Don’t ignore the signs

Parkinson’s disease is the most common movement disorder. It is a progressive illness and is characterised by loss of muscle control due to a chemical imbalance in the brain.

This leads to trembling of the limbs and head while at rest, stiffness, slowness, and impaired balance. As symptoms worsen, it may become difficult to walk, talk, and complete simple tasks of daily living. In this article, I will be talking about the causes and symptoms of Parkinson’s disease in addition to highlighting who is at risk of developing it.

The progression and degree of disability related to impairment differs from one person to another. Some people live a normal life while others become quickly disabled. Parkinson’s disease unfortunately reduces life expectancy and death is usually caused by injuries related to recurrent falls or chest infections.

Parkinson’s disease is named after the British doctor, James Parkinson, who described the disease as a shaking palsy in 1817. However, descriptions of such disease have been found to date back as far as 5000 BC in ancient circulations in current day India.

What causes Parkinson’s disease?

Parkinson’s disease is related to a chemical imbalance in the brain. The substance dopamine is the main chemical that is affected. It works as a messenger that transfers signals in an area in the brain called the substantia nigra to produce smooth, controlled movements. In Parkinson’s disease, there is a loss of dopamine-producing cells leading to low dopamine levels and hence loss of smooth controlled movements.

It is not clear why the dopamine-producing brain cells deteriorate. Genetic and pathological studies have revealed that various factors can lead to dysfunction in cells including inflammation and infections. In general, scientists suspect that loss of dopamine is related to a combination of genetic and environmental factors.
What genes have been linked to Parkinson’s disease?

Most cases of Parkinson’s disease are idiopathic, meaning ‘with no cause’. Some individuals diagnosed have family members who are also suffering from the same condition. By studying families and genes, scientists have identified several genes that are related to this disorder. These usually are associated with Parkinson’s disease that starts at a younger age. These genes include SNCA, PARK2, PARK7, and PINK1. Others have also been identified. Generally speaking, having a first-degree relative (parent or sibling) with Parkinson’s disease is associated with a four to nine-fold increased chance of developing the condition, in comparison with someone in the general population.

Which factors increase the risk of developing Parkinson’s disease?

Age is the largest risk factor. Usually people who develop Parkinson’s disease are 60 and older. It affects men more than women. If you have a first degree relative diagnosed with Parkinson’s disease then you have a higher chance of developing it. Other factors that might increase the risk include head injuries or exposure to environmental toxins such as pesticides.

What are the symptoms of Parkinson’s disease?

The main symptoms are related to the movements that you can control and initiate (voluntary movements) and the ones that you can’t control (involuntary movements). Usually, the symptoms start on one side of the body (eg. left arm) and eventually involve the other side as they worsen. These symptoms include:

* Tremors: Trembling in fingers, hands, arms, feet, legs, jaw, or head. These happen when the person is resting and subside as they move the affected part.
* Rigidity: Stiffness of the limbs and back. This worsens with movement.
* Bradykinesia: Slowness of voluntary movement for example, you might notice difficulty in getting up from the chair.
* Postural instability: Loss of  reflexes that can make it difficult to adjust posture to maintain balance. This instability may lead to falls.
* Parkinsonian gait: Individuals may have a slow walking pattern with freezing episodes during walking.

Other symptoms can also accompany Parkinson’s disease. These include depression, memory problems and swallowing difficulties. Next week I will focus on diagnosing Parkinson’s disease.