Parkinson's Disease Diagnosis Treatments Care
Research Diagnosis Treatment Care Mutant Genes Parkinson's Disease
Mar 14, 2009
Parkinson's Disease diagnosis and treatment predominates today. A cure is worked for tomorrow. Millions suffer with Parkinson's Disease (PD). Michael Fox, the actor and Kinsley, the journalist -commentator, are better known PD patients. Millions carry mutant forms of a normal LRRK2 gene that predisposes to a 20-80% greater PD risk. Serg Brin, the co-founder of Google, harbors this mutant gene. This gene, like all genes, can be passed on to children. PD touches immediate families of many, and close friends of many more.
Parkinson's Disease Diagnosis, A Chronic Neurological Brain Disease
Parkinson's Disease is a harmful condition of cells, tissues or organs. PD is a chronic, progressive, neurologic brain disease. About 1.5 million Americans have active disease and 60,000 new cases are diagnosed each year ( National Parkinson's Foundation). Exposure to certain herbicides, pesticides and drugs may initiate and induce Parkinson's in some cases. The mutant gene is another potential factor in PD.
Parkinson's Disease Signs Diagnosis Tests
Parkinson's Disease is not easy to diagnose. Complete and comprehensive neurological exams, including brain scans and lab tests, are used to rule out other disease possibilities. Drug-induced, Parkinson's-like disease (parkinsonism) conditions may occur with:
- Antipsychotics: metaclopramide, reserpine, tetrabenazine
- Selected calcium-channel blockers (cinnarizine and flunarizine)
- Contaminants in illicit street drugs
When these drugs are discontinued, the parkinsonism signs of tremor and postural instability usually disappear.
Parkinson's disease typically has onset at about ages 50-65, but it may appear earlier, or as late as 70 or 80.
There are no blood or simple tests for PD.
The sum of all the disease signs leads to PD diagnosis. Onset and progression of PD are variable, but important signs become more obvious:
- shaking or tremors (hands, arms, legs, jaw, and face)
- stiffness of the arms and legs
- slowness of movement (bradykinesia) with poor balance and coordination
- Small, cramped handwriting, stiff facial expression and a shuffling walk
Parkinson's Disease signs may mimic simple aging, or Altzheimer's disease. Progressively, simple motions, speaking and walking become problematic and make daily life difficult. PD patients may experience episodes of
- Sleep disruption, hallucinations
- Vision difficulty
- GI and urinary tract problems
- Depression
- Speech difficulty and chewing, swallowing issues
- skin problems
Parkinson's Disease Dopamine Chemical Deficiency: Important Effects
Parkinson's Disease defects begin in the nigra region of the brain that produces dopamine. Dopamine and acetylcholine are neurotransmitters, chemicals involved in neuron cells' communication and signaling in the brain. The dopamine deficiency and chemical imbalance leads to the movement and perception problems listed above.
The less dopamine, the more pronounced PD becomes. Dopamine affects electrical discharges in the brain. The loss or decreases of dopamine cause abnormal electrical discharges in at least two areas of the brain that have corresponding "Go" or "No Go" regions that dopamine affects. When dopamine is low, the "No Go" regions are overworking. This leads to PD effects and signs ( Shen et al.).
Parkinson' Disease Treatments and Current Research
Parkison's Disease first therapies involve L-Dopa ( levodopa ), which converts internally to dopamine. Unfortunately, enzymes breakdown L-Dopa. Another drug , Carbidopa, blocks enzyme attack. L-DOPA therapy helps and works for a time, but eventually it becomes ineffective. Other drugs can be used to limit the amount of acetylcholine. This creates a temporary, good balancing ratio with dopamine.The balancing act is difficult and PD relapses are common.
Medication side effects include nausea, vomiting, dry mouth and dizziness. Dyskinesias (abnormal movements) may occur as the dose is increased. In some , levodopa may cause confusion, hallucinations, or psychosis.
Parkinson's Disease Treatment by Brain Ablations or Electrical Stimulation
Neuron ablations and neuron stimulation are used sometimes in PD. The ablations permanently destroy brain tissue. They mitigate, not cure, the disease. Ablations are decreasing, instead electrical stimulation by wires inserted into the brain is favored ( NIH figure below ). This activates nerve cells. It mitigates, not cures, the disease. These procedures have some usefulness, however the beneficial effects are not always realized nor permanent.
Parkinson's Patients Benefit from Exercise and Physical Therapy
NIH Senior Health reports on the benefits of exercise therapy for increase in the release of neurohormones and overall health benefit.
Parkinson's Disease Gene Therapy and Stem Cell Therapy
The normal LRRK2 gene produces dardarin, a kinase enzyme that controls brain energy transfers . Gene mutations can alter this. Mutant gene correction by gene therapy is still distant. Viral delivery of normal genes to target cells is a possibility.
Stem cell remediation will be a major research focus . Stem cells would be surgically implanted in precise areas of the brain in an attempt to restore normal and new functional dopamine-producing cells.
Researchers press forward. All wish them well.
This article honors and acknowledges patients, assisting family and professionals, who fight the battles of PD such as: Bob Harned D.D.S., an outstanding retired professsional, and Frank Blackwelder, honored senior chemist from Coca Cola, who both recently. Blackwelder died in 2008, after 28 years of slow, progressive Parkinson's Disease.
Resources and References
American Parkinson's Disease Association. at apdaparkinson.org
Centers for Disease Control. 2009. Street-Drug Contaminant causing Parkinsonism http://www.cdc.gov/mmwr/preview/mmwrhtml/00000360.htm
Kumar, P. and M. Clark. 1995. Clinical Medicine. Third Ed. BalliereTindalle, London. 1135 pp
Nationa Institutes of Health at nih.gov
National Parkinson Foundation. at parkinson.org
National Institutes of Health Senior Health. at nih.seniorhealth.gov
Shen W, Flajolet M, Greengard P and Surmeier DJ. August 28, 2008. Dichotomous Control of Striatal Synaptic Plasticity. Science, Vol. 321: 848-851.
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