© The Indian Express Pvt Ltd
Tags:
Journalism of Courage
Parkinson’s disease is a neuro-degenerative disorder that affects millions of people around the world. While the disease is mostly diagnosed in individuals over the age of 60 years, it can also affect younger adults, with approximately four per cent of the cases occurring in individuals under the age of 50. World Parkinson’s Day is observed every year on April 11 and to raise awareness about the nervous system disorder, Dr Amit Shankar Singh, Associate Consultant, Neurology, Fortis Hospital, Mohali, and Dr Ishu Goyal, Associate Consultant, Neurology, Sir HN Reliance Foundation Hospital, Mumbai answer some commonly asked questions.
What causes Parkinson’s Disease (PD)?
Parkinson’s is caused due to the degeneration of nerve cells in the brain, thereby causing a dopamine deficit. Dopamine is responsible for causing several body functions such as movement, memory, reward and motivation. “The loss of dopaminergic neurons in the brain leads to the deficiency of dopamine in the basal ganglia. This deficiency causes a range of motor symptoms, including tremors, rigidity, and bradykinesia (slowness of movement), as well as non-motor symptoms such as cognitive impairment, depression, and autonomic dysfunction,” says Dr Singh.
“It may be familial, when it runs in families. Such patients generally have a younger age at onset and a more severe manifestation of the disease. Majority of cases are sporadic, which means doctors cannot predict if a person will develop Parkinson’s Disease in the future or not. Poor lifestyle factors like lack of physical activity, poor dietary habits, exposure to toxins and certain drugs may hasten the development of disease and its worsening,” says Dr Goyal.
Parkinson’s Disease progresses slowly over the years. “The rate of progression however varies from patient to patient. It may sometimes worsen very slowly, leaving the patient independent for a majority of his lifetime, whereas in other cases, it debilitates the patients within a few years of onset. In such patients, a high dose of medication may be required, which in turn produces unavoidable side effects. In such cases, surgical modalities can be looked into in selected patients,” adds Dr Goyal.
What are symptoms?
The warning signs of Parkinson’s disease that are easily identifiable are:
· Tremors or shaking in the hands, arms, legs, or face.
· Stiffness or rigidity in the arms, legs, or trunk.
· Slowness of movement.
· Impaired balance and coordination.
· Changes in speech and writing.
· Depression or anxiety.
· Sleep disturbances.
· Memory and cognitive problems.
Are all involuntary hand movements a sign of Parkinson’s Disease?
“In neurology practice, we commonly come across patients presenting themselves with tremulousness of hands. But every time, a hand tremor cannot be attributable to Parkinson’s Disease. It is a combination of rigidity, tremors, bradykinesia and postural imbalance. Tremors or rigidity are predominant but only tremors are seldom a symptom. There are various other causes of tremors like essential tremors, physiological tremors, drug induced and other degenerative diseases like spino-cerebellar ataxias, to name a few. Tremors due to Parkinson’s Disease typically affect one hand first and spread to the others. Tremors while holding cups and pouring tea may not be because of Parkinson’s Disease,” says Dr Goyal.
How to diagnose Parkinson’s?
Though there is no specific test to diagnose Parkinson’s Disease, neurologists look at specific symptoms associated with the disease. Early diagnosis and treatment can help manage symptoms and improve the quality of life for individuals living with it.
What are treatment options?
Discussing the treatment options, Dr Singh says, “Several treatment options are available for Parkinson’s Disease, including medication, physical therapy and deep brain stimulation. Treatment is focussed on managing symptoms and improving the quality of life. The mainstay of treatment is pharmacotherapy, with medications aimed at increasing dopamine levels in the brain. Levodopa, a precursor of dopamine, is the most effective medication for the treatment of Parkinson’s Disease. Other medications, such as dopamine agonists, Monoamine Oxidase Inhibitors (MAOIs), and anticholinergics, may also be used. In addition to pharmacotherapy, non-pharmacological interventions, such as physical therapy and Deep Brain Stimulation (DBS), may be used to improve motor symptoms.” He also calls for “raising awareness so that we can help ensure that individuals living with this disease receive the care and support they need. “
How to prevent onset of Parkinson’s Disease?
Studies suggest that certain toxic chemicals in the form of free radicals accumulate in the brain with ageing and exposure to environmental toxins. “This ‘oxidative stress’ may lead to neuronal death. Regular aerobic exercises, reducing exposure to toxins like pesticides, exposure to tobacco, managing stress, getting enough sleep and healthy eating habits may help in preventing this free radical injury. Regular exercises not only help in muscle strengthening, maintaining balance, endurance and coordination, but also ensure adequate blood and oxygen delivery to the brain, alleviating any form of oxidative damage. Following a healthy diet pattern is an equally important aspect of Parkinson’s Disease prevention. The Mediterranean diet has always been recognised as a model of balanced diet, constituting adequate antioxidants in the form of fruits and berries, along with healthy fats like Omega-3 and Omega-6 fatty acids. These fatty acids seem to provide neuroprotection, thus slowing the disease process,” explains Dr Goyal.
