By Adaobi Rhema Oguejiofor
Available records from the College of Medicine in the University of Ibadan indicate that Nigeria records over a 100 thousand cases of an age-related degenerative brain condition known as Parkinson’s disease on an annual basis. Parkinson’s disease is a brain disorder, which causes parts of a patient’s brain to deteriorate.
While Parkinson’s disease is a condition best known for how it affects muscle control, balance and movement, it is also known for causing a wide range of other effects on a patient’s senses, thinking ability, mental health and more. This brain disorder causes unintended or uncontrollable movements, such as shaking, stiffness, and difficulty with balance and coordination.
History of Parkinson’s Disease
The condition is named after a London physician, James Parkinson who, in 1817, described the disease as a “shaking palsy” (paralysis agitans). At the time, he published a detailed medical essay on the subject with the title, “An Essay on the Shaking Palsy”. This essay established Parkinson’s disease as a recognised medical condition. Dr. Parkinson studied and reported six cases of the disease in his own practice.
Six decades later, the idea was picked up by a French neurologist, Jean-Martin Charcot. He was the first to recognise the importance of Parkinson’s work and named the disease after him. Charcot and his students described the clinical spectrum of this disease. They found two types, which include the tremor stage and the rigidity stage. They described in full detail the physical changes seen in a patient.
Causes
While the precise cause of Parkinson’s Disease (PD) is unknown, PD is a progressive neurological disorder of the brain that results from a loss of nerve cells in the substantia nigra part of the brain. These cells are responsible for producing a chemical called dopamine, which is a neurotransmitter or chemical messenger that transmits signals between neurons in the brain that help control and co-ordinate body movements.
If these nerve cells die or become damaged, the amount of dopamine in the brain is reduced and a loss of this dopamine causes neurons to spiral out of control, leading to the manifestation of its symptoms, implying that the part of the brain controlling movement cannot function well. This further causes movement to become slow and abnormal. The loss of nerve cells is a slow process and the symptoms of Parkinson’s disease usually only start to develop when around 50 per cent of the nerve cell activity in the substantia nigra has been lost.
It is not known why the loss of nerve cells associated with Parkinson’s disease occurs. However, research is ongoing to identify the potential causes. Currently, a combination of genetic changes and environmental factors are assumed to maybe responsible for the condition.
Symptoms
There are many different symptoms associated with Parkinson’s disease. The symptoms usually develop gradually and are mild at first and the order in which they develop, as well as their severity, is different for each individual. It is also unlikely that a person with Parkinson’s disease would experience all or most of these symptoms.
The symptoms of the disease include:
< Instability of posture or balance,
< Locomotive difficulty
< Stiffness or rigidity of the arms, legs or neck – General slowness of movement and tremors or trembling (bradykinesia)
< Loss of sense of smell (anosmia)
< Nerve pain
< Excessive sweating (hyperhidrosis)
< Swallowing difficulties (dysphagia)
< Excessive production of saliva (drooling)
< Problems sleeping (insomnia)
< Constipation
Other symptoms may include depression, mental confusion, difficulty writing and speech problems.
Treatment and Cure
According to the World Health Organization (WHO), PD gets worse over time and there is no cure for the disease, although therapies, medicines surgery and rehabilitation can reduce its symptoms.
The most common medication for PD is Levodopa/carbidopa, a combination medicine that increases the amount of dopamine in the brain. However, doctors may use other medicines, such as anticholinergics to reduce involuntary muscle movement.
Also, Deep brain stimulation and other therapies can help the tremors and reduce the need for medicines. Rehabilitation, including physiotherapy can offer relief for Parkinson disease and other degenerative neurologic disorders.
The therapies involve strength training, locomotive and balance training, and hydrotherapy. These therapies, healthy diet and exercises can help to improve the functioning and quality of life for people living with PD.
Risk Factors
< Age: The average age where symptoms become apparent is estimated at about 70 years, and the incidence rises significantly with older age. However, a small percentage of people with PD have “Early-onset” disease that begins before the age of 50.
< Biological sex: When it comes to gender, PD tends to affect more men than women.
< Heredity: People with one or more close relatives who have PD have an increased risk of developing the disease themselves. An estimated 15 to 25 per cent of people with PD have a known relative with the disease. Some cases of the disease can be traced to specific genetic mutations.
< Exposure to pesticides: research has shown that there is an increased risk of PD in people who live in rural areas with increased pesticide use.
For those living with Parkinson’s disease, the average life expectancy is generally the same as for people who do not have the disease. There are many treatment options available for people with the disease. However, in its late stages, PD may no longer respond to medications and can become associated with serious complications, such as choking, pneumonia, and falls.
Parkinson’s disease is a very common condition and most of its effects and symptoms are manageable with treatment, even as the treatments become less effective and more complicated over time. It is therefore important for people to look out for the signs and not ignore them. It is also important for those with the disease to adhere to doctor’s instructions and take prescribed medications because, although it takes a while, the disease gets worse over time. However, researches are being conducted to further discover and understand the depths of the disease and if it can be eventually cured. Institutions like the National Institute of Neurological Disorders and Stroke (NINDS), a component of the National Institutes of Health (NIH), have made it their mission to seek fundamental knowledge about the brain and nervous system so as to use the knowledge to reduce the burden of neurological disease. NINDS conducts and supports research on Parkinson’s disease to better understand and diagnose PD, develop new treatments, and ultimately, prevent the disease.