What Is Parkinson's Disease?
Parkinson's disease is a health condition that affects the brain and nervous system . It is classified as a neurological movement disorder because it affects the brain’s ability to control movement. This condition is characterized by symptoms like tremors, muscle rigidity, and difficulties with movement, balance, and coordination.
Parkinson’s disease is a progressive health condition, which means it gets worse over time. Unfortunately, there is no cure for this condition; however, it can be managed with medication and surgery, often for a significant period of time. The average life expectancy of a person with Parkinson’s disease is similar to that of a person who does not have the condition.
Approximately 60,000 people are diagnosed with Parkinson’s disease in the United States every year.
The symptoms of Parkinson’s disease fall into two groups: motor symptoms and nonmotor symptoms.
Motor symptoms are movement-related problems that occur because the brain cannot send signals to the muscles the way it is supposed to.
These are some of the motor symptoms of Parkinson’s disease:
- Tremors in the hands, feet, or jaw
- Slow movements
- Rigid muscles
- Limited range of motion
- Unsteady walk
- Stooped posture
- Difficulty with balance and coordination
- Muscle cramps and spasms
- Reduced facial expressions
- Slurred or softer speech
- Smaller handwriting
The movement-related symptoms of Parkinson’s disease can make daily activities like bathing, getting dressed, walking, talking, writing, and driving difficult. They can also increase your risk of falling and injuring yourself.
The nonmotor symptoms of Parkinson’s disease occur because this condition also affects the sympathetic nervous system, which is responsible for many autonomic body functions , such as digestion, heart rate, and blood pressure.
These are some of the nonmotor symptoms of Parkinson’s disease:
- Loss of smell
- Low blood pressure
- Difficulty chewing and swallowing
- Loss of bladder control
- Memory loss
- Lack of interest
- Weight changes
- Vision changes
- Sleep disturbances
- Restless leg syndrome
Nonmotor symptoms like loss of smell, constipation, restless legs, and difficulty sleeping often appear before motor symptoms like tremors and muscle stiffness become noticeable.
Diagnosing Parkinson’s disease can be tricky because there isn’t a straightforward blood test or screening test that can determine whether or not you have it.
Instead, Parkinson’s disease is diagnosed clinically, which means a healthcare provider will perform a physical and neurological exam where they may ask you to do certain exercises to evaluate your movements.
Your healthcare provider will also review factors like your medical history, family history of neurological diseases, and potential exposure to toxins and pesticides to determine your risk factors for this condition.
You may have to get lab tests such as blood and urine tests and imaging scans such as MRI, CAT, and DaT scans, to help rule out other possibilities. Certain other health conditions can mimic the symptoms of Parkinson’s disease and are often misdiagnosed as Parkinson’s.
The current standard for diagnosing Parkinson’s disease is a checklist developed by the International Parkinson and Movement Disorder Society .
Since diagnosing Parkinson’s disease relies heavily on clinical judgment, your primary care physician may refer you to a neurologist who specializes in movement disorders for an accurate diagnosis.
Parkinson’s disease is caused by unusual changes in the brain, although the reason behind these changes isn’t fully clear yet.
These are some of the neurological changes associated with Parkinson’s disease:
- Reduced dopamine levels: Parkinson’s disease can harm nerve cells in the brain that produce dopamine, causing them to die. Dopamine is a neurotransmitter (brain chemical) that transmits messages to the part of the brain that controls muscle movement. Low dopamine levels are responsible for the motor symptoms of this condition.
- Reduced norepinephrine levels: Parkinson’s disease is also marked by low levels of another neurotransmitter , norepinephrine. This chemical messenger is crucial to the function of the sympathetic nervous system. Low norepinephrine levels are responsible for the nonmotor symptoms of this condition.
- Accumulated Lewy bodies: Many people with Parkinson’s disease also have abnormal deposits of the protein alpha-synuclein in their brain, known as Lewy bodies . This is a major area of focus among researchers.
Risk Factors Associated With Parkinson's Disease
- Age: This is the most significant risk factor for the condition since most people develop it after the age of 60.
- Family history: Having a family history of this condition can raise your chances of getting it.
- Sex: 50% more men than women develop Parkinson’s disease.
- Exposure to pesticides and toxins: Air pollution, pesticides, and certain industrial pollutants are linked to an increased risk of Parkinson’s disease.
