Parkinson's Disease: Symptoms and Causes

 

 

 

     Currently, Thailand has steadily transitioned into an aging society. As of 2021, the population aged 65 and above in Thailand is approximately 9 million, accounting for about 13% of the total population. This demographic is expected to continue growing. Parkinson’s disease and Normal Pressure Hydrocephalus (NPH) are neurological disorders commonly seen in the elderly. 

 

The Prologue of 2 Diseases

     Both diseases increase in prevalence with age, and while they share similarities, they also have distinct differences. Understanding these diseases and exploring treatment options can help patients and caregivers identify early symptoms and seek medical attention promptly.

 

 

 

 

What is Parkinson's Disease?

     Parkinson’s disease is a neurodegenerative disorder that affects the brain's nerve cells responsible for producing dopamine, a neurotransmitter. The degeneration of these cells occurs in the midbrain, leading to abnormal movements as the primary symptom. This is different from Alzheimer's disease, where memory loss is the main symptom. The exact cause of Parkinson’s disease remains unknown.

 

Causes of Parkinson's Disease

Studies suggest that Parkinson’s disease may be triggered by several factors, including:

 

• Exposure to chemicals in industries or agriculture, such as pesticides or herbicides
• A history of drug abuse, such as heroin or amphetamines
• Repeated head trauma over time
• A family history of Parkinson’s disease

 

 

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These risk factors suggest that Parkinson’s disease occurs in about 1% of elderly individuals aged 60 and above, with the prevalence rising to 4% in those over 80 years of age.

 

 

 

 

 

Symptoms of Parkinson’s Disease

The symptoms of Parkinson’s disease are categorized into:

 

• Motor Symptoms (related to movement)
• Non-motor symptoms (unrelated to movement)

 

Motor Symptoms

These include four main symptoms:

 

• Tremors Shaking, often in the hands, arms, or chin, typically occurring at rest.
• Rigidity Stiffness in the muscles, often detectable in the arms, legs, neck, or torso.
• Bradykinesia Slowness of movement, with reduced range and speed of repetitive movements. For example, hand clenching may slow down, and the hand will open with a smaller range each time. Early on, symptoms typically affect one side of the body before spreading to the other side as the disease progresses.
• Postural Instability Difficulty maintaining balance, leading to frequent falls. Patients may also have a hunched posture, walk with shorter steps, or exhibit a frozen facial expression with little emotion.

 

Non-Motor Symptoms

Non-motor symptoms can appear before or alongside movement issues and include:

 

• Sleep Disorders Snoring, insomnia, daytime sleepiness, or sleep talking and acting out dreams.
• Autonomic Dysfunction Urinary incontinence, constipation, erectile dysfunction, dizziness, or fainting due to low blood pressure when changing positions.
• Mood, Behavior, and Cognitive Impairments Depression, anxiety, memory loss, and cognitive decline often occur in the later stages of the disease.
• Loss of Smell Reduced or absent sense of smell may appear before movement issues.
• Pain, Numbness, or Muscle Fatigue Musculoskeletal discomfort, which may occur when medication effectiveness wanes or takes effect.

 

 

 

 

Treatment Options for Parkinson’s Disease

     Since Parkinson's is a neurodegenerative disease, there is currently no cure, and treatments focus on improving mobility and quality of life. Treatment methods include:

 

1.  Medication

Medications help control symptoms, particularly rigidity and bradykinesia. They include: These medications aim to help patients live more normal lives and improve their quality of life.

 

• Side Effects: After 3-5 years of treatment, 30-50% of patients may experience movement-related complications, such as dyskinesia (involuntary movements) or "wearing off" (when the medication's effects wear off too quickly).
• Levodopa Combinations: Stimulate dopamine receptors directly.
• MAO-B Inhibitors: Protect dopamine from breakdown in the brain.
• COMT Inhibitors: Block the breakdown of levodopa.

 

2.  Surgical Treatment

     In cases where medication is ineffective, Deep Brain Stimulation (DBS) may be used. This involves implanting a device that sends electrical impulses to the brain. Although effective for controlling symptoms, it does not cure the disease and is not suitable for all patients.

 

3.  Exercise 

     Regular physical activity is beneficial for all stages of Parkinson’s disease. Activities such as stretching, dancing (e.g., tango), and tai chi can improve mobility and balance.

 

Diet and Stem Cell Therapy in Parkinson’s Disease

     Patients with Parkinson’s disease can generally maintain a normal diet. Currently, there is no conclusive evidence that supplements, injections, or stem cell transplants can cure, slow, or prevent Parkinson's disease.

 

Normal Pressure Hydrocephalus (NPH), or hydrocephalus, is another condition commonly found in the elderly. For more information, click here.