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Parkinson's Disease is a chronic neurodegenerative disorder that affects movement. Some symptoms a patient might experience is tremors, postural instability, and gait problems. Parkinson's causes nerve cells in the brain to weaken, become damaged, and ultimately die off.

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Parkinson's from a Family Member P.O.V. (Ruth)

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Parkinson's from a Family Member P.O.V. (Ruth)

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After visiting my grandpa, I noticed that sadly his parkinson's disease is getting worse, and his tremors and memory are decreasing. His ability to talk and cramped facial expression has gotten more severe and he can barely talk. We only visited him for a few hours because he was so tired, but I hope he gets better.

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As a patient, you typically experience different motor and nonmotor symptoms that last throughout the duration of the illness. During the process of neurological degeneration patient's experience: slowness, tremors, stiffness, pain and loss of smell and taste. A patient taking medications in this process would often experience mood changes, drooling, and sleep problems including insomnia and daytime sleepiness.

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Parkinson’s disease - Symptoms and causes

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There’s no cure for this progressive movement disorder, but treatments can help significantly improve your symptoms.

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What are the primary causes of Parkinson's Disease?

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What are the primary causes of Parkinson's Disease?

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Family history / genetics

Loss of nerve cells (dopamine triggers)

Possible environmental factors

Pesticides and herbicides (Inconclusive)

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Genes often correlated with Parkinson's Disease include SNCA, LRRK2, GBA, PRKN (Parkin), PINK1, DJ-1 (PARK7) and VPS35. Depending on if the person has these certain genes will result in the different forms of Parkinson's. Out of all of these genes, PRKN (Parkin) is most related in autosomal recessive Parkinson's Disease through genetic mutation. Because it is caused by a recessive expression, both copies of the recessive (PRKN) gene mutation need to be included in the genotype its phenotype to be expressed.

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The age at which Parkinson's is most likely to develop is around 60 years old. This is due to the aging process, as we get older it is natural for the body to not be as efficient in cellular repairs, leading to declines in neurological functions. Men are typically at higher risk of developing Parkinson's disease compared to women, due to increased exposure to toxins and head trauma from men. Genetics play a role, someone who has a family history of Parkinson's disease is 2x more likely to develop Parkinson's later in life. Repeated blows to the head can cause cellular damage leading to the potential development of PD.

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How to Slow Expression of Parkinson's Disease At 60+

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How to Slow Expression of Parkinson's Disease At 60+

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Physical activities that build endurance such as...

Strength

Balance

Coordination

Most Encompassed in Aerobics

Stress Management

Chronic Stress Can Impact Brain Function

Caffeine Consumption

Getting Enough Sleep

Balanced Diet

Omega-3 Fatty Acids

Omega-6 Fatty Acids

Hydration

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The structures related to Parkinson's disease are the basal ganglia (interconnected nuclei that control movement) and substantia nigra (midbrain structure that contains dopamine producing neurons). When dopamine production is decreased this affects the motor ability of the person affected.

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Processes that become impaired are motor functions, overall cognitive ability, ability to reach REM sleep, and emotional regulation.

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Processes that cause Parkinson's Disease include:

Genetic and environmental factors

including gene mutations,

exposure to outside factors such as pesticides, or inherited genetic mutations.

Most causes are largely unknown.

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An abnormal walking pattern or trouble balancing. Tendency to be unsteady, prone to falls, or wad

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Gradual difficulty detecting scents (even those that may be strong)

Can be delayed recognition of strong smells

Non-motor symptom

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Bradykinesia is the medical term for slow movement. Decrease in the speed of overall motor ability such as walking, talking, and writing.

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Neurological Exam & History (Diagnosis 1)

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Neurological Exam & History (Diagnosis 1)

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One way Parkinson's can be diagnosed is by a thorough clinical assessment where doctors will observe symptoms, medical history, and a motor examination of the patient.

