Parkinson’s disease is a progressive disease of the nervous system, characterized by various symptoms, including the main symptoms (the so-called Parkinson’s triad):
- tremor (muscle tremors),
- slowed movements (bradykinesis),
- Rigor (muscle stiffness).
The “substantia nigra” (black matter) is a small area in the brain that is affected by this disease.
This area of the brain receives signals via the nerves of the spinal cord to control the muscles of the body.
The messages are transmitted by the neurotransmitters, which are substances that make communication between neurons possible.
Dopamine is the main neurotransmitter produced and released by brain cells in the substantia nigra.
With Parkinson’s disease, degeneration and death of the neurons of the substantia nigra occur.
As cell damage progresses, the amount of dopamine produced is reduced.
The result is altered nerve signals with a significant slowing down of motor functions.
Course and progression of Parkinson’s disease
The progression of Parkinson’s disease varies among patients.
Parkinson’s is chronic and slowly progressive because symptoms persist and worsen over the years.
Parkinson’s is not a fatal disease.
The way of progression is different for everyone:
– Motor symptoms vary from patient to patient.
– The course of the disease is not precisely determined.
– Motor problems vary depending on activities during the day.
– Some people with Parkinson’s live for many years with mild symptoms, while others quickly develop movement difficulties.
– The non-motor symptoms are very individual and occur in all phases of the disease. Some people with Parkinson’s explain that symptoms such as depression or fatigue affect daily life more than motor problems.
Causes of Parkinson’s disease
The causes of Parkinson’s disease are still unknown despite decades of research.
Many experts believe that the disease is caused by a combination of genetic and environmental factors that vary from person to person.
- Scientists have recognized age as an important risk factor, in fact 2-4% of patients are older than 60 years.
- Between 15 and 25% of Parkinson’s sufferers have a relative with this disease.
Researchers have discovered several genetic mutations that can directly cause this disease, but this only affects a small number of families.
Some of these mutations affect genes that play an important role in the cellular function of dopamine.
Some studies have shown that prolonged occupational exposure to certain chemicals is associated with a higher risk of Parkinson’s:
- herbicides (herbicides),
- Heavy metals
Despite these studies, exposure to a single environmental toxin is not thought to be the cause of Parkinson’s.
Factors that reduce the risk of Parkinson’s
According to a recent study, people who regularly eat foods such as wild berries, apples, vegetables and red wine can drastically reduce the risk of Parkinson’s.
The reason for this is that these foods contain flavonoids, which, according to one study, have a protective effect.
The study also shows that regular intake of flavonoids increases the risk of other diseases such as:
- Heart disease
- some cancers.
First symptoms of Parkinson’s disease
The first signs of the disease are:
- swallowing disorders, which also leads to saliva accumulation,
- decreased or total loss of the sense of smell.
Some people may have a condition called sleep behavior disorder in the REM phase.
Parkinson’s patients with this disorder do not lose muscle control in the REM phase and therefore behave as if they were awake, kicking and talking in their sleep.
Signs and symptoms regarding movements
The brain and nerve cells affected by Parkinson’s disease have a coordinating function and should make the muscle movements fluid.
Therefore, with Parkinson’s disease, the following cardinal symptoms develop:
– Slowed movement (bradykinesis).
The gait pattern of the Parkinson’s patient is characterized by:
- short steps,
- the feet drag across the floor.
The gait begins slowly and the feet seem to stick to the ground. This is followed by a progressive acceleration (Festination – walking faster and faster so as not to fall forward), which can eventually end in a fall.
Walking or getting up from a sitting position can be difficult.
This first symptom is often confused with age-related disorders. In addition, difficulties in running, standing still and turning can be observed while walking.
– Stiffness and tension of the muscles (rigor). While walking, the arms often do not swing forward and backward. The body also resists passive movement, but every now and then a joint moves jerkily (gear phenomenon); this can be observed especially on the wrist.
– Resting tremor. This symptom is common and usually affects fingers and arms, but can also affect other parts of the body.
- occurs mainly when the patient is at rest,
- disappears during movement and sleep,
- has a frequency of about 5 beats per second.
In the hands, the rhythmic tremor movement is similar to the processes of pill turning and is therefore also referred to as pill twister tremor.
The patient’s posture is referred to by the term camptocormia and is characterized as follows:
- forward flexion of the trunk,
- bent knees,
- Arms lie against the body.
The movement disorder (dystonia) of the foot is manifested by a long-lasting contraction of the muscles, which leads to an abnormal posture of the foot:
- inward rotation,
- plantar flexion,
- Toe extension (upwards).
Symptoms tend to get worse slowly; the rate at which they worsen varies from person to person.
The patient does not notice symptoms until the loss of the neurons of the substantia nigra has reached 50% of the total.
Years can pass before the symptoms affect the daily lives of the sick.
In the first phases, only one side of the body (right or left) is affected.
Other symptoms may develop depending on the cells affected by the disease.
These symptoms include:
- reduction of facial expressions (apparent lack of expression);
- difficulties in fine motor skills, such as tying shoes or buttoning shirts;
- writing difficulties;
- difficulty maintaining balance and frequent falls;
- speech can become slow and monotonous;
- Fatigue, muscle and joint pain.
Other symptoms of Parkinson’s disease
In the following phases of the disease, other symptoms may develop, such as:
- bladder disorders and incontinence;
- hallucinations (seeing or hearing what does not exist);
- increased sweating;
- sexual dysfunction;
- odor disorders;
- pain – due to stiffness; the patient feels pain everywhere, especially in the neck and shoulders; this symptom is exacerbated by the incorrect posture provoked by stiffness;
- Depression and anxiety.
Orthostatic hypotension – this means low blood pressure when the Parkinson’s patient stands up (from a lying or sitting position). This happens because this disease acts on the self-regulation mechanism of blood pressure.
Other factors that can reduce low blood pressure are:
- physical activity
- some Parkinson’s medications.
Symptoms of a drop in blood pressure include:
- blurred vision,
Complications of Parkinson’s disease
Parkinson’s disease often has the following consequences:
- There could be cognitive problems (dementia) and difficulties in thinking, which usually manifest themselves in the advanced phases of Parkinson’s disease.
The patient has memory loss and difficulty planning and organizing.
Such cognitive problems cannot be treated very well with medication.
- Depression and personality changes. Many people with Parkinson’s disease have depression. Treating depression makes it easier to deal with the other symptoms caused by this disease. You can also have other emotional changes such as anxiety, anxiety or loss of motivation.
- Sleep problems and sleep disorders. People with Parkinson’s disease often suffer from insomnia and often wake up during the night. During the day, sudden sleep attacks may occur.
Sleep disorders include: sleep apnea (stopping breathing during sleep) and restless legs syndrome (restlessness and urge to move in the lower limbs).
Medication can help stabilize the sleep-wake cycle.
- Parkinson’s disease can lead to problems with the bladder, including incontinence and urinary retention.
- Sexual dysfunction. Some people with Parkinson’s disease may see a decrease in libido or decreased performance.
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