Definition / What is Parkinson
Parkinson’s disease (PD) is a chronic neurodegenerative disorder that primarily affects movement control. It is characterized by a progressive loss of brain neurons that produce dopamine, which results in symptoms that are both motor and non-motor.
PD occurs when the nerve cells in your brain don’t make enough of a body chemical called dopamine -dopamine in the brain region responsible for promoting movement. Insufficient levels of dopamine prevent the brain from sending signals that are necessary for proper movement coordination
History
ÂJames Parkinson’s seminal book “An Essay on the Shaking Palsy,” which served as the first clinical description of the illness, was published in 1817.
The term “Parkinson’s disease” was first used in the 1870s by Jean-Martin Charcot in recognition of Parkinson’s groundbreaking observations.
An important turning point in the understanding of the disease was the mid-20th century discovery that dopamine deficiency was a major contributing factor. Public awareness campaigns include world Parkinson day and the use of a red Tulip symbolizes Parkinson’s awareness. Among those with Parkinson’s disease (PD) who have raised public awareness of the illness is boxer Muhammad Ali.
Causes
Parkinsons is also called idiopathic parkinsonism, meaning that it has no identifiable cause
Parkinson’s disease continues to have a multifactorial etiology, resulting from the intricate interaction between genetic predisposition and environmental factors. It is believed that oxidative stress, environmental pollutants (such as pesticides and some drugs), and genetic abnormalities have an impact on the development of Parkinson’s disease (PD).
Getting older is a major risk factor for Parkinson’s disease (PD), and the disease is more common with age.
Risk Factors for Parkinson’s Disease:
Genetic Factors:
1. Complex Interaction:
– PD results from a complex interplay of genetic and environmental factors.
2. Familial Association:
– Around 15% of diagnosed individuals have a first-degree relative with PD.
– 5–10% have a mutation in genes.
3. Gene Mutations:
   – At least 11 autosomal dominant and nine autosomal recessive gene mutations were implicated.
– Autosomal dominant genes include SNCA, PARK3, UCHL1, LRRK2, etc.
– Autosomal recessive genes include PRKN, PINK1, DJ-1, ATP13A2, etc.
– X-linked and unknown inheritance pattern genes include USP24, PARK12, PARK16.
4. GBA1 Gene Mutations:
– About 5% of people with PD have mutations in the GBA1 gene.
– Increased risk 20–30-fold, earlier age of onset, and more rapid cognitive and motor decline.
5. Alpha-synuclein and Lewy Bodies:
   -PD patients with alpha-synuclein mutations (SNCA gene) develop Lewy bodies.
   – Alpha-synuclein aggregation is associated with decreased DNA repair and the death of brain cells.
6. LRRK2 and GBA Mutations:
   – The most prevalent known cause of PD, both sporadic and familial, is mutations in LRRK2.
– GBA mutations present the greatest genetic risk of developing PD.
7. Parkinson-Related Genes and Lysosomes:
– Parkinson-related genes are involved in lysosomal function.
– Lysosomal disorders affecting alpha-synuclein breakdown may cause PD.
Non-genetic Factors:
1. Chemical and Pharmaceutical:
– Increased likelihood with agricultural work, pesticide exposure, and rural habitation.
   – Chlorinated solvents,
   – Manganese exposure , traffic fumes
2. Medical Drugs:
   – Drug-induced parkinsonism is reversible by stopping offending agents.
– Implicated drugs include phenothiazines, butyrophenones, metoclopramide, and Tetrabenazine.
3. Biological Factors:
– Traumatic Brain Injuries (TBIs):
– Strongly implicated as risk factors for PD.
     – Association distorted by the recall and sampling bias.
– Mechanisms may include alpha-synuclein accumulation, inflammation, and metabolic dysregulation.
– Vascular Parkinsonism:
– Presence of PD symptoms with findings of vascular events.
– Similar dopaminergic pathway damage as idiopathic PD.
4. Infection:
   – PD and Helicobacter pylori infection may be related, which could impact medication absorption.
5. Psychological Factors:
   – Neuroticism is associated with a higher risk of incident PD.
– Loneliness in adults linked to a greater risk of developing PD over a 15-year follow-up.
AGE OF ONSET
Early onset Although persons under 50 can be affected by Parkinson’s disease, most cases of the condition are discovered in those 60 years of age and beyond (late-onset Parkinson’s disease). Parkinson’s disease (PD) is more common in older adults, with men typically being slightly more susceptible than women.
TYPES OF PARKINSONS
a neurodegenerative condition that progresses Parkinson’s disease (PD), also known as idiopathic parkinsonism because it lacks a known cause, is the most prevalent type of parkinsonism. It includes tremor, bradykinesia, rigidity, and postural instability.
