Parkinson’s is a disease of the brain that affects fine motor skills and balance. This progressive disorder happens when there is a loss of dopamine neurons in the brain. The decrease in dopamine causes abnormal brain activity.
Parkinson disease symptoms vary
Often, symptoms develop on one side of your body. They can be mild and often initially overlooked.
“When patients come in we look for the four cardinal motor features – asymmetric resting tremors, bradykinesia, postural instability and rigidity,” said Dr. Katie Spangler, neurologist with Marshfield Clinic Health System.
- Asymmetric resting tremors are tremors or shaking, often with your hands, that occurs on one side of the body while you are at rest.
- Bradykinesia is slowed movement that causes trouble with simple daily tasks like buttoning shirts, tying shoes and cutting food.
- Rigidity is muscle stiffness that can limit your range of movement.
- Postural instability involves balance issues that cause near falls or falling while turning, bending over or reaching above your head.
Environmental and genetic causes
Why dopamine cells stop working is unknown. The younger that you start showing symptoms, typically there is a stronger genetic link. If you have a first-degree relative, you have a higher risk of developing Parkinson’s at a younger age. Most cases are people who are older than 55 years old.
“We have found evidence with certain herbicide and pesticides where prolonged exposure may slightly increase risk for some people,” Spangler said. “Through research, we’ve seen a link between Agent Orange and Vietnam veterans as well.”
Spangler recommends to see your doctor if you have any symptoms from the four cardinal motor features. Other signs include shuffling or dragging your feet or difficulties with fine motor skills. Some people may have loss of their sense of smell or may act out their dreams at night many years before the onset of the motor symptoms. Your doctor looks at your medical history, presence of symptoms and does a neurological and physical examination. Diagnosis is still based clinically, meaning there is no specific or sensitive test to diagnose Parkinson Disease. Tests MAY be done, but these are done typically to rule other things out that could be causing the symptoms.
Living with progression
As you live with Parkinson disease, symptoms increase. Daily living activities can be difficult and you are at a greater risk for falls. People who have been living with Parkinson’s for longer periods, from 10-20 years, may notice more memory difficulties as well.
“We are starting to realize that there are different subsets based on what you are experiencing,” said Spangler. People with tremors have a slower progression and have less memory and balance issues. People with balance issues may have a more aggressive path and have more complications with medications as well as non-motor symptoms, such as memory or drops in blood pressure.
Treatments and lifestyle ease symptoms
While there is no medication that cures or slows the progression of Parkinson’s disease, there are options to ease symptoms. Medications work with dopamine in the brain to increase or substitute dopamine. They also help manage problems with walking, movement and tremors. Deep brain stimulation also can reduce symptoms for people with advanced Parkinson’s or aren’t responding well to medications. Surgeons implant electrodes into your brain to send pulses to reduce involuntary movements, tremors and improve slowed movement.
“We can also give Botox to help with excess saliva and abnormal postures,” said Spangler. “Physical, occupational and speech therapy also are very helpful to allow people to increase function and overall do better with their disease.”
Exercise is also a good option to help improve quality of life. Exercises that have been studied and show the biggest impact range from high-intensity biking, yoga and tai chi. These exercises help retrain the brain for balance and cadence.
Spangler encourages people to connect with local support groups as well as Wisconsin Parkinson Association to learn more and find resources.