Parkinson's
Disease
(also
known as Paralysis Agitans; Shaking Palsy)
A
Summary
by:
George Pararas-Carayannis, Ph.D.*
(Excerpts
from summary prepared under contract for the ReGenesis Medical
Center/ Dec 2000)
*
Disclaimer -
I am not a medical doctor. All material provided at this website
is for informational purposes only. Readers are encouraged to
confirm the information contained herein with other sources.
Patients and consumers should review the information carefully
with their professional health care provider. The information
is not intended to replace medical advice offered by physicians.
I will not be liable for any direct, indirect, consequential,
special, exemplary, or other damages arising therefrom.
Introduction
Parkinson's disease
was first described in England in 1817 by James Parkinson. The
disease is a progressive neurological disorder of the brain affecting
muscle control and movement. It is characterized by shaking and
difficulty with walking, movement, and coordination. It affects
both men and women and is one of the most common neurologic disorders
of the elderly.
Parkinson's disease
affects people worldwide. Approximately 2 out of 1,000 people,
more than a million people in North America, suffer from it.
About 50,000 more are diagnosed with the disease each year. Most
often it develops after age 50. It is rare in children. The disease
rarely occurs in people younger than 40. However, younger people
who took the drug MPTP, a synthetic narcotic street drug, developed
symptoms similar to those caused by Parkinson's.
Parkinson's
is a Serious Disease
Parkinson's disease
typically progresses slowly, is not usually fatal, but it reduces
longevity and impairs the quality of life. A person can live
for many years after the disease is diagnosed. The symptoms can
often be alleviated or controlled with medications. The treatments
may even slow down the progression of the disease. However, over
time, the side effects of many of these medications can be nearly
as distressing as the disease itself. The drugs may eventually
lose their effectiveness.
The Central Nervous
System
Causes and
Origins of the Disease
Parkinson's disease
is sometimes referred to as idiopathic, which means that the
primary cause is unknown, in order to distinguish it from "parkinsonism",
which are the symptoms occurring from a known cause.
Parkinson's disease
is a degenerative disorder of the central nervous system, in
which the region of the brain that controls movement gradually
deteriorates. It is caused by progressive decay of the nerve
cells that control muscle movement (the basal ganglia and the
extrapyramidal area of the brain).
Dopamine, which is
one of the substances used by cells to transmit impulses (transmitters),
is normally produced in this area. Dopamine is one of three major
neurotransmitters known as catecholamines, which help the body
respond to stress and prepare it for the fight-or-flight response.
Deterioration of this
area of the brain reduces the amount of dopamine available to
the body. Insufficient dopamine disturbs the balance between
dopamine and other transmitters, such as acetylcholine. Without
dopamine, the nerve cells cannot properly transmit messages,
and this results in the loss of muscle function and coordination.
The exact reason that the cells of the brain deteriorate is unknown.
The disorder may affect one or both sides of the body, with varying
degrees of loss of function. Parkinson's disease is sometimes
categorized as either tremor predominant, or postural instability
and gait disturbed (PIGD)(walking disorders).
Recent studies also indicate that people affected
by Parkinson's have a defficiency in glutathione, another critical
amino acid that appears to play a significant role in neural
transmission of messages. In fact intravenous treatment with
glutathione appears to restore muscle movement.
Neuron Dots Multiple
Synopses
Biologic and genetic
factors are important in causing Parkinson's, although a recent
study found that these factors are rarely critical in cases which
develop after the age of fifty. Also, current research indicates
that genetic factors may not be significant to developing typical
Parkinson's disease. According to a study by the National Institute
of Neurological Disorders and Stroke, genetic factors play less
of a role in causing Parkinson's than was previously thought.
None the less, the search for a Parkinson's gene continues.
Brain Neuron - Dots
are multiple synopses points
Environmental factors
are believed to play a more significant role in the development
of the disease, particularly exposure to heavy metal and pesticides.
Symptoms
Parkinson's disease
manifests in symptoms that interfere with many daily activities.
The disease affects the functional abilities of sufferers, resulting
in their reactions being slowed or spastic. For example, driving
difficulties can be brought on by the many factors of the disease,
including sleepiness caused by the medications. In later stages
of the disease, there may be some intellectual deterioration
and memory loss.
