Parkinson's Disease

Parkinson’s attacks the brain, primarily affecting the patient’s movement capabilities. This long-term progressive disease manifests in each person uniquely.

What's Parkinson's?

Parkinson’s Disease (PD) is a progressive neurodegenerative disorder characterized by muscle stiffness, tremors, and general inability to control voluntary movements. Parkinson’s may also affect involuntary/autonomic controls, including swallowing, digesting, heart rate, blood pressure, and urinary continence.

Parkinson's Key Statistics

Parkinson’s is one of the world’s fastest-growing neurological disorders. Here are the key statistics about this brain disease.

  • Currently, about one million people are living with Parkinson’s in the US.
  • An additional 60,000 Americans receive a Parkinson’s diagnosis each year. 
  • Globally, PD affects about 10 million people.
  • Parkinson’s is more prevalent among people ages 80+, nearly 1,900 people per 100,000.
  • Early-onset of PD is relatively rare, estimated about 4% of people with Parkinson’s are diagnosed before age 50
  • Men are 1.5 times more likely to develop Parkinson’s than women.
  • More people have Parkinson’s than those with multiple sclerosis, muscular dystrophy, and amyotrophic lateral sclerosis combined.

What Causes Parkinson's?

Sadly, the actual cause of Parkinson’s is still unknown. However, research shows that Parkinson’s disease is related to the protein – Synuclein. When normal Synuclein misfolds into toxic shapes, they become prion-proteins. The misfolded Synuclein causes damage to the brain.

What Drives Parkinson's Progression?

From a molecular perspective, Parkinson’s results from a toxic, misfolded Synuclein build-up in the brain. This ongoing accumulation forms large insoluble aggregates referred to as Lewy Bodies.

What is a Lewy Body?

A Lewy Body is composed of misfolded Synuclein plus other cellular proteins and lipids. As with plaque (caused by misfolded Abeta) and tangles (caused by misfolded Tau,) Lewy Bodies represent a major site for misfolded Synuclein deposition in the brain.

Bottom line: Lewy Bodies cause cell death.

Ever wonder why Parkinson’s patients have difficulty with their movements? This is because the brain region responsible for bodily motor controls – substantia nigra – has suffered irreversible damage. 

Parkinson's Biomarker

Synuclein is produced by most brain cells and therefore found abundantly throughout the brain.

With Parkinson’s, the initial damage from misfolded Synuclein takes place in the substantia nigra region of the midbrain. That first-wave of rogue prion-proteins expands their reach, corrupts other healthy proteins to misfold, and causes continuous widespread damage.

This undercover destruction silently damages the brain, while the body shows no symptoms. This goes on for years, sometimes even decades!

The long asymptomatic stage makes early detection of misfolded Synuclein crucial. Knowing what to look for helps researchers prioritize their focus to accelerate breakthroughs.

The only way to stop Parkinson’s is by stopping what drives it.

Parkinson’s Key Symptoms

PD is known for its movement disorders at first.  However, in later stages of Parkinson’s, the permanent damage extends beyond the substantia nigra to include memory areas in the hippocampus and cerebral cortex. As these additional brain regions degenerate, symptoms of dementia may follow.

Here are details of each key symptom for you to better understand Parkinson’s Disease:

Motor Symptoms

Cramped Handwriting

You might start to develop micrographia or small handwriting. Has your handwriting started to shrink recently? Compare some of your earlier writing samples.

You might begin to notice the way you write has changed. Letters could appear smaller while words seem crowded together. Some patients find it’s physically more difficult to write as well. Changes in the brain can impact your fine motor skills like those needed for handwriting.

Tremors

One of the most recognizable signs of Parkinson’s is a tremor. You might notice your hand, finger, or foot is twitching or shaking more often. Others may not notice this indicator at first, but you will.

As the disease progresses, the shaking could become worse. Others will likely notice your tremors at this point.

As a worthy note, medicine, stress, injuries, and extreme physical work-out/exertion can also cause tremors.

Trouble Sleeping

Difficulty sleeping is normal from time to time. However, if you notice you’re tossing and turning more often, it could be an early sign of Parkinson’s. Early sleep-related signs of Parkinson’s can include:

  • Flailing your arms
  • Thrashing
  • Kicking
  • Falling out of bed

Discuss these early signs of Parkinson’s disease with a doctor right away.

Trouble Moving

Parkinson’s affects nerve cells in the brain that control body movement.

