Parkinson's Disease: Risk Factors, Symptoms, Management, and Emerging Therapies

By Dr. Puneet Agarwal in Neurosciences , Neurology

Apr 30 , 2024 | 2 min read

Newer Therapies in Parkinson's Disease

Parkinson's disease is a neurodegenerative disorder affecting body movement; it occurs when certain nerve cells (neurons) in the brain gradually break down. These neurons produce dopamine, a chemical messenger that helps control limb movement and balance. As dopamine levels decrease, the symptoms of Parkinson's disease begin to emerge.

Risk Factors of Parkinson's Disease

The exact cause of Parkinson's disease is still unknown; however, genetic and environmental factors are believed to play a role. Recurrent head injuries sometimes can make one predisposed to it. While most cases occur sporadically, about 15% of people with Parkinson's have a family member, suggesting a genetic component.

Symptoms of Parkinson's Disease

Early symptoms may precede main symptoms by 5-10 years, which include loss of smell, REM sleep disturbances, depression and constipation.

The primary symptoms of Parkinson's disease are:

Resting involuntary tremors or shaking hands, usually starting in one hand or arm.
Bradykinesia: Slowed movement and difficulty initiating movements at will, such as walking or getting out of a chair.
Rigidity: Stiffness and resistance to movement in the limbs and joints.
Postural instability: Impaired balance and coordination.

Other symptoms are:

Freezing episodes, where a person feels temporarily unable to move.
Reduced arm swing while walking.
Soft or slurred speech.
Micrographia, or small, cramped handwriting.
Facial masking
Cognitive changes
Memory loss

Diagnosis of Parkinson's Disease

Parkinson's is diagnosed by a person's medical history, symptoms, and neurological examinations. There is no single test that can help diagnose. Some investigations required include an MRI brain plane and RODAT scan of the brain when there is doubt.

Parkinson's Disease Management

While there is no cure for Parkinson's disease, treatment aims to manage symptoms, improve the quality of life, and slow down the progression. Medications that are converted into dopamine in the brain can help alleviate motor symptoms. Plenty of newer drugs are available on the market to supplement dopamine or prolong its effects on the brain, therefore helping to control these symptoms.

Deep brain stimulation (DBS) surgery

DBS is recommended in cases where medicines create side effects or do not relieve symptoms. Deep brain stimulation (DBS) surgery works by implanting electrodes in certain areas of the brain and connecting them to a device like a pacemaker, which delivers electrical impulses to modulate abnormal brain activity and reduce symptoms. Now, newer technology in DBS, called directional lead DBS, is more effective and has fewer side effects.

Focused ultrasound can help achieve symptomatic relief by making thermal lesions deep in the brain that interrupt the circuits involved with tremors and dyskinesia. At this time, focused ultrasound is being assessed to treat one side of the brain so that it will affect tremors or dyskinesia unilaterally.

Gene therapies may increase dopamine levels in the striatum by introducing genes that mediate dopamine synthesis. Two gene therapies involving the genes encoding these enzymes are currently undergoing clinical trials for Parkinson's.

Stem cells can offer a renewable source of dopaminergic neuron progenitor cells that can be grafted into patients. Clinical trials of these products are now underway but have not yet been approved by the FDA or DCGI.

With medical interventions, lifestyle modifications like regular exercise and physical therapy and speech therapy can help manage symptoms and improve overall well-being.