Parkinson's Disease: Symptoms, Causes, Risk Factors & Treatment

Parkinson’s disease is one of the most widely found forms of Parkinsonism and is also referred to as idiopathic Parkinsonism. Medical professionals also classify Parkinson’s as a type of neurodegenerative disease known as synucleinopathy.

This is because PD is the result of an abnormal accumulation of the alpha-synuclein protein in the brain. This blog will guide you through the various early Parkinson’s symptoms, causes, diagnostic procedures, etc., for your convenience.

Dopamine enables and coordinates smooth bodily movement. This dopamine is produced in the brain part known as the substantia nigra. Parkinson’s disease or PD is a progressive nervous system disorder that hinders proper body movements. It is a neurodegenerative disease that affects the dopamine-producing neurons in the substantia nigra.

Several scientists over the years put in every effort to classify PD into different sub-categories based on age, symptom progression, etc. However, till now, these classifications are not yet adopted officially.

Signs and symptoms of Parkinson’s disease develop gradually over time, depending on the age of onset. These can depend from individual to individual, and some early signs may even go unnoticed.

Usually, early Parkinson’s symptoms first reveal on one side of the body and remain worse on that side, even after it affects both sides.

Some of the first symptoms of Parkinson’s disease include:

Tremors: One of the common early signs is a slight tremor or shaking. It usually begins with a limb, often the hand or finger. It may cause patients to rub their thumb and forefinger back and forth. This is referred to as a pin-rolling tremor. Hand or feet may tremble when at rest.

Rigid Muscles: Another one among widely found Parkinson’s disease symptoms is muscle rigidity or stiffness. It can occur in any part of the body, limiting the movement of that particular muscle. One also feels considerable pain.

Erratic and Slow Movement: Also known as bradykinesia, Parkinson’s disease may slow down your body movements, cause distinct discomfort completing simple tasks, and make it time-consuming. For example, you will find increased difficulty getting out of the bed or chair and require dragging your feet while you walk.

Loss of Automatic Movements: Parkinson’s disease also decreases your body’s ability to perform automatic functions like blinking, smiling, swinging arms while walking, etc. 

Impaired Body Posture and Balance: Parkinson’s patients often suffer from a stooped posture and face difficulty maintaining body stability.

Speech Impairments: Speech impediments can also occur due to PD. One might speak softer, quicker or speeches may even become blurry in some cases. Further, it becomes more of a monotone, losing the usual inflections.

Writing Changes: As your hands become shaky and tremble, you will also face trouble while writing. It becomes slower, and writings may even appear smaller than they used to be.

Sleep Problems: Restless legs and other factors affect various sleep problems among PD patients. It also causes insomnia, dementia, hallucinations and delusions.

Loss of Smell: Another common symptom of several Parkinson’s disease symptoms is loss of sense of smell among patients.

Additional complications caused by Parkinson’s disease

• Mental health and emotional issues
• Problem while swallowing food or beverage
• Difficulty in chewing and eating
• Bladder problems
• Sleeping disorder
• Blood pressure fluctuations
• Constipation
• Difficulty in performing cognitive functions
• Sexual dysfunction
• Fatigue

Parkinson’s disease is usually a result of certain neurons in the brain dying after gradually breaking down. This causes a fall in dopamine levels, which leads to abnormal brain activity. This, in turn, causes impaired body movements and triggers other PD symptoms.

However, the exact causes of Parkinson’s disease are still unknown. There are some factors that play a role according to scientific research. These are:

Genes: Studies reveal that specific genetic mutations can cause PD. However, it is uncommon unless several family members are affected by the disease. Although certain gene variations indicate higher risks of Parkinson’s, there is a relatively lower risk of PD for each of these genetic markers.

Environmental Triggers: In some cases, Parkinson’s disease is caused by environmental factors like toxins in the atmosphere or exposure to other factors. However, the risk is lower.

Scientists also claim that they notice distinct changes in the brain affected by Parkinson’s. These are:

Lewy Bodies: Clumps of specific substances within your brain cells are microscopic markers to identify Parkinson’s. These clumps are referred to as Lewy bodies. Scientists believe that these clumps hold the clue to determine what causes Parkinson’s disease.

Alpha-synuclein Found in Lewy Bodies: Lewy bodies contain several substances, of which scientists strongly believe alpha-synuclein (a-synuclein) is an important link. This is found in all Lewy bodies. Usually present in a clustered form, cells cannot break them down. It is one of the major focuses of modern Parkinson’s research.

Some of the common risk factors of PD are:

Age: PD is rare among young adults. It is more prevalent among middle-aged adults and above. The risk continues to increase with age. Generally, people aged over 60 years develop Parkinson’s disease.

Heredity: People with a close relative with PD are at higher risk of developing the disease. However, unless several people in the family have the disease, the chances are low that a person will develop PD genetically.

Exposure to Toxins: Increased and continued exposure to herbicides and pesticides can increase the risks of Parkinson’s disease. 

Gender: As per research, most doctors and scientists find that PD is more likely to affect men than women usually.

