Learn to live with Parkinson’s disease

A patient is ready for a brain scan. (picture: Dieter Schütz/pixelio.de)
A PD diagnosis is based on a detailed neurological examination. (picture: Dieter Schütz/pixelio.de)

Parkinson disease (PD) is one of the most common diseases of the human nervous system. The disease causes tremor, slowness of movements and rigidity. Although there is no cure available to PD patients, scientists are making progress in identifying the best treatment options.

The Parkinson disease (PD) is a neurodegenerative brain disorder. Normally, the brain cells in the human body produce dopamine. Dopamine supports the coordination and the smooth muscle movements. PD symptoms appear, when the body fails to produce enough dopamine.

The classical symptoms of PD are:

  • slowness of movements
  • tremor (shaking)
  • muscle rigidity
  • imbalance

However, there are many other PD symptoms which are not related to movement (non-motor symptoms) such as pain, depression and indigestion.

The prevalence of PD

PD is the second most common neurodegenerative disorder after Alzheimer's disease. The prevalence (proportion in a population at a given time) of PD is about 0.3% of the whole population in industrialized countries. In the US, alone, 50,000-60,000 new cases of PD are diagnosed each year, adding to the one million people who currently have PD.

PD is more common in the elderly and prevalence rises from 1% in those over 60 years of age to 4% of the population over 80. The mean age of onset is around 60 years, although 5–10% of cases, classified as young onset, begin between the ages of 20 and 50. Some studies have proposed that it is more common in men than women, but others failed to detect any differences between the two sexes. The incidence of PD is between 8 and 18 per 100,000 person–years.

How does your doctor make a diagnosis?

Currently, there is no test to confirm whether or not a person has PD. PD is a clinical diagnosis and most of the time, the neurologist may order brain scans and blood tests to rule out any other medical conditions, that may have symptoms similar to PD. So, a neurologist will make the diagnosis based on:

  • A detailed medical history and physical examination
  • A detailed history of your current and past medications, to make sure you are not taking medications that can cause symptoms similar to PD
  • A detailed neurological examination during which a neurologist will ask you to perform tasks to assess the agility of arms and legs, muscle tone, your gait and your balance.
A heap of pills and capsules. (picture: Andrea Damm/pixelio.de)
Some drugs may hem the effect of dopamine loss. (picture: Andrea Damm/pixelio.de)

There is no best treatment

If the medical examination confirms the PD diagnosis, your doctor will have to find the ideal therapy form for you. Currently, there is no cure for PD and, consequently, no “best treatment” that applies to every patient. The aim of a therapy is to alleviate the most bothersome symptoms. This may include medication treatment, lifestyle modifications (exercise) physical or occupational therapy and surgical treatment.

Deep brain stimulation

Deep brain stimulation (DBS) is a successful surgical method in which a battery-operated medical device (called neurostimulator) is implanted in the brain. The neurostimulator will deliver electrical impulses to certain areas in the brain which control movement. These impulses will suppress and/or block the electrical signals that cause PD symptoms.

Physical therapy

There are numerous therapy options to support the PD treatment. Physical therapy, for instance, will maintain and improve the active and passive mobility of joints and muscles. Swimming, hiking or biking generally improves the agility and mobility. Lastly, ergo therapy is a good method to coordinate body movements and to enhance cognition and orientation. Yoga, meditation and a well-balanced nutrition are also methods to improve your quality of life.

No impairment of life expectancy

Today, PD patients can be relieved of the symptoms through a combination of medical treatment and different therapy forms. The development of modern therapy forms has also increased the life expectancy of PD patients, so that PD patients have the same life expectancy as healthy persons with the same age.

Text: Michel Benedetti – 09/2011

Picture: pixelio.de