Parkinson's Disease Causes

The causes of Parkinson's disease come down to genetic and environmental factors that, in turn, produce changes in the brain's chemical makeup, such as

Reduced dopamine levels. Parkinson’s disease can kill nerve cells in the brain that produce dopamine. Dopamine is a neurotransmitter (brain chemical) that carries messages to the part of the brain that controls muscle movement. Low dopamine levels are responsible for the motor symptoms of Parkinson's.

Reduced norepinephrine levels. Another neurotransmitter, norepinephrine, is crucial to the function of the sympathetic nervous system. Low norepinephrine levels foster the nonmotor symptoms of this condition.

Accumulation of Lewy bodies. Many people with Parkinson’s disease develop Lewy bodies, abnormal deposits of alpha-synuclein, a protein, in the brain. This is a major area of focus among researchers.

What Is Parkinson's Disease?

Parkinson's disease, a health condition that affects the brain and nervous system, It's classified as a neurological movement disorder because it affects the brain’s ability to control movement. Signs and symptoms include tremors, muscle rigidity, and difficulties with movement, balance, and coordination.

Parkinson’s disease is progressive, meaning it gets worse over time. There's no cure, but a person with Parkinsons typically can manage it with medication and surgery, often for a significant time. The average life expectancy of a person with Parkinson’s disease is similar to that of a person who does not.

Symptoms

The symptoms of Parkinson’s disease fall into two groups: motor symptoms and nonmotor symptoms. 

Motor Symptoms

Motor symptoms are movement-related problems that occur because the brain cannot send signals to the muscles the way it is supposed to.

These are some of the motor symptoms of Parkinson’s disease:

• Tremors in the hands, feet, or jaw
• Slow movements
• Rigid muscles 
• Limited range of motion
• Unsteady walk 
• Stooped posture
• Difficulty with balance and coordination
• Muscle cramps and spasms
• Reduced facial expressions
• Slurred or softer speech
• Smaller handwriting

Nonmotor Symptoms

Parkinson's affects the sympathetic nervous system, which is responsible for autonomic body functions such as digestion and circulation. Some of the nonmotor symptoms of Parkinson’s disease are:

• Loss of smell
• Constipation 
• Low blood pressure
• Difficulty chewing and swallowing
• Drooling
• Loss of bladder control
• Depression
• Anxiety
• Memory loss
• Hallucinations 
• Delusions
• Lack of interest
• Fatigue
• Dementia
• Weight changes
• Vision changes
• Sleep disturbances
• Restless leg syndrome

Diagnosis

Diagnosing Parkinson’s disease can be tricky because there is no straightforward blood test or screening that can determine whether you have it. Instead, Parkinson’s disease is diagnosed clinically, which means a healthcare provider performs a physical and neurological exam.

Your healthcare provider will also review your medical history, family history of neurological diseases, and potential exposure to toxins and pesticides to determine your risk factors for Parkinson's disease.

Labwork such as blood and urine tests and imaging scans such as MRI, CAT, and DaT scans can help rule out other possibilities.

The current standard for diagnosing Parkinson’s disease is a checklist developed by the International Parkinson and Movement Disorder Society.

Types

Parkinson’s disease falls into two broad categories, based on the age when the symptoms first appear:

Treatment

Treatment for Parkinson’s disease can help slow its progression and reduce its symptoms; however, it cannot cure the disease. Your healthcare provider can evaluate you and suggest a course of treatment, which may include medication and surgery.

Medication

Healthcare providers generally prescribe from this list to treat Parkinson’s disease:

• Levodopa. The brain's nerve cells use levodopa to make dopamine. Another drug, carbidopa, makes levodopa more effective and reduces its side effects. Brand names include Rytary, Sinemet, and Inbrija.
• Dopamine agonists. This group of drugs mimics the effects of dopamine and includes Neupro (rotigotine), Requip (ropinirole), Mirapex (pramipexole), and Apokyn (apomorphine).
• COMT and MAO B inhibitors, These block the function of COMT and MAO B enzymes, which break down dopamine in the brain. COMT inhibitors include Ongentys (opicapone), Comtan (entacapone), and Tasmar (tolcapone). MAO-B inhibitors include Xadago (safinamide), Azilect (rasagiline), Eldepryl (selegiline), and Zelapar (selegiline).
• Anticholinergics. These drugs help with symptoms such as tremors and muscle rigidity. Anticholinergics include Artane (trihexyphenidyl) and Cogentin (benztropine).
• Amantadine: This antiviral medication can help with the symptoms of Parkinson’s disease and the side effects of levodopa. It is sold under the brand names Gocovri, Symmetrel, and Osmolex ER. 

Surgery

Surgery may be an option for some people if medication is no longer helpful. 

Deep brain stimulation is an FDA-approved procedure involving surgically implanted electrodes in the brain and an electrical device in the chest. The device emits painless electrical signals that stimulate the brain and block the irregular brain activity that causes the motor symptoms of Parkinson’s.

Pallidotomy and thalamotomy selectively destroy small parts of the brain responsible for symptoms such as tremors, muscle rigidity, and involuntary movements. 

Coping

These are some strategies that can help you cope with Parkinson’s disease:

• Learn about the condition: Educating yourself about the condition can help you take an active role in your care and prepare yourself for the stages ahead. 
• Expect changes: The symptoms of Parkinson’s disease can make routine activities difficult. Being patient with yourself and accepting your limitations can help prevent anger and frustration.
• Accept support from loved ones: Sharing your feelings with loved ones, asking for what you need, and accepting their support and assistance can help you cope with the condition.
• Stay mentally and physically active: Staying active and engaged can help reduce the rate of physical and cognitive decline.
• Seek support and resources: It can be helpful for you and your loved ones to identify support groups and resources nearby for advice, information, and medical care.
• Prevent falls: You can optimize your living situation to prevent falls, a health hazard associated with Parkinson’s disease.

Summary

Parkinson’s disease is marked by a gradual decline in physical and cognitive abilities; however, medication and surgery can help you enjoy a better quality of life for longer. Being informed and prepared can help you and your loved ones cope with this condition and the changes it brings.