The effects of the
disease may vary widely from patient to patient. Initial symptoms
may be mild and nonspecific (mild tremor, slight feeling that
one leg/foot is stiff and dragging, and so on). Additional symptoms
that may be associated with this disease may include:
muscle
rigidity;
stiffness
(difficulty bending arms or legs);
shaking,
tremors (varying degrees, may become severe enough to interfere
with activities and may be worse when tired, excited, or stressed)
slow
and difficult movements;
problems
with loss of balance and difficulty walking (frequent falls);
unstable,
stooped, or slumped-over posture;
muscle
aches and pains (myalgia);
changes
in facial expression ("mask" appearance, may be unable
to close mouth; reduced rate of blinking);
voice/speech
changes (slow speech, low-volume voice, monotone, difficulty
speaking);
loss
of fine motor skills (difficulty writing, eating or any activity
that requires small movements);
memory
loss;
decline
in intellectual function (may or may not occur but can be severe);
gastrointestinal
symptoms (mainly constipation);
seborrhea
(skin);
muscle
atrophy;
drooling;
loss
of smell, vision or color perception;
Depression: In addition to the loss of muscle
control and the physical symptoms, some people with Parkinson's
disease become severely depressed. Depression is often present
as one of the first symptoms and is probably partially caused
by a chemical imbalance in the brain. Although early loss of
mental capacities is uncommon, with severe Parkinson's the person
may exhibit overall mental deterioration (including dementia,
hallucinations, confusion, anxiety, stress and tension).
Dementia can also
be a side effect of some of the medications used to treat the
disorder. These symptoms can also be controlled with medications.
Unfortunately some of the medications may provide only temporary
relief, but may have a long term adverse effect, such as an increase
in oxidants and brain damaging free radicals.
Parkinsonism: Other disorders and external
factors may cause symptoms similar to those caused by Parkinson's
disease. The term "parkinsonism" refers to any condition
that involves a combination of the types of changes in movement
seen in Parkinson's disease, which happens to be the most common
condition causing this group of symptoms.
Risk Factors
for Parkinson's Disease
Age: The elderly are at higher risk for both parkinsonism
and Parkinson's disease, although there is some evidence that
the very elderly (over 75) are at low or no risk. Only About
10% of Parkinson's cases are in people younger than 40 years
old. The average age of onset of the disease is 55.
Generally, the symptoms of parkinsonism (tremor, gait disturbance,
bradykinesia, and rigidity) appear in an estimated 8 million
people over 65. In one study, parkinsonism occurred in about
15% of people 65 to 74 years of age, about 30% in those 75 to
84, and over half of people older than 85. However, this particular
study included people with very mild symptoms and the percentages
are higher than ones using stricter criteria.
Gender: The disease appears to affect
equally both men and women, although the symptoms may differ.
For example, older women seem to be more at risk for gait disturbance
(walking difficulty) and men for rigidity and tremor.
Heredity: People with family members who
developed Parkinson's at a younger age are at higher risk for
Parkinson's disease, but relatives of those who were elderly
when they had the disease, appear to have an average risk.
Ethnicity and Geography: African-
and Asian-Americans have a lower risk than European-Americans.
A higher incidence of parkinsonism is found in people who live
in rural areas, particularly those who drink private well water
or are agricultural workers exposed to pesticides and herbicides.
These risks, however, seem to vary depending on ethnicity, indicating
that genetic factors are also at work.
Smoking: Cigarette smokers appear to have
a lower risk for Parkinson's disease. This finding, of course,
is no excuse to smoke, but such protection may help researchers
develop new therapies.
Diagnosis
Standard allopathic
(medical) clinical approaches are used to diagnose Parkinson's
disease. The role of risk factors in the development of the disease
are examined to determine prevention.
Treatment
and Drug Therapy for Parkinson's
Both pharmacological
and surgical treatments may be used to mitigate the symptoms
of Parkinson's Disease. However, recent studies have shown that
L-dopa therapy - a common treatment used to reduce Parkinson's
symptoms - enhances the production of brain-damaging free radicals
and increases the levels of homocysteine in the body. Homocysteine
is an amino acid. An increase in its level has been linked to
higher incidences of heart disease and stroke.
