Understanding Parkinson’s


Parkinson’s disease is a progressive, chronic disease, with symptoms continuing and worsening over a period of years. If you or someone you know has been diagnosed with Parkinson’s, you may have questions about the diagnosis.

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Parkinson’s disease develops from an imbalance of dopamine in the brain. Neurons in the brain produce dopamine, which is responsible for coordination and movement. In adults with Parkinson's disease, those neurons slowly stop producing dopamine, making movement more and more difficult to control.

By the time roughly 70 percent of dopamine-producing neurons are damaged, motor symptoms of Parkinson’s disease start to appear. Symptoms are categorized in two ways: motor and nonmotor. Both motor and nonmotor symptoms can vary from person to person, although some symptoms are more common than others. Primary motor symptoms may include:

  • Tremors, often in the arms, hands, legs, jaw or face, and often on one side of the body
  • Slowness of movement
  • Rigidity or stiffness in the arms, legs and torso
  • Instability while standing upright
  • Impaired coordination or balance

Seventy percent of people with Parkinson's experience tremors as a primary motor symptom, but that can vary from person to person. Some people may experience loss of balance as a symptom instead. Common nonmotor symptoms are:

  • Depression, anxiety or cognitive mood swings
  • Constipation
  • Sudden drop in blood pressure upon standing
  • Loss of sense of smell
  • Cognitive issues, such as memory loss, confusion, slowed thinking, or in some severe cases, hallucinations or dementia

How Parkinson’s Proceeds

Some people live with mild symptoms of Parkinson’s disease for several years, while others have symptoms that progress rapidly. The Parkinson’s Disease Foundation outlines three characterizations of disease severity:

  1. Mild Parkinson’s—Movement symptoms in this stage are more of an inconvenience than a hindrance. Tremors often occur on only one side of the body, and medication often suppresses symptoms.
  2. Moderate Parkinson’s—Movement symptoms now occur on both sides of the body, and problems with balance and coordination may develop. People may move more slowly, and medications may wear off between doses or cause side effects.
  3. Advanced Parkinson’s—Walking can be difficult to nearly impossible. Parkinson’s disease patients whose symptoms progress to this stage often need assistance with daily activities and may be unable to live alone.

While Parkinson’s disease remains incurable, medication can help with the severity of symptoms.

The Parkinson’s Pipeline

Although there’s no known cure for Parkinson’s disease (PD), research for new medication and treatment continues. The Parkinson’s Disease Foundation calls this the “PD Pipeline.”

Currently, scientists are focusing on medications that can ease the symptoms of Parkinson’s disease and medications that can slow the progression. Scientists use two ways to identify new medications.

The first involves testing compounds that are already approved by the U.S. Food and Drug Administration (FDA) and used to treat other diseases to see if they can also be used to treat Parkinson’s. The second is to find drugs that target the chemical changes Parkinson's causes in the body. Either way, new medications have to go through several preclinical and clinical trials before they can be approved.

Recently, three new Parkinson’s disease therapies received FDA approval during a two-year period. Two of them deliver an already-approved medication, while the third addresses psychosis that sometimes occurs as a symptom of Parkinson’s.

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