Distinguishing Different Stages Of Parkinsons Disease Using Composite Index Of Speed And Pen
- 1School of Engineering, RMIT University, Melbourne, VIC, Australia
- 2Dandenong Neurology, Melbourne, VIC, Australia
The speed and pen-pressure while sketching a spiral are lower among Parkinsons disease patients with higher severity of the disease. However, the correlation between these features and the severity level of PD has been reported to be 0.4. There is a need for identifying parameters with a stronger correlation for considering this for accurate diagnosis of the disease. This study has proposed the use of the Composite Index of Speed and Pen-pressure of sketching as a feature for analyzing the severity of PD. A total of 28 control group and 27 PD patients were recruited and assessed for Unified Parkinsons Disease Rating Scale . They drew guided Archimedean spiral on an A3 sheet. Speed, pen-pressure, and CISP were computed and analyzed to obtain their correlation with severity of the disease. The correlation of speed, pen-pressure, and CISP with the severity of PD was 0.415, 0.584, and 0.641, respectively. MannWhitney U test confirmed that CISP was suitable to distinguish between PD and CG, while non-parametric k-sample KruskalWallis test confirmed that it was significantly different for PD SL-1 and PD SL-3. This shows that CISP during spiral sketching may be used to differentiate between CG and PD and between PD SL-1 and PD SL-3 but not SL-2.
What Are The Symptoms Of Parkinsons Disease
Symptoms of Parkinsons disease and the rate of decline vary widely from person to person. The most common symptoms include:
Other symptoms include:
- Decreased facial expressions: You may not smile or blink as often as the disease worsens; your face lacks expression.
- Speech/vocal changes: Speech may be quick, become slurred or be soft in tone. You may hesitate before speaking. The pitch of your voice may become unchanged .
- Handwriting changes: You handwriting may become smaller and more difficult to read.
- Depression and anxiety.
- including disrupted sleep, acting out your dreams, and restless leg syndrome.
- Pain, lack of interest , fatigue, change in weight, vision changes.
- Low blood pressure.
What If You Have Parkinsons
After Parkinsons is diagnosed, your doctor will help you develop an individualized plan to address the symptoms that have the biggest impact on your everyday life and help slow down the progression of the disease. The first step is getting a referral to a neurologist for expert care especially one who is trained in movement disorders.
How Does Parkinsons Progress
Parkinsons is a chronic and slowly progressive disorder. This means that symptoms normally appear slowly and develop gradually over time. The stage at which symptoms appear, speed at which they progress and the severity of those symptoms will vary from person to person. The most important point is that Parkinsons affects everyone differently.
There are a wide range of symptoms, but it is highly unlikely that you will experience every possible symptom. Some of the early of Parkinsons include handwriting changes, reduced sense of , and . As Parkinsons progresses symptoms will change over time, and new symptoms will emerge. It can take many years for symptoms to progress to a point where they cause problems.
Currently, there is no known way to slow the progression of Parkinsons. However, and other can help to effectively manage your . To ensure the effectiveness of medications, they will need to be reviewed regularly by your specialist or doctor.
Most experts agree that Parkinsons does not directly cause death. However as Parkinsons progresses it will impact significantly on quality of life. It is recommended to speak to your doctor about advance care planning so that you have a say in your future health decisions.
Do What You Can While You Can
I have had Parkinsons disease for nearly 20 years. My wife is a teacher, so we travel every summer when she is not working. Since my diagnosis, I have been to China, Nepal, Prague, Paris and many other places. The Parkinsons comes along, too, so our trips require more planning than they used to and we involve my care team. We factor in daily naps and take it slow. My balance isnt as good as it used to be and too much walking wears me out so we bring a collapsible wheelchair along or make sure one is available. I also use a cane. I dont know how many more places we will get to visit as my disease continues to progress, but we have made some wonderful memories that we wouldnt have if we had let my Parkinsons dictate every aspect of our lives. Nicholas, diagnosed at 52, still traveling at 72
Many people with Parkinsons disease are not allowing the condition to take over their lives. Despite the everyday setbacks they face, they are still creating fulfilling lives for themselves by redirecting their attention to people and activities that bring them joy. You can do the same. Try building a few hobbies into your routine that will give you a break from dwelling on the disease. Find some activities that help you forget about Parkinsons for a while. That may be painting, writing, gardening, or reading to your grandchildren.
