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What is Parkinson’s Disease?

October 12, 2021

Parkinson’s disease (PD) is a progressive disorder of the nervous system and the second most common degenerative condition of the brain. It is a result of damage to regions in the brain which are responsible for producing dopamine – a chemical messenger responsible for permitting smooth, purposeful movement. Dopamine is vital to our functioning as it is involved in so many physical and behavioural processes such as, learning, motivation, sleep, mood, attention, pain processing and movement. For this reason, PD can cause a wide variety of symptoms which can vary from person to person and change over time. The most common symptoms can include:

  • Tremor/shaking at rest or when tired 
  • Slow movements or freezing (inability to initiate movement)
  • Stiffness in muscles particularly in the arms, legs and trunk
  • Poor posture and balance difficulties 

Some of the lesser-known symptoms and commonly preceding warning signs of PD include:

  • Fine-motor difficulties (such as with handwriting)
  • Slurred or slow speech
  • Difficulty swallowing
  • Loss of smell
  • Constipation
  • Urinary incontinence 
  • Fatigue
  • Sleep disturbances (vivid dreams, involuntary talking and moving during sleep)
  • Anxiety and/or depression

Early indicators of PD can occur long before movement difficulties arise and they often go unrecognised. It is important to note that many symptoms of PD can be caused by various other conditions. However, if you are worried by experiencing any of these, speak to your doctor.

Disease Stages

The Hoehn and Yahr scale is typically used to evaluate the progression of PD symptoms and the level of disability in individuals with this condition. 


So, What Causes It? 

Currently, it is not known exactly what causes PD although it is believed that both genetic and environmental components are involved. Factors that are believed to play a role include: 

  • Age: Incidence of PD rises with age.
  • Sex: Males are much more prone to development of PD.
  • Race: Higher prevalence in Caucasian and Hispanic people compared to African, Asian and Arabic. 
  • Environmental toxins: Prolonged exposure to pesticides, herbicides and heavy metals is associated with an increased risk of developing PD. 
  • Genetics: In approximately 10-15% of PD cases, a family history of the condition is present.

Treatment and Management

Medicine and diet are two key components to managing PD and its associated symptoms. There are numerous drugs used to treat this disease, with the majority of which acting similarly to increase dopamine levels in the brain. Medication is not a one size fits all for PD though and is chosen based on symptom severity, cost and individual effectiveness. Diet, on the other hand, does not contribute towards treating or preventing PD directly although it does have a role in managing this condition. A well-balanced, nutritious diet can help with symptoms of PD such as constipation and consuming foods high in omega-3 fatty acids has shown to be neuroprotective. These can include seafood, nuts, seeds, and plant oils. Surgical interventions are also an option but are generally reserved for those who don’t respond to other conservative treatments.

Benefits of Exercise

Exercise is the other cornerstone of PD treatment as the association between regular physical activity and disease progression slowing is well recognized. Not only does exercise help generally with aerobic fitness, muscle strength, balance and mobility but it can also reduce symptoms specific to PD like freezing. Exercise induced physical changes within the brain that have been linked to decreased PD impairments are also documented. 

Like medication though, there is no one size fits all approach to exercise with not-one specific type singled out as best for treating this condition. Multi-modal exercise which challenges an individual’s aerobic fitness, balance, coordination and strength is considered to be optimal. To maximise benefits, aerobic exercise should be performed to a high-moderate intensity aiming for at least 30 minutes on most days. Other exercise approaches such as tai chi and dancing are also very beneficial strategies, particularly for balance.  

References

Hoehn, M., & Yahr, M. (1967). Parkinsonism: onset, progression, and mortality. Neurology17(5), 427-427. doi: 10.1212/wnl.17.5.427

Kerr, G. (2020). Parkinson’s Disease & Exercise [Ebook] (pp. 1-2). QUT: Exercise is Medicine Australia. Retrieved from http://exerciseismedicine.com.au/wp-content/uploads/2021/01/EIM-FactSheet_Parkinsons_Professional-2020.pdf

Kouli, A., Torsney, K., & Kuan, W. (2018). Parkinson’s Disease: Etiology, Neuropathology, and Pathogenesis. Parkinson’S Disease: Pathogenesis And Clinical Aspects, 3-26. doi: 10.15586/codonpublications.parkinsonsdisease.2018.ch1

Rizek, P., Kumar, N., & Jog, M. (2016). An update on the diagnosis and treatment of Parkinson disease. Canadian Medical Association Journal188(16), 1157-1165. doi: 10.1503/cmaj.151179

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