The Genetics Of Parkinsons
A 2020 study including 1,676 people with Parkinsons in mainland China suggested that genes play a role in the development of the condition. An estimated 10 to 15 percent of people with Parkinsons have a family history of the condition.
In fact, a number of specific genes have been linked to the development of Parkinsons.
How do genetics factor into Parkinsons in some families? According to Genetics Home Reference, one possible way is through the mutation of genes responsible for producing dopamine and certain proteins essential for brain function.
What If You Have Parkinson’s Disease And A Stroke
Stroke is relatively common and so is Parkinson’s disease, so one person can have both. If you or your loved one has a stroke as well as Parkinson’s disease, it is normal for you to be concerned.
The conditions have different causes, but the movement problems of Parkinson’s disease combined with the effects of a stroke can make it even more difficult for you or your loved one to get around than if you only had one of the two problems.
If you have both conditions, it is more important to pay attention to things such as safeguarding your home to prevent falls and getting a walker or a cane in order to avoid falls.
Depression May Be An Early Symptom Of Parkinsons
Depression is one of the most common, and most disabling, non-motor symptoms of Parkinsons disease. As many as 50 per cent of people with Parkinsons experience the symptoms of clinical depression at some stage of the disease. Some people experience depression up to a decade or more before experiencing any motor symptoms of Parkinsons.
Clinical depression and anxiety are underdiagnosed symptoms of Parkinsons. Researchers believe that depression and anxiety in Parkinsons disease may be due to chemical and physical changes in the area of the brain that affect mood as well as movement. These changes are caused by the disease itself.
Here are some suggestions to help identify depression in Parkinsons:
- Mention changes in mood to your physician if they do not ask you about these conditions.
- Complete our Geriatric Depression Scale-15 to record your feelings so you can discuss symptoms with your doctor. Download the answer key and compare your responses.
- delusions and impulse control disorders
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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.
Other Causes Of Parkinsonism
“Parkinsonism” is the umbrella term used to describe the symptoms of tremors, muscle rigidity and slowness of movement.
Parkinson’s disease is the most common type of parkinsonism, but there are also some rarer types where a specific cause can be identified.
These include parkinsonism caused by:
- medication where symptoms develop after taking certain medications, such as some types of antipsychotic medication, and usually improve once the medication is stopped
- other progressive brain conditions such as progressive supranuclear palsy, multiple systems atrophy and corticobasal degeneration
- cerebrovascular disease where a series of small strokes cause several parts of the brain to die
You can read more about parkinsonism on the Parkinson’s UK website.
Page last reviewed: 30 April 2019 Next review due: 30 April 2022
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Living With Parkinson’s Disease
As Parkinson’s develops, a person who has it may slow down and won’t be able to move or talk quickly. Sometimes, speech therapy and occupational therapy are needed. This may sound silly, but someone who has Parkinson’s disease may need to learn how to fall down safely.
If getting dressed is hard for a person with Parkinson’s, clothing with Velcro and elastic can be easier to use than buttons and zippers. The person also might need to have railings installed around the house to prevent falls.
If you know someone who has Parkinson’s disease, you can help by being a good friend.
Discuss With Your Physician
Non-motor symptoms can sometimes be difficult to recognize. Therefore, it is important to make your doctor aware of them.
One useful resource is the PD NMS Questionnaire. You can use this to record your symptoms and discuss them with your doctor.
Dr. Ron Postuma, whose research was funded by donations to the Parkinson Canada Research Program, has also developed tools to help people with Parkinsons and their physicians identify and manage non-motor symptoms.
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What Are The Surgical Treatments For Parkinsons Disease
Most patients with Parkinsons disease can maintain a good quality of life with medications. However, as the disease worsens, medications may no longer be effective in some patients. In these patients, the effectiveness of medications becomes unpredictable reducing symptoms during on periods and no longer controlling symptoms during off periods, which usually occur when the medication is wearing off and just before the next dose is to be taken. Sometimes these variations can be managed with changes in medications. However, sometimes they cant. Based on the type and severity of your symptoms, the failure of adjustments in your medications, the decline in your quality of life and your overall health, your doctor may discuss some of the available surgical options.
Medications For People With Parkinsons Disease
Symptoms of Parkinsons disease result from the progressive degeneration of nerve cells in the brain and other organs such as the gut, which produce a neurotransmitter called dopamine. This causes a deficiency in the availability of dopamine, which is necessary for smooth and controlled movements. Medication therapy focuses on maximising the availability of dopamine in the brain. Medication regimes are individually tailored to your specific need. Parkinsons medications fit into one of the following broad categories:
- levodopa dopamine replacement therapy
- dopamine agonists mimic the action of dopamine
- COMT inhibitors used along with levodopa. This medication blocks an enzyme known as COMT to prevent levodopa breaking down in the intestine, allowing more of it to reach the brain
- anticholinergics block the effect of another brain chemical to rebalance its levels with dopamine
- amantadine has anticholinergic properties and improves dopamine transmission
- MAO type B inhibitors prevent the metabolism of dopamine within the brain.