What Is The Treatment For Parkinsons Disease
There is currently no treatment to cure Parkinsons disease. Several therapies are available to delay the onset of motor symptoms and to ameliorate motor symptoms. All of these therapies are designed to increase the amount of dopamine in the brain either by replacing dopamine, mimicking dopamine, or prolonging the effect of dopamine by inhibiting its breakdown. Studies have shown that early therapy in the non-motor stage can delay the onset of motor symptoms, thereby extending quality of life.
The most effective therapy for Parkinsons disease is levodopa , which is converted to dopamine in the brain. However, because long-term treatment with levodopa can lead to unpleasant side effects , its use is often delayed until motor impairment is more severe. Levodopa is frequently prescribed together with , which prevents levodopa from being broken down before it reaches the brain. Co-treatment with carbidopa allows for a lower levodopa dose, thereby reducing side effects.
In earlier stages of Parkinsons disease, substances that mimic the action of dopamine , and substances that reduce the breakdown of dopamine inhibitors) can be very efficacious in relieving motor symptoms. Unpleasant side effects of these preparations are quite common, including swelling caused by fluid accumulation in body tissues, drowsiness, , , hallucinations, and .
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Stage 3As motor symptoms become worse, patients may begin to experience loss of balance leading to falls and movement can become very slow. Although many patients can still live independently they may have difficulty in everyday activities such as eating or dressing.
Stage 4In this later stage, symptoms are now extremely limiting. Many patients can still stand without assistance but movement is greatly impaired. Most will need help with everyday activities and will not be able to look after themselves.
Stage 5This is the most advanced stage of the disease and most patients will experience difficulty in walking and standing, often requiring a wheelchair. Assistance will be needed in all areas of daily life as motor skills are seriously impaired. In addition, people with advanced Parkinsons disease may also begin to suffer hallucinations.
Parkinsons News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
Surgery And Deep Brain Stimulation
Deep brain stimulation is a treatment for Parkinsonâs disease that uses an implantable pacemaker-like device to deliver electrical pulses to parts of the brain involved in movement. The DBS system consists of leads precisely inserted into a specific brain target, the neurostimulator implanted in the chest, and extension wires that connect the leads to the neurostimulator. Though implantation of the system requires a neurosurgical procedure, the treatment itself consists of long-term electrical stimulation. Advantages of DBS include its ability to reduce the high doses of medications , its adjustability , and its reversibility DBS was approved by the Food and Drug Administration as a treatment for PD in 2002 and according to Medtronic , more than 80,000 patients have undergone DBS surgery worldwide.
Typical candidates are those who have motor fluctuations or periods of âoffâ time with troublesome symptoms alternating with periods of âonâ time with good symptom control, and also with possible periods of excessive movement .
Not all patients with Parkinsonâs disease are good candidates for treatment with DBS. Approximately 10â20% of patients considered for possible treatment with DBS include those:
Two Types Of Parkinsons Disease
Parkinsons symptoms develop when approximately 80 percent of the neurons that produce dopamine become damaged or die. Statistics indicate approximately one million adults in the United States live with the debilitating disorder. While many people have heard about Parkinsons, few may realize there are two types of the disease.
Parkinsons Disease Symptoms Of Dementia
Up to one-third of people living with Parkinson’s disease experience dementia, according to the Parkinson’s Disease Foundation. Problems with dementia may include trouble with memory, attention span, and what is called executive function the process of making decisions, organizing, managing time, and setting priorities.
Diagnosis Of Parkinsons Disease
A number of disorders can cause symptoms similar to those of Parkinson’s disease. People with Parkinson’s-like symptoms that result from other causes are sometimes said to have parkinsonism. While these disorders initially may be misdiagnosed as Parkinson’s, certain medical tests, as well as response to drug treatment, may help to distinguish them from Parkinson’s. Since many other diseases have similar features but require different treatments, it is important to make an exact diagnosis as soon as possible.
