Parkinson's disease: symptoms, causes and treatment

By Cristiano Antonino Last updated May 30, 2023

Parkinson’s disease – which many people call and know as Parkinson’s disease – is linked to a progressive degeneration of certain structures of the nervous system, degeneration that affects the control of a number of functions, including movement

It often begins with a barely perceptible tremor in one hand.

In addition to tremors, muscle rigidity and slowed movement are also common.

In the early stages of the disease, the face may lose expressiveness, the arms may not swing when walking, handwriting changes and characters become smaller.

As the disease progresses, symptoms also worsen.

Although Parkinson’s disease cannot be cured definitively, medication can significantly improve the symptoms.

Occasionally, the doctor may suggest surgery to regulate certain regions of the brain and alleviate the discomfort experienced.

Parkinson’s disease: pathological basis

Parkinson’s is a fairly widespread neurological disease characterised by a slow and progressive loss of neurons in the brain, the nerve cells.

In particular, in the case of the disease, there is degeneration of the cells that make up the black substance: a part of the brain that contains a dark pigment, called neuromelanin, which is responsible for producing dopamine, a neurotransmitter involved in the functioning of the nerve structures that are essential for controlling movement. This is why Parkinson’s causes movement difficulties.

In most cases, the onset of symptoms occurs around the age of 50 to 60, but in a small percentage of patients it can occur even earlier, before the age of 40.

Parkinson’s disease, symptoms

The signs and symptoms of Parkinson’s disease (also known as Parkinson’s disease) are not always the same, but vary from person to person.

Often the first signs are mild and go unnoticed.

They initially affect only one side of the body and even after they begin to affect the other side, they tend to worsen more on the first affected side.

Signs and symptoms of Parkinson’s may include

tremor, which usually starts in one limb, often in the hand or fingers. The patient may have a tendency to rub his thumb and forefinger back and forth and his hand tends to tremble more when at rest;
slowed movement (bradykinesia): over time, the disease may slow down movements, making even the simplest tasks difficult and time-consuming. The patient takes shorter steps when walking; has difficulty getting up from a chair; drags his feet while trying to walk;
muscle stiffness, which can occur in any part of the body. Stiff muscles may also be painful and limit range of motion;
impaired posture and balance: the patient assumes a hunched posture and/or has balance problems;
loss of automatic movements: the person may have a reduced ability to perform unconscious and involuntary movements, such as blinking, smiling or swinging the arms when walking;
changes in speech: the patient speaks more slowly or may alternate slowing down with sudden speeding up, is not very fluent during speech, hesitates before speaking. In addition, he may have a more monotonous tone, his voice becomes more feeble, hoarse, hesitant;
problems with writing: the disease makes writing difficult and the patient’s handwriting may become smaller.

Other signs

There are other symptoms that may appear some years after the onset of the disease (which many call Parkinson’s disease) or, often, precede its onset.

Here are the most common ones

alterations in intestinal motility, with the appearance of constipation
depression;
reduced olfactory sensitivity;
changes in blood pressure;
various types of pain (cramps, numbness, burning sensation) especially in the legs;
disturbances during sleep (agitation with the emission of screaming, abrupt and violent movements);
reduced facial expressiveness;
difficulties with concentration and memory;
reduced ability to perform complex tasks or several activities at the same time.

Parkinson’s disease, causes

As mentioned, in Parkinson’s disease, certain nerve cells (neurons) in the brain degrade and gradually die.

Many of the symptoms are due, in particular, to a loss of neurons that produce dopamine, a chemical messenger.

Decreased dopamine levels cause abnormal brain activity, leading to the appearance of altered movements and other disorders typical of the disease.

Furthermore, it has been seen that in the case of disease, insoluble protein aggregates called Lewy bodies form within certain neurons of the brain.

Even today, the causes that lead to these changes are poorly understood.

However, it seems that genetics plays an important role.

Researchers have identified some specific genetic mutations that can cause Parkinson’s disease.

Exposure to certain toxins or environmental factors may also increase the risk of later Parkinson’s disease.

Risk factors

Risk factors for Parkinson’s disease include:

age. Young adults rarely experience Parkinson’s disease. Usually, the disease begins in middle or late age and the risk increases with age. People generally develop the disease around age 60 or older, although early forms of the disease do exist;
presence of other cases in the family: having a close relative with Parkinson’s disease increases the chances of developing the disease. However, with only one sick relative the risks remain low;
gender: men are more likely to develop Parkinson’s disease than women;
exposure to toxins: continuous exposure to herbicides and pesticides, e.g. for professional reasons, can slightly increase the risk of Parkinson’s disease.

The complications of Parkinson’s

Parkinson’s disease can cause certain complications, such as:

difficulty in thinking: as the disease progresses, the patient may experience cognitive problems (dementia) and difficulty in thinking;
emotional changes: over time, the patient may develop fear, anxiety or loss of motivation;
swallowing problems: as the disease progresses, swallowing difficulties may develop. Due to slowed swallowing, saliva may also accumulate in the mouth, leading to drooling;
chewing and eating problems: advanced Parkinson’s disease affects the muscles in the mouth and swallowing. This can lead to choking and poor nutrition;
sleep disorders: people with Parkinson’s disease often have sleep problems, such as waking frequently during the night, waking early or falling asleep during the day;
Bladder problems: Parkinson’s disease can cause bladder problems, including the inability to hold urine and difficulty urinating;
Constipation: Many patients develop constipation, mainly due to a slower digestive system;
changes in blood pressure: the patient may experience dizziness or light-headedness when standing up due to a sudden drop in blood pressure (orthostatic hypotension);
feeling of fatigue: many people with Parkinson’s disease lose energy and experience fatigue, especially during the day. The cause is not always known;
pain: some patients experience pain, either in specific areas or throughout the body;
sexual dysfunction: some sufferers notice a decrease in sexual desire or performance. In other cases, the opposite occurs.

Parkinson’s disease cures

Parkinson’s disease, which many call Parkinson’s disease, cannot be cured definitively. However, pharmacological treatments can help control symptoms, often very effectively.

In particular, they help manage problems with walking, movement and tremor.

Many of these drugs increase the availability of or replace dopamine, the levels of which are reduced during illness.

It must be known, however, that their benefits may diminish over time.

In some more advanced cases, surgery may be recommended.

The most widely used intervention today is deep brain stimulation, which cancels or diminishes the alterations in the brain’s motor circuitry and the symptoms typical of the disease.

The doctor may also recommend lifestyle changes, in particular advising more movement and aerobic exercise.

In some cases, physical therapy, which focuses on balance training and stretching, is also important.

A speech therapist can help improve speech problems.

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