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Can A Stroke Cause Parkinson’s Disease
A stroke can cause some symptoms of Parkinson’s disease, but not Parkinson’s disease itself. This condition is called Parkinsonism. Parkinsonism is associated with many of the same movement problems of Parkinson’s disease, such as tremors and stiffness. However, it usually does not worsen over time as Parkinson’s disease does. If a stroke causes brain damage in the area of the brain that is associated with Parkinson’s disease, then Parkinsonism can occur.
What Are The Symptoms Of Parkinson Disease
Parkinson disease symptoms usually start out mild, and then progressively get much worse. The first signs are often so subtle that many people don’t seek medical attention at first. These are common symptoms of Parkinson disease:
- Tremors that affect the face and jaw, legs, arms, and hands
- Slow, stiff walking
What Else Do We Know
As scientists try to learn what’s at the root of Parkinson’s, they’re looking far and wide to pick up clues where they can.
They’ve found that people with Parkinson’s tend to have something called Lewy bodies in their brain. These are unusual clumps of a protein called alpha-synuclein. The protein itself is normal, but the clumps are not. And they’re found in parts of the brain that affect sleep and sense of smell, which could explain some symptoms of Parkinson’s not related to movement.
Your gut may also have a part in it, as some of its cells make dopamine, too. Some doctors think that this might be where the earliest signs of Parkinson’s show up, but that idea needs more research.
What Is The Number One Risk Factor For Parkinson’s
Age is the greatest risk factor. About 1% of those over 60 and 5% of those over 85 are diagnosed with it. The increased risk is due to decreasing levels of dopamine metabolism and other changes that make the neurons vulnerable.
Reeve A, Simcox E, Turnbull D. Ageing and Parkinsons disease: Why is advancing age the biggest risk factor?Ageing Research Reviews. 2014 14:19-30. doi:10.1016%2Fj.arr.2014.01.004
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Living With Parkinson Disease
These measures can help you live well with Parkinson disease:
- An exercise routine can help keep muscles flexible and mobile. Exercise also releases natural brain chemicals that can improve emotional well-being.
- High protein meals can benefit your brain chemistry
- Physical, occupational, and speech therapy can help your ability to care for yourself and communicate with others
- If you or your family has questions about Parkinson disease, want information about treatment, or need to find support, you can contact the American Parkinson Disease Association.
The Spread Of Parkinsons
Researchers have found that areas of the brain stem below the substantia nigra show cell loss in Parkinsons. And cells in these areas have been found to contain clumps of alpha-synuclein protein, which may form before those in the substantia nigra.
These findings have led some researchers to suggest that Parkinsons spreads up the spinal cord to the substantia nigra. Indeed, there is evidence that, for some, Parkinsons may start in the gut and travel up the vagus nerve, which connects the gut and the brain, to the substantia nigra.
The theory that Parkinsons may spread up the brain stem and progress throughout the brain is the basis of the Braak staging of Parkinsons.
The 6 stages in Braaks theory aim to describe the spread of Parkinsons through the brain:
While there is still some debate over the origin of Parkinsons, and even competing and more complex theories about the spread of Parkinsons, attempts to understand how and why different areas of the brain are involved in the motor and non-motor symptoms are helping in the development of better treatments.
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What Raises Someone’s Risk For Parkinson’s
It’s a complex picture, but you may be more likely to get Parkinson’s based on:
Age. Since it mostly affects people 60 and older, your risk goes up as the years go by.
Family history. If your parent, brother, or sister has it, you’re a little more likely to get it.
Job. Some types of work, like farming or factory jobs, can cause you to have contact with chemicals linked to Parkinson’s.
Race. It shows up more often in white people than other groups.
Serious head injury. If you hit your head hard enough to lose consciousness or forget things as a result of it, you may be more likely to get Parkinson’s later in life.
Gender. Men get it more than women. Doctors aren’t sure why.
Where you live. People in rural areas seem to get it more often, which may be tied to chemicals used in farming.
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Dementia With Lewy Bodies
Dementia with Lewy bodies is a disease that leads to deposits of alpha-synuclein proteins in the brain. These proteins are also called Lewy bodies.
Abnormal build-up of these chemicals can cause movement, behavior, mood, and cognitive changes.
More than 1 million people in the United States have Lewy body dementia. It most often occurs in adults over 50 and can progress for 2 to 20 years from its onset to death.
