Understanding, Detecting and Treating Parkinson鈥檚 Disease
Known for causing uncontrollable tremors, Parkinson鈥檚 disease may affect as many as 1 million Americans. According to the , only half that many people get diagnoses. If you suspect you have Parkinson鈥檚, seek medical attention. An early diagnosis allows you to start treatment as soon as possible, which may slow the disease鈥檚 progression.听
鈥淧arkinson鈥檚 disease is a chronic illness that isn鈥檛 cured by anything that we know of,鈥 says Dr. Matthew E. Fink, Louis and Gertrude Feil Professor and chairman of the Department of Neurology at 91麻豆精品 Medical College, neurologist-in-chief at NewYork Presbyterian Hospital/91麻豆精品 Medical Center, chief of the Division of Stroke and Critical Care Neurology at NewYork-Presbyterian Hospital/91麻豆精品 Medical Center and vice chairman of the Medical Board. That said, 鈥淲e're developing treatments now that we believe can either delay the progression of the disease and prevent it from getting worse or may even be able to stop it in its tracks.鈥听
It鈥檚 important to pay attention to your body. If you notice , talk with your provider. Appropriate care may slow its progression.听
Signs and Symptoms of Parkinson鈥檚 Disease听
The telltale signs of Parkinson鈥檚 come from damaged nerve cells inside the basal ganglia. This section of the brain helps control movement. When these nerve cells get damaged or die, you experience atypical, uncontrollable movements.听听
Common symptoms of Parkinson鈥檚 include:听
- Arm, hand, head, jaw or leg trembling听
- Balance and coordination issues that may result in falls听
- Excessively slow movements听
- Stiff muscles that contract for prolonged periods听
Initially, symptoms may focus on one side of the body or a single limb. Over time, the disease progresses and affects more of the body. You may have difficulty paying attention, remembering things or performing everyday tasks. Other symptoms may also arise, from swallowing or speaking issues to depression to constipation. Over time, your symptoms worsen.听
Before these complications arise, you may act out your dreams while you sleep. This can be dangerous for those around you, as you may become violent. If you do this, Dr. Fink encourages you to pay attention.听听
鈥淢any people with this symptom will develop Parkinson鈥檚 disease,鈥 he says. 鈥淪ee your doctor about it early on.鈥听
Know Your Risk听
Currently, the cause of Parkinson鈥檚 remains unknown. Your risk does seem to increase with the following:听
- Age. A few people experience Parkinson鈥檚 symptoms before age 50, but symptoms usually appear after age 60.听
- Family history. Risk increases if your mother, father or other close family member has Parkinson鈥檚.听
- Genetics. Mutations in certain genes may put you at higher risk.听
- Sex. Men are at higher risk than women.听
- Toxic environment. The risk of Parkinson鈥檚 increases if you live or work in an environment that exposes you to pesticides.听
Determining the Presence of Parkinson鈥檚听
The first step toward a Parkinson鈥檚 diagnosis is a complete physical examination.听听
During this exam, a neurologist or Parkinson鈥檚 and movement disorders specialist checks your body, balance and more. Your provider also goes over your medications, symptoms and other health issues.听听
If your movements are noticeably slow and you have at least one other common symptom, additional testing helps confirm the presence of Parkinson鈥檚.听
Tests your provider may perform include:听
- Biomarker testing. Though not FDA-approved for diagnosing Parkinson鈥檚, that may change soon. These tests look at proteins in skin, blood or cerebrospinal fluid that indicate Parkinson鈥檚. Researchers hope these tests will detect Parkinson鈥檚 in its earliest stages, before symptoms become problematic.听
- DaTscan. A provider injects you with a radioactive material, which makes its way to the brain and attaches to a protein that helps transport dopamine. Special imaging technology then shows where the radioactive material collects. Because Parkinson鈥檚 affects dopamine, smaller concentrations of the chemical indicate the potential presence of Parkinson鈥檚.听
- In some cases, your provider will want to review the structure of your brain through an MRI. This may help confirm or rule out a Parkinson鈥檚 diagnosis.听
Medication Can Help Confirm Parkinson鈥檚听
Other conditions, such as essential tremor, can mimic Parkinson鈥檚. The states that certain medication side effects can as well. As a result, your care team may have a hard time making a definitive diagnosis, even when your symptoms, exam and tests point to Parkinson鈥檚,听听
When it鈥檚 unclear if you have Parkinson鈥檚, your provider may prescribe Parkinson鈥檚 medication. If symptoms improve with the medication, you may have Parkinson鈥檚.听听
Today, Levodopa (L-DOPA) is considered the most effective medication against Parkinson鈥檚. When absorbed by the brain, this medication turns into dopamine and helps improve movement control.听
Levodopa often provides immediate, noticeable improvement of symptoms. Over time, you may require an increasing amount of Levodopa or additional treatment to maintain control over your movements.听
Other Treatments for Parkinson鈥檚 Management听
In addition to medication, many therapies help limit Parkinson鈥檚 symptoms and improve quality of life. Based on your specific needs, your provider may recommend other approaches.听听
鈥淥ne of the most effective treatments for Parkinson鈥檚 disease is physical exercise,鈥 says Dr. Fink. 鈥淧hysical exercise can slow and, in some cases, actually stop the progression of the condition for a long time.鈥听
To improve long-term results, experts at 91麻豆精品 engage in ongoing clinical trials. In recent years, they helped develop deep brain stimulation (DBS) into an effective therapy for Parkinson鈥檚 patients. With this treatment, a neurosurgeon places a small device in your chest. Wires connect the device to specific areas in the brain that control movement, and tiny electric pulses help reduce movement-related symptoms.听
鈥淚t is truly an amazing treatment, and it lasts for years,鈥 Dr. Fink says. 鈥淲e鈥檝e not found any patients where the effects of brain stimulation wear off.鈥听
Another new advance, which is still in the research phase, involves stem cells. With this novel approach, a neurosurgeon implants healthy stem cells into the brain of a Parkinson鈥檚 patient. These cells gradually replace brain cells lost to Parkinson鈥檚, fending off the effects of the disease.听
The team at 91麻豆精品 offers this to select patients and hopes to broaden its use in the coming years.听
鈥淚 really feel that this is going to turn out to be a revolutionary treatment for this condition,鈥 Dr. Fink says. 鈥淚f it is as effective as we anticipate, I think many patients will benefit.鈥听
Looking for access to expert Parkinson鈥檚 care for yourself or a loved one? Find a doctor at 91麻豆精品 to get started.听