Understanding, Detecting and Treating Parkinson’s Disease
Known for causing uncontrollable tremors, Parkinson’s disease may affect as many as 1 million Americans. According to the , only half that many people get diagnoses. If you suspect you have Parkinson’s, seek medical attention. An early diagnosis allows you to start treatment as soon as possible, which may slow the disease’s progression.
“Parkinson’s disease is a chronic illness that isn’t cured by anything that we know of,” says Dr. Matthew E. Fink, Louis and Gertrude Feil Professor and chairman of the Department of Neurology at Weill Cornell Medical College, neurologist-in-chief at NewYork Presbyterian Hospital/Weill Cornell Medical Center, chief of the Division of Stroke and Critical Care Neurology at NewYork-Presbyterian Hospital/Weill Cornell Medical Center and vice chairman of the Medical Board. That said, “We're developing treatments now that we believe can either delay the progression of the disease and prevent it from getting worse or may even be able to stop it in its tracks.”
It’s important to pay attention to your body. If you notice , talk with your provider. Appropriate care may slow its progression.
Signs and Symptoms of Parkinson’s Disease
The telltale signs of Parkinson’s come from damaged nerve cells inside the basal ganglia. This section of the brain helps control movement. When these nerve cells get damaged or die, you experience atypical, uncontrollable movements.
Common symptoms of Parkinson’s include:
- Arm, hand, head, jaw or leg trembling
- Balance and coordination issues that may result in falls
- Excessively slow movements
- Stiff muscles that contract for prolonged periods
Initially, symptoms may focus on one side of the body or a single limb. Over time, the disease progresses and affects more of the body. You may have difficulty paying attention, remembering things or performing everyday tasks. Other symptoms may also arise, from swallowing or speaking issues to depression to constipation. Over time, your symptoms worsen.
Before these complications arise, you may act out your dreams while you sleep. This can be dangerous for those around you, as you may become violent. If you do this, Dr. Fink encourages you to pay attention.
“Many people with this symptom will develop Parkinson’s disease,” he says. “See your doctor about it early on.”
Know Your Risk
Currently, the cause of Parkinson’s remains unknown. Your risk does seem to increase with the following:
- Age. A few people experience Parkinson’s symptoms before age 50, but symptoms usually appear after age 60.
- Family history. Risk increases if your mother, father or other close family member has Parkinson’s.
- Genetics. Mutations in certain genes may put you at higher risk.
- Sex. Men are at higher risk than women.
- Toxic environment. The risk of Parkinson’s increases if you live or work in an environment that exposes you to pesticides.
Determining the Presence of Parkinson’s
The first step toward a Parkinson’s diagnosis is a complete physical examination.
During this exam, a neurologist or Parkinson’s and movement disorders specialist checks your body, balance and more. Your provider also goes over your medications, symptoms and other health issues.
If your movements are noticeably slow and you have at least one other common symptom, additional testing helps confirm the presence of Parkinson’s.
Tests your provider may perform include:
- Biomarker testing. Though not FDA-approved for diagnosing Parkinson’s, that may change soon. These tests look at proteins in skin, blood or cerebrospinal fluid that indicate Parkinson’s. Researchers hope these tests will detect Parkinson’s in its earliest stages, before symptoms become problematic.
- DaTscan. A provider injects you with a radioactive material, which makes its way to the brain and attaches to a protein that helps transport dopamine. Special imaging technology then shows where the radioactive material collects. Because Parkinson’s affects dopamine, smaller concentrations of the chemical indicate the potential presence of Parkinson’s.
- In some cases, your provider will want to review the structure of your brain through an MRI. This may help confirm or rule out a Parkinson’s diagnosis.
Medication Can Help Confirm Parkinson’s
Other conditions, such as essential tremor, can mimic Parkinson’s. The states that certain medication side effects can as well. As a result, your care team may have a hard time making a definitive diagnosis, even when your symptoms, exam and tests point to Parkinson’s,
When it’s unclear if you have Parkinson’s, your provider may prescribe Parkinson’s medication. If symptoms improve with the medication, you may have Parkinson’s.
Today, Levodopa (L-DOPA) is considered the most effective medication against Parkinson’s. When absorbed by the brain, this medication turns into dopamine and helps improve movement control.
Levodopa often provides immediate, noticeable improvement of symptoms. Over time, you may require an increasing amount of Levodopa or additional treatment to maintain control over your movements.
Other Treatments for Parkinson’s Management
In addition to medication, many therapies help limit Parkinson’s symptoms and improve quality of life. Based on your specific needs, your provider may recommend other approaches.
“One of the most effective treatments for Parkinson’s disease is physical exercise,” says Dr. Fink. “Physical exercise can slow and, in some cases, actually stop the progression of the condition for a long time.”
To improve long-term results, experts at ĢƵ engage in ongoing clinical trials. In recent years, they helped develop deep brain stimulation (DBS) into an effective therapy for Parkinson’s patients. With this treatment, a neurosurgeon places a small device in your chest. Wires connect the device to specific areas in the brain that control movement, and tiny electric pulses help reduce movement-related symptoms.
“It is truly an amazing treatment, and it lasts for years,” Dr. Fink says. “We’ve not found any patients where the effects of brain stimulation wear off.”
Another new advance, which is still in the research phase, involves stem cells. With this novel approach, a neurosurgeon implants healthy stem cells into the brain of a Parkinson’s patient. These cells gradually replace brain cells lost to Parkinson’s, fending off the effects of the disease.
The team at ĢƵ offers this to select patients and hopes to broaden its use in the coming years.
“I really feel that this is going to turn out to be a revolutionary treatment for this condition,” Dr. Fink says. “If it is as effective as we anticipate, I think many patients will benefit.”
Looking for access to expert Parkinson’s care for yourself or a loved one? Find a doctor at ĢƵ to get started.