There are currently no blood or laboratory tests to diagnose nongenetic cases of Parkinson’s disease. Diagnosis is based on a person’s medical history and a neurological examination. Improvement after initiating medication is another important hallmark of Parkinson’s disease.
Parkinson’s Disease Diet And Nutrition
Maintaining Your Weight With Parkinson’s Disease
Malnutrition and weight maintenance is often an issue for people with Parkinson’s disease. Here are some tips to help you maintain a healthy weight.
- Weigh yourself once or twice a week, unless your doctor recommends weighing yourself often. If you are taking diuretics or steroids, such as prednisone, you should weigh yourself daily.
- If you have an unexplained weight gain or loss , contact your doctor. He or she may want to modify your food or fluid intake to help manage your condition.
- Avoid low-fat or low-calorie products. . Use whole milk, whole milk cheese, and yogurt.
Is Parkinsons Disease Fatal
Parkinsons disease itself doesnt cause death. However, symptoms related to Parkinsons can be fatal. For example, injuries that occur because of a fall or problems associated with dementia can be fatal.
Some people with Parkinsons experience difficulty swallowing. This can lead to aspiration pneumonia. This condition is caused when foods, or other foreign objects, are inhaled into the lungs.
What Is The Prognosis For Parkinsons Disease
Unfortunately, there is no cure for Parkinsons disease. Medicine has not yet found ways to stop the disease, even if treatment begins at an early stage.
However, the earlier a disease is discovered, the longer health can be maintained and the time when the disease will destroy many functions can be postponed. With proper treatment, diet, and exercise therapy, you can live a long time, remaining active and sane.
Modern medicine allows a person with Parkinsons disease to live an active life for at least 15 years, only then will the person begin to need external care. And death usually occurs for other reasons: heart disease, pneumonia, etc. If all the recommendations of the doctor are followed, a person can not only be independent in everyday life, but also be in professional demand.
If left untreated, unfortunately, after 10-12 years, a person can be bedridden. And it is impossible to make up for lost time, the changes are irreversible.
What Is The Treatment For Parkinson’s Disease
There is currently no treatment to cure Parkinson’s disease. Several therapies are available to delay the onset of motor symptoms and to ameliorate motor symptoms. All of these therapies are designed to increase the amount of dopamine in the brain either by replacing dopamine, mimicking dopamine, or prolonging the effect of dopamine by inhibiting its breakdown. Studies have shown that early therapy in the non-motor stage can delay the onset of motor symptoms, thereby extending quality of life.
The most effective therapy for Parkinson’s disease is levodopa , which is converted to dopamine in the brain. However, because long-term treatment with levodopa can lead to unpleasant side effects , its use is often delayed until motor impairment is more severe. Levodopa is frequently prescribed together with , which prevents levodopa from being broken down before it reaches the brain. Co-treatment with carbidopa allows for a lower levodopa dose, thereby reducing side effects.
In earlier stages of Parkinson’s disease, substances that mimic the action of dopamine , and substances that reduce the breakdown of dopamine inhibitors) can be very efficacious in relieving motor symptoms. Unpleasant side effects of these preparations are quite common, including swelling caused by fluid accumulation in body tissues, drowsiness, , , hallucinations, and .
Who Gets Parkinsons Disease
Parkinsonâs disease, documented in 1817 by physician James Parkinson, is the second most common neurodegenerative disease after Alzheimerâs disease. Estimates regarding the number of people in the United States with Parkinsonâs range from 500,000 to 1,500,000, with 50,000 to 60,000 new cases reported annually. No objective test for Parkinsonâs disease exists, so the misdiagnosis rate can be high, especially when a professional who doesnât regularly work with the disease makes the diagnosis.
Prescription Medications To Treat Parkinsons
Most movement symptoms are due to a lack of dopamine. Therefore, drugs prescribed to treat PD are dopaminergic; they either replenish dopamine or mimic its effects on the brain. The most common is called levodopa. The body converts this medication into dopamine to help control movement symptoms.
Make sure your doctor knows all medications you take including over-the-counter and supplements. This helps reduce the risk of drug interactions, a common issue for Parkinsons patients.
