Parkinson’s Disease

• Parkinson’s disease is a progressive neurodegenerative disorder affecting movement.
• It is caused by the degeneration of dopamine-producing neurons in the substantia nigra, a part of the brain that controls movement.

Causes of Parkinson’s Disease

1. Genetic Factors: Mutations in specific genes (e.g., LRRK2, PARK2).
2. Environmental Factors: Exposure to toxins like pesticides and heavy metals.
3. Age: Incidence increases with age.
4. Gender: More common in men than in women.

Symptoms of Parkinson’s Disease

1. Motor Symptoms:

   • Tremor: Shaking, often starting in one hand.
   • Bradykinesia: Slowness of movement.
   • Rigidity: Stiffness in limbs and trunk.
   • Postural Instability: Impaired balance and coordination.

2. Non-Motor Symptoms:

   • Cognitive impairment and dementia.
   • Mood disorders: Depression and anxiety.
   • Sleep disturbances: Insomnia, REM sleep behavior disorder.
   • Autonomic dysfunction: Constipation, orthostatic hypotension, and urinary problems.

Diagnosis

1. Clinical Evaluation: Based on medical history and neurological examination.
2. Imaging Tests: MRI or DaTscan (dopamine transporter scan) to support the diagnosis.
3. Response to Medication: Improvement of symptoms with dopaminergic medications supports the diagnosis.

Pathophysiology of Parkinson’s Disease

1. Dopamine Deficiency: Degeneration of dopaminergic neurons in the substantia nigra of the brain.
2. Lewy Bodies: Abnormal aggregates of the protein alpha-synuclein inside neurons.
3. Basal Ganglia Dysfunction: Impaired regulation of motor activity leading to symptoms like bradykinesia, tremors, and rigidity.

Treatment 

1. Medications:

   • Levodopa: The most effective treatment, often combined with carbidopa.
   • Dopamine Agonists: Mimic dopamine effects (e.g., pramipexole, ropinirole).
   • MAO-B Inhibitors: Prevent breakdown of brain dopamine (e.g., selegiline, rasagiline).
   • COMT Inhibitors: Prolong the effect of levodopa (e.g., entacapone).

2. Surgical Treatment:

   • Deep brain stimulation (DBS) for patients with advanced symptoms not controlled by medication.

3. Physical Therapy:

   • To improve mobility, balance, and flexibility.

4. Occupational Therapy:

   • To assist with daily living activities.

5. Speech Therapy:

   • To address speech and swallowing difficulties.

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