  • Your arms, legs, or entire body could start to feel stiff and often leads to trouble moving or walking.
  • Some of the first signs of Parkinson’s include stiffness or pain in the shoulders or hips.
  • Otherwise, you could develop bradykinesia or slowed movement.
  • Parkinson’s can make it difficult for you to get out of a chair.
  • You might start dragging your feet.
  • Your steps could become shorter when you walk as well.
  • Automatic movements, like blinking or smiling, may become more difficult.

Keep in mind with these movement-related symptoms, doctors might misdiagnose you with other movement disorders instead of PD.

Voice Changes

Has your voice started to change? You might notice you’re speaking faster or softer. Some Parkinson’s patients hesitate before they speak or start slurring their words.

You might even speak in monotone instead of with your usual inflections.

Less dramatic voice changes, such as extra clear enunciation, voice pitching lower, or sounding hoarse, can also be early signs of Parkinson’s.

Facial Masking

Has anyone ever told you that your face looks masked, depressed, or too serious? If you’re not in a bad mood, you may be experiencing facial masking.

Some medications can cause facial masking. However, it’s also one of the signs of Parkinson’s.

Parkinson’s can affect your facial expressions by impacting the small muscles in your face.

Posture Changes

Small posture changes sometimes occur during the initial stages of PD, causing you to lean or slouch. You might notice changes in your balance and coordination as well. Keep an eye out for posture changes as warning signs of Parkinson’s.🚶🏾‍♀️

Nonmotor Symptoms

Did you know that 80-90% of PD patients also develop nonmotor symptoms? These include fatigue, cognitive changes, and mood changes. Here are a few examples:

Dizziness or Fainting

You might feel dizzy when you stand up from a chair. Severe lightheadedness could cause you to faint or blackout. Dizziness and fainting could indicate blood pressure changes. These symptoms might mean you’re developing Parkinson’s.

Loss of Smell

Some patients develop hyposmia (reduced sensitivity to scents) or anosmia (loss of smell). For some people, these are early signs of Parkinson’s. For others, these symptoms don’t develop until years after the traditional motor symptoms emerge.

Constipation

Some patients also experience gastrointestinal issues, including constipation. It occurs when the disease slows the digestive system’s automatic movements. Make sure you include enough water and fiber in your diet.

Loss of Bladder Control

Parkinson’s can cause bladder problems. You might experience difficulty with urine control.

Fatigue

Have you noticed changes in your energy levels? Fatigue is a common PD symptom.

Weight Loss

Some patients also experience weight loss, which often occurs in later stages of this disease.

Cognitive Changes

Older patients or advanced Parkinson’s patients sometimes experience cognitive changes. You might have difficulty finding the right words, thinking, or making judgments. Other cognitive abilities you might experience a decline include:

  • Memory
  • Moodiness
  • Behavior

Mood Disorders

Parkinson’s could bring mood disorders. You might experience depression, fear, or anxiety. Some patients also experience personality changes, including impulsive behaviors and hypersexuality.

Vision Problems

How is your vision? Parkinson’s could diminish your eyes’ movement abilities. You could start blinking slowly. Some patients experience dry eyes as a result.

Understanding the warning signs of Parkinson’s can help you receive the care you need. Here is a searchable directory to find the Parkinson’s research/treatment center closest to you.

Parkinson’s Stages

Here are the critical stages of Parkinson’s, representing the disease’s progression:

The Prodromal Stage

The prodromal stage is the earliest stage of Parkinson’s Disease before the classic movement symptoms appear. The prodromal stage symptoms include:

  • Loss of taste and smell
  • Unusual sleep behaviors
  • Constipation

These symptoms are commonly shared with other disorders. Therefore using conventional methods, accurate PD diagnosis at this stage is challenging.

Early-Stage

Early-stage diagnosis reflects the earliest measurable changes in motor control. These symptoms are unlikely to be noticed by anyone other than the patient.

Early-stage Parkinson’s symptoms have significant overlap with symptoms caused by normal brain aging and other non-progressive motor disorders. Biometric detection using machine learning and molecular biomarkers represents the best chance for diagnosis at this stage.

In particular, biometric tracking of eye movements, vocalization, and typing shows promise as indicators of early-stage Parkinson’s.

Intermediate Stage

At this stage, the Parkinson’s patient shows one or more noticeable motor disorders, including tremors, rigidity, and shuffling. Drugs such as dopamine precursors and agonists may provide temporary improvement. However, these drugs have significant side effects that include nausea, confusion, and involuntary movements.

