Parkinson’s disease is a progressive and chronic degenerative neurological disorder currently without a cure. You may be familiar with Michael J. Fox, the unofficial face of Parkinson’s, who has a foundation dedicated to finding a cure. Parkinson’s attacks your brain’s substantia nigra, where most of your dopamine is produced. Dopamine is a neurotransmitter that helps facilitate messages between nerves and is involved in your brain’s reward and pleasure processing centers. It is crucial for controlling your body’s muscle movements.

Parkinson’s patients also have decreased production of the neurotransmitter norepinephrine. This is the primary messenger for your sympathetic nervous system. Its decrease causes most non-movement symptoms. It is common for cells in your substantia nigra to die as you age but at a prolonged rate. Researchers don’t know the exact cause of this accelerated cell death, but when 50 to 60% of the cells in your substantia nigra are gone, you will start to show symptoms of Parkinson’s disease.

Risk Factors

There isn’t one definitive cause of Parkinson’s disease, as research is still ongoing. Here are some of the known risk factors so far:

• Advancing Age: The average age of onset is 60. When diagnosed under 50, it is called young-onset Parkinson’s, and it accounts for less than 10% of the overall Parkinson’s patient population.
• Sex: Researchers are unclear why Parkinson’s disease is more likely to affect men than women.
• Genetics: According to Johns Hopkins, genetic causes can account for 10 to 20% of cases. You are two times more likely to develop Parkinson’s disease if you have a parent or sibling diagnosed with it. You can inherit one copy of a mutated gene from one parent, considered a dominant trait, or two copies of mutated genes from both your parents to cause Parkinson’s with a recessive trait.
• Environmental Hazard Exposure: Research has linked Agent Orange from the Vietnam era, working with heavy metals, pesticides, herbicides, detergents, and solvents with Parkinson’s, but more research is needed to explore the link.
• Traumatic Brain Injury: Participants in the male-dominated sports of football and boxing, where repeated head blows and injuries are common are at significantly increased risk for developing Parkinson’s disease later in life, according to recent studies. An increasing number of NFL retirees are diagnosed with Parkinson’s, and Muhammad Ali is probably the most famous example who died from Parkinson’s in 2016.

Motor Symptoms

The main symptoms of Parkinson’s include tremors or shaking, impaired balance, slowed movements, and muscle stiffness. However, many other symptoms are associated with the disease, such as speech, writing, and emotional changes. Here are the most common side effects of losing most of your natural dopamine:

1. Tremors: The hallmark symptom of Parkinson’s, it often begins in your fingers or hands when at rest. It can also occur around your jaw or head. It looks like rhythmic shaking or pill-rolling when you rub your thumb and forefinger together. The tremor typically starts very minute and increases with time, and it can decrease when you are performing tasks initially.
2. Slowed Movements: Also called bradykinesia, it can be either a collective slowness or progressive hesitations and halts resulting in jerky movements.
3. Muscle Stiffness: Rigidity of your muscles can occur anywhere in your body, causing pain and limiting your movements.
4. Impaired Posture, Balance, and Automatic Movements: You can struggle to stand upright, having a pronounced stoop. You may fall or trip more easily, and your unconscious movements, such as swinging your arms when you walk, blinking, swallowing, and smiling, can decrease.
5. Writing and Speech Changes: As the disease progresses, you can struggle to write clearly. Your speech pattern can also change: you can either sound monotonous, slur your words, speak more quickly, quietly or have hesitations before starting to speak.

Non-Motor Symptoms

Most non-motor symptoms result from losing crucial neurotransmitters, dopamine, and norepinephrine: You can have sleep issues, including insomnia, restless leg syndrome, violent outbursts during sleep, and REM sleep disorders. Fatigue is widespread, which can be a result of those sleep issues. Skin problems are also common; you may have flaky or oily skin, especially around your face and scalp. You may also experience blood pressure fluctuations and excessive sweating and may be more prone to melanoma skin cancers. You can lose your sense of smell, which will also impact your taste. While somewhat motor related, you can experience bathroom issues such as voiding. Often a side effect of all the other symptoms, you can experience fluctuating amounts and types of pain throughout your day when living with Parkinson’s disease.

Again a factor of all your other symptoms and change in your quality of life, you can have mental health issues. Anxiety can arise from not wanting to tell people what is going on with you or what your future will hold. You can experience depression and other emotional changes from your diagnosis as well.

Treatments for Parkinson’s Disease

Medications

Pills typically affect neurotransmitters to help control involuntary movements, tremors, muscle rigidity, and non-movement symptoms. They will also increase the dopamine available in your brain.

Deep Brain Stimulation

Similar to the brain stimulation device for epilepsy, this involves surgery where doctors can implant electrodes into your brain connected to a device in your chest to stimulate areas of the brain that control movement painlessly.

Transcranial Magnetic Brain Stimulation (TMS)

This therapy is a neuro treatment for depression and is not FDA-approved for the treatment of Parkinson’s yet. However, it can help with the emotional changes associated with Parkinson’s, and studies show TMS is effective at combating motor symptoms, a breakthrough as medications eventually lose their effectiveness.

Supportive Therapies

Doctors will recommend a healthy diet to help your overall wellness, massage therapy to help with muscle tension, and yoga or tai chi to combat muscle rigidity. You often will have speech, physical, and occupational therapies to help with the other disease-related declines.

Currently, there are no laboratory tests to diagnose non-genetic cases of Parkinson’s. If you have symptoms, your doctor will take your medical history and perform a neurological exam. They may send you to see a specialist or perform other tests to rule out other explanations. Still, they typically trial Parkinson’s medication if they believe it is causing your issue. If your symptoms resolve, that’s their primary indicator you have it. More research on Parkinson’s is crucial to determine the cause, effective treatments like trans magnetic stimulation, and ultimately a cure.