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Parkinson’s Disease - What’s New?

After 22 years as an RN, I now write about medical issues and new medical advances. Diet, exercise, treatment, and lifestyle are important.

Balance and Walking Problems

Balance and Walking Problems

Statistics for Parkinson’s Disease

Parkinson’s disease is increasing in numbers, and about 60,000 people are affected in the USA, 145,000 in England and 10 million worldwide. It is the second most common neurodegenerative disease. There is no blood test or other tests for a diagnosis.

Medications are expensive, averaging $2,500 annually, and surgery may cost up to $10,000.

Risk Factors

Men are 1.5 times more likely than women to get this disease. There is a genetic component for some people, with about 15% of patients having a relative with Parkinson’s disease. It is thought, while rare, there are some environmental components, such as herbicides or pesticides.

This disease is 50% less likely for blacks and Asians than whites, however, the risk is slightly higher in Hispanics. The risk also increases with age. While research is inconclusive, there is some evidence that head or neck trauma may be a factor. Scientists do not know exactly what causes this disease.

Deep Brain Stimulation Treatment for Parkinson's Disease

Body and Brain Changes

This is a degenerative disorder that affects the central nervous system causing movement disorders. It is a chronic disorder that is progressive and persists over the years. Nerve cells (neurons) in the brain die or are impaired. The loss of neurons occurs in the base of the brain (substantia nigra).

This area should produce dopamine, which is a chemical messenger that transmits signals between the base area to the corpus striatum, to allow smooth and purposeful movement. The loss of dopamine causes a host of problems related to movement and chronic brain inflammation.

Researchers have found a small substance in Lewy bodies in the brain, which is believed to be the cause of Parkinson’s disease, and research is ongoing.

Brain Effects for Parkinson's Disease pixabay.com

Brain Effects for Parkinson's Disease pixabay.com

Symptoms and Signs of Parkinson's Disease

The symptoms and signs of this disease may be different for different patients. Some people write off early symptoms to aging. Sometimes the symptoms may start on one side of the body, and that side will remain worse when both sides become involved.

The symptoms typically include:

  • A tremor or shaking, which usually begins in one limb and may occur when resting.
  • The muscles may become stiff in any part of the body, be painful or limit the range of motion.
  • Movements may be slowed (bradykinesia) causing shorter steps, or it may be hard to rise from a chair. Simple tasks may be more difficult. Some even drag their feet when walking.
  • Automatic movements may be lost, such as blinking, smiling or swinging your arms when walking.
  • Balance and posture may become a problem.
  • Speaking may be softer, or speech can be slurred, hesitant or speaking in a monotone is a possibility.
  • Writing may become difficult or it may appear much smaller.

Possible Disease Complications

Parkinsons is frequently accompanied by many complications, some of which are treatable.

These complications include:

  • Cognitive problems like dementia and thinking difficulties may occur in the late stages.
  • Depression and emotional problems may occur in the early stages.
  • Difficulty in swallowing and as swallowing is slowed, and saliva may accumulate in the mouth and cause drooling.
  • Late stage disease affects the muscles of the mouth, therefore eating and chewing problems may occur. This can cause choking or poor nutrition.
  • Sleep disorders, such as insomnia, waking up too early or daytime sleeping may occur.
  • Bladder problems include difficulty in urinating or unable to control the urine.
  • Constipation can be a problem due to the slower digestive tract.

Other possible problems include lower blood pressure upon standing, smell dysfunctions, fatigue, pain and sexual dysfunction.

Brain Surgery wicipedia.com

Brain Surgery wicipedia.com

Treatments

Doctors may order an MRI, CT, ultrasound or PET scan of the brain to rule out other neurological diseases as they can only diagnose a patient by their symptoms, and Parkinson's disease is difficult to diagnose.