- postural instability
Parkinsons Tremors: Causes Types And Treatments
Tremors are one of the major symptoms of Parkinsons disease for many people living with the condition. They can affect either side of the body, impacting arms and hands as well as the head and torso. Tremors can be frustrating to live with, especially when accompanied by other symptoms of PD like slowness, freezing, and loss of balance.
If you have PD, its important to understand the different types of tremors and treatments, as well as how tremors caused by Parkinsons are different from tremors caused by other conditions.
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What Causes Parkinson’s Disease
Parkinson’s disease occurs when nerve cells, or neurons, in an area of the brain that controls movement become impaired and/or die. Normally, these neurons produce an important brain chemical known as dopamine. When the neurons die or become impaired, they produce less dopamine, which causes the movement problems of Parkinson’s. Scientists still do not know what causes cells that produce dopamine to die.
People with Parkinson’s also lose the nerve endings that produce norepinephrine, the main chemical messenger of the sympathetic nervous system, which controls many functions of the body, such as heart rate and blood pressure. The loss of norepinephrine might help explain some of the non-movement features of Parkinson’s, such as fatigue, irregular blood pressure, decreased movement of food through the digestive tract, and sudden drop in blood pressure when a person stands up from a sitting or lying-down position.
Many brain cells of people with Parkinson’s contain Lewy bodies, unusual clumps of the protein alpha-synuclein. Scientists are trying to better understand the normal and abnormal functions of alpha-synuclein and its relationship to genetic mutations that impact Parkinsons disease and Lewy body dementia.
Symptoms Of Peripheral Neuropathy
The symptoms of PN can be non-specific, and a person therefore may not be able to distinguish on their own whether his/her symptoms are due to PN or another condition. PN, however, often results in specific findings on a neurologic exam, such as decreased sensation to pin prick or vibration or the lack of ability to discern which way a toe is being pointed without looking. Other tests such as Electromyogram and Nerve conduction studies may be necessary to confirm the diagnosis. Small fiber neuropathy which typically causes pain, burning, tingling and/or numbness in the feet, may have normal EMG and NCS and a skin biopsy may be necessary to confirm the diagnosis. With the appropriate examination and supportive tests however, a neurologist should be able to distinguish the symptoms of peripheral neuropathy from other conditions, including PD, that may cause similar symptoms.
There are many known causes of PN including diabetes, vitamin deficiencies, certain infections, and autoimmune diseases. Many of these causes can be treated, so it is important to know if you do have PN and what the cause is. There are those people however, who have the signs and symptoms of PN, but no known cause can be identified.
How Do I Prevent Falls From Common Hazards
- Floors: Remove all loose wires, cords, and throw rugs. Minimize clutter. Make sure rugs are anchored and smooth. Keep furniture in its usual place.
- Bathroom: Install grab bars and non-skid tape in the tub or shower. Use non-skid bath mats on the floor or install wall-to-wall carpeting.
- Lighting: Make sure halls, stairways, and entrances are well-lit. Install a night light in your bathroom or hallway and staircase. Turn lights on if you get up in the middle of the night. Make sure lamps or light switches are within reach of the bed if you have to get up during the night.
- Kitchen: Install non-skid rubber mats near the sink and stove. Clean spills immediately.
- Stairs: Make sure treads, rails, and rugs are secure. Install a rail on both sides of the stairs. If stairs are a threat, it might be helpful to arrange most of your activities on the lower level to reduce the number of times you must climb the stairs.
- Entrances and doorways: Install metal handles on the walls adjacent to the doorknobs of all doors to make it more secure as you travel through the doorway.
Movement Disorders Similar To Parkinsons
Conditions causing excess movement or decreased movement that are sometimes associated with Parkinson’s disease-like symptoms include:
What Movement Disorder Could I Have?
When making a Parkinson’s diagnosis, your doctor will review your medical history and symptoms, perform a careful neurological exam, and, if necessary, carry out further tests to rule out other movement disorders.
Your symptoms may be caused by a movement disorder other than Parkinson’s disease if:
- You display Parkinson’s disease symptoms and features that are characteristic of an additional movement disorder.
- The results of a brain imaging study or laboratory test, such as a blood test, confirm the presence of another movement disorder.
- Your symptoms do not respond to Parkinson’s disease medication.
Because movement disorders are not all treated the same way, it is important to get a proper diagnosis as early as possible so you can formulate the right treatment plan with your doctor.
What Are The Causes
The cause of Parkinson’s is largely unknown. Scientists are currently investigating the role that genetics, environmental factors, and the natural process of aging have on cell death and PD.
There are also secondary forms of PD that are caused by medications such as haloperidol , reserpine , and metoclopramide .