Parkinson’s disease is a progressive brain disorder that primarily affects the ability to control body movement and causes a variety of deterioration of function—named after Dr. James Parkinson, who originally described the disease almost 200 years ago.

Parkinson’s disease is a complicated disease that affects millions of people globally. It primarily affects older persons but can occur at any age, and it is a major cause of disabilities and death.

The increasing number of aging Nigerians has prioritized studies evaluating the epidemiology and causes of Parkinson disease (PD), the prevalence of which is estimated at 10 to 235/100,000 people.

CAUSES

The exact cause is unknown, but when it develops, brain cells that produce dopamine, a chemical that helps control movement, begin to degenerate and die. When the level of dopamine in the brain decreases significantly, it causes erratic brain activity, culminating in impaired ability to control movement and other symptoms.

Environmental Factors in Parkinson’s Disease: These substances include the insecticides rotenone and permethrin (which may be found in clothing or nets treated to kill mosquitoes, for example); organochlorines, such as beta-hexachlorocyclohexane; and the herbicides paraquat and 2,4- dichlorophenoxyacetic acid (2,4-D).

SYMPTOMS

Parkinson’s disease symptoms vary from person to person; early symptoms are mild, often beginning on one side of the body and later involving both sides and progressively worsening over time.

Symptoms of Parkinson’s are of two categories:

• Motor symptoms (those affecting movement) and
• Non-motor symptoms (those affecting other aspects of life).

MOTOR SYMPTOMS

• Facial Masking: Difficulty in making facial expressions or reduced expression, often starts in the early stage of Parkinson’s
• Tremor: Shaking or trembling that typically begins in the hands or fingers. It typically occurs when the person is at rest and can decrease with movement.
• Speech: Speech may become slurred or soft and challenging to initiate, with an altered monotonous voice
• Slow Movements: Movements become slower and more difficult to initiate. Everyday tasks can take significantly longer than usual. More functions like getting up from the chair and walking may become more challenging. Writing can also become very difficult.
• Stiff Muscles: Muscles in any part of the body can become tight and difficult to move, resulting in severe pain.
• Chewing and eating problems: Late-stage Parkinson’s disease affects the muscles in the mouth, making chewing and swallowing difficult. This can lead to choking, drooling of saliva, and poor nutrition.
• Balance issues: Difficulty maintaining balance and normal postures. Poeple with parkinson’s are more prone to fall.
• Loss of automatic movements: There may be decreased ability to maintain involuntary movements, such as blinking.

NON-MOTOR SYMPTOMS

• Memory and thinking Problems: Some people may struggle with memory and thinking clearly.
• Mood Changes: Depression, anxiety, and a lack of motivation are all frequent.
• Sleep Issues: Difficulty falling or staying asleep, a lack of rest, frequent waking up throughout the night, waking up early, or falling asleep during the day are common problems.
• Bladder problems. Parkinson’s disease may cause bladder problems, including being unable to control urine or having difficulty urinating.
• Other body functions may include constipation, difficulty urinating, blood pressure fluctuations, and sexual issues.

RISK FACTORS

The specific cause of Parkinson’s disease is unknown; however, it is believed to be a combination of genetic and environmental factors.

Genetics: Approximately 10-15% of Parkinson’s patients have a family member with the condition. Specific genes may enhance the risk.

Environmental Factors: Exposure to specific substances, such as pesticides, solvents, and air pollutants, may increase the risk.

Age: The risk of having Parkinson’s disease increases with age, particularly after 60.

Gender: Men are more prone than women to develop Parkinson’s disease.

Head Injuries: Severe previous head injuries may increase the risk.

DIAGNOSIS

Diagnosing Parkinson’s may be difficult because there is no specific test for Parkinson’s disease; healthcare professionals typically rely on a combination of medical history, symptoms, and physical exams to make a diagnosis.

• Medical history: The healthcare professional will enquire about the symptoms and any family history of the disease.
• Physical Exam: A healthcare professional will look for Parkinson ‘s-related symptoms such as tremors, slow movement, and stiffness.
• Imaging examinations: While not conclusive, tests such as MRI scans can help rule out alternative possibilities. A single-photon emission computerized tomography (SPECT) scan called a dopamine transporter (DAT) can also help support diagnosis.
• Response to Medication: Healthcare providers may offer Parkinson’s medication to test whether symptoms improve, which can help confirm the diagnosis.

Novel method: Researchers are studying a Parkinson’s test that can detect the disease before symptoms begin.

The test is called an alpha-synuclein seed amplification assay.

PREVENTION

There are no scientifically proven ways to prevent the disease; however, some research has shown that regular aerobic exercise might reduce the risk of Parkinson’s disease. Some studies also found that coffee, tea, and cola may be beneficial.

TREATMENT

While there is no cure for Parkinson’s disease, there are therapies available to help control symptoms and enhance quality of life. These include drugs, surgery, and lifestyle changes.

MEDICATIONS

• Levodopa is the most common and successful treatment. It is available in tablets, inhaled form, and infusion form. It helps to replace the brain’s dopamine levels, reducing motor symptoms. It is frequently used with other drugs to increase its effectiveness.
• Dopamine agonist drugs: These mimic dopamine in the brain and can be taken alone or with other drugs.
• MAO-B Inhibitor drug: These drugs help to conserve dopamine levels in the brain by blocking its breakdown.
• COMT Inhibitor drugs: These medications extend the life of levodopa by preventing its breakdown.

Other medications: Amantadine can aid with symptoms, and anticholinergics can help with tremors—side effects of other drugs.

SURGERY

Surgery is often recommended in advanced Parkinson’s when medical treatment is no longer effective.

• Deep Brain Stimulation (DBS) is a surgical treatment in which electrodes are placed in the brain to control aberrant movements. It can significantly alleviate symptoms for some people.
• Advanced treatments, MRI-guided focused ultrasound (MRgFUS), is a minimally invasive surgical treatment that has been used to manage tremors in Parkinson’s disease.

LIFESTYLE AND SUPPORTIVE THERAPY

• Physical therapy: Regular physical activity helps to enhance movement, balance, and flexibility
• Occupational Therapy: Assists with daily activities and recommends more effortless living.
• Speech therapy: Helps to treat speech and swallowing problems.
• Healthy Eating: A well-balanced diet with enough fiber can improve overall health and relieve constipation.

Living with Parkinson’s disease can be difficult, but with the correct support and therapy, many people can continue to live productive lives. Here are some guidelines for living with Parkinson’s:

Stay Active: Regular exercise can help maintain muscle strength and enhance mood.

Seek Help: Joining support groups or speaking with other Parkinson’s patients can provide emotional and practical assistance.

Communicate: Keep in touch with your healthcare team and inform them of any changes in your symptoms or how you feel.

Stay Informed: Stay updated on the latest information about Parkinson’s disease so that you may make informed decisions about your treatment.