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Levodopa is a drug administered to patients who are suffering from Parkinson's disease to help treat symptoms. Levodopa works by increasing the brains dopamine levels. When the brains dopamine levels are increased it has a positive impact on movement. PD is characterized by lack of dopamine reception to the brain. Levodopa is able to cross the blood-brain barrier.

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Rhythmic shaking in a limb(s)

Often stops or lessens when the person voluntarily moves affected limb(s)

Often simplified by the depiction oof "pill-rolling" motion

Often start on one side of the body

Can affect the jaw or face

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Medical Imaging; DaTscan & MRI (Diagnosis 2)

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Medical Imaging; DaTscan & MRI (Diagnosis 2)

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Another way Parkinson's can be diagnosed is through a DaTscan, (dopamine transporter scan) which visually shows levels of dopamine presented in the brain. MRI (magnetic resonance imaging) can also be used to differentiate Parkinson's from other disorders with similar symptoms like stroke or brain tumors. Both of these imaging devices cant diagnose parkinson's on it's own, but they can be a way to single out parkinson's.

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Improve muscle control

Allows more normal movements

Symptoms are reduced

Works by acting as anticholinergic

Blocks the neurotransmitter acetylcholine

Help to restore brain balance of acetylcholine and dopamine

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2. Dysphagia - Physical Effect (long-term consequences)

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2. Dysphagia - Physical Effect (long-term consequences)

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In dysphagia, which can be a chronic condition, muscles used in swallowing can weaken, leading to difficulties in chewing and swallowing food. This can also result in loss of ability to speak or speak properly, cause weight loss, dehydration, and an increased risk of pneumonia.

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1. Tremors (Long Term Consequences) Physical

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1. Tremors (Long Term Consequences) Physical

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Tremors are the involuntary rhythmic shaking movements typically of the hands, but can affect other body parts. In Parkinson's disease these can present themselves as resting tremors; which occur when the body is at rest. Postural tremors which happen when holding posture such as standing or sitting; and action tremors which occur during voluntary movements such as writing or talking.

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Obstructive Sleep Apnea (Long-Term Consequences 3)

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Obstructive Sleep Apnea (Long-Term Consequences 3)

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Showcased by:

Loud snoring

Observed Pauses in Breathe (Apnea)

Choking while sleeping

Gasping for air during sleep

A Physical Long-Term Consequence of Parkinson's Disease

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Deep Brain Stimulation (Insurance Treatment)

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Deep Brain Stimulation (Insurance Treatment)

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Deep brain stimulation may be a long term treatment for individuals who suffer from Parkinson's Disease. The expected cost of DBS is between $35,000 to $100,000. The potential that DBS is covered by insurance is high but depends on individual insurance policies. On a scale of 1-5 the likelihood of this treatment being fully covered is about a 3. If someone refuses to take the treatment due to costs it would mean a lower quality of life as the symptoms progress. It would also mean managing symptoms with medication and therapy alone which is still costly and leads to more difficulty in every day life.

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Continuous Infusion Therapies (Insurance Treatment 2)

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Continuous Infusion Therapies (Insurance Treatment 2)

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Continuous Infusion Therapies may be suitable for patients who suffer from Parkinson's Diseases as a form of long term treatment. The average cost for Continuous Infusion Therapies tend to be around $40,000-$50,000 dollars per year. On a scale from 1-5 where 5 is the most likelihood for insurance to cover the long term therapy, Continuous Infusion Therapies are deemed to be a 4.5. FDA approved therapies such as Continuous Infusion Therapies for Parkinson's Disease are usually covered by insurance. If someone were to NOT seek treatment due to the cost they might suffer from the following long-term consequences: increased dyskinesia (uncontrolled movement), cognitive fatigue, depression, anxiety, worse off periods and lower functional lifespan.

