You’ve been hearing about Parkinson’s disease. You’ve probably been reading about it in the news as well, either in conjunction with stem cell research or because of Michael J. Fox.
Parkinson’s isn’t a new condition, however. Far from it, this is a disease with a long history, first identified by James Parkinson in 1817.
Parkinson’s disease had previously been called “shaking palsy.” It is a degenerative disease of the nerves which results in loss of muscle control and the characteristic tremors or shaking.
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In Parkinson’s disease, patients experience a depletion of the neurochemical dopamine in the nervous system. This depletion is thought to result from the degeneration of something called the dopaminergic nigrostriatal system. This system is responsible for the manufacture of dopamine, and result is an imbalance with too little dopamine and too much of another neurochemical, acetylcholine.
Without the right amounts of these neurochemicals in the nervous system, muscle control is impaired. You can remember the symptoms using the acronym
More than 100,000 Canadians are affected, probably including someone you know. These facts from new research will help you understand what they’re going through
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TRAP, made up of tremors, rigidity, akinesia, and postural instability.
Akinesia is hesitation in movement. Another “kinesia” symptom, bradykinesia, is slow movement. They contribute to the shuffling, short steps with the stiff, non-swinging arm movement that is so characteristic in Parkinson’s patients.
Although Parkinson’s disease is the fourth most common nervous system, its cause is not well understood. Genetics may play a role, since the condition does have a family tendency. Head injuries may contribute as well: some estimates say the risk of Parkinson’s is four times greater after head trauma.
Exposure to toxins, potentially including some pesticides, may be a factor since toxins can disrupt the normal functioning of the nervous system.
Parkinson’s disease is also more common among older people, and Caucasians are at higher risk. Men and women seem to be affected equally.
While drugs, most commonly anti-psychotic drugs, can cause Parkinsonlike symptoms, once the drug is stopped, the symptoms do too.
Drug therapy is aimed at correcting the imbalance of neurochemicals in the nervous system. Anticholinergic drugs such as benztropine and procyclidine reduce acetylcholine levels. Amantadine is able to improve symptoms and works best for mild symptoms.
Levodopa in combination with carbidopa is the gold standard of drug therapy. Carbidopa inhibits the breakdown of the levodopa outside of the brain. The levodopa then crosses into the brain where it is converted to dopamine.
Sometimes levodopa is given with another type of drug, a COMT inhibitor, which prolongs the action of the levodopa by slowing its breakdown.
Dopamine agonists stimulate dopamine receptors in the brain, so they act like the dopamine would if there were actually enough dopamine present. Examples include pramipexole and ropinirole. Selegiline is used to inhibit the breakdown of dopamine leaving more of the neurochemical in the nervous system.
As you can see, there are various treatment options for Parkinson’s disease and often two or more drugs are combined for maximum effectiveness.
The most recent research focuses on stem cells. These are the cells that are “parents” to all other cells. The hope is that science will be able to cultivate stem cells so that they become nerve cells, replacing the lost ones in Parkinson’s patients to produce the missing dopamine.
If you or someone you know has Parkinson’s disease, you are not alone. Among many others, Michael J. Fox, Pierre Trudeau, Johnny Cash, Charles M. Schulz and Vincent Price have been affected by the condition.
Regular exercise, physical therapy, and a high-fibre diet along with drug therapy can help maintain regular daily activity.
Marie Berry is a lawyer/pharmacist interested in health care and education