The most effective medication at this time is Carbidopa-levodopa as it is converted to dopamine in the body. It is typically very helpful, but after several years it is not as effective. The carbidopa is combined with levodopa to reduce nausea. Higher doses can also produce involuntary movements (dyskinesia). Duopa is a brand name for this medication, and it can also be given through a feeding tube that is surgically placed to deliver the medication in the small intestine for more advanced disease.

There are dopamine agonists that mimic the dopamine effects in the brain that are not as effective, but they last longer. These medications include Mirapex, Requip, Neupro (in patch form) and in injection named Apokyn.

Other medications include:

  • MAO B inhibitors are sometimes used to help prevent the breakdown of dopamine in the brain.
  • Catechol O-methyltransferase (COMT) inhibitors are prescribed to prolong the effect of levodopa therapy.
  • Anticholinergics are prescribed to help control tremors.
  • Amantadine is used for short-term relief for patients when in an early stage of the disease.

Surgery may be done for patients with advanced-stage Parkinson’s disease. An adjustable generator is implanted in the chest just below the collarbone, and the electrodes are connected to a specific area in the brain. Electrical pulses are sent to the brain to reduce symptoms.

Brain Swelling

Brain Swelling

New Research

There is an inhaled form of levodopa that will soon be on the market. It has a quicker onset. Researchers are currently studying two types of pumps that would give continuous dopaminergic stimulation. Apomorphine is used in a subcutaneous pump that has been available in Europe for several years. The second pump is a solubilized form of levodopa methyl ester salt used subcutaneously.

There is anecdotal evidence that marijuana helps reduce tremors. This has not been fully researched.

Mayo Clinic is working on an adaptive rhythmic auditory stimulus to improve walking and other new medications. Scientist at the University of Queensland has worked using MCC950, a small molecule, in several animal studies, which stopped the progression of Parkinson's. The human trials will begin in 2020.

Parkinson's Disease: Progress and Promise in Stem Cell Research

Conclusion

Michael J. Fox is probably the best-known celebrity with Parkinson’s Disease, and he was diagnosed at age 29. He has a foundation seeking cures and giving people information. This is a difficult disease for many people as it eventually gets worse, and treatments have not been very successful at this stage.

When I was working as an RN in Cardiac Rehabilitation I had a patient who was so nice, an older man who had suffered a heart attack and had Parkinson’s disease. He had fairly severe tremors in his hands, but he could still walk well. He told me his wife complained every morning because he made too much noise reading the paper, which he certainly could not control. I felt bad for him, and I am sure support from loved ones is always important when dealing with any difficult disease.

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2019 Pamela Oglesby

Comments

Pamela Oglesby (author) from Sunny Florida on July 30, 2020:

Hi RT, People with this tough disease do need a out of support. I am glad this article increased your understanding of this disease and I apreciate your comments.

Pamela Oglesby (author) from Sunny Florida on March 01, 2020:

Hi Peggy,

I hope we see a cure as this is a tough disease to tolerate. There are advances but we sure have a ways to go. Thank you for your comments, Peggy.

Peggy Woods from Houston, Texas on March 01, 2020:

Improved treatments for Parkinson's Disease is much needed for all of those people affected by this horrendous disease. It is good to know that research is still being done. Perhaps someday, this disease will be a thing of the past. One can hope! Like you, I am amazed that Michael J. Fox is doing as well as he seems to be doing, given his age when it was diagnosed.

Pamela Oglesby (author) from Sunny Florida on June 07, 2019:

Hi Ruby, I hope a cure is coming soon also. I am glad you learned some new facts, and I appreciate your kind comments.

Pamela Oglesby (author) from Sunny Florida on June 07, 2019:

Hi Ms Dora, Thank you so much for your generous comments. This is a horrible disease, and it is good to know what to expect.

Ruby Jean Richert from Southern Illinois on June 07, 2019:

This is a valuable article. I learned new info. from reading your detailed presentation of this disease. I felt so badly when Michael J Fox was diagnosed with Parkinson's. Hopefully a cure is coming soon.