It is extremely difficult to make an accurate diagnosis of Parkinson’s disease. Doctors consider the symptoms, family history, genetics, etc., to arrive at a definitive conclusion. The standard diagnosis of PD is currently clinical. This essentially means there is no specific Parkinson’s disease test that can give a conclusive result.

However, people diagnosed with Parkinson’s usually undergo an X-ray or other tests to rule out other diseases with the same symptoms.

Parkinson’s disease is usually diagnosed based on the results of the following exams:

Examination of Medical History: Doctors will take the details regarding your medications, enquiring about your family history and if anybody in your family developed Parkinson’s.

Physical Examination: Medical personnel will then take an extensive physical exam. This will include walking, the ability to coordinate your limbs, and completing usual tasks. They diagnose a patient with PD if:

• One exhibits two or more symptoms of Parkinson’s, like trembling, shaking, slow movement, rigidity, etc.
• A patient experiences the issues only on one side of the body.
• Tremors and trembles are more noticeable and pronounced when at rest. For example, your hands are shaking more while sitting on a chair or lying on the bed.
• There is an improvement when the patient uses a medication called Levodopa.

There is no standard treatment to cure Parkinson’s disease. It depends on the individual and the symptoms he or she exhibits. Treatments broadly include medication and surgery, along with lifestyle modifications, including taking more rest and exercising regularly.

Let’s have a look at the treatment procedures:

Medication

Medication generally helps to reduce the intensity of symptoms of Parkinson’s disease, like shaking, tremors, etc. However, medications are not always useful for every Parkinson’s patient. Moreover, the short-term and long-term effects of these treatments also vary.

Levodopa: The majority of PD patients require a medication named Levodopa. It is absorbed by the nerve cells in the brain and converted to chemical dopamine that transmits neural messages from the brain to the nerves that control movement.

It is usually consumed as a tablet or liquid combined with other medication like benserazide or carbidopa. These stop levodopa from breaking down before it gets to the brain.

Initially, it is prescribed in smaller doses, and then doctors gradually increase them according to the symptoms and their intensity.

Dopamine Agonists: Another Parkinson’s disease treatment is an application of dopamine agonists. They are often consumed as tablets and also available as skin patches (rotigotine). These exhibit a similar effect to that of Levodopa but milder. They are often taken less frequently than Levodopa. It is also consumed with levodopa to lower the dosage of the latter.

Other medical treatments include:

Monoamine oxidase-B inhibitors like rasagiline and selegiline block the brain substance or enzymes to break down dopamine. This increases the dopamine levels in your brain. They are used alongside levodopa and dopamine agonists.

Catechol-O-methyltransferase inhibitors are usually prescribed to patients who are in advanced stages of Parkinson’s disease. These inhibitors prevent the enzyme COMT from breaking down Levodopa.

Non-oral Therapies: When medicines alone cannot control the symptoms of PD, doctors resort to other treatments. These are:

• Apomorphine
• Duodopa

Surgery

In some cases, surgery can help treat Parkinson’s disease. However, it is not suitable for everyone. The surgery is called deep brain stimulation. It involves implanting a pulse generator, much like a pacemaker in a chest wall. This connects 1 or 2 wires placed under the skin and is inserted in specific areas of the brain. The pulse generator passes a tiny electric current to stimulate the brain part affected by PD. It does not cure Parkinson’s, but it eases the symptoms.

Stem Cell Treatment

One new Parkinson’s treatment is stem cell treatment. This involves introducing new dopamine cells into the brain, which can then replace the lost dopamine cells. This does reduce its symptoms and can also reduce the side effects of medications like Levodopa. The implanted cells usually survive for two years.

Scientists completed the first attempt of Parkinson’s stem cells treatment in 2018 and will perform six more in 2022.

Since there is no known cure for Parkinson’s disease, it is always beneficial to prevent the symptoms from arising. Doctors generally prescribe a healthy diet with specific nutrients and taking less stress as preventive measures for Parkinson’s disease.

Some key factors of this diet include:

Organic Food: Studies implicate pesticides and herbicides causing Parkinson’s. Therefore, doctors recommend consuming food and vegetables produced locally and organically.

Fresh Vegetables: Another factor one needs to remember while planning a diet to prevent Parkinson’s is including lots of fresh and raw vegetables in it. Studies show that larger amounts of the B vitamin folic acid primarily found in vegetables can reduce the risks of Parkinson’s. Broccoli, spinach, Brussels sprout, asparagus, etc., are all rich in this B vitamin.

Other diet changes that help prevent Parkinson’s disease are:

• Include Omega-3 fatty acids in your diet
• Sufficient sources of vitamin-D
• Green tea
• Consume animal meat to ensure optimal levels of the CoQ10 coenzyme
• Anti-oxidants
• Fava beans, etc.

Parkinson’s disease is a lifelong condition that does not come with a specific cure. Therefore, doctors recommend including regular exercise, diet, avoiding toxins, etc., in your diet to prevent symptoms from arising or alleviating.