- Head injury: Having a head injury can lead to lower dopamine levels, particularly in people who have also been exposed to pesticides.
Parkinson’s disease is broadly classified into two types, based on the age when the symptoms first appear:
People with this type of Parkinson’s disease first see symptoms before the age of 50.
This form of Parkinson’s may be inherited.
People with this type of Parkinson’s disease first see symptoms after the age of 60.
Certain genetic mutations may also play a role in some cases of late-onset Parkinson’s.
Treatment for Parkinson’s disease can help slow the condition's progression and reduce its symptoms; however, it cannot cure the disease. Your healthcare provider will evaluate you and suggest a course of treatment based on your age and symptoms.
Medication and surgery can treat Parkinson’s disease.
These are some of the types of medication that treat Parkinson’s disease:
- Levodopa: This drug is the main therapy for Parkinson’s disease. The nerve cells in your brain use it to make dopamine and replenish the brain’s diminishing supply. This drug is typically combined with another drug, known as carbidopa, which makes levodopa more effective and reduces its side effects. Brand names include Rytary, Sinemet, and Inbrija.
- Dopamine agonists: This group of drugs mimics the effects of dopamine in your brain. Dopamine agonists include Neupro (rotigotine), Requip (ropinirole), Mirapex (pramipexole), and Apokyn (apomorphine).
- COMT and MAO B inhibitors: These drugs block the function of COMT and MAO B enzymes, which break down dopamine in the brain. COMT inhibitors include Ongentys (opicapone), Comtan (entacapone), and Tasmar (tolcapone). MAO-B inhibitors include Xadago (safinamide), Azilect (rasagiline), Eldepryl (selegiline), and Zelapar (selegiline).
- Anticholinergics: These drugs help with symptoms like tremors and muscle rigidity. Anticholinergics include Artane (trihexyphenidyl) and Cogentin (benztropine).
- Amantadine: This is an antiviral medication that can help with the symptoms of Parkinson’s disease and the side effects of levodopa. It is sold under the brand names Gocovri, Symmetrel, and Osmolex ER.
Medication can make a significant difference to the symptoms of Parkinson’s disease, especially in the early stages. Over time, however, it can become less effective, and the symptoms may start to reappear.
Surgery may be an option for some people if medication is no longer helpful.
These are the types of surgery that can help with Parkinson’s disease:
- Deep brain stimulation: This FDA-approved procedure involves surgically implanting electrodes in the brain and an electrical device in the chest. The device emits painless electrical signals that stimulate the brain and block the irregular brain activity that causes the motor symptoms of Parkinson’s.
- Pallidotomy and thalamotomy: These procedures involve selectively destroying small parts of the brain, i.e., the globus pallidus and the thalamus, responsible for symptoms like tremors, muscle rigidity, and involuntary movements.
These are some strategies that can help you cope with Parkinson’s disease :
- Learn about the condition: Educating yourself about the condition can help you take an active role in your care and prepare yourself for the stages ahead.
- Expect changes: The symptoms of Parkinson’s disease can make routine activities difficult. Being patient with yourself and accepting your limitations can help prevent anger and frustration.
- Accept support from loved ones: Sharing your feelings with loved ones , asking for what you need, and accepting their support and assistance can help you cope with the condition.
- Stay mentally and physically active: Staying active and engaged can help reduce the rate of physical and cognitive decline.
- Seek support and resources: It can be helpful for you and your loved ones to identify support groups and resources nearby for advice, information, and medical care.
- Prevent falls: You can optimize your living situation to prevent falls, a health hazard associated with Parkinson’s disease.
A Word From Verywell
Parkinson’s disease is marked by a gradual decline in physical and cognitive abilities ; however, medication and surgery can help you enjoy a better quality of life for longer. Being informed and prepared can help you and your loved ones cope with this condition and the changes it brings.
Cleveland Clinic. Parkinson’s disease: causes, symptoms, stages, treatment, support .
Johns Hopkins Medicine. Parkinson’s disease and dementia .
Johns Hopkins Medicine. How Parkinson’s disease is diagnosed .
National Institute of Environmental Health Sciences. Parkinson’s disease .
National Institute of Neurological Disorders and Stroke. Parkinson’s disease: hope through research .
National Institute on Aging. Parkinson’s Disease .
Parkinson’s Foundation. Activities of daily living .
Parkinson’s Foundation. Coping with a diagnosis .