What is Parkinson’s disease?

Parkinson’s disease is a neurological condition that progresses slowly and worsens with age. With 90,000 new diagnoses each year, Parkinson’s disease is a common movement disorder that currently affects about one million Americans. While the incidence of Parkinson’s disease increases with age, about four percent of people with Parkinson’s are diagnosed before age 50. Men are one and a half times more likely to be diagnosed.

What causes Parkinson's disease?

There is no clear cause of Parkinson’s disease. However, doctors believe it is likely a blend of genetics and environmental or other unknown factors.

Parkinson’s occurs with the loss of certain brain cells that produce a substance called dopamine. Dopamine is essential for smooth and coordinated muscle movement throughout the body, in addition to other functions. As we age, it’s normal for these cells to die and it usually happens at a very slow rate. However, for some people, the loss happens rapidly. When 50 to 60 percent of the cells are gone, the symptoms of Parkinson’s appear.

What are the most common Parkinson’s disease symptoms?

The cardinal movement-related (motor) symptoms of Parkinson’s include:

  • tremor or trembling of the arms, jaw, legs, or face
  • stiffness or rigidity of the limbs and torso
  • slow movement, also known as bradykinesia
  • impaired balance and gait dysfunction

Non-motor symptoms of Parkinson’s disease include:

  • depression
  • anxiety
  • restlessness
  • sleep difficulty
  • memory problems
  • fatigue
  • soft speech
  • vivid dreams and dream enactment

The symptoms and their severity and progression may vary from person to person. Because different movement disorders can have the same symptoms, careful diagnosis is vital for proper treatment.

What are the early signs of Parkinson's disease?

When it comes to the early signs of Parkinson’s disease, it can be hard to tell what’s normal and what’s not. Some early signs of Parkinson’s can also be very similar to the warning signs of other movement disorders. A single sign isn’t always a concern, but if you have more than one of these common signs, you should talk to your physician about the possibility of Parkinson’s disease.

Parkinson's disease treatment options

Medications

Like other movement disorders, medications are usually the preferred treatment for Parkinson’s disease. During early stages of the condition, there are different oral medications that can be very effective in reducing the bothersome symptoms.

Like any medication, there can be side effects, and all medications vary in effectiveness. That is why it is critical that you see a neurologist who can monitor effectiveness, manage side effects, and determine when a medication is no longer working as it should.

Within about 10 years, many patients begin to develop changes in their symptoms, with more abnormal, involuntary movements, called dyskinesias. Progression of the disease leads to shorter-lasting benefit of medication, and then more frequent dosing is needed.

At this point, alternative treatments can be considered. Your neurologist can refer you to our multidisciplinary team to determine if you are a candidate for one of these treatments. When surgical procedures are determined to be the ideal treatment, our team uses the latest technologies to provide the best, safest option for you.

Deep brain stimulation

One treatment option for Parkinson’s disease is deep brain stimulation (DBS). This procedure offers patients a proven option that reduces the motor symptoms of Parkinson’s disease, as well as other conditions including dystonia and tremor. DBS uses electrodes – or wires – surgically implanted in the brain, and connected to a pacemaker-like battery implanted in the chest.  The battery is programmed in the office to deliver small amounts of electricity to correct abnormal firing in the targeted brain region.

Duopa therapy

Another treatment option for Parkinson’s disease is Duopa therapy. This is a gel infusion of the same medication people take orally, but is delivered directly into the intestine through a surgically inserted tube, which is connected to an external pump that contains medication.

Focused Ultrasound

A neurosurgical technology known as focused ultrasound is another treatment for Parkinson’s disease. This technology uses focused beams of ultrasound energy to target and heat specific circuits of the brain. First, low energy is delivered to disrupt abnormal brain activity while an MRI monitors the temperature of the target location. When the tremor is reduced or eliminated, the temperature is then increased so that the target can be ablated, disrupting the circuit responsible for the tremor.

What is life like with Parkinson's disease?

Life with Parkinson’s disease can be a challenge. However, by taking an active role in treatment, adhering to a medication schedule, and making healthy lifestyle choices, people with Parkinson’s can live their lives to the fullest.

If you have Parkinson’s, speak with your doctor about creating a plan to stay as healthy and active as possible. Some ways to do this may include:

  • Seeing a neurologist who can provide specialized treatment
  • Receiving rehabilitation therapy or speech therapy
  • Starting a regular exercise routine to maintain activity and delay worsening symptoms
  • Using assistive devices to make walking, eating, getting dressed, and writing easier
  • Meeting with a social worker to discuss how Parkinson's will affect your life
  • Making adaptations to the home to make daily life easier and safer
  • Talking with family and friends to get the support you need

Whichever stage of Parkinson’s disease you are in, our team is here to help you. Our program offers a number of treatment options that complement our medical and surgical treatments, including nutrition, social work, nursing, and genetic counseling.

Learn more about our Movement Disorders Program and treatment options for Parkinson’s disease.

Umer Akbar, MD

Umer Akbar, MD

Dr. Umer Akbar is a neurologist and director of the Movement Disorders Program at Rhode Island Hospital, part of the Norman Prince Neurosciences Institute