Parkinson’s disease

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Parkinson’s disease  

Parkinson’s disease is a common,a progressive, neurodegenerative, movement disorder  that belongs to the group of motor system disorders.

It results from the slow death of neuron cells which create a chemical called dopamine, in a part of the brain, called the substantia nigra.  Dopaminehelps control muscle movement throughout the body.

The Cause of the disease is still not well known, so it is coming under idiopathic disorders.

-Some atypical cases are genetic in origin

-As a normal aging process

-Increased risk is there in persons exposed to  certain pesticides, Toxins and a reduced risk in tobacco smokers.

Pathology

The accumulation of a protein called alpha-synuclein into the inclusions called Lewy Bodies, in neurons, and lead to insufficient production of Dopamine in Midbrain.

Symptoms

Early Symptoms

Slowness of all voluntary movements, mainly for walking or rolling over in bed.

Decreased facial expression, monotonous speech, and decreased eye blinking.

A shuffling gait with poor arm swing and stooped posture.

Unsteady balance; difficulty rising from a sitting position.

Continuous “pill-rolling” motion of the thumb and forefinger.

Abnormal tone or stiffness in the trunk and extremities.

Swallowing problems in later stages.

Forgetfulness

The Common Motor Symptoms in The Developed Stage.

Tremor- is the most apparent, common and well-known symptom. Mostly present  when the limb is at rest and disappearing with voluntary movement and sleep. It begins in the hands and arms, although it can also occur in the jaw or foot. In Beginning it usually only affects one side of the body or one limb.

Bradykinesia- is the slowing down of movement and the gradual loss of spontaneous activity. Initial symptoms start while

performing daily tasks which require fine motor control such as writing, sewing or getting dressed

Muscle rigidity-  As muscle tone is more, there is stiffness and resistance to the  movements, leading to rigidity. There is inability for the muscles to relax normally. There will be aches or pains from affected muscles

Postural Instability-  The impaired movements and balance, lead to frequent falls . The number of falls being related to the severity of PD

Changes in walking (Gait)-  there is an  inability  to swing the arms naturally while walking and taking short shuffling steps. There  may be also difficulty in starting to walk and difficulty in stopping also.

Other Symptoms-

Stooped Posture, Forward or backward lean that can cause falls, Drooling, Difficulty swallowing and chewing, Urinary problems, Sexual dysfunction, Constipation And Loss of other motor skills can be seen in some patients.

Dementia, Depression, Psychosis and Anxiety are also seen

Treatments

-Modern Treatments use Levodopa (L-Dopa) and  Dopamine agonists to control the early motor symptoms.

As the disease progresses and dopaminergic neurons continue to be lost.  And the drugs eventually become ineffective at treating the symptoms and at the same time produce a complications like  involuntary writhing movements.

- Diet and some forms of rehabilitation help in alleviating the symptoms.

- Surgery and Deep Brain Stimulation to help the reduce the symptoms.

-Gene Therapy

Stem Cell Treatments

The Stem cell Therapy  is based on their ability of  regenerating the dopamine releasing cells in Substantia Nigra, leading  to long term recovery.

The Stem cells will differentiate into  dopaminergic neurons prior to transplantation. This can then regain the capacity of transmitting the massages and giving recovery from the symptoms. The most important scientific conclusion to be drawn from the clinical trials involving neural transplantation in PD is that cell replacement can be effective in the diseased human brain.

Currently, dopamine neurons generated from stem cells seem to be the most promising an safest therapy that can give the recovery.

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