Advanced stage

In addition to rapidly declining motor symptoms, patients may show progressive symptoms of dementia and loss of memory resembling Alzheimer’s Disease.

If dementia and memory loss appear at earlier stages of Parkinson’s, doctors might diagnose the condition as Lewy Body Dementia.

Parkinson’s Risk Factors

Parkinson’s disease is more prevalent than people realize. That’s why it’s important to track your risk factors. So far, research has revealed the following as risk factors for PD.

Genetics

Approximately 10-15% of Parkinson’s patients carry genes that may be responsible for the disease. These individuals may have one or more first-degree relatives with Parkinson’s. Naturally, such a family history increases the chances of developing PD.

Now let’s go deeper. If you are not into science, skip this part. You have our permission. 🤓

For individuals carrying specific mutations in the GBA-1 or LRRK2 genes, their risk of Parkinson’s significantly increases. The action mechanism for these genes is not yet entirely understood. However, both of these genes may be involved in the accumulation of misfolded proteins.

  1. Mutations in GBA-1 cause the accumulation of specific lipids (fats) in the brain that trigger Synuclein misfolding.
  2. Mutations in LRRK2 may impair the removal and degradation of misfolded Synuclein proteins in nerve cells.

Both mutations drive up the level of Misfolded Synuclein and therefore increases the risk of Parkinson’s.

Traumatic Head Injuries

There is an increased risk of Parkinson’s among contact-sport athletes who suffered multiple head injuries.

A greater number of Parkinson’s patients come from these sports: basketball, boxing, and football. A notable example is the world-famous Muhammad Ali.

Environmental Effects

Both internal and external environmental factors play a role in Parkinson’s.

  • Internal Environment

For some people, Parkinson’s disease originates from toxic bacteria in the gastrointestinal (GI) tract. Certain bacterial strains may promote Synuclein misfolding in the gut. Those misfolded Synuclein travel via the vagus nerve from the intestines to the brain. Patients who have had their vagus nerve surgically removed show a decreased risk of PD or delayed onset of Parkinson’s.

  • External Environment

Long-term exposure to environmental toxins may increase the risk of Parkinson’s. Here are some examples:

  • Insecticides
  • Herbicides
  • Toxic metals such as lead, mercury, barium, zinc, etc. ☠️

PD Isn't An Old Person's Disease

According to research, Parkinson’s occurs over 100X more often in the seventh decade of life than the fourth. However, for Parkinson’s patients, the brain protein misfolding may have started during their youth, without the body showing any symptoms. 

During this asymptomatic phase, the destruction of brain cells advances silently and undetected. Symptoms show up decades later. Consider the following:

Check the Appendix for Clues

You’ve now learned that large groups of misfolded Synuclein are key indicators of PD, right? 

Well, brace yourself for this next finding: Researchers examined teenage appendectomies and discovered misfolded Synuclein aggregates within. 

This indicates Parkinson’s can develop early in life!

Misfolded Protein Synuclein Athlete
Muhammad Ali Parkinson's Fighter

Repeated Head Traumas

Athletes with multiple head injuries in their 20’s and 30’s have an increased risk of Parkinson’s later in life.

The boxing champion Muhammad Ali is a famous example.

Early Onset Parkinson's

Approximately 5% of Parkinson’s patients are diagnosed with early-onset.

One of the prominent examples is Brian Grant, the NBA player. He was diagnosed at age 36 with Parkinson’s in 2009.

He founded the Brian Grant Foundation, dedicated to raising awareness and inspiring those living with Parkinson’s to include exercise as medicine.

Web-Diagnosis-PD Early onset

Traditional Diagnosis

Currently, doctors can only diagnose Parkinson’s after clinical symptoms appear. 

Here is the irony: PD’s debilitating symptoms only appear after much of the brain has been destroyed. So this is a late too-late stage diagnosis.

It’s no surprise that Parkinson’s looks like a disease of the elderly.

NEW Definitive Diagnosis

Great News! Change is here.

Amprion now offers Parkinson’s Early Biomarker Testing.

Sign Up Here

doctor pointing at a brain image on laptop

NEW Definitive Diagnosis

Great News! Change is here.

Amprion now offers Parkinson’s Early Biomarker Testing.

Sign Up Here

Parkinson's Misdiagnosis

Conservatively, 1 in 4 Parkinson’s patients is misdiagnosed initially. Why is diagnosing Parkinson’s such a daunting challenge? 

Among many factors, other movement disorders may mimic Parkinson’s early symptoms, leading to confusion even for seasoned physicians. 