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Focused Ultrasound (Insurance Treatment 3)

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Focused Ultrasound (Insurance Treatment 3)

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During focused ultrasound (FUS) medical professionals use ultrasound beams to target tiny areas of cells that can cause motor symptoms by Parkinson's. The beams are harmless on their own, but when further concentrated into multiple rays, they can create enough heat to kill neurons in the brain that contribute to tremor patients Parkinson's symptoms. Different areas can be traversed to erase various symptoms of Parkinson's. The cost of FUS treatment can be anywhere from $20,000-$40,000 depending on insurance coverage of the patient.

Insurance coverage for FUS varies, as some private insurers and Medicare coverage the procedure, especially for tremor-dominant Parkinson's. Unfortunately coverage is not universal and typically depends on a case by case decision by the insurer. Long term consequences that may occur are worsening of untreated symptoms like tremors, muscle stiffness, bradykinesia, and loosing essential abilities such as walking, writing, speaking, which can potentially decrease quality of life.

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Music therapy is a type of treatment composed of listening to music, making the patient sing, or playing various instruments.

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Cognitive Behavioral Therapy (CBT) - Psychosocial Rehab Treatment 2 (Description)

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Cognitive Behavioral Therapy (CBT) - Psychosocial Rehab Treatment 2 (Description)

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CBT highlights a reframing of negative thoughts and unhelpful behaviors that maintain an anxiety

Replaces negative thoughts with healthy, logically sound thinking to improve mental health and lessen or resolve anxiety

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This could help aid symptoms of Parkinson's Disease by using rhythmic and musical activities to improve motor symptoms such as speech irregularities. The type of professional that executes this therapy is a music therapist.

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Cognitive Behavioral Therapy (CBT) - Psychosocial Rehab Treatment 2 (Treated Effect & Professionals)

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Cognitive Behavioral Therapy (CBT) - Psychosocial Rehab Treatment 2 (Treated Effect & Professionals)

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A short term condition treated by CBT is anxiety

A Psychologist or a Psychiatrist is a professional to deal out CBT.

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Dysarthria is resulted in a soft, monotone, or hoarse voice. This is caused by the muscles in the larynx and raspatory system not working correctly.

Speech therapy is used to asses the communicative abilities of the patient, using individualized treatment

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Amplitude Training focuses on larger movements to counteract small movements caused by Parkinson's Disease (resulting from Bradykinesia) by doing motions such as wide swinging of arms while taking large steps

Amplitude training is used to treat Bradykinesia (slow movements) and the lack of total motion caused by Parkinson's by exaggerating motion.

A Physical therapist usually helps carry out amplitude training; however, an occupational therapist can also carry out amplitude training.

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Static and Dynamic Balance (Rehab Treatment 2)

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Static and Dynamic Balance (Rehab Treatment 2)

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Static and dynamic balance training occurs by having patients stand on unstable surfaces such as foam pads or balance boards to challenge stability and improve postural control

Static and Dynamic balance training is used to treat postural instability caused by Parkinson's disease.

A Physical therapist would be the professional designated to carry out static and dynamic balance training for Parkinson's patient dealing with postural instability.

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Regular exercise for someone with Parkinson's Disease may include the gradual incorporation of increased movements. This can include yoga, dance, Pilates, etc. On a scale of 1-10 for difficulty, regular exercise would be a 3. With Parkinson's disease it is typical and beneficial for patients to preform some sort of modified exercise at least 4 times a week. These activities can help reduce the presence of tremors and gait abnormalities. A professional that can lead these activities would be a physical therapist, or instructor.

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Changing a diet encompasses eating things with the nutrients that are positively correlated with more positive quality of life outcomes for patients that suffer from Parkinson's Disease. These foods might include: berries, fish, whole grains, olive oil, and legumes. They are beneficial due to each of their individual micro qualities such as antioxidant, omega-3 fatty acid, and fiber.

A diet change might be difficult if the patient cannot shop for themselves or they do not have the funding to supply such variety of food or supplements.

A dietitian may be the health professional that could help administer a diet change for a patient with Parkinson's Disease.

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Veterans are at a greater risk for PD due to exposure to environmental toxins and prolonged stress due to combat.

