Parkinson's Disease: A Comprehensive Overview
Parkinson's disease (PD) is a neurodegenerative disorder of the central nervous system that primarily affects the motor system.
It is one of the most common neurodegenerative diseases of adulthood and a major cause of neurologic morbidity and mortality worldwide.
Epidemiology
The prevalence of PD has doubled in the past 25 years.
Global estimates in 2019 showed over 8.5 million individuals with PD.
The disease majorly affects elderly persons and the frequency of affecting men is more as compared to women.
The median age of onset is 60 years, with a slight male preponderance.
Symptoms
PD causes motor symptoms including slow movement, tremor, involuntary movement, rigidity, trouble walking, and imbalance.
Non-motor symptoms include cognitive impairment, mental health disorders, dementia, sleep disorders, pain, and sensory disturbances.
Many people with PD also develop dementia during the course of their disease.
Pathophysiology
The mechanism of PD that causes tremors, rigidity, and bradykinesia is a decrease in striatal dopamine. Microglia and astrocytes can cause neuroinflammation, which can speed the course of pathogenic damage to substantia nigra (SN).
Genetics
Genes prominently CYP1A2 (Cytochrome P450 A2), GRIN2A, and SNCA are Parkinson’s disease (PD) hazard factor modifiers.
Most common genes which when affected by mutation lead to development and progression of Parkinson’s disease (PD) are LRRK2, SNCA (alpha-synuclein protein), DJ-1, PRKN (Parkin protein), PINK1, GBA1, and VPS35.
The MIND Diet
The MIND diet combines elements from the Mediterranean diet and the Dietary Approaches to Stop Hypertension (DASH) diet.
The Mediterranean diet, rich in fruits, vegetables, olive oil, fish, and whole grains, is associated with a decreased risk of PD and delayed onset of symptoms. This diet also limits dairy product intake, which is linked to an increased risk of PD.
It is also linked to a lower risk of and delayed onset of Parkinson’s disease.
The Power of Physical Activity
Physical Activity
Perform physical activities and take practical measures to avoid falling.
Regular physical activity has been shown to have several significant benefits for people with Parkinson's disease.
These benefits seem to stem from two specific neurological changes that occur when you work out:
the release of a chemical called dopamine, which positively impacts your movement, mood, and sensation of pain, and growth and change in the cortical striatum, an area of the brain that controls your voluntary movements.
Recommended Exercise Regimen
The Parkinson's Foundation suggests performing 150 minutes of moderate to vigorous exercise weekly. Your fitness regimen should include these four main categories of exercise:
1. Aerobic activity: Perform at least three times weekly for at least 30 minutes per session of continuous or intermittent movement at moderate or vigorous intensity.
2. Strength training: Perform two to three non-consecutive days per week of at least 30 minutes per session for major muscle groups; resistance, speed, or power focus.
3. Balance, agility, and multitasking: Perform two to three days per week with daily integration if possible.
4. Stretching: Perform two to three days per week with daily stretching being most effective.
Tips for Exercising at Home
Invest in a treadmill, elliptical, or exercise bike to conveniently perform aerobic exercise from your home, regardless of the weather.
Obtain a set of light hand weights for a wide variety of strength training exercises.
Follow along with online exercise classes on YouTube that are tailored to people with Parkinson's disease.
Treatment
While there is no cure for PD, therapies and medicines can reduce symptoms. Levodopa/carbidopa, the most effective medicine for improving symptoms, functioning, and quality of life is not accessible, available, or affordable everywhere, particularly in low- and middle-income countries.
Treatment Options
While Parkinson's disease cannot be cured, medications can help control symptoms. In some later cases, surgery may be advised.
Medications for Parkinson's disease include Levodopa, Entacapone, Tolcapone, Opicapone, Nitecapone, Bromocriptine, Pergolide, Pramipexole, Ropinirole, Safinamide, Selegiline, and Rasagiline.
Surgical Procedures
Deep brain stimulation is a surgical procedure to treat motor symptoms such as stiffness, slowed movement, tremor, rigidity, and walking problems.
Carbidopa/Levodopa enteral suspension is a method where the drug is delivered to the small intestine through a tube in the stomach through a keyhole made through surgery.
Thalamotomy involves the destruction of a part of the thalamus to help alleviate movement disorders.
Pallidotomy is the destruction of the globus pallidus, the part of the brain responsible for symptoms of Parkinson’s disease.
Therapy for Parkinson's Disease
Physical therapy can help with balance and mobility problems.
Occupational therapy helps in day-to-day activities such as eating foods, reading, dressing up of patients.
Conclusion
PD is a complex disease with a wide range of symptoms and a significant impact on quality of life.
Ongoing research is crucial to better understand the disease and develop more effective treatments.
