Parkinson's disease, also referred to as Parkinson's disease, is a Disease of nerve cells in the brain. The loss of nerve cells results in a slowing down of movement sequences. An initial indication of Parkinson's disease is provided by movement restrictions that are initially limited to only one side of the body. In the course of the disease, symptoms such as muscle rigidity and muscle tremors may appear. Affected people often also have problems remembering things or become demented.
To be able to treat the symptoms of Parkinson's disease, an early start of therapy is recommended. The therapy can be individually adjusted according to age. Adapt the duration of the disease. Although Parkinson's disease is not yet curable, medication and accompanying exercise therapies can significantly improve the quality of life and life expectancy of patients.
What is Parkinson's disease?
Parkinson's disease is a disease of the brain in which there is a loss of nerve cells, also known as neurons. The brain consists of a complex network of many neurons that are responsible for the communication and transmission of nerve impulses.
In PD, neurons that produce and secrete the neurotransmitter dopamine are affected. These so-called dopamine-producing (dopaminergic) neurons are important for conscious (voluntary) and subconscious (involuntary) movements. If dopamine is no longer produced in sufficient quantities, this leads, among other things, to a slowing down and reduction of movements, as well as to muscle rigidity or tremor.
More elderly people suffer from Parkinson's disease; on average, the disease breaks out between 55 and 60 years of age. In Germany, around 219.000 people have the disease, women and men in about equal numbers.
What are signs of Parkinson's disease?
At the beginning of PD, the brain can still compensate for the loss of nerve cells. However, this is no longer possible if more than half of the dopamine-producing neurons have died (degenerated).
A creeping unilateral onset of symptoms is characteristic of Parkinson's disease. Early symptoms include decreased and slowed spontaneous movements, which means that a simple action, such as changing clothes, may take longer than before. But also sleep disturbances as well as pain in the shoulder area or in the spine occur.
In the course of Parkinson's disease, the typical leading symptoms appear:
– Slowing of movement (bradikinesia) to inhibition of movement (akinesia) – Muscle stiffening (rigor) – Muscle tremor (tremor), especially of the arms and legs – Disturbance of upright posture (postural instability)
In addition, accompanying symptoms may occur, in particular:
– Disturbances in bladder and bowel function – Sensory disturbances of the skin (for example, increased pain sensation to normal stimuli) – Psychological symptoms (for example, depression) and sleep disturbances – Cognitive impairments (for example, forgetfulness, in advanced stages dementia)
In addition to the leading and accompanying symptoms, other symptoms may occur, depending on the stage of Parkinson's disease and the course of the disease. As the disease progresses, patients adopt a stooped posture when standing and walking, which is typical of the disease. In addition, there are reduced facial expressions and gestures and a disturbance of the swallowing process (dysphagia). In addition, in the course of Parkinson's disease, the volume of speech decreases (hypophonia), so that the voice becomes quiet and monotonous. The motor impairments additionally increase the need for care of the patients.
How Parkinson's disease develops?
In Parkinson's disease, there is a loss of dopamine-producing neurons; this process is also known as the Neurodegeneration denoted.
In ca. 75% of all cases of neurodegeneration occur without a clear cause. This form of Parkinson's disease is also called idiopathic Parkinson's syndrome (IPS). In rare cases, there are underlying genetic causes. In addition, an atypical Parkinson's syndrome can occur in the context of other neurodegenerative diseases. In very rare cases, harmful substances (e.g., manganese, carbon monoxide, cyanide), medication (e.g., antipsychotics) or inflammation of the brain cause Parkinson's disease. This form of Parkinson's disease is referred to as symptomatic or secondary Parkinson's syndrome described.
In Parkinson's disease, there is initially a progressive death of the dopamine-producing nerve cells located in the black matter of the brain (substantia nigra). The substantia nigra is located in the midbrain. Is a component of the basal ganglia. The basal ganglia are significantly involved in the processing of motoric. Non-motor movement processes involved. In addition, they suppress movements that are not currently needed. Accordingly, the basal ganglia make an important contribution to the part of the brain that plays a particularly significant role in planning and starting a movement. A loss of dopaminergic neurons usually only becomes noticeable when only 20 to 30 percent of functioning neurons are still available. As a result, the brain can no longer process the signals for various movement sequences and motor restrictions occur.
How does the doctor diagnose Parkinson's disease?
If Parkinson's disease is suspected, it is advisable to consult an experienced neurologist. An initial indication of Parkinson's disease is provided by movement restrictions that initially only occur on one side.
The treating physician first conducts a questioning about the course of the disease and the leading and accompanying symptoms (anamnesis). The doctor will ask questions about previous illnesses, medication and family history. In addition, physical examinations are performed to check the functions of the nervous system (for example, reflex reactions and mobility).
In the case of an initial diagnosis, the doctor also uses imaging techniques such as computer tomography (CT) or magnetic resonance imaging (MRI) to rule out other brain diseases. The treating neurologist can also use a dopamine transporter scintigraphy to show the amount of dopamine-producing nerve pathways, which is usually reduced in Parkinson's disease. The levodopa test enables idiopathic Parkinson's syndrome to be distinguished from atypical Parkinson's syndrome. If symptoms improve after a single dose of levodopa (L-dopa), this indicates idiopathic Parkinson's disease. L-dopa is a precursor of the neurotransmitter dopamine. Is converted to dopamine in the brain.
How the doctor treats Parkinson's disease?
The treating physician chooses to Therapy strategy individually under consideration of age, stage of the illness and the presence of further illnesses. It is advisable to start the therapy of Parkinson's disease at an early stage, since the symptoms can progress at different rates. Maintain quality of life. Recover.
Idiopathic Parkinson's syndrome is currently not curable, but leading and accompanying symptoms can be treated well. Drug treatment includes the combination of different agents and is an important component of the therapy. In a patient with early disease onset (age less than 70 years). No other diseases, dopamine-like substances (dopamine agonists) often lead to symptom relief. These drugs mimic the effect of the missing neurotransmitter dopamine. For older sufferers (age over 70) with additional illnesses, L-dopa, a precursor of dopamine, is used. If only very mild symptoms are present, MAO-B inhibitors can also be used, which are less effective but usually better tolerated. These agents increase the amount of dopamine in the brain by preventing its breakdown. Treatment with dopamine agonists and L-dopa can lead to fluctuations in effect with increasing therapy duration. In addition, side effects such as movement disorders, psychiatric changes (insomnia, restlessness, psychosis) and cardiac rhythm disorders can occur.
Further supportive therapies of the Parkinson's disease represent the Physiotherapy and Occupational Therapy dar. These are important for the preservation of