Veterans typically delay going to medical professionals which can cause diagnosis of PD to be severely delayed. They are typically also managing other symptoms that are caused by the military whether it be mental or physical.

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Agricultural populations are affected by Parkinson's Disease at a higher level than other populations due to their exposure to pesticides and well water that are often correlated with Parkinson's.

Agricultural population might struggle with prevention due to the large usage of pesticides on farms, as well as trouble with access to clinics due to the urban nature of clinics and the often rural nature of agriculture.

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Physical exercise can reduce the loss of dopamine neurons, increase synaptic communication, and regulate neurotrophic levels to improve symptoms of Parkinson's disease.

It can be hard for individuals to make these changes to their daily lives. This can be true due to a lack of motivation, lack of equipment, or feeling overwhelmed with the pressure of exercising.

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Regular Caffeine consumption has been attributed with blocking receptors (A2A) that are responsible for the regulation of dopamine activity; therefore, increasing the production of dopamine.

A dopamine deficiency is often listed as the main cause of Parkinson's Disease motor functional related issues.

One might struggle to enact the consumption of caffeine due to lifestyle choices as well as the cost of caffeine consumption due to prices of caffeinated beverages produced outside of the household.

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Treatment Technologies for Parkinson's Disease

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Treatment Technologies for Parkinson's Disease

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Deep Brain Stimulation (DBS) is a surgically implanted treatment device that works by sending controlled electrical impulses to specific regions of the brain to reduce motor fluctuations, tremors and rigidity of movement.

Possible Negative Impacts: Bleeding during surgery, motor side effects (dysarthria), and painful sensations

Wearable Tremor-Suppression Devices (Ex: gyroscopic gloves or wristbands) are devices used to counteract tremors caused by Parkinson's disease through the stabilization of hand movement during daily tasks.

Possible Negative Impacts: Physical discomfort of fatigue, reduced fine motor control, increased fall risk (heavier weights on hands)

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Diagnostic Technologies for Parkinson's Disease

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Diagnostic Technologies for Parkinson's Disease

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DaTscan (Dopamine Transporter SPECT) is a nuclear medicine scan that can visualize the activity of dopamine transporters in the striatum. This helps distinguish symptoms of Parkinson's disease from those of other conditions such as essential tremor.

Possible Negative Impacts: Exposure to radiation (ionizing radiation higher than that of an x-ray), allergic reactions, false results, and expensive cost

Advanced MRI Imaging (High-field Magnetic Resonance Imaging) is a type of imaging that utilizes strong radio and magnet waves to create detailed pictures of the brain to look for tiny structures that are commonly affected by Parkinson's (Ex: substantia nigra) to see if they are starting to lose dopamine-producing cells.

Possible Negative Impacts: High cost due to low availability, false results, anxiety or claustrophobia irritation (due to the tight and loud nature of MRI machines)

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Promoting Physical Activity

It enhances neuroprotection reduced oxidative stress

A challenge could be the lack of motivation from a patient

Improving Diet

Limiting unhealthy foods reduces the risk of PD due to red meats

Some individuals do not have access or the luxury to choose clean food options

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National Parkinson's Awareness Month:

The National Parkinson's Awareness Month is a PSA created by the NIH, CDC and the Parkinson's Foundation to inform the public environment about the early symptoms and the risk factors commonly associated with the disease. The main challenge faced with PSA's is the inability for some subgroups of the population to receive information via social media or the internet; therefore, needing a more diverse and complex release of information for most of the public to be informed.

Bans and Restrictions:

Various bans and restrictions have come about due to research linking various chemicals, more specifically: pesticides, to Parkinson's Disease. The goal to limit those with Parkinson's disease through the implementation of legislation and policy to improve public health. Possible challenges may be associated with specific trades such as farming where certain pesticides are still utilized in certain countries where there is still a link to Parkinson's; however, the way of life and need for mass food production in a highly populated world often bends the rules for the majority.