What Can You Do If You Have Pd
- Work with your doctor to create a plan to stay healthy. This might include the following:
- A referral to a neurologist, a doctor who specializes in the brain
- Care from an occupational therapist, physical therapist or speech therapist
- Meeting with a medical social worker to talk about how Parkinsons will affect your life
For more information, visit our Treatment page.
Page reviewed by Dr. Chauncey Spears, Movement Disorders Fellow at the University of Florida, a Parkinsons Foundation Center of Excellence.
Early Symptoms Of Parkinsons Disease
Parkinsons disease is a progressive disease of the nervous system that affects movement. Approximately 1 million people in the U.S. are living with the disease. This year, about 60,000 more will be diagnosed with Parkinsons disease.
Many people associate Parkinsons disease with tremors or shaking of their hands. While this is a common symptom, other important symptoms include stiffness of muscles and slowing of movement.
Symptoms of Parkinsons disease usually start on one side of the body. They usually remain worse on that side even after symptoms begin to affect both sides.
The early signs and symptoms are different for each person. The symptoms may be mild enough to go unnoticed for months or years.
Here are early symptoms that can raise concern for Parkinsons disease:
- Smaller handwriting
- Family members may observe that one arm swings less on one side when walking.
- Soft or low voice Again, it is family members or friends who may ask one to speak louder. The speech may be more of a monotone without the usual inflections.
It is the combination of several symptoms that would raise suspicion for Parkinsons disease. A single symptom is not enough to make a diagnosis of Parkinsons disease.
It is important to talk with your health care provider if you have any of the symptoms associated with Parkinsons disease. This is to properly diagnose the condition and rule out other conditions with similar symptoms.
Parkinsons Disease Is A Progressive Disorder
Parkinsons Disease is a slowly progressive neurodegenerative disorder that primarily affects movement and, in some cases, cognition. Individuals with PD may have a slightly shorter life span compared to healthy individuals of the same age group. According to the Michael J. Fox Foundation for Parkinsons Research, patients usually begin developing Parkinsons symptoms around age 60. Many people with PD live between 10 and 20 years after being diagnosed. However, a patients age and general health status factor into the accuracy of this estimate.
While there is no cure for Parkinsons disease, many patients are only mildly affected and need no treatment for several years after their initial diagnosis. However, PD is both chronic, meaning it persists over a long period of time, and progressive, meaning its symptoms grow worse over time. This progression occurs more quickly in some people than in others.
Pharmaceutical and surgical interventions can help manage some of the symptoms, like bradykinesia , rigidity or tremor , but not much can be done to slow the overall progression of the disease. Over time, shaking, which affects most PD patients, may begin to interfere with daily activities and ones quality of life.
Forms And Stages Of Development
The trigger for Parkinsons is believed to be a lack of the neurotransmitter hormone dopamine in the body. Science does not know why it stops being produced in sufficient quantities. But its lack gradually leads to pathological changes, which at first are not noticeable, and then are already irreversible. The insidious disease affects, first of all, the elderly. But sometimes it also happens at a young age.
It is customary to divide the disease into three ways:
- Rigid-bradykinetic. The first visible sign of this form is stooped. Muscle tone increases and movements slow until completely immobilized;
- Shaky, stiff. A common form characterized by stiffness of motion. But at first there is a progressive tremor of the arms, legs;
- Shaking. This form is manifested by tremors of the hands, legs, tongue, lower jaw. At the same time, a person can move, walk, do something. Muscle tone can be increased, but in any case, the rhythm of normal movements is maintained.
At first, the symptoms of Parkinsons disease are completely invisible, both to the patient himself and to those around him:
- hands shake a little;
There are many recipes for herbal decoctions, exercise.
Popular wisdom suggests:
Special exercises help. You need to go to the wall, press the back, the buttocks, the hips, the back of the head, lower the arms along the body and press the palms of the hands against the wall. Then press against the wall for 10-15 seconds, relax. So repeat 10-15 times in a row.
Is Early Diagnosis Possible
Experts are becoming more aware of symptoms of Parkinsons that precede physical manifestations. Clues to the disease that sometimes show up before motor symptoms and before a formal diagnosis are called prodromal symptoms. These include the loss of sense of smell, a sleep disturbance called REM behavior disorder, ongoing constipation thats not otherwise explained and mood disorders, such as anxiety and depression.
