John Winston Clark
Stability With Knowledge

Understanding Parkinson's

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UNderstanding Parkinson's

There is a lot to know about Parkinson's disease. Learn about symptoms, how it is diagnosed, and what treatment options are available. Causes and statistics of Parkinson’s Disease (PD) is an extremely diverse disorder. While no two people experience Parkinson’s the same way, there are some commonalities. Parkinson’s affects about one million people in the United States and ten million worldwide. The main finding in brains of people with PD is loss of dopaminergic neurons in the area of the brain known as the substantia nigra.

PD symptoms may be related to movement (motor symptoms) or unrelated to movement (non-motor symptoms). Each person with Parkinson's will experience symptoms differently. For example, many people experience tremor as their primary symptom, while others may not have tremors, but may instead have problems with balance. By definition, Parkinson’s is a progressive disease. Although some people with Parkinson’s only have symptoms on one side of the body for many years, eventually symptoms will also affect the other side. Symptoms on the other side of the body often do not become as severe as symptoms on the initial side.

There is no “one way” to diagnose PD. However, there are various symptoms and diagnostic tests used in combination. Making an accurate diagnosis of Parkinson’s — particularly in its early stages — is difficult, but a skilled practitioner can come to a reasoned conclusion that it is PD. It is important to remember that two of the four main symptoms must be present over a period of time for a neurologist to consider a PD diagnosis.

There is no standard treatment for PD. Treatment for each person with Parkinson's is based on his or her symptoms. Treatments include medication and surgical therapy. Other treatments include lifestyle modifications, like getting more rest and exercise. There are many medications available to treat the Parkinson’s symptoms, although none yet that reverse the effects of the disease. It is common for people with PD to take a variety of these medications — all at different doses and at different times of day — to manage symptoms. While keeping track of medications can be a challenging task, understanding your medications and sticking to a schedule will provide the greatest benefit from the drugs and avoid unpleasant “off” periods due to missed doses.

 

What is Parkinson's Disease?

Parkinson's Disease belongs to a group of conditions called motor system disorders, which are the result of the loss of intropin-producing brain cells.

 

The four primary symptoms

1. Tremor or trembling in hands, arms, legs, jaw, and face
2. Rigidity or stiffness of the limbs and trunk
3. Bradykinesia or slowness of movement
4. Postural instability or impaired balance and coordination

 

the four stages

stage one

During this initial stage, the person has mild symptoms that generally do not interfere with daily activities. Tremor and other movement symptoms occur on one side of the body only. Changes in posture, walking and facial expressions occur.

Stage Two

Symptoms start getting worse. Tremor, rigidity and other movement symptoms affect both sides of the body. Walking problems and poor posture may be apparent. The person is still able to live alone, but daily tasks are more difficult and lengthy.

Stage Three

Considered mid-stage, loss of balance and slowness of movements are hallmarks. Falls are more common. The person is still fully independent, but symptoms significantly impair activities such as dressing and eating.

Stage Four

At this point, symptoms are severe and limiting. It’s possible to stand without assistance, but movement may require a walker. The person needs help with activities of daily living and is unable to live alone.

Stage Five

This is the most advanced and debilitating stage. Stiffness in the legs may make it impossible to stand or walk. The person requires a wheelchair or is bedridden. Around-the-clock nursing care is required for all activities. The person may experience hallucinations and delusions. The Parkinson’s community acknowledges that there are many important non-motor symptoms as well as motor symptoms.

 

TESTing FOR THE DISEASE

No specific test exists to diagnose Parkinson's Disease. Your doctor trained in nervous system conditions (neurologist) will diagnose Parkinson's Disease based on your medical history, a review of your signs and symptoms, and a neurological and physical examination. Learn More >

 
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THE START

Parkinson's disease is a neurological disorder that is named after "the English physician who first described it fully in 1817". The disease causes disturbances in the motor functions resulting in patients having trouble moving. Other characteristics that are not always present in every patient are tremors and stiffening of limbs. All of these characteristics, of the disease are caused by "degeneration of a group of nerve cells deep within the center of the brain in an area called the substantia nigra". Dopamine is the neurotransmitter for these cells to signal other nerve cells. However as the cluster of nerve cells fail to operate, the dopamine can not reach the areas of the brain that affects one's motor functions. On average Parkinson's patients have "less than half as much dopamine in their systems as healthy people do". The problem and controversy that arises from this disease is in the cure. Researchers, for years, have been attempting to unravel the mystery of what causes Parkinson's disease and how it can be treated and or cured. While many medications have been developed the most controversial treatment is the use of stem cells, which has raised debate not only in the scientific realm, but in political and religious circles as well.

