Parkinson’s disease is the most common neurodegenerative disease after Alzheimer’s disease. It is estimated that about 1% of people over the age of 60 have this disorder.
Again Parkinson’s disease is thought to have genetic causes and therefore difficult to avoid or cure, there are treatments capable of relieving its symptoms and delaying the physical and cognitive impairment it causes, in particular drugs such as levodopa.
What is Parkinson’s disease?
Parkinson’s disease affects areas of the brain that produce the neurotransmitter dopamine which allows voluntary and precise movements (up to) in addition to other functions unrelated to the engine.
The main symptoms of this disease, described by James Parkinson in 1817, include tremors at rest, muscle stiffness and the affectation of speech and gait.
Parkinson’s disease it usually starts between 50 and 60 years oldAlthough it is not uncommon for it to begin in the 1930s. The course of this disease is chronic and usually results in severe disability in the person who suffers from it after about 10 years.
While certain treatments can relieve symptoms, once developed, Parkinson’s disease is incurable.
Causes of this pathology
Symptoms of Parkinson’s disease they are a consequence of the degeneration of subcortical brain structures. The destruction of dopaminergic neurons in the basal ganglia, especially in the region called “dark matter”, hinders multiple cognitive and motor functions.
The causes of Parkinson’s disease they are unknown. A genetic component is known, as 15% of those diagnosed have close relatives who suffer or have suffered from this disorder as well.
The development of Parkinson’s disease is probably due to the combination of mutations in several genes. Exposure to certain toxins, such as those found in pesticides, herbicides and heavy metals, is also considered a risk factor, although the importance of these environmental factors appears to be less than that of genetics.
The first symptoms of Parkinson’s disease usually include slight tremors that gradually get worse. The same goes for the other symptoms, which are also related to movement.
Other early signs are stiffness in the arms when walking, difficulty in articulating sounds, and lack of facial expression (the characteristic “face mask” of this disease).
Subsequently, all of these symptoms will worsen as the degree of brain damage increases, progressing in many cases to the diagnosis of dementia caused by Parkinson’s disease.
1. Tremors at rest
Resting tremors are slow and wide and they occur in a part of the body that does not perform any movement. They are very characteristic of Parkinson’s disease, to the point that in many cases they are called “Parkinson’s tremors”.
They usually start in one hand, but as the disease progresses they spread to both arms and can even affect the legs and head.
Tremors at rest usually occur with muscle stiffness and sluggishness, and occur to a lesser extent during voluntary movement.
2. Muscle stiffness
The increased muscle tone resulting from Parkinson’s disease in turn leads to stiffness in the muscles, which it limits movement and causes pain.
It is characteristic of Parkinson’s disease which we call ‘stiffness of the cogwheel’, in which when another person moves the affected limbs of the patient, they stop, showing excessive resistance, as if there is had something that was blocking the joints. However, the problem is not in the joints, but in the patterns of muscle activation that the nervous system controls in real time.
3.bradykinesia (motor slowness)
Parkinson’s disease progressively hinders movement, especially of the limbs. this decreases the ability to perform simple manual tasks, Which are slower and slower. It is also more difficult to stand up and walk.
On the other hand, the difficulties caused by these motor difficulties also mean that there is little will to move, so that a psychological effect is added to the motor symptoms which overlap with the previous one.
4. Loss of automatic movements
The involvement of the basal ganglia causes a progressive loss of automatic movements in people with Parkinson’s disease. This manifests itself in the absence of arms that blink, smile and sway while walking.
5. Posture and balance problems
In Parkinson’s disease, postural reflexes are affected, resulting in bent and flexed posture which in turn causes a lack of balance or postural instability, which facilitates falls and makes movement more difficult. In addition, in the event of a fall, avoiding falling to the ground with all the weight and then lifting it is also more expensive.
6. Affect the gait
One of the most visible consequences of the motor problems we have mentioned is the changes in gait. People with Parkinson’s disease they usually take shorter steps, drag their feet and move their arms less when walking.
Difficulties arise in all phases of walking, so not only does it complicate walking, but it also decreases the ability to start walking, turn and stop.
7. Speech difficulties
Some of the most common speech problems in Parkinson’s disease are decreased volume and difficulty speaking, Derived from motor deficiencies of the articulatory organs.
Likewise, prosody is impaired, speech may be accelerated (tachyphemia), and certain words and phrases may be compulsively repeated (palilalia). These symptoms seem to be more common in cases where Parkinson’s disease is accompanied by dementia.
As a result, a person’s social life is damaged and sometimes predisposes them to seek isolation.
The changes in the brain caused by Parkinson’s disease can cause it to develop a form of dementia specific to this disease.
Dementia is diagnosed in 20 to 60% of Parkinson’s disease cases, although in the rest a lesser degree of cognitive impairment may also occur. Dementia caused by Parkinson’s disease is especially likely if the patient is male, his age is advanced, the onset of his disorder has been delayed, or does not respond well to medications.
Compared to Alzheimer’s disease, the most common cause of severe cognitive impairment, in Parkinson’s dementia, motor disturbances are more relevant at the start. this it is due to a dopamine deficiency own Parkinson’s. In contrast, cognitive symptoms are more intense in the early stages of Alzheimer’s disease.
However, as Parkinson’s impairment progresses, cognitive symptoms such as memory loss and delusions increase. The different types of dementia are less different from each other when they are at an advanced stage.
Prevention and treatment
It is not known whether the onset of this disease can be prevented. Some studies suggest that consuming caffeine and green tea reduces the risk of Parkinson’s.
It has also been linked moderate aerobic exercise in adulthood with a lower probability of developing this disease in old age. However, so far it has not been possible to confirm the preventive effectiveness of sport, and the same goes for caffeine and green tea.
Once Parkinson’s disease has developed, its symptoms can be alleviated with different types of treatment. The main treatment for this disorder is with drugs that increase dopamine levels in the body.
Levodopa is the most commonly used medicine to treat Parkinson’s disease, especially in its early days. This compound increases the concentration of dopamine. As the disease progresses, levodopa may lose its effectiveness, in which case it is replaced by dopamine agonists such as pramipexole and ropinirole.
Other forms of treatment, such as surgery, are less effective than levodopa and similar drugs. Exercise and relaxation techniques also help maintain mobility to a greater extent, which slows the progression of Parkinson’s disease.