Parkinson’s disease is a chronic neurological condition that affects a significant number of people world-wide. The condition was named after Dr James Parkinson, who first identified it in 1817 and affects more people than multiple sclerosis, muscular dystrophy and Lou Gehrig’s disease combined.
Parkinson’s disease is characterized by degeneration of neurons in the region of the brain that controls muscle movement (the basal ganglia and the extra pyramidal area). When functioning normally, these neurons produce a vital brain chemical known as dopamine. This shortage is the cause of the motor and muscular deficits.
Dopamine is produced and stored in a small, pigmented group of nerve cells in the upper brainstem called the substantia nigra. Dopamine is a neurotransmitter (chemical messenger) critical to relaying brain messages that control both balance and movement. When there isn’t enough dopamine, cells don’t signal each other properly and people eventually develop symptoms such as:
- resting tremor
- slowness of movement
- rigidity and instability in walking
- sleep disturbances
This disease classified as motor movement disorder is a progressive neuro-degenerative problem, which affects movement or the control of movement, including speech and body language. It is known to affect people from all ethnic and socio-economic groups. However, it does appear to affect more women than men.
Symptoms usually appear after the age of 50 and the risk of developing Parkinson’s increases with age. Three percent of the population over 65 is affected and this percentage increases dramatically between the ages of 70 and 85.
Symptoms of Parkinson’s Disease appear slowly and in no particular order. Many years may pass before early symptoms progress to the point where they interfere with normal activities.
These symptoms usually begin in the upper extremities (arms), and are usually unilateral (one-sided) or asymmetrical at onset. This means that the hand on one side and the leg on the other side of the body may be affected at the same time. Symptoms may be nonexistent one minute only to suddenly reappear for no clear reason. These variations can be due to the disease or medications.
There are surgical therapies such as pallidotomy, bilateral subthalamic deep brain stimulation and fetal transplantation which can be considered for those who fail medical therapy. Molecular science techniques including gene therapy, neurotrophic factors, stem cell technology are the next frontier of Parkinson’s research.
Individuals with cognitive problems, including dementia, cannot be treated surgically for PD as the surgery can make the cognitive problems worse.
Exercise has a very positive effect on a day-to-day function. Staying active and to keeping their bodies moving can help to slow the effects of the disease. Exercises will not stop disease progression, but they may improve body strength so that the person is less disabled. Exercises also improve balance and can strengthen certain muscles so that people can speak and swallow better. Exercise should continue, with the level of activity adjusted to meet the changing energy levels that may occur. Regular rest periods and avoidance of stress are recommended, because fatigue or stress can make symptoms worse.
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