Idiopathic Parkinson’s disease (IPD):
The majority of IPD cases are marked by a progressive emergence of motor symptoms that have no clear explanation.
Secondary Parkinsonism
develops as a result of outside causes like head trauma, other neurodegenerative diseases, or specific drugs (like antipsychotics).
Atypical Parkinsonism
This category includes conditions that have unique features but share some clinical traits with Parkinson’s disease (PD), such as:
- Atypical Parkinsonian symptoms and autonomic dysfunction are the hallmarks of Multiple System Atrophy (MSA).
- Progressive Supranuclear Palsy (PSP): Identified by abnormal eye movements, early postural instability, and cognitive impairment.
Drug-induced Parkinsonism
Certain drugs can cause Parkinsonian symptoms, particularly antipsychotics and some antiemetics.
Signs and Symptoms
Sign and symptoms
1. Motor Symptoms:
– Tremor:
– Coarse, slow tremor at rest.
– Pill-rolling movement.
– Bradykinesia (Slowness of Movement):
– Disturbances in motor planning.
– Impaired performance of movements.
– Rigidity:
– Uniform or ratcheted rigidity.
– Postural Instability:
     – leads to falls and poor balance.
– Gait and Posture Disturbances:
– Festination, freezing of gait, altered voice, mask-like facial expression.
2. Cognitive Symptoms:
– Executive Dysfunction:
– Impaired planning and cognitive functions.
– Other Cognitive Difficulties:
– Slowed cognitive processing, impaired recall.
3. Psychosis:
– Prevalence- 26% to 83%.
– Hallucinations or delusions.
– Types of Hallucinations:
– Vivid visual hallucinations, paranoid ideation.
4. Neuropsychiatric Symptoms:
– Mood Alterations:
– Depression, anxiety.
– Apathy and Anhedonia:
– Loss of motivation, emotional indifference.
5. Gastrointestinal Symptoms:
– Constipation: – Affects more than 80%.
– Other Gastrointestinal Issues:
– Impaired stomach emptying, swallowing impairment.
6. Other Symptoms:
– Sleep Disorders:
– Daytime drowsiness, sudden sleep attacks.
– Autonomic Nervous System Alterations:
– Orthostatic hypotension, excessive sweating.
– Changes in Perception:
– Impaired sense of smell, disturbed vision, pain.
Diagnosis
DIAGNOSIS OF PARKINSONS
Clinical diagnosis of Parkinson’s disease (PD) is made after a thorough assessment of the patient’s symptoms, medical history, and sometimes additional tests. Healthcare providers use a variety of criteria to accurately diagnose Parkinson’s disease, even though there isn’t a single, conclusive laboratory test for the condition. The procedures for diagnosing Parkinson’s disease are as follows:
- Clinical Assessment:
- Medical History: A thorough discussion of the patient’s past illnesses, family medical history, prescription use, and exposure to toxins.
- Symptom presentation.
Examining both motor and non-motor symptoms linked to Parkinson’s disease
- Physical Exam:
- Neurological Exam: A thorough evaluation of balance, coordination, motor skills, and muscle tone.
- Brachykinesia: Evaluation of sluggishness in movement.
- Rest tremor is the term used to describe tremors felt by the body while it is at rest.
- Rigidity: Assessment of the rigidity of muscles.
- Postural instability
- Diagnostic Standards:
Criteria such as the Queen Square Brain Bank Criteria or the Movement Disorder Society (MDS) Criteria may be used.
Bradykinesia, rigidity, rest tremor, and postural instability are important characteristics.
4. Supportive Features:
Rest tremor is the term used to describe tremors felt by the body while it is at rest.
5. Exclusion of Secondary Causes:
Rule out other conditions or medications that could cause Parkinsonism as secondary Parkinsonism.
6. Response to Medication:
Improvement of symptoms with dopaminergic medications, particularly levodopa, can be indicative of Parkinson’s disease.
7. Imaging Studies:
CT or MRI Scan: To rule out other conditions that may mimic Parkinson’s symptoms.
DaTSCAN (SPECT or PET): Measures dopamine transporter activity and can help differentiate Parkinson’s from other Parkinsonian syndromes.
8. Monitoring Over Time:
PD symptoms typically progress over time, and continuous monitoring may be necessary for a conclusive diagnosis.
9. Movement Disorder Specialist:
Consultation with a neurologist, preferably a movement disorder specialist, who has expertise in Parkinson’s disease.
10. Consideration of Other Parkinsonian Syndromes:
Differentiating PD from other parkinsonian syndromes (e.g., multiple system atrophy, progressive supranuclear palsy) based on specific clinical features.
