How does the degenerative brain cells cause Parkinson’s?

What is Parkinson’s Disease?

Parkinson’s is one type of dementia that starts to affect the brain cells slowly around the brainstem, where a neurotransmitter called “Dopamine” is produced; it controls the body movement and when it becomes imbalanced in the brain symptoms such as spasms of various muscles (legs, arms, neck) and tremor may appear.

Risk factors for Parkinson’s disease

Parkinson’s disease found more in people aged over 50, according to calculated ratio1:1, most of them are males; moreover, in Thailand there is every one person from one thousand of populations becomes patient of the disease which is why it is ranked as the second common disease next to Alzheimer’s; furthermore, it is mostly found in the central region of a country as well.

Apart from age that contributes to the disease, patients with mental instability, those who have been to head injury especially athletes (boxer, soccer player) who are at higher risk than others; for example, Muhammed Ali (Cassius Clay) who suffered from the disease beside, genetic is one of triggers link to the disease as well.

Symptoms of Parkinson’s disease

Many people may think that Parkinson’s disease only shows symptoms which are tremor during a walk, being unable to balance the body while standing; there are more conditions involved apart from these as below: such as having a bad dream, chronic constipation, stress, slurred speech, dysphagia and choking in those having severe conditions.

• sleepwalking or having nightmare
• chronic constipation
• depression
• slurred speech, stridor voice, slow at speaking
• having difficulty at swallowing foods, frequent choking especially in patients with severe symptoms

Effects of Parkinson’s disease

• Because the body movement is difficult to be done as well daily activities which makes quality of life becomes worse.
• Risk of injury from falling and various types of accident
• Personality change which may decrease confidence in a person leads to anti-socializing, becoming an introvert or having depression.
• having problems with communicating to others which later leads to low quality of life.
• In the case of severe illness close supervisionis needed from a family member.
• When symptoms that patient is having is very severe family needs to be prepared to provide care for that reason if the preparation is unsteady that could lead to many worse consequences.
• Treatment costs

Diagnosis

When the patient arrives at a hospital, a doctor will start asking patients for more personal history and provides screening for some disorders including examination of the nervous system and MRI Brain to provide an accurate diagnosis as there are several symptoms which may not cathegorize as parts of the disease. Therefore, for more accuracy and effective treatment must be evaluated precisely.

The PET Brain F-Dopa examination detects brain activity and looks for some abnormalities in dopamine which the doctor considers doing it to certain patients only when it is necessary.

Parkinson’s Disease Treatment

Although there is no treatment approach for Parkinson’s disease, in medical term, patients can still be treated regarding symptoms to improve a better quality of life as follows:

• Drug treatment Drug therapy can adjust the balance of dopamine in the brain considered as palliative care however, it still cannot recover the degenerated brain; as a result, patients have to catch up their appointments constantly to receive medical treatment which adjusted appropriately according to the improvement of conditions.
• Physical therapy Apart from taking a medicine that balances body patients should receive physical rehabilitation, such as walking, practicing speaking, swallowing as well as exercising according to what a doctor has adviced; a step of the rehabilitation depends on body condition, severity, age and preparation of that person.

Deep Brain Stimulation, DBS

Patients treated with medicine, after a while the body can be resistance to the drug used since it becomes ineffective and cause some side effects; a doctor considers changing dose of the drug used however, if it still does not work out well a new treatment approach must be applied called Deep Brain Stimulation instead.

The approach procedure performed by creating two small holes around the skull so that a doctor can insert a wire into the brain connnecting through the scalp until throat and chest that link to connecting with the electronic device embedded in the chest that releases electricity to stimulate the brain.

During the procedure, a doctor will make patients sleep at start; after that, in order to test a result of this Deep Brain Stimulation that can improve the symptoms pateints will have his or her consiousness back while inserting a device before suture of the wounds. Advantages of this surgical approach is that a doctor can set up device manually after the surgery to make it relevant with symptoms.

Caring for Parkinson’s patients

As the symptoms of Parkinson’s disease often affect the movement of the body making each day activity becomes difficult, a family member or those taking care of the patient plays a rule to provide close supervision and support them to improve healthy physical body and mental state which also includes space in a house as well as other appliances as below:

• Selecting shoes soles that do not slip to prevent accidents from happening
• selecting glassware, spoons, cup, water glass that is unbreakable and has a holder
• Provision of food that is easy to be chewed, scooped, eaten slowly, wait until finish swallowing it completely before having another amount of food in the mouth
• Making a handrail inside a bathroom also every area where patients regularly use
• Patients should sleep on the first floor of a house to prevent them from walking up and down stairs.
• Always make a patient do physical therapy regularly to follow what a doctor as suggested such as slow walking, high foot lifting, and big step of the walk.
• Make the patients take a medicine on time and take him or her to see a doctor by following an appointment
• Encouraging patients by inviting them to talk or do activities together
• There should be no obstructions in the path and equipment attached to provide adequate light

Prevention of Parkinson’s disease

Although the medical profession is not yet aware of the cause for brain cell degeneration, there is assumption for the risk that we can actually avoid by taking care of health such as…

• Exercise regularly
• Get enough sleep
• Not being too serious and relax your mind with meditation
• Avoid being in the environment where the air is polluted

Finally, paying attention and observing yourself and everyone in a family especially an eldery if they have any physical abnormalities ; receiving a diagnosis since the begining of symptoms can partially makes treatment result be more effective than having treatment while severity of the symptoms have already spread.

Dr.Sitthi Petchrutchatachart
Neurologist specialized in Parkinson’s Disease and Movement Disorders