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Parkinson's Disease 

Parkinson’s Disease (PD) is a complex neurodegenerative brain

disorder where there is a depletion of dopamine, a neurotransmitter, in the brain.  Dopamine is produced in an area of the brain called the substantia nigra and it helps to carry messages between neurons in the brain thereby regulating smooth coordinated movements. 

In those with PD, there is a loss of dopamine-producing brain cells being produced in the brain.  Therefore, neurons in the brain are not able to function properly leading to poor control of movements.  It is often when one loses 60-80% of these dopamine-producing cells that PD symptoms are noticed.  The loss of cells is described as neurodegeneration. 

Symptoms of Parkinson's Disease

The most common symptoms of Parkinson’s Disease include:

  • Tremor (shakiness)
  • Rigidity (stiffness)
  • Bradykinesia (slowness of movements)
  • Postural instability (impaired balance and coordination)

Parkinson’s symptoms often progress gradually in most people and signs and symptoms vary among those who suffer from this disease.  As the disease progresses, other symptoms, aside from those listed above, may be seen.  These symptoms may include difficulty swallowing, trouble speaking, urinary incontinence, altered sleep, constipation, depression, and emotional changes.  As the disease advances, cognitive decline may be seen. 

There is no specific laboratory test or scan that can be done to diagnose Parkinson’s Disease.  Along with the medical history of the patient, the neurological exam must have the presence of two of the three cardial signs of PD: tremor at rest, rigidity, and/or bradykinesias.  The final diagnosis is made after ruling out all other potential causes of such symptoms such as certain medications causing symptoms or another disease process. 

There is no cure for PD.  At this time, there have not been any medications or treatments that have conclusively been shown to reverse the disease process.  The initial treatment is medication that replaces dopamine deficit in the brain.  There are other medications that also assist in alleviating the symptoms that one may experience with PD. 

Deep brain stimulation has been a successful surgical treatment option for those that suffer from PD.  DBS acts like a brain pacemaker.  It releases high frequency electrical stimulation to a particular target area of the brain causing reorganization of the imbalanced neurotransmitters circuit thereby reducing the motor symptoms seen in PD.  Again this is not a cure for the disease but a highly successful treatment option that alleviates some of the PD symptoms.