TREATMENT
Treatment for Parkinson’s disease often consists of supportive therapy, surgery, conventional medicine, and sometimes alternative therapies. It’s important to remember that although there isn’t a cure for Parkinson’s disease, there are treatments that can help control symptoms, enhance functional abilities, and improve quality of life. An overview of the various treatment modalities is provided below:
1. Conventional Medicine:
a. Medications:
Levodopa: Converts to dopamine in the brain, alleviating motor symptoms.
Dopamine Agonists: Mimic the action of dopamine.
MAO-B Inhibitors: Increase dopamine levels by inhibiting its breakdown.
COMT Inhibitors: Extend the effectiveness of levodopa.
Anticholinergic drugs. Help control symptoms like tremors. These drugs are used along with levodopa.
b. Physical Therapy:
Neuroplasticity, or the brain’s capacity to adapt to changes in behavior, can be stimulated through exercise. When you begin physical treatment, new motor and cognitive abilities are developed in your brain.. Exercise also maintains the health of brain cells. Â simply, physical treatment might slow down the progress of Parkinson’s disease.
Helps improve balance, flexibility, and coordination.
c. Occupational Therapy:
Focuses on daily activities and fine motor skills.
d. Speech Therapy:
Aids in addressing speech and swallowing difficulties.
e. Assistive Devices:
Walking aids, adaptive utensils, etc., to enhance independence.
2. Surgical Interventions:
a. Deep Brain Stimulation (DBS):
Involves implanting electrodes in specific brain regions to regulate abnormal impulses.
b. Lesioning Procedures:
Thalamotomy or pallidotomy
Alternative treatment for Parkinsons’ disease
1- Herbal Treatment fo Parkinsons
i-The velvet bean, Mucuna Pruriens: Mucuna pruriens is regarded as a natural source of dopamine since it is rich in levodopa, which is a precursor to the neurotransmitter. One of the most often recommended drugs for Parkinson’s is levodopa.
ii-Ginkgo Biloba: Besides its reputation as an antioxidant, ginkgo biloba may also have neuroprotective benefits. According to certain research, it might aid in enhancing cognitive performance in Parkinson’s disease patients.
iii-Curcumin, or turmeric, is an antioxidant and anti-inflammatory spice that has been researched for possible neuroprotective benefits. The active ingredient in turmeric, curcumin, may be able to prevent Parkinson’s disease.
iv-Bacopa monnieri: Known for boosting cognition, this plant may help maintain optimal brain function. Few research have looked into its possible advantages for Parkinson’s.In Ayurvedic medicine, bacopa is primarily used to treat insomnia, epilepsy, memory loss, and anxiety. Using bacopa has been shown in numerous clinical studies to increase verbal learning, delayed word recall, memory acquisition, and anxiety reduction.
Homeopathy treatment for Parkinsons
1- Causticum: For rigidity
The best natural remedy for Parkinson’s disease is causticum. For patients who have extreme stiffness, it is perfect for individuals experiencing stiffness, trembling, and difficulty in initiating movement. It may also be beneficial for those who have emotional sensitivity and a tendency to feel better with warmth.
2-Gelsemium: Gelsemium may be taken into consideration when there is a feeling of weakness, trembling, and loss of coordination. It’s used when tiredness and an aversion to company are present.
3-Lycopodium: Lycopodium may be beneficial for Parkinson’s sufferers who feel stiffness, weakness, and tremors, particularly on the right side of the body. It’s also recommended for intestinal problems.
4-Cocculus Indicus:This cure is recommended in cases of weakness, vertigo, and a sense of emptiness. For those who are physically and mentally exhausted and feel worse when moving, it might be taken into consideration.
5-Baryta Carbonica: Baryta Carbonica may be suggested when there is a slowdown in both mental and physical functions. It is frequently applied to senior Parkinson’s patients.
6-mercurius vivus – for easing Parkinson’s that is worse at night, and for panic attacks
7-zincum metallicum – for restlessness and depression.
Acupunture Treatment for Parkinsons
ACUPUNCTURE
Acupuncture is a traditional Chinese medicine practice that involves the insertion of thin needles into specific points on the body to stimulate energy flow (Qi) and promote healing. While acupuncture is not considered a cure for Parkinson’s disease, some people with Parkinson’s may explore acupuncture as a complementary therapy to manage symptoms.
Here are some acupuncture points
1. Tai Chong (LV3):
– Located on the top of the foot in the depression between the first and second metatarsal bones.
– Believed to benefit the liver and improve overall energy flow.
2. Hegu (LI4):
– Found on the back of the hand, in the webbing between the thumb and index finger.
– Often used for pain relief and to promote relaxation.
3. Fengchi (GB20):
– Situated on the back of the neck, in the hollow between the two large vertical neck muscles.
– Targeted for headaches, dizziness, and overall well-being.
4. Neiguan (PC6):
– Located on the inner forearm, about two inches above the wrist crease, between the tendons.
– Commonly used for nausea, anxiety, and to calm the spirit.
