Resources at Hebrew SeniorLife

Parkinson's Disease

Approximately 1 million American's suffer from Parkinson's disease, with nearly 500,000 new cases diagnosed each year. Three out of every 100 people in the United States over the age of 60 has Parkinson's. Robert Schreiber, M.D.,Medical Director of Outpatient Primary Care Practice, Community-Based Programs, Innovation and Development at HSL and a specialist on chronic diseases in seniors, says that Parkinson's is a neurological disorder that gets progressively worse over time.

Definition

A chronic, progressive neurological disease that affects neurons in the region of the brain that is responsible for coordinating smooth and balanced movement. 

Causes

Death or destruction of nerve cells in the brain's substantia nigra, the region of the brain that releases dopamine, which causes muscles to make smooth, controlled movements.

Symptoms

  • Tremor
  • Slowed movement
  • Rigid muscles
  • Impaired balance
  • Loss of automatic movements like blinking or swinging of the arms when walking
  • Impaired speech
  • Difficulty swallowing
  • Dementia

Risk Factors

  • Age (risk increases with age)
  • Heredity
  • Sex (men more than women)

Diagnosis

  • Computerized tomography (CT) scan
  • Magnetic resonance imaging (MRI)
  • Neurological examination, including evaluation of gait, coordination and simple tasks of dexterity

Treatment

  • Levodopa and carbidopa to increase dopamine production
  • Dopamine agonists
  • COMT inhibitors
  • Anticholinergics
  • Thalamotomy
  • Pallidotomy
  • Deep brain stimulation
  • Physical, occupational and speech therapy to improve quality of life

Glossary

Anticholinergics - drugs that help control tremors in the early stages of Parkinson's.

Carbidopa - a medication given in conjunction with Levodopa to prevent the breakdown of dopamine in the brain.

Computerized tomography (CT) scan - a noninvasive diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce cross-sectional images of the body, showing detailed images of bone, muscle, fat and organs.

COMT inhibitors - drugs that prolong the effect of carbidopa-levodopa therapy.

Deep brain stimulation - the implantation of a pacemaker-like unit in the chest wall that transmits electrical impulses to the subthalamic nucleus, the part of the brain that controls many aspects of motor function.

Dementia - a condition of deteriorated mentality characterized by a marked decline in an individual's intellectual level and often by emotional apathy.

Dopamine - a chemical messenger in the brain that controls muscle movement.

Dopamine agonists - drugs that mimic the action of dopamine and cause neurons to react as if sufficient of dopamine were present.

Levodopa  - a drug that is transported to nerve cells in the brain that produce dopamine and is converted to dopamine, aiding in the treatment of tremors and movement disorders.

Magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies and computers to produce detailed images of organs and structures in the body.

Neurons  - cells throughout the nervous system, including the brain, spinal cord and nerves.

Pallidotomy - a surgical procedure in which electrical currents are used to destroy the global pallidus, the part of the brain responsible for many Parkinson's symptoms.

Substantia nigra - the region of the brain responsible for the production of dopamine and for controlling voluntary movement and regulating mood.

Thalamotomy - a surgical procedures that helps reduce Parkinson's-related tremors.

Links

National Parkinson Foundation - www.parkinson.org
Parkinson's Disease Foundation - www.pdf.org
Michael J. Fox Foundation for Parkinson's Research - www.michaeljfox.org


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