How Is Parkinsons Disease Diagnosed
There are currently no specific tests that diagnose PD. The diagnosis is based on:
- medical history and a neurological examination
- blood and laboratory tests, to rule out other disorders that may be causing the symptoms
- brain scans to rule out other disorders. However, computed tomography and magnetic resonance imaging brain scans of people with PD usually appear normal.
In rare cases, where people have a clearly inherited form of PD, researchers can test for known gene mutations as a way of determining an individuals risk of developing the disease. However, this genetic testing can have far-reaching implications and people should carefully consider whether they want to know the results of such tests.
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When is it considered young-onset Parkinsons disease?Its considered young-onset if diagnosed before the age of 40. The youngest recorded case of Parkinsons was a 12-year-old patient.
How is it diagnosed?There is no blood test or scan that can diagnose Parkinsons disease. Doctors look for four classic symptoms of the disease before reaching a diagnosis: tremors, rigidity in the wrist and elbow joints, lack or slowness of movement, and an unstable posture.
It affects mostly men. Parkinsons disease is twice as likely to affect men than women.
Theres no known cause. There is no known cause of Parkinsons disease although a family history of the disease will increase your risk. Researchers think environmental factors such as smoking, pollution, heavy metals, medications and illegal drugs may be responsible for the onset of the disease. Head trauma, brain inflammation, and stroke have also been associated with the disease.
Parkinsons is expensive. Treating patients with Parkinsons disease costs the U.S. around $25 billion a year. The average patient will need $2,500 worth of medication each year and therapeutic surgery could cost up to $100,000.
Theres a correlation between Parkinsons and depression. Dopamine is also associated with mood as well as movement. Its estimated that more than half of Parkinsons disease patients suffer from depression and around 40 percent suffer from anxiety.
Parkinsons Disease Has Many Stages
There are five stages of Parkinsons disease:
- Stage 1: At this stage, you will have only mild symptoms and can go about your day-to-day life relatively easily.
- Stage 2: Symptoms such as tremors and stiffness begin to worsen and affect both sides of the body. You may develop poor posture or have trouble walking.
- Stage 3: In this stage, your movement will begin to slow down and you lose balance. Symptoms can hinder your ability to perform daily tasks such as getting dressed or cooking.
- Stage 4: Symptoms are severe and cause significant issues with day-to-day living. At this point, you are unable to live alone because you cannot complete daily tasks on your own.
- Stage 5: Walking or standing could be impossible at this point. Typically, people at this stage are confined to a wheelchair or bed and require a nurse to take care of them at home.
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When Does Parkinson Disease Really Start
This is one of the million dollar questions in Parkinsons disease research. We actually dont know the answer. From the clinical trial or research perspective, we arbitrarily base the answer on either the occurrence of the first symptom or alternatively the date of diagnosis. The date of diagnosis is however biased, and largely based on obvious motor symptoms such as tremor, stiffness, or slowness. We know that this estimate therefore is grossly inaccurate. In fact, by the time a Parkinsons disease patient manifests the first symptom , significant degeneration of the dopaminergic neurons in the brain has already occurred.
We now know that the loss of the sense of smell, constipation, depression, personality changes, sleep problems, and even anxiety may long precede the motor symptoms of Parkinsons disease. The problem with using these symptoms as diagnostic markers however, is that they commonly occur in the general population, making it very difficult to judge what is part of Parkinsons disease, and what is not.
Complicating the picture as to the onset of Parkinsons disease has been the discovery that many patients may have rapid eye movement sleep disorders many years prior to the onset of motor symptoms. Additionally, Braak and colleagues have recently proposed that the degeneration in Parkinsons disease actually starts well before dopaminergic cells in the midbrain begin to die. The cells that die in Parkinsons disease are deep in an area called the brainstem.
Pathogenesis Of Parkinsons Disease
Despite extensive animal and clinical studies, the etiology of PD is still unclear . Most of our information on the pathomechanism of Parkinsons disease originate from 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine and 6-hydroxydopamine animal models. Presumably PD is much more complex than can be modeled with toxin experiments. The most important pathological processes are the followings :
Patomechanism and potential neuroprotective targets in Parkinsons disease
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Changes In Cognition And Parkinsons Disease
Some people with Parkinsons may experience changes in their cognitive function, including problems with memory, attention, and the ability to plan and accomplish tasks. Stress, depression, and some medications may also contribute to these changes in cognition.
Over time, as the disease progresses, some people may develop dementia and be diagnosed with Parkinsons dementia, a type of Lewy body dementia. People with Parkinsons dementia may have severe memory and thinking problems that affect daily living.
Talk with your doctor if you or a loved one is diagnosed with Parkinsons disease and is experiencing problems with thinking or memory.
How Is Parkinsons Diagnosed
Doctors use your medical history and physical examination to diagnose Parkinsons disease . No blood test, brain scan or other test can be used to make a definitive diagnosis of PD.