5. Shousanli (LI10):
– Found on the outer part of the forearm, in the depression between the radius and ulna bones.
– Addressing upper limb issues and promoting circulation.
6. Zusanli (ST36):
– Located on the lower leg, about four finger-widths below the kneecap and one finger-width to the outside of the shinbone.
– Known for strengthening the body and improving overall energy.
7. Baihui (GV20):
– Situated on the top of the head, at the intersection of the midline and a line drawn between the ears.
– Thought to have a calming effect and enhance mental clarity.
Bioresonance Therapy for Parkinsons
For people who value an all-natural approach to health, bioresonance therapy offers a way to manage the neurological problem or illness. Cellular communication is enhanced by the device’s ability to deliver wholesome, calming frequencies to cells, which is exactly bioresonance functions on a cellular level.
With the help bioresonance we can give specific frequency for some symptoms
Like tremors, slurred speech memory, hearing
provides natural relief, manages symptoms, and improves quality of life for those suffering from the disease. Improves motor functionality and coordination.
Chinese Cupping Therapy for Parkinsons Disease
Cupping therapy involves placing cups on the skin to create suction, and the placement of the cups, or cupping points, can vary based on the intended therapeutic goal. While cupping therapy is often used for various purposes
1. Back and Shoulders:
– Cups are often applied to the upper back and shoulders to address tension and muscle stiffness.
– Cups may be stationary or moved around to target specific muscle groups.
2. Legs and Thighs:
– Cups may be applied to the legs and thighs to address muscle soreness or tightness.
– Stationary or sliding cupping techniques may be used.
3. Arms and Forearms:
– Cups may be applied to the arms and forearms to address muscle tension or discomfort.
Nutritional Supplements
Nutrition and Supplements for Parkinson’s Disease:
– Low-Protein Diet
Enhances the efficiency of levodopa and carbidopa absorption.
Source: Fish, poultry, eggs, dairy, beans, and nuts. Focus on evening protein intake.
-Fiber Supplement:
Helps prevent constipation, a common symptom of Parkinson’s disease.
Source: Psyllium husk, bran, fruits, and vegetables.
– Coenzyme Q10 (CoQ10):
Some studies suggest it may slow the progression of Parkinson’s disease.
Source: Spinach, broccoli, fish, and whole grains.
– Creatine:
May slow disease progression in early stages without medication.
Source: Red meat, fish, and poultry.
Vitamin C and Vitamin E:
Delayed need for medication in some studies.
Source: Citrus fruits, strawberries, nuts, and seeds.
– Food (Vitamin E):Nuts, seeds, spinach, and broccoli.
– Cytidinediphosphocholine (CDP-choline):
May allow for a reduction in levodopa dose.
Source Meat, fish, dairy, and nuts.
Phosphatidylserine (PS):
Improved mood and brain function in some studies.
Source: Fish, meat, dairy, and soy.
– NADH (Nicotinamide Adenine Dinucleotide):
– **Benefits:** Mixed results; potential dopamine level increase.
– **Examples of Food:** Meat, poultry, fish, and nuts.
– Vitamin D:
Prevents osteoporosis; often low in people with Parkinson’s.
Source: Fatty fish, fortified dairy, sunlight exposure.
– Vitamin B6 (Pyridoxine):
potential reduction of side effects from medications.
-Source: Chicken, turkey, potatoes, bananas.
– Coffee and Caffeine:
Linked to lower risk and progression of Parkinson’s disease.
Source: Coffee, tea, dark chocolate.
– Fava Beans (Vicia faba):
Contains levodopa; may help with symptoms for some.
source Fava beans or broad beans.
-Epigallocatechin-3 Gallate (EGCG):
Exhibits powerful neuroprotective effects.
Green tea.
Some Physical (movement) Therapies
Movement Therapies for Parkinson’s:
Yoga:
Improves flexibility, balance, and may alleviate muscle stiffness.
Tai Chi:
: Enhances balance, coordination, and overall mobility.
Considerations: Slow, flowing movements are well-suited for individuals with Parkinson’s.
Dance Therapy:
Aids in improving motor skills, balance, and mood.
Qigong:
Combines gentle movements, breathing, and meditation to promote well-being..
Exercise Programs:
Regular aerobic exercise may improve overall fitness and reduce symptoms.
Note: The information in this article is taken from a number of reliable sources, and it’s important to understand that treating Parkinson’s disease requires for a comprehensive and individualized strategy. Always seek the advice of a licensed healthcare provider or specialist for a precise diagnosis and treatment programs that are customized to meet the needs of each patient. The treatment of Parkinson’s disease frequently combines medicine, counseling, and lifestyle modifications. For the best care and support, it’s important to not rely just on one type of treatment, and healthcare decisions should be made in consultation with a healthcare professional.
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