Parkinson's disease is a disorder that progressively affects human’s nervous system thereby affecting their movement. The condition develops slowly, in some cases beginning with a barely noticeable tremor in an individual’s hand. Other than the tremor that is widely known, the disease further causes stiffness on the individuals as well as a slowed movement among other symptoms. Parts of the victim’s brain progressively get destroyed over many years. This paper discusses the etiology of Parkinson's disease, its diagnosis, signs, and symptoms associated with the condition and how one would rule out the differences between the different illnesses similar to it.
Etiology of Parkinson's disease
The etiology of Parkinson's disease can be attributed to two factors. They include genetics and environment. Studies have shown Genetic mutations to play a role in the causality of Parkinson's disease. There are certain gene variations that that increases an individual’s risk to Parkinson's disease ( Trinh & Farrer, 2013) . On the other end, there are environmental triggers. Such include exposure to specific environmental factors and toxins which may significantly increase the risk of an individual contacting Parkinson's disease ( Goldman, 2014) . When an individual gets the disease, many changes occur in their brains. Such changes may include the presence of Lewi bodies as well as the Alpha-Synuclein often found within the Lewi bodies.
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However, the disease is majorly caused by the loss of nerve cells in the Parkinson's disease of an individual’s brain ( Walker, Lue, Serrano, Adler, Caviness, & Beach, 2016) . The Nerve cells are known as dopaminergic neurons and are found in the substantia nigra. The cells die when an individual experiences low levels of dopamine. The chemical is responsible for the body movement. When the levels of dopamine go down, the symptoms of Parkinson's disease begin to show. A person then starts to find it hard to get things done or even control their movements. As the dopamine levels continue to drop, the symptoms get more severe in the individual. Noteworthy is the fact that dopamine plays an important role in sending messages to the part of the brain that is coordinates and controls movement.
Reeve, Simcox, and Turnbull (2014) identify age as one of the aspects that affect the etiology of Parkinson's disease. Therefore, young adults are less likely to experience Parkinson's disease. In most cases, the condition begins with middle or late life. The risk increases with age making individuals at 60 years or older have a high risk of the disease. It is because the substantia nigra neurons are susceptible to lose with age thereby exposing the older people to the high risk of the disease. Hereditary factors too play a role. However, genetic factors do not present high risks as it is usually low unless so many of one's relatives have Parkinson's disease. The other risk factor is sex. Men have a higher chance of developing Parkinson's disease than women. Researchers posit that the male gender itself could be a threat factor, or an indicator for other risk factors men expose themselves to like head injuries or chemicals as compared to women. The other reason is that estrogen could have a defensive impact on female's nervous system reducing their risks for Parkinson's disease.
Diagnosis of Parkinson's Disease, Radiology, and Necessary Clinical Tools
The UK Parkinson’s Disease Society Brain Bank identifies bradykinesia as the best way to diagnose Parkinson’s Disease ( Tuite, Mangia & Michaeli, 2013) . The procedure involves a slow initiation of a repetitive voluntary movement with fluctuations in both amplitude and speed. They involve muscular rigidity assessed on a passive range of motion as well as resting tremor of between 4-6Hz. The postural instability that does not result from visual functions or other proprioceptive function.
The recent development of methods used for brain imaging has changed the way diagnosis for people with Parkinson’s disease is conducted. Pyatigorskaya, Gallea, Garcia-Lorenzo, Vidailhet, and Lehericy, (2014) details an collection of procedures that include diffusion tensor imaging and iron-sensitive methods such as T2. Others include adiabatic methods R1ρ and R2ρ and the resting-state functional MRI. Additionally, the magnetic resonance spectroscopy has proven to be a useful testing tool.
Tuite, Mangia, and Michaeli, (2013) point out that w hen the MRI is used, radiographic features reveal Initial subtle findings. However, if the disease is at an advanced stage, it can demonstrate some non-specific generalized minor cerebral volume loss. The most promising diagnostic sign that medics would look out for is in the substantia nigra. It would reveal a loss in the normal swallow tail appearance seen on the susceptibility signal pattern as observed on the axial imaging. Similarly, the changes observed on substantia nigra would vary with the degree of loss of neuromelanin as well as iron accumulation.
Significant Signs and Symptoms Common to this Disease
Three main symptoms are common to Parkinson's disease. They all affect the physical movement of the individual. Sveinbjornsdottir, (2016), explains, t he first is as tremor – shaking. It usually begins with the individual’s hand or arms. The shaking is much likely to tackle place when the individual is calm, and the hand is relaxed. The second is resting slowness of movement also referred to as bradykinesia. In such a case, the physical movements of the individual victim are much slower than of a normal healthy person. The condition could also make day to day activities difficult for the individual. In some cases, it can result in a characteristic slow, shuffling walk characterized by tiny steps. The third is muscle stiffness or rigidity. It majorly involves stiffness and tension in the victim’s muscles which would make one unable to make facial expressions or move around. Similarly, it can be associated with painful muscle cramps also referred to as dystonia. The above three symptoms are often referred to Parkinsonism they may also result from other causes rather than Parkinson’s disease.
