In short, a person’s brain slowly stops producing a neurotransmitter calleddopamine. With less and less dopamine, a person has less and less ability to regulate their movements, body and emotions. There is currently no cure for Parkinson’s. So, doctors goal is to treat the symptoms to keep quality of life as high as possible.
Parkinson’s disease itself is not fatal. However, complications from the disease are serious; the Center for Disease Control rated complications from PD as the 14th top cause of death in the United States.
Normally, there are brain cells (neurons) in the human brain that produce dopamine. These neurons concentrate in a particular area of the brain, called the ‘substantia nigra’. Dopamine is a chemical that relays messages between the ‘substantia nigra’ and other parts of the brain to control movements of the human body. Dopamine helps humans to have smooth, coordinated muscle movements. When approximately 60 to 80% of the dopamine-producing cells are damaged, and do not produce enough dopamine, the motor symptoms of Parkinson’s disease appear. This process of impairment of brain cells is called neurodegeneration.
The current theory (called Braak’s hypothesis) is that the earliest signs of Parkinson’s are found in the enteric nervous system, the medulla and in particular, the olfactory bulb, which controls your sense of smell. Under this theory, Parkinson’s only progresses to the substantia nigra and cortex over the years. This theory is increasingly borne out by evidence that non-motor symptoms, such as a loss of sense of smell, hyposmia, sleep disorders and constipation may precede the motor features of the disease by several years. For this reason, researchers are increasingly focused on these “non-motor” symptoms to both detect PD as early as possible and to look for ways to stop its progression.
The symptoms in Parkinson’s disease are:
|Bradykinesia (slowness of movement)|
|Rigidity (stiffness of movement)|
|Tremor (involuntary shaking of the hands, feet, arms, legs, jaw, or tongue, usually more prominent at rest)|
|Postural Instability (tendency to fall without explanation, usually when pivoting)|
|Mood (depression, anxiety, irritability)|
|Cognitive changes (attention, visuo-spatial problems, memory problems, personality changes, psychosis/hallucinations)|
|Orthostatic hypotension (lightheaded and low blood pressure upon standing)|
|Constipation and early satiety (a feeling of fullness after eating small amounts)|
|Hyperhidrosis (excessive sweating), especially of hands and feet|
|Seborrhea dermatitis (dry skin) dandruff|
|Urinary urgency, frequency and incontinence|
|Loss of sense of smell (Anosmia)|
|Insomnia, Excessive Daytime Sleepiness (EDS), Rapid Eye Movement Behavioral Disorder (RBD) or active dreaming, dream enactment, involuntary movements and vocalizations during sleep, Restless Legs Syndrome (RLS)/Periodic Leg Movements Disorder (PLMD)|
|Sensory (pain, tightness, tingling, burning)|
|MIXED MOTOR AND NON-MOTOR SYMPTOMS|
|Drooling due to slowed swallowing (Sialorrhea)|
|Speech and swallowing problem|
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