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Understanding Parkinson's

By Dr. Craig G. Van Horne from February 2014 Issue

Parkinson's disease is one of the most common neurological disorders, affecting about 1 million Americans. The disease is often misunderstood, despite its prevalence and its increased profile because of celebrities who have it, such as Michael J. Fox.

What is Parkinson's disease?
Parkinson's disease is a progressive neurological condition that affects movement and body functions. Its four primary effects are tremors, rigidity, slow movement, and unstable posture. PD is caused by the death of neurons deep in the brain, which decreases the level of dopamine, a neurotransmitter involved in controlling voluntary movement. It generally develops after age 65, but about 15 percent of patients have a young onset form of the disease that can appear before 50.

Is there a cure?
There currently is no cure, but there are options to treat and manage symptoms. PD patients are initially treated with medication, but over time it becomes less effective. The next line of treatment is deep brain stimulation, in which electrodes are placed in the brain to regulate abnormal brain impulses. Deep brain stimulation can greatly improve a patient's quality of life.

American Parkinson's Disease Association: www.apdaparkinson.org

Davis Phinney Foundation for Parkinson's: www.davisphinneyfoundation.com

What causes Parkinson's disease?
We don't know what causes PD. There seem to be many factors at play, including environmental and genetic factors. Only 5 percent to 10 percent of cases have a true genetic link.

Do all people with this disease have tremors?  While tremor is the most recognized symptom of PD, many patients do not have tremors but have rigidity and slow movements. The extra, uncontrolled movements (dyskinesia) associated with PD aren't caused by the disease, but are a side effect of the medication used to treat it.

Does the disease affect only movement?
Because PD affects multiple areas of the brain, it has an array of nonmotor symptoms, including swallowing disturbances, whispering, loss of smell, cognitive difficulties, depression, loss of impulse control, sleeping problems, and bladder problems and constipation.


DR. CRAIG G. VAN HORNE  is associate professor of neurosurgery at University of Kentucky College of Medicine.