Similar Diseases That Might Get Confused with Parkinson’s Disease
Other conditions might be confused with Parkinson’s Conditions. Edwards, Stamelou, Quinn, and Bhatia, (2016) identifies them to include the following: the first is Progressive supranuclear palsy. As a condition, it affects ones walking and balance leading to falls. It may also cause vision problems. The other one is multiple system atrophy. It is a nervous system disorder that shows similar symptoms as Parkinson's disease. Such signs include like poor coordination, and slurred speech among others. Thirdly, there is the viral Parkinsonism. They may include encephalitis lethargica, both Western and eastern equine encephalomyelitis. They all infect the brain causing symptoms much similar to Parkinson's disease. The fourth is essential tremor which produces uncontrolled shaking in a person’s hands or head yet such tremors are not associated with Parkinson's disease symptoms.
Also, taking certain medications which, may include Thorazine, Haldol, metoclopramide and reserpine among others, can cause Parkinson's disease symptoms. Similarly, exposures to manganese dust and carbon monoxide among other toxins can as well cause the Parkinson’s disease symptoms. However, in the case of the medications, the symptoms usually would subside once one stops the medication. Severe or head injuries also has the potential of resulting into a post-traumatic Parkinsonism. Parkinsonism-dementia complex of Guam is another that presents similar symptoms as Parkinson's disease.
| Condition | Compare with Parkinson’s disease | Contrast with Parkinson’s disease |
| Progressive supranuclear palsy | Affects a person’s walking, balance and causes falls | Does not respond to medication. |
| Multiple system atrophy | Poor coordination | slurry speech |
| Essential tremor | Uncontrolled tremors or shaking | Not responsive to Parkinson's disease medication |
| Viral parkinsonism | Involves shaking or tremors | Symptoms begin two days and only lasts a week |
| Cortical-basal ganglionic degeneration |
basal ganglia wastes away loss of balance |
Non-responsive to treatment with medication. |
| Normal pressure hydrocephalus (NPH) | difficulties with walking and balance | Fluid builds up in the brain |
The Genetic Component to Parkinson Disease
Parkinson disease most likely results from an intricate interaction between the environmental and genetic factors. The cases could be sporadic occurring in individuals with no apparent family history of Parkinson disease. An estimated 15 percent of individuals with Parkinson disease have a family history. That means the chance of inheriting the disease could be 15%. Such cases could result from mutations in the following genes: LRRK2, PARK7, PINK1, PRKN, and SNCA. It may also be the same for the sporadic cases. However, alteration in GBA and UCHL1, although do not cause the condition, play an imperative role in the risk of developing Parkinson disease. Other genetic variations targeting other genes unidentified above could also cause Parkinson disease.
How the Disease is Commonly Treated in the Medical Community and Its Prognosis after Treatment
Parkinson's disease can be treated through Surgery, Gene Therapy, or Other Interventions that may include drug treatment. Surgery is often an option where the patients have severe symptoms or do not respond to medication. They may involve removal as well as the destruction of the thalamus in the brain so that the tremors are reduced. Such surgical operation includes Pallidotomy and subthalamotomy. However, such surgery may fail to overcome all the symptoms. One of the most applied surgery is known as deep brain stimulation. It involves placing electrodes in the brain to stimulate tissues with an electrical current. The second is Parkinson's disease Gene Therapy. It involves the use of modified liposomes or modified viruses that contain genes to reduce or eliminate the disease symptoms by delivering genes to human brain cells. The injected genes end up producing specific compounds that become dopamine.
Parkinson's disease Prognosis affects the life of the patient. It may reduce both the quality and length of the patient. It is a disease that may end up taking an individual to a state of complete disability. The progression varies across individuals and may take up to 20 years. Parkinson's disease could be tremor (predominant among young people) predominant or resulting to postural instability and gait disturbed (PIGD). Muscle control problems often characterize the disease among younger people as well. Postural instability and gait disrupted symptoms are common amongst older people. They also suffer a lot of fall risk. Many would suffer depression while others may suffer thinking challenges. An estimated 30% Parkinson's disease patients often experience altered mental status.
References
Edwards, M. J., Stamelou, M., Quinn, N., & Bhatia, K. P. (2016). Parkinson's disease and other movement disorders . Oxford: Oxford University Press.
Goldman, S. M. (2014). Environmental toxins and Parkinson's disease. Annual review of pharmacology and toxicology , 54 , 141-164.
Pyatigorskaya, N., Gallea, C., Garcia-Lorenzo, D., Vidailhet, M., & Lehericy, S. (2014). A review of the use of magnetic resonance imaging in Parkinson’s disease. Therapeutic advances in neurological disorders , 7 (4), 206-220.
Reeve, A., Simcox, E., & Turnbull, D. (2014). Ageing and Parkinson's disease: why is advancing age the biggest risk factor? Ageing research reviews , 14 , 19-30.
Sveinbjornsdottir, S. (2016). The clinical symptoms of Parkinson's disease. Journal of neurochemistry , 139 (S1), 318-324.
Trinh, J., & Farrer, M. (2013). Advances in the genetics of Parkinson disease. Nature Reviews Neurology , 9 (8), 445-454.
Tuite, P. J., Mangia, S., & Michaeli, S. (2013). Magnetic resonance imaging (MRI) in Parkinson’s disease. Journal of Alzheimer's disease & Parkinsonism , 001.
Walker, D. G., Lue, L. F., Serrano, G., Adler, C. H., Caviness, J. N., Sue, L. I., & Beach, T. G. (2016). Altered expression patterns of inflammation-associated and trophic molecules in substantia nigra and striatum brain samples from Parkinson's disease, incidental lewy body disease and normal control cases. Frontiers in neuroscience , 9 , 507.
