Parkinson’s Disease
This week we’ll briefly discuss the neurodegenerative disease known as “Parkinson’s Disease.” Parkinson’s Disease (PD) was first described in 1817 by English surgeon James Parkinson in an article titled An Essay on the Shaking Palsy. Interestingly, many eponymous (named after a person) diseases have been renamed in a manner to reflect their pathology, but Parkinson’s Disease has withstood the test of time so far. In all fairness, Mr. Parkinson did not name the disease after himself, rather another physician did 60 years after he described it! (Another fun fact is that English male surgeons are addressed as “Mr.” rather than “Dr.”)
PD is a progressive disorder in which the most common symptoms are a resting tremor, muscle rigidity, and slow movements, usually noticed as a shuffling gait. As mentioned in the medication section regarding PD, the main problem is a loss and lack of dopamine in a specific part of the brain called the “substantia nigra.” On the flip side, the development of schizophrenia is thought to be due to an excess of dopamine, and so the treatment of both PD and schizophrenia walk a fine balance of trying to get medication levels just right so there is not an excess or deficiency of dopamine. Diet is also a critical component of PD as meals that are high in protein may decrease medication effectiveness.
There are a significant number of other symptoms in PD, and as we age some of the more concerning ones are swallowing, balance, falls, and cognition. Ensuring proper bone health, working with physical, occupational, and speech therapy, as well as doing the things that are important to us are critical as PD is a progressive disorder for which there is no cure. In his Essay Mr. Parkinson says in Chapter 5 “Considerations Respecting The Means Of Cure”
The inquiries in the preceding pages yield, it is to be much regretted, but little more than evidence of inference: nothing direct and satisfactory has been obtained…But although, at present, uninformed to the precise nature of the disease, still it ought not to be considered as one against which there exists no countervailing remedy.
200 years later, we are more informed to the precise nature of the disease and have some “countervailing remedies,” but still looking for answers. Clinical trials are ever ongoing, and maybe in another 200 years things will be much different!
PD does not necessarily limit life expectancy, but it certainly can limit life quality. Because of the variability in the disease course, it is important to the things that Matter Most with the people that Matter Most!
Key Points:
Parkinson’s Disease is a progressive disease affecting many functions of the body
PD does not have a known cure at this time, but several medications are available
PD symptoms require a whole interdisciplinary treatment team including physical/occupational/speech therapists and dietitians