Dora Weithers from The Caribbean on June 07, 2019:

Pam, thank you for such a good presentation on this topic. There is so much to learn. I've seen people shaking but never taken the time to research the problem. Your article becomes a little reference guide.

RTalloni on June 07, 2019:

This was very helpful to my understanding of Parkinsons. We have friends suffering from this but are not close to them so I have not learned much about it. We are thankful to be a part of their support system, though only the outer ring of it. Clearly, the caregivers need support too, but the person suffering needs people close to them who truly understand the disease.

Pamela Oglesby (author) from Sunny Florida on June 05, 2019:

Hi Christine, Yours is an all too common story. I am sorry your father suffered like that. It is a horrible didease. Thank you for sharing your experience.

Christine Mulberry on June 05, 2019:

My father had Parkinson's Disease. (He died in 2001 so it has been quite some time ago) He had a tremor, the masked facial expression, a shuffling gait, and depression. I can remember him developing a hand tremor several years before he was diagnosed and he survived several years following diagnosis although he was quite frail before his death. Like so many degenerative diseases it robs us of so much before we die.

Pamela Oglesby (author) from Sunny Florida on June 05, 2019:

Hi Audrey, I am sorry to hear about your sister, and I think many people write off their symptoms to again. I am glad this article was helpful for I you. I appreciate your comments. God bless.

Audrey Hunt from Idyllwild Ca. on June 04, 2019:

My sister was recently diagnosed with Parkinson's disease. For a long time, I thought her symptoms were due to aging but I was wrong. No one in our family history has had this disease so this diagnosis comes as a bit of a shock.

I'm grateful for this article Pamela. I feel more informed after reading about the symptoms and signs.

Thank you.

Pamela Oglesby (author) from Sunny Florida on June 04, 2019:

Hi Peg, I could not agree with you more. I wish that could diagnose it earlier also. I appreciate your comments.

Peg Cole from North Dallas, Texas on June 04, 2019:

The first person that comes to mind when this disease is mentioned is of course, Michael J. Fox. I never knew the extent of the symptoms before reading this. What a terrible disease for a young person like him (or for anyone) to suffer. Hope there comes a day when this is either eradicated or curable. Thanks for sharing this eye-opening information.

Pamela Oglesby (author) from Sunny Florida on June 04, 2019:

Hi Liz, I wish they could find a way to diagnose this disease earlier. I did not find any reason for a higher incidence of Parkinsons. I wonder if maybe people are living longer with an increase in numbers of the older population.

I am sorry you knew someone that died from this disease. Thank you for your comments.

Liz Westwood from UK on June 04, 2019:

I knew someone who died of Parkinsons a year ago. It took a long time for him to be doagnosed and it was sad to see the deterioration thereafter. In your article you mention an increase in cases of Parkinsons. Is there any suggestion of a reason for this increase?

Pamela Oglesby (author) from Sunny Florida on June 04, 2019:

Hi Kaili, You are so right about a cure sooner than later. I appreciate your nice comments.

Pamela Oglesby (author) from Sunny Florida on June 04, 2019:

Hi Pop, You are right about a correct diagnoses. Since there is no clear test for this disease I imagine your friend is not the only one with a wrong diagnoses. That is why many doctors do brain scans to eliminate other possible causes for the symptoms. Thanks for commenting.

Pamela Oglesby (author) from Sunny Florida on June 04, 2019:

Hi Billy, If you don't have any symptoms now I would think your chances are good to avoid this ugly disease. I appreciate your coments.

Kaili Bisson from Canada on June 04, 2019:

What a thorough and informative article Pamela. I know a couple of people who have been stricken by Parkinson's. I am so glad to learn about the advances in treatment...these can't come soon enough for we Boomers!

breakfastpop on June 04, 2019:

Recently, someone I know was diagnosed with this disease. Her symptoms worsened in a matter of days and it turned out that she has a hideous fatal brain tumor instead. I can't tell you how many cases I have heard about that involve a wrong diagnosis. Early and correct diagnosis makes a difference. I truly hope that a cure is on the way.