Researchers believe that in most people, Parkinsons is caused by a combination ofenvironmental and geneticfactors. Certain environmental exposures, such as pesticides and head injury, are associated with an increased risk of PD. Still, most people have no clear exposure that doctors can point to as a straightforward cause. The same goes for genetics. Certain genetic mutations are linked to an increased risk of PD. But in the vast majority of people, Parkinsons is not directly related to a single genetic mutation. Learning more about the genetics of Parkinsons is one of our best chances to understand more about the disease and discover how to slow or stop its progression.
Aging is the greatest risk factor for Parkinsons, and the average age at diagnosis is 60. Still, some people get PD at 40 or younger.
Men are diagnosed with Parkinsons at a higher rate than women and whites more than other races. Researchers are studying these disparities to understand more about the disease and health care access and to improve inclusivity across care and research.
Aging is the greatest risk factor for Parkinsons, and the average age at diagnosis is 60. Still, some people get PD at 40 or younger.
The Michael J. Fox Foundation has made finding a test for Parkinsons disease one of our top priorities.
Myths And Facts About Parkinsons Disease
For those living with Parkinsons, separating the myths from the facts can be a big challenge. So, from causes to treatment to quality of life, weve answered some of your common questions.
Every hour, at least two people are diagnosed with Parkinsons in the UK however theres still a lot that people dont know about the disease. Weve separated the fact from the fiction.
Symptoms Of Parkinson’s Disease
These common symptoms of Parkinson’s disease often begin gradually and progress over time:
- Shaking or tremor
- Poor posture
- Slowing of body movements
As the disease continues to progress, additional symptoms can occur such as slurred or soft speech, trouble chewing and/or swallowing, memory loss, constipation, trouble sleeping, loss of bladder control, anxiety, depression, inability to regulate body temperature, sexual dysfunction, decreased ability to smell, restless legs and muscle cramps.
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Fact: Stem Cells Are A Possible Treatment For Parkinsons Disease
Stem cells have the potential to lead to better treatments for Parkinsons disease, but were not there yet.
These special cells are grown in a lab and can be turned into almost any type of cell. Researchers have been able to turn them into dopamine producing cells to replace those lost to Parkinsons.
However, before becoming an available treatment doctors need to provide more proof stem cells are safe and effective.
What Causes The Disease
The precise cause of PD is unknown, although some cases of PD are hereditary and can be traced to specific genetic mutations. Most cases are sporadicthat is, the disease does not typically run in families. It is thought that PD likely results from a combination of genetics and exposure to one or more unknown environmental factors that trigger the disease.
The protein alpha-synuclein. The affected brain cells of people with PD contain Lewy bodiesdeposits of the protein alpha-synuclein. Researchers do not yet know why Lewy bodies form or what role they play in the disease. Some research suggests that the cells protein disposal system may fail in people with PD, causing proteins to build up to harmful levels and trigger cell death. Additional studies have found evidence that clumps of protein that develop inside brain cells of people with PD may contribute to the death of neurons.
Genetics. Several genetic mutations are associated with PD, including the alpha-synuclein gene, and many more genes have been tentatively linked to the disorder. The same genes and proteins that are altered in inherited cases may also be altered in sporadic cases by environmental toxins or other factors.
Environment. Exposure to certain toxins has caused parkinsonian symptoms in rare circumstances . Other still-unidentified environmental factors may also cause PD in genetically susceptible individuals.
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Exercise Helps Manage Parkinsons Symptoms
For people with Parkinsons, exercise is more than healthy it is a vital component to maintaining balance, mobility and activities of daily living. Exercise and physical activity can improve many PD symptoms. The Parkinsons Outcomes Project shows that people with PD who start exercising earlier and a minimum of 2.5 hours a week experience a slowed decline in quality of life compared to those who start later. Tai chi, yoga, Pilates, dance, weight training, non-contact boxing and more all have positive effects on PD symptoms. Watch our Fitness Friday videos.
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Diagnosis Of Parkinsons Disease
There are currently no blood or laboratory tests to diagnose non-genetic cases of Parkinsons. Doctors usually diagnose the disease by taking a persons medical history and performing a neurological examination. If symptoms improve after starting to take medication, its another indicator that the person has Parkinsons.
A number of disorders can cause symptoms similar to those of Parkinsons disease. People with Parkinsons-like symptoms that result from other causes, such as multiple system atrophy and dementia with Lewy bodies, are sometimes said to have parkinsonism. While these disorders initially may be misdiagnosed as Parkinsons, certain medical tests, as well as response to drug treatment, may help to better evaluate the cause. Many other diseases have similar features but require different treatments, so it is important to get an accurate diagnosis as soon as possible.
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Stigma Associated With Pd
Consequently, we believe that some of the main challenges for PD research faced on the African continent are:
Stigma of a visible impairment and the perception that the disease may be caused by a curse or is a bad omen.
Delay in diagnosis and treatment due to traditional medicine being used as a first step for the majority of patients outside urbanized regions.
Low rate of healthcare insurance coverage preventing affordability of long-term treatment in chronic disorders such as PD.
Denial of a positive family history of a possibly genetic condition so as to prevent discredit to individuals or their relatives.