Several new treatments
are being continuously developed tested and evaluated to slow
the onslaught of Parkinson's symptoms. Recent advances in the
drug and surgical treatments of Parkinson's disease have greatly
improved the lives of the approximately 1 million Americans suffering
from it.
Non-Surgical
Treatments
The National Institute
of Neurological Disorders and Stroke (NIH) has reported on benefits
to some Parkinson's patients derived from what is known as Fetal
Cell Therapy. The therapy involves fetal dopamine cell implants.
Although promising, this form of therapy is not the panacea some
expected.
The use of certain
medications could also cause some Parkinson's patients to become
very drowsy and suddenly fall asleep. Therefore, driving while
under the influence of medications is discouraged.
Lifestyle
Changes
Parkinson's disease
slows down a person's reaction time. Many patients with Parkinson's
are not safe to drive, not only because of potential sleepiness
but because their reaction times are compromised, their thinking
and judgment affected. Driving is a hazard to themselves and
to others. The disease itself makes life changes necessary.
On-going
Research
Since dopamine deficiency
is the primary defect in Parkinson's disease, researchers are
presently attempting to discover how the dopamine is lost. The
research is concentrating in determining the effect of both genetic
susceptibility and environmental assaults.
Identifying genetic
and fundamental abnormalities that cause early-onset Parkinson's
disease is one area of research on the basic mechanisms of the
disease itself. Scientists are studying abnormalities in a protein
called alpha synuclein, which has been detected in some early-onset
Parkinson's patients of European descent. It appears that a genetic
defect causes defective alpha synuclein proteins to collect and
clump together, most likely forming fibrous deposits known as
Lewy bodies in the substantia nigra -- the place in the brain
where dopamine is first released. In fact Lewy bodies appear
to have an effect not only on reducing the dopamine, but also
in causing other neurologic diseases.
Genetic researchers
have also discovered a gene that may be responsible for a rare
form of Parkinson's disease that occurs in children and adolescents.
The gene regulates a newly found protein that the researchers
call parkin and is similar to a protein known as ubiquitin found
in Parkinson's disease and other neurologic disorders. Whether
this defective protein is relevant for late-onset Parkinson's
remains to be seen.
Additional research
is focusing on the observation that some Parkinson's patients
have a 30% to 40% decrease in an enzyme called complex I. Low
amounts of complex I lead to energy loss and the inability of
the cell to withstand the assault of free radicals. Free radicals
set off a chemical chain reaction that damages any type of cell,
including nerve cells in the brain. People who have insufficient
amounts of complex I, either from genetic abnormalities or other
factors, may be more susceptible to developing Parkinson's disease
from exposure to chemicals and toxins.
A great deal of research
is focusing on the effects of environmental toxins and the effects
of oxygen free-radicals. Viral infections and intense exposure
to environmental and industrial chemicals have each been associated
with the development of parkinsonism.
Recent research has
shown that in addition to dopamine reduction, a difficiency of
glutathione also contributes to the development of Parkinson's
disease. The role of glutathione in neural trasnmissions is being
investigated.
Alternative
treatments for Parkinson's patients
Several protocols
of treatment can be given to Parkinson's patients, but mainly
intravenous Glutathione. Glutathione is an important nutrient
and energy source for the brain and acts as a major antioxidant
within each cell in patients with Parkinson's or other age related
diseases.
Intravenous
Glutathione Therapy: Immediate beneficial results
may be experienced by Parkinson's patients even after one treatment
of Glutathione. Apparently the glutathione either helps directly
neurotransmission or triggers production of dopamine. Whatever
the mechanism may be, the results are often amazing. Glutathione
treatments improve considerably some of the symptoms of Parkinson's
disease including difficulties with rigidity, walking, movement,
coordination and speech. A marked reduction of tremor has been
observed as well as a decrease in depression.
Miscellaneous
Summaries on Chronic Illnesses
heart disease | |
stroke | diabetes |
| high blood
pressure
| | high cholesterol | | Alzheimer's | |
Parkinson's
| |
arthritis | |
chronic
fatigue
|
| poor circulation | | brain injury | | multiple sclerosis | | cerebral palsy | | life extension | | memory
loss |
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