What is Parkinson’s disease?

Parkinson’s disease is a progressive, neurodegenerative brain disease. Parkinson’s disease causes a part of the brain that is essential for movement, known as the substantia nigra, to degenerate. The major neurotransmitter in this region of the brain is called dopamine. Since this part of the brain degenerates, there is insufficient dopamine to facilitate normal movement. As a result, movement problems develop and progress over time. The most prominent motor symptoms of Parkinson’s disease are shaking or tremors, slowness of movement, stiffness of muscles or rigidity and problems with balance and gait.

It is believed that other regions of the brain are affected by Parkinson’s disease many years before the movement disorders associated with it become apparent or the disease impacts the substantia nigra. Damage to these other regions of the brain accounts for a variety of the non-motor symptoms that are also present in this disease. These symptoms include, among others, the loss of the sense of smell, and insomnia. Anxiety and depression are also common symptoms in people with Parkinson’s disease. This is due not only to the process of neuro-degeneration but also to the emotional trauma of living with this relentless and merciless disease.

As this disease progresses, damage continues to spread through the brain resulting in the worsening of symptoms. This occurs slowly over time robbing its victims of their ability to function and live normally. Patients in advanced stages of Parkinson’s disease lose their mobility, independence, and ability to care for themselves. Parkinson’s disease can be fatal. Falls, choking and aspiration pneumonia are among the common causes of death related to Parkinson’s disease. Though these events can occur, people with Parkinson’s disease can often manage their symptoms for many years.

Although Parkinson’s disease is currently incurable, its symptoms can adequately be managed for a number of years with routine vigorous exercise, a variety of medications, and with a surgical procedure known as deep brain stimulation or “DBS.” It is believed that vigorous routine exercise helps people maintain their mobility, coordination, flexibility, balance and gait. There is some evidence to suggest that exercise is neuroprotective in that it enables the brain to function more efficiently.

The primary drug treatment is L-Dopa. This drug is converted in the brain into dopamine. Since dopamine is lost in the process of neurodegeneration, replacing it in the substantia nigra alleviates the motor symptoms of the disease for a period of time. There is another class of drugs known as dopamine agonists that are useful in treating Parkinson’s disease because they increase dopamine-like activity in the substantia nigra that is lost as this part of the brain degenerates. Although they are effective in alleviating the motor symptoms of Parkinson’s disease, dopamine agonists are not as effective or as easily tolerated as the various formulations of  L-dopa. Dopamine agonists are commonly used on their own or in combination with L-Dopa and other drugs in the treatment of the motor symptoms of Parkinson’s disease. Other types of medications are available to treat the various non-motor symptoms of the disease.

The “DBS” surgical procedure is used in the treatment of the motor symptoms of Parkinson’s disease. It can offer significant symptomatic relief to people suffering from the disease.

A great deal of research is currently underway in the United States and elsewhere to find ways to predict and prevent Parkinson’s disease from developing, to improve the treatment options that are available, and to find a cure for the disease.

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