What is Parkinson's?

According to the definition, Parkinson's is one of the so-called neurodegenerative diseases. In the process, nerve cells in the brain perish. Experts also call the disease Parkinson's disease or Parkinson's syndrome. Colloquially, the clinical picture is known as paralysis. People with Parkinson's disease often have trouble moving. Arms and legs are typically stiff, and hands are shaky.

Parkinson is the second mosts common neurodegenerative disease after Alzheimer's . On average, about 1 to 2 in 1,000 people are affected. Men get it slightly more often than women. The disease occurs much more frequently in old age. Among those over 70, 20 in 1,000 people have Parkinson's disease. However, doctors assume that the patients become ill much earlier and that it will take many years or even decades for the first symptoms to appear.

Parkinson's disease: forms and their causes

Researchers cannot yet conclusively explain how Parkinson's occurs. So far it has been known that nerve cells in the brain that produce the important messenger substance dopamine are damaged in the disease . The nerve cells die in a special region in the brain - the substantia nigra, which is named for its dark color. The lack of dopamine and the destroyed nerve cells are responsible for the fact that the brain is unable to transmit electrical impulses via the nerves to the muscles. This leads to the classic Parkinson's symptoms such as movement problems, stiffness and tremors .

Special protein molecules are responsible for the destruction of nerve cells. These clump together in the nerve cells to form a kind of tangle that doctors call Lewy bodies . The protein clumps mean that the nerve cell can no longer function normally and dies. The Lewy bodies then migrate into neighboring nerve cells. This in turn set off a chains reaction in which many cells die one after the other. The brain then produces less and less dopamine. However, this neurotransmitter is necessary for smooth communication between the nerve cells.

New studies suggest that the protein clumps may first form in the intestines. The researchers suspect that the tangles can get into the brain from there via a large network of nerves, the so-called vagus nerve.

Whether first in the intestine or in the brain: Scientists cannot conclusively say how the protein clumps are formed. The actual cause of Parkinson's is therefore still unclear. Doctors then speak of idiopathic Parkinson's syndrome (IPS) .

Around one percent of those affected have a genetic or familial form of Parkinson's . In them, doctors can detect changes in certain genes that are inheritable.

Researchers suspect that a combination of factors may be responsible for the disease in some patients - such as genetic and environmental factors such as exposure to pesticides. Secondary Parkinson's syndrome

must be distinguished from these classic types of Parkinson's disease. Doctors speak of this when other clinical pictures trigger Parkinson's disease. These include brain tumors, circulatory and metabolic disorders, inflammation of the brain and poisoning with carbon monoxide or manganese.

In addition, there is the so-called atypical Parkinson's syndrome. Although this is similar to common Parkinson's disease, there are other neurodegenerative diseases behind it - for example a special type of dementia.

There are also differences in Parkinson's in the age at which the disease occurs. Doctors usually make the diagnosis between the ages of 50 and 70. In around ten percent of those affect, the disease is already noticed before the age of 40. In this case, doctors speak of Parkinson's onset early. In rare cases, symptoms show up before the age of 21. This is what doctors call juvenile Parkinson's disease.

Parkinson's: symptoms

Parkinson's disease often begins insidiously. Symptoms in the early stages include, for example, that fine motor skills decrease and the writing becomes more shaky. Some people lose their sense of rhythm and no longer swing their arms when they walk. The expression on the face becomes rigid. Some suffer from insomnia , nightmares, irritability, depressive moods and withdraw socially. Those affected and their relatives often interpret these early symptoms as normal signs of old age and not as an illness. In any case, they do not associate the warning signals with Parkinson's and therefore do not initially go to a doctor's office.

Later Parkinson's Symptoms

Only in the further course do more clear signs of Parkinson's disease appear. There are typically three classic symptoms that doctors call the Parkinson's triad :

• A sedentary lifestyle (akinesia): those affected take slower and smaller steps. The first step in particular is difficult for many patients. Others have trouble stopping suddenly. Fine motor skills are getting worse and worse. Activities like tying your shoes, opening and closing buttons, or grasping small objects are becoming increasingly difficult. The facial muscles also lose their mobility. The face looks rigid and mask-like. The corners of the mouth stay the same and the eyelids close less often than usual. Many people with Parkinson's disease find it difficult to swallow. Some patients speak softly, monotonously, and indistinctly.
• Muscle stiffness (rigidity): The muscles of the arms, legs and neck become increasingly stiff. The movements of those affected often seem petrified or frozen (so-called freezing). They typically assume a hunched posture. Some patients experience muscle pain because of this tension .
• Shaking (tremor): Many - but not all - people with Parkinson's have their hands shaking. As a result, the writing becomes increasingly shaky and indistinct. Many people find it difficult to bring a full cup of coffee to their mouth without spilling liquid. The tremor occurs mainly at rest. It decreases with movement.