Bill Holland from Olympia, WA on June 04, 2019:

This is one of those "ugly" diseases I hope I don't get, like hoping is any defense. :) Great information as always, Pamela!

Pamela Oglesby (author) from Sunny Florida on June 04, 2019:

Hi John, It seems we all know someone with this horrible disease. It sounds like treatment and maybe even a cure may happen in the not to distant future. I appreciate your kind comments.

Pamela Oglesby (author) from Sunny Florida on June 04, 2019:

Hi Flourish, I can certainly see why you are concerned about your husband, and I agree that this disease is horrible. At least that seem to have some idea as to what might be caussing it, but a cure is needed soon. Thanks so much for your comments.

John Hansen from Queensland Australia on June 04, 2019:

A wonderful article about a disease that seems to be diagnosed more and more frequently. I have a long time friend who had Parkinson's disease. All advancements in treatment are a positive. Thank you for sharing.

FlourishAnyway from USA on June 04, 2019:

My husband’s grandmother had this and died of complications so I am constantly watching him for any sign of tremor. He exercises every morning at 4 am. It’s such a cruel disease and you just never know where it will strike. I’m glad there are advances. A cure cannot come soon enough.

Pamela Oglesby (author) from Sunny Florida on June 04, 2019:

Hi Maria, It is interesting how important exercise is for good health. I'm glad you found the article helpful, and I appreciate your kind comments.

Love, Pam

Maria Jordan from Jeffersonville PA on June 04, 2019:

Thanks for this update, dear Pam - very interesting and hopeful.

It was cool learning about the pump (Thorn) in the first video. It's wonderful to see exercise / movement recognized as 'just as' important as medications in the second video.

Outstanding, as usual! Love, Maria

Pamela Oglesby (author) from Sunny Florida on June 04, 2019:

Hi Lorna, I am sorry to hear about your father as I know that was so difficult. I think it is not uncommon for a person to have Parkinson's disease and dementia I appreciate you sharing your experience and commenting.

Lorna Lamon on June 04, 2019:

Great article Pamela. This is such a cruel disease and I hope that one day there will be a cure. Research is ongoing and I was interested to note the research being carried out by the Mayo Clinic. My Dad had a form of Parkinson's which was linked to his Dementia. His tremors were quite bad and unfortunately a combination of the two illnesses resulted in a more rapid progression. Support and empathy is so important for those suffering, as it can be extremely difficult to live with.

Pamela Oglesby (author) from Sunny Florida on June 04, 2019:

Hi Eric, I think you have enough to be concerned with, and I sure hope you don't have any Parkinson;s disease symptoms. Thank you for your kind comments.

Pamela Oglesby (author) from Sunny Florida on June 04, 2019:

Hi LoI think they are closer to finding a cure, but not there yet. I appreciate your comments.

Eric Dierker from Spring Valley, CA. U.S.A. on June 03, 2019:

Interesting. They watch me.They worry because of markers. Too close for comfort. That cancer thing has everyone worried about everything.

This is wonderfully done.

Lori Colbo from United States on June 03, 2019:

I've known and lost friends and loved ones to this disease. I hope one day they will find a cure. Thanks for this informative article.

Pamela Oglesby (author) from Sunny Florida on June 03, 2019:

Hi Linda, While they have a way to go it seems like they are testing many new treatments. Michael J. Fox has done so much for this disease, and he seems to be still functioning better than I would have tought considering he was diagnosed so young. Thank you for your comments.

Linda Rogers from Minnesota on June 03, 2019:

I hope they can make big strides to help those suffering from this terrible disease. I know Michael J Fox has done so much in regards to fundraising & educating the public. Thanks for a well written article.

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