Whether we are newly diagnosed or have been living with Parkinson's disease for years, sometimes it is helpful to have a refresher on the most basic factual information about Parkinson's. This is also a valuable tool to share with family members and friends to help them understand more about the condition as well. Below are some frequently asked questions that provide a high-level overview of Parkinson's disease.
What is Parkinson's disease?
Parkinson's disease (PD) is a neurodegenerative, progressive disorder that affects predominantly dopamine producing neurons in a specific area of the brain called substantia nigra.
How Common is PD?
Nearly one million Americans and 20 million people worldwide live with PD, with approximately 90,000 people in the U.S. diagnosed with PD each year. An estimated 16,000 people are living with PD in the state of Alabama. PD is the second most common neurodegenerative condition after Alzheimer's. The number of people with PD will increase substantially over the next 20 years due to population aging and increased environmental exposures.
What are Common Symptoms of PD?
Symptoms generally develop slowly over many years. The progression is different for each person. That is why you hear a common phrase, "if you have met one person with Parkinson's, you have met one person with Parkinson's." The most common symptoms of PD, include:
Tremor, mainly at rest and described as pill rolling tremor in hands
Slowness of movements (bradykinesia)
Gait and balance problems
In addition to movement-related (often called motor symptoms,) Parkinson's can exhibit "non-motor" symptoms such as apathy, depression, constipation, sleep behavior disorders, loss of smell and cognitive impairment.
Who Gets PD?
As we age, we are all subject to some condition. Most people are diagnosed with PD in their 60s. However, in rare cases, some people before age 50, known as Young Onset PD (YOPD) can be impacted. Men are 1.5 times more likely to get PD than women.
In general, women and men diagnosed with Parkinson's experience differences in presenting symptoms, including sleep problems, cognitive impact, responses to surgery, medication side effects, emotional health, and the care partner experience. When a woman is diagnosed with YOPD, you can add challenges related to contraception, pregnancy, menstruation, menopause, hormones, body image, aging, and more to their plate.
Directly inheriting the disease is rare. Only about 10-15% of all cases of Parkinson's are thought to be genetic forms of the disease. In the other 85-90% of cases, the cause is unknown.
What is Young Onset Parkinson's Disease (YOPD)?
The emotional, social, physical, and psychological needs of people diagnosed with YOPD are different from those diagnosed at an older age. While YOPD is characterized by four common motor symptoms of Parkinson's (rigidity, slowness of movement, tremor, and postural instability), these symptoms often progress more slowly. The most common initial symptoms for YOPD are rigidity and painful cramps, while most common initial symptoms for older-onset Parkinson's are tremor and instability with balance and walking. Another significant difference is that YOPD has a strong genetic component. For example, one gene abnormality, called PARK2 (Parkin gene), is found in up to 15% of younger individuals with Parkinson's.
How is PD Diagnosed?
Currently, there are no definitive blood tests or brain scans that can positively identify Parkinson's with certainty, except during an autopsy. However, new diagnostic skin biopsy testing is now available to help narrow which family of neurodegenerative condition's symptoms may be related to Parkinson's based on the presence of the alpha-synuclein proteins. Also, new technology is being developed utilizing a PET scan that demonstrates active alpha-synuclein proteins present in the living brain.
In some cases, brain MRIs or CAT scans are performed to rule out a stroke or other condition, but neither of these tests reveals Parkinson's. The DaTscan is a diagnostic test that measures levels of dopamine nerve cells in the basal ganglia structures of the brain. The FDA approved it in 2011 to help differentiate a Parkinson's tremor from other types of tremor, namely familial or essential tremor.
Another way to reach a Parkinson's diagnosis is to test your responsiveness to carbidopa/levodopa, a medication that boosts dopamine in the brain and improves motor symptoms. However, your response to this medication alone does not ensure an accurate diagnosis; other conditions can improve with carbidopa/levodopa, and a placebo effect can occur in some people.
After diagnosis, many people with Parkinson's look back and realize they had non-motor symptoms years before their motor symptoms began. Early non-motor symptoms, which are often called pre-motor symptoms can include:
Rapid eye movement sleep behavior disorder (RBD)
Depression or anxiety
Loss of smell
Low blood pressure
How is Parkinson's Treated?
Treatment for each person with Parkinson's is based on the symptoms. Therefore, there isn't one specific regimen that is given to any given Parkinson's patient. Based on the most aggravating symptoms, one or many medications may be prescribed. Surgical therapy may also be an option. Lifestyle modifications, such as nutrition, rest, and exercise also play a key role in managing Parkinson's symptoms and progression.
Currently, there are no medications that reverse the effects of Parkinson's Disease.
Parkinson's Foundation, About Parkinson's Disease. www.parkinson.org/newlydiagnosed. Accessed 11/30/2022.
Davis Phinney Foundation for Parkinson's. Every Victory Counts, Your Go-To Resource of Essential Information and Inspiration for Living Well with Parkinson's. "Manual." Sixth Edition, 2021.