Other symptoms of Parkinson's

In addition to these typical signs, there may be other accompanying symptoms in Parkinson's disease . These include, for example:

• Indigestion and constipation
• impaired bladder function
• Balance disorders
• Circulatory problems
• Disorders of the sense of taste and smell
• Trouble sleeping
• Difficulty concentrating
• Speech disorders
• forgetfulness
• Lust and lack of interest
• depressions
• fears

Parkinson's disease: course and life expectancy

Parkinson's disease typically has the following stages:

• Stage 0: At this stage the patient is already suffering from Parkinson's disease and the first nerve cells perish. The affected person does not feel any symptoms yet.
• Stage 1: The   first symptoms appear. The fine motor skills of the hands decrease and facial expressions and posture change. At this stage, the symptoms usually only occur on one side of the body.
• Stage 2: In this Parkinson's stage, symptoms affect both sides of the body. Posture and gait are now visibly impaired. Problems with speaking and listlessness can also arise.
• Stage 3: Now the body movements become significantly slower and the muscles stiffer. Many sufferers develop problems with their balance when walking and standing. The hands are shaking.
• Stage 4: At this stage, the three main symptoms of Parkinson's disease - sedentarism, muscle stiffness and tremors - are fully developed. Patients have initial problems coping with their everyday lives on their own.
• Stage 5: In the so-called final stage of Parkinson's, those affected depend on the help of other people. You move with a rollator or a wheelchair and need help with personal hygiene, eating and drinking, and household chores. Some patients develop memory disorders and even dementia.

How fast Parkinson's disease progresses individually different and can not be accurately forecast. Several years can pass between the individual stages.

It is important to know that Parkinson's is not a life-threatening disease . Even if the paralysis severely restricts those affected in the later course - it does not lead to death. Most patients have a good prognosis after diagnosis. They live with a good quality of life for many years to decades before they have to rely on help with Parkinson's symptoms. Many of those affected only die from another cause in old age.

Parkinson's: diagnosis

In order to diagnose Parkinson's, the doctor will first ask you in detail about your symptoms. It is important, for example, what symptoms you have had, how long they have existed, how pronounced they are and where they appear exactly. Any previous illnesses and the use of medication are also clues that help with the diagnosis. Then the doctor will examine you physically. For example, it tests whether you can respond to pressure and move your joints normally.

Usually a so-called L-Dopa test is then used. You will take the drug L-Dopa for a certain test period. If your symptoms improve, it is more likely that you have Parkinson's.

In order to rule out other diseases, additional imaging procedures such as computed tomography ( CT ) or magnetic resonance imaging ( MRI ) are useful in some patients . Both methods show changes and abnormalities in the brain.

Parkinson's: Therapy

At the beginning of the disease, people with Parkinson's usually have only minor symptoms. Treatment is often not necessary at this point. If symptoms worsen, the drug L-dopa (levodopa) is the drug of choice. It replaces the missing dopamine in the brain and relieves symptoms such as difficulty moving, stiffness and tremors. In addition to L-dopa, doctors also use other drugs. Examples are:

• Dopamine agonists stimulate the docking points (receptors) of the nerve cells, which are responsible for the uptake of dopamine. Chemically, these drugs have a similar structure to L-Dopa. However, they seem weaker. The only drug used is dopamine agonists in early Parkinson's disease.

• COMT inhibitors block an enzyme called catechol-O-methyl transferase (COMT), which breaks down some of the L-dopa ingested. By inhibiting the enzyme, more L-Dopa reaches the brain.
• MAO-B inhibitors block the dopamine-breaking enzyme called monoamine oxidase-B (MAO-B). This keeps more dopamine in the brain. MAO-B inhibitors as the sole medication have a comparatively lower effect. Doctors therefore often combine the drugs with L-Dopa.
• NMDA antagonists weaken the effect of a messenger substance, the so-called glutamate, in the brain and bring the nerve messenger substances back into balance. The excess of this messenger substance is also responsible for the stiff muscles and the tremors.
• Antidepressants , if patients are also depressed.

According to the current state of research, Parkinson's is not curable . Despite taking medication, more nerve cells die in the course of the disease and doctors have to adjust the dosage again and again. In some patients, doctors put a drug pump under the skin. This releases the active ingredient evenly to the body.

 businessdirectorymarketing  businessdirectorypc  grupofashions  fortunetextile businessfashionfabric