Parkinson’s Disease

The first symptom many people notice is a subtle tremor in their hands. However, research has found that Parkinson’s disease can actually begin years or even decades before motor problems start. By the time motor-related symptoms appear, people with Parkinson’s disease have already lost 50% of a specific type of dopamine cell found in the brain. They may also have experienced non-motor symptoms, such as sleep disturbances, sudden body movements or vocalizations, mood changes, anxiety, constipation and loss of smell.

This disease can progress to other parts of the body and increase in severity, leading to a loss of functional independence. Symptoms can include: trembling of hands or limbs, which typically starts on one side; trouble making facial expressions; quieter voice volume; rigid muscles; slowness or “freezing” of movement; impaired balance or coordination; depression or mood issues; sleep problems; and difficulty walking, completing tasks or remembering things.

People with Parkinson’s disease can be more susceptible to illness and infection, and when they do get sick, it can cause their Parkinson’s symptoms to worsen.

Diagnosis is based on medical history and a physical and neurological exam. Because Parkinson’s disease can resemble other brain disorders, it can be challenging to make a definitive diagnosis and pinpoint a specific treatment.

There is no cure for Parkinson’s disease, but medications can help relieve or control the symptoms by enhancing dopamine function. Levodopa, a medication that helps nerve cells in the brain make dopamine, has been the main choice of treatment for more than 50 years. While medications can be helpful, over time many people may experience periods when the medication “wears off” and no longer controls their symptoms, leading to motor fluctuations or involuntary movements.

If adjusting the dose or timing of medication doesn’t help, some patients may benefit from a surgical treatment option called deep brain stimulation (DBS). With this treatment, a transmitter device implanted under the skin sends electrical signals through a wire to electrodes implanted in the brain, helping to improve symptoms and reduce involuntary movements. More recently, infusion therapies have also been used to provide a continuous flow of medication.

Exercise, in conjunction with other rehabilitation therapies and medication, can help mobility and quality of life by increasing strength, boosting mood and improving balance. Regular exercise can also improve thinking, learning and memory through neuroplasticity, which is the way the brain forms and organizes connections.

Be sure to work with your doctors to develop the best treatment plan for you.

More research needs to be done to better understand many aspects of Parkinson’s disease, including the cause of the progressive loss of dopamine-producing brain cells and the development of drugs that can prevent this degeneration.

James Curtis, PhD, who received a Next Generation Research Grant from the American Brain Foundation, is looking at a common complication of Parkinson’s: swallowing difficulties. Doctors call this disorder dysphagia, and it can reduce a patient’s quality of life. It can also lead to pneumonia—the leading cause of death for Parkinson’s patients.

Dr. Curtis is a Speech-Language Pathologist and Postdoctoral Research Fellow at Columbia University and is working to develop a more effective treatment for dysphagia specifically for Parkinson’s patients and others suffering from other movement disorders.