in the brain.
- COMT Inhibitors: These medications can prolong how long levodopa therapy lasts by blocking an enzyme that breaks down dopamine.
- Anticholinergics: These medicines can help in controlling tremors linked to Parkinson’s.
If someone does receive a Parkinson’s diagnosis, they can still live a full life, and even though it can’t be cured, treatments are available. Treatments are also advancing.