Interesting Facts About Alzheimers Disease
Alzheimers disease is a progressive brain disease that changes the way a person thinks, reasons, and solves problems. It is one of the most prevalent chronic conditions in the world, and over 5 million Americans su?er from it. Here are some Alzheimers facts that may surprise you.
Alzheimers is linked to loss of smellA person with Alzheimers may lose their sense of smell, according to the National Institutes of Health. It is important to note, however, that loss of smell could be a result of several other things, including Parkinsons Disease or a common sinus infection. If you or a loved one experience a loss of smell, see a doctor for diagnosis and treatment options.
Alzheimers is often accompanied by another conditionU.S. News and World Report says that most people with Alzheimers are also diagnosed with another serious medical condition. In fact, almost 60 percent of Alzheimers patents have high blood pressure, 36 percent have coronary heart disease, and 23 percent have diabetes.
Alzheimers risk can be lowered by learningAccording to the National Institute on Aging, the more you nourish your brain by feeding it new information, the lower your risk of getting Alzheimers. Keeping your brain active as you age by taking classes, learning a new language, or taking up new hobbies are all good things to pursue.
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What Genes Are Linked To Parkinsons Disease
Several genes have been definitively linked to PD:
- SNCA. This gene, which makes the protein alpha-synuclein, was the first gene identified to be associated with Parkinsons. Research findings by the National Institutes of Health and other institutions prompted studies of the role of alpha-synuclein in PD, which led to the discovery that Lewy bodies seen in all cases of PD contain clumps of alpha-synuclein. This discovery revealed the link between hereditary and sporadic forms of the disease.
- LRRK2. Mutations in LRRK2 were originally identified in several English and Basque families as a cause of a late-onset PD. Subsequent studies have identified mutations of this gene in other families with PD as well as in a small percentage of people with apparently sporadic PD. LRRK2 mutations are a major cause of PD in North Africa and the Middle East.
- DJ-1. This gene normally helps regulate gene activity and protect cells from oxidative stress and can cause rare, early forms of PD.
- PRKN . The parkin gene is translated into a protein that normally helps cells break down and recycle proteins.
- PINK1. PINK1 codes for a protein active in mitochondria. Mutations in this gene appear to increase susceptibility to cellular stress. PINK1 has been linked to early forms of PD.
- GBA . Mutations in GBA cause Gaucher disease , but different changes in this gene are associated with an increased risk for Parkinsons disease as well.
Plus Common Misconceptions About What Its Like
There are many misconceptions about Parkinsons disease, which has led to widespread misunderstanding about what the disease really is and the effects it has on someone who is living with it.
Many people believe that having Parkinsons means you would look sick, but thats not always the case. Living with Parkinsons disease looks slightly different for everyone. The condition can cause symptoms like tremors or balance issues and mental health struggles such as depression. Learn more about the facts and myths about this disease.
Verywell / Zoe Hansen
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What Causes Parkinsons Disease
We do not know what causes Parkinsons disease. There is some evidence to suggest that there is a genetic factor which increases the risk of Parkinsons disease within some families. Also, there might be an increased risk if people have come into contact with a particular toxin or toxins found in the environment via pesticides and other chemicals used in agriculture. The specific toxin or toxins have not yet been identified but there is ongoing research into this possible cause.
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Research And Statistics: Who Has Parkinsons Disease
According to the Parkinsons Foundation, nearly 1 million people in the United States are living with the disease. More than 10 million people worldwide have Parkinsons.
About 4 percent of people with Parkinsons are diagnosed before age 50.
Men are 1.5 times more likely to develop the disease than women.
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Prognosis Of Parkinsons Disease
As Parkinsons progresses, symptoms often worsen. Some people who respond well to therapy have minimal disability issues. Others, however, become severely incapacitated.
Although Parkinsons isnt considered a fatal disease itself, it can cause life-threatening complications that may shorten your life span.
Today, most people living with Parkinsons disease have close to a normal life expectancy.
How Is Parkinson’s Treated
Although there’s currently no cure for Parkinson’s, treatments are available to help reduce symptoms and maintain quality of life for as long as possible. These include:
- supportive therapies, such as physiotherapy and occupational therapy
- deep brain stimulation .
If you have mild symptoms of Parkinsons, your doctor might not recommend medication and instead focus on supportive therapy and lifestyle improvements such as exercise and relaxation. As your symptoms progress, you will be prescribed medication.
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Standard Treatments Are Being Tweaked
Since the late 1960s, levodopa has been the most effective treatment for addressing motor symptoms of Parkinson’s disease. The problem for some patients, however, is levodopa does not provide the constant flow of dopamine necessary for smooth function throughout the day.
“Patients’ symptoms may be well-controlled, and they may function well while the medication is working, but as the medications wear off, the symptoms return,” Witek says. “It is hard to live a normal life when facing this unpredictability.”
New research is focused on developing treatments that will give people a more steady flow of dopamine and decrease fluctuations.
One common side effect of not having steady levels of dopamine is dyskinesia .