Consider this simple fact: the early signs of Parkinson’s (tremor, stiffness, balance disorders, constipation) overlap substantially with signs of normal aging and other neurological diseases.

The overwhelming misdiagnosis of Parkinson’s is the reason biomarker-testing is so critical.  It will empower doctors to diagnose Parkinson’s accurately and confidently prescribe proper treatments. 

Parkinson’s Treatment

PD patients diagnosed at early and intermediate stages respond initially to drugs that increase dopamine’s brain concentrations. These include:

  • Levodopa
  • Carbidopa

Sadly, long-term treatment using these drugs leads to severe side effects, with diminishing benefits over time.

Recently, deep brain stimulation (DBS) showed improvement of voluntary movement in a subset of patients.

However, there is no silver bullet treatment that stops Parkinson’s. 

With biomarker early testing, we’ll find the cure! 

Who Gets Parkinson’s?

Parkinson’s affects men more frequently and severely than women. About 65% of Parkinson’s patients are men.

On the flip side, this PD gender bias is reversed in Alzheimer’s, affecting women more frequently and severely.

parkinson's affects men more than women

Who Gets Parkinson’s?

Parkinson’s affects men more frequently and severely than women. About 65% of Parkinson’s patients are men.

On the flip side, this PD gender bias is reversed in Alzheimer’s, affecting women more frequently and severely.

How Diet May Delay Parkinson's Onset

9 dragons tea-healthy foods vitamine-c-vitimine-e

Did you know that a diet rich in vitamins C and E may reduce the risk for Parkinson’s? Read the study published in Neurology

How Early Detection Helps Delay Onset of Parkinson's?

9 dragons tea-healthy foods vitamine-c-vitimine-e

Parkinson's Disease Frequently Asked Questions

Parkinson's primarily affects a region of the midbrain called the substantia nigra. Brain cells in this region produce high concentrations of the neurotransmitter dopamine and help initiate and control voluntary movements. Early stage Parkinson's patients can also show evidence of the disease in the brainstem. Late stage Parkinson's patients may show evidence of the disease in the hippocampus, which controls memories and the cerebral cortex which controls higher level thinking and planning.
Approximately 10% of patients with Parkinson's disease are believed to have inherited or genetic forms of the disease. The vast majority of patients do not appear to have any genetic or familal predisposition. Genes that can increase the probability of Parkinson's include SNCA, LRRK2, PARKIN, PINK1 and GBA.
Parkinson's Disease is caused by the loss of neurons in the substantia nigra region of the midbrain. At present, there are no treatments that can restore these cells or their connections. However, several treatments can substitute for the lost cells, at least temporarily. Cells of the substantia nigra produce and release large amounts of the neurotransmitter, dopamine. L-DOPA is a precursor drug that is converted in the brain to dopamine and can restore some lost functions in Parkinson's patients. In addition, the electrical activity of cells in the substantia nigra can be mimicked by sending electrical pulses through thin wires embedded selectively in brain regions where signals from the substantia nigra have been lost.
Patients with Parkinson's Disease can progress over time to dementia that further complicates the usual motor symptoms. In addition, some Parkinson's patients show signs of early dementia at the same time that the typical motor symptoms present. In some patients, the dementia associated with Parkinson's is difficult to distinguish from Alzheimer's Disease. For these reasons, it may be helpful to view Alzheimer's and Parkinson's as two diseases along a spectrum of related diseases, which has been referred to as the Parkinzheimer Spectrum.
Parkinson's Disease appears to have different causes in different people. In approximately 10% of cases, the cause appears to be genetic or familial. Other patients with Parkinson's share a history of repeated head traumas, as seen in boxers and some soldiers. Still other patients appear to show a link to abnormalities in the gut and possibly the bacteria that colonize the gut. Once Parkinson's has been started, it slowly progresses and moves through different regions of the brain including the substantia nigra of the midbrain, which is responsible for the classical motor symptoms of the disease.
The earliest clinical signs associated with Parkinson's disease tend to be distinct from the motor symptoms most commonly associated with Parkison's. These "prodromal signs" include constipation not linked to other known problems, sleep disorders mainily associated with the rapid-eye-movement (REM) phase of sleep, and loss of sense of smell and taste. For individuals with one of these symptoms, approximately 60% go on within 10 years to develop clinical symptoms associated with Parkinson's. It is possible that treatment of patients at this prodromal stage may slow or prevent the eventual onset of Parkinson's symptoms
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