THE PILL

In the past twenty years, many drugs have been developed to treat the disease. Although the cause of Parkinson's disease is still unknown, scientists have been developing methods of treatment and therapy. The idea is to replace dopamine in the brain, which is accomplished, to some extent, with the administration of L-Dopa. In conjunction with other drugs, L- Dopa "inhibits the enzymes that break down L-dopa in the liver, thus making a greater part of it available to the brain". This treatment is very successful, but it only hinders the disease for a time and it is by no means a cure. That leaves us with stem-cells and the role they play in treatment of Parkinson's disease. 

STEM CELLS

There are many different types of stem-cells which can be implanted in patients to regenerate or replace the damaged or abnormal cells caused by not only diseases like Parkinson's but also Alzheimer's and spinal cord injuries. A specific example in relation to Parkinson's is the harvesting of embryonic stem cells. These human embryonic stem cells can be transplanted into the brain to replace and create dopamine neurons. The controversy is in how one can obtain these stem cells. During fertilization, in humans, the embryo is hollow and contains cells that eventually develop into a fetus. Researchers have discovered, as recently as 1998, that the cells in the embryo contain all the tissues types, therefore becoming any cell in the body. Thus the stem cells can be transplanted into patients with diseases dealing with cell abnormality. 

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THE POLITICS

Many religious groups argue that stem cell research should be discontinued by the federal government, because the killing of the embryos is just as heinous as abortion. Stem-cells are extracted from a few different sources, either from surplus embryos created for infertile couples, umbilical cords, and from elective abortions. For pro-lifers the embryos used to extract the stem cells are equal to human lives being destroyed. The other side of the argument is that embryonic cells are not living- they do not have a soul. Much of this debate is rooted and overlaps with the debate over whether abortion, of any form should be lawful. Scientists have also argued that many of the embryos used would have been destroyed at some point anyway, so why not use them for furthering the good of the human race. Consequently, political debate over whether federal funds should be used to support the further research of stem cell transplantation continues to this day. An example of the relevance and immediacy of this issue is the speech President Bush gave in the summer of 2001, in which he approved funding from the government on research of 64 human embryonic cells. 

THE EARLY STAGE

These arguments are all valid and much debated however there are other reasons, less explored that account for the reason some feel stem cell research should not be pursued. Much of the time when stem cells are inserted into the brain "they grow into every cell type and form tumor-like masses called teratomas, eventually killing there hosts". The problem is not that stem cells fail to become dopamine neurons; the failure is in controlling the growth of these cells. While there has been research completed with successful control of the stem cell growth, the percentage is small and inconsistent. Therefore, at this stage it is still too early to attempt these transplantations of stem cells on human patients. However these studies represent a ray of light and hope for Parkinson's patients who could benefit greatly by the transplantation of stem cells into their brain and the resulting production of dopamine neurons. 

THE RESEARCH

There are no easy answers when it comes to a cure or a treatment for Parkinson's patients. The most promising cure is in stem-cells. Not only does the research and implantation of these cells into a treatment raise debate with religious groups, but it extends into the political realm as well. These debates all hold merit, but the bigger more important issue that is rarely talked about is that of whether stem cells can actually be effective in humans. Can researchers learn to harness the growth of these cells and if they can what does that mean for the future of these type of stem cell therapies? What moral and ethical implications does this process pose? While these questions are unanswerable at this point the only way to prove one way or another, whether these cells will be effective is to be able to research them, so that maybe one day Parkinson's disease can be an aliment of the past.