Research into these and other early symptoms holds promise for even more sensitive testing and diagnosis.
For example, biomarker research is trying to answer the question of who gets Parkinsons disease. Researchers hope that once doctors can predict that a person with very early symptoms will eventually get Parkinsons disease, those patients can be appropriately treated. At the very least, these advances could greatly delay progression.
Parkinson’s Disease and Movement Disorders Center
Our center provides compassionate and timely treatment to patients with movement disorders, such as dystonia, ataxia, essential tremor and similar conditions. But our mission goes beyond patient care excellence. By offering educational events and support groups, we empower patients and caregivers to become better partners in their health.
How Is Parkinsons Disease Treated
There is no cure for Parkinsons disease. However, medications and other treatments can help relieve some of your symptoms. Exercise can help your Parkinsons symptoms significantly. In addition, physical therapy, occupational therapy and speech-language therapy can help with walking and balance problems, eating and swallowing challenges and speech problems. Surgery is an option for some patients.
What Doctors Look For When Diagnosing Parkinsons
Certain physical signs and symptoms noticed by the patient or his or her loved ones are usually what prompt a person to see the doctor. These are the symptoms most often noticed by patients or their families:
Shaking or tremor: Called resting tremor, a trembling of a hand or foot that happens when the patient is at rest and typically stops when he or she is active or moving
Bradykinesia: Slowness of movement in the limbs, face, walking or overall body
Rigidity: Stiffness in the arms, legs or trunk
Posture instability: Trouble with balance and possible falls
Once the patient is at the doctors office, the physician:
Takes a medical history and does a physical examination.
Asks about current and past medications. Some medications may cause symptoms that mimic Parkinsons disease.
Performs a neurological examination, testing agility, muscle tone, gait and balance.
Medicines For Parkinson’s Disease
Medicines prescribed for Parkinson’s include:
- Drugs that increase the level of dopamine in the brain
- Drugs that affect other brain chemicals in the body
- Drugs that help control nonmotor symptoms
The main therapy for Parkinson’s is levodopa, also called L-dopa. Nerve cells use levodopa to make dopamine to replenish the brain’s dwindling supply. Usually, people take levodopa along with another medication called carbidopa. Carbidopa prevents or reduces some of the side effects of levodopa therapysuch as nausea, vomiting, low blood pressure, and restlessnessand reduces the amount of levodopa needed to improve symptoms.
People with Parkinson’s should never stop taking levodopa without telling their doctor. Suddenly stopping the drug may have serious side effects, such as being unable to move or having difficulty breathing.
Other medicines used to treat Parkinsons symptoms include:
- Dopamine agonists to mimic the role of dopamine in the brain
- MAO-B inhibitors to slow down an enzyme that breaks down dopamine in the brain
- COMT inhibitors to help break down dopamine
- Amantadine, an old antiviral drug, to reduce involuntary movements
- Anticholinergic drugs to reduce tremors and muscle rigidity
What Are The Different Stages Of Parkinsons Disease
Each person with Parkinsons disease experiences symptoms in in their own unique way. Not everyone experiences all symptoms of Parkinsons disease. You may not experience symptoms in the same order as others. Some people may have mild symptoms; others may have intense symptoms. How quickly symptoms worsen also varies from individual to individual and is difficult to impossible to predict at the outset.
In general, the disease progresses from early stage to mid-stage to mid-late-stage to advanced stage. This is what typically occurs during each of these stages:
Early symptoms of Parkinsons disease are usually mild and typically occur slowly and do not interfere with daily activities. Sometimes early symptoms are not easy to detect or you may think early symptoms are simply normal signs of aging. You may have fatigue or a general sense of uneasiness. You may feel a slight tremor or have difficulty standing.
Often, a family member or friend notices some of the subtle signs before you do. They may notice things like body stiffness or lack of normal movement slow or small handwriting, lack of expression in your face, or difficulty getting out of a chair.
Standing and walking are becoming more difficult and may require assistance with a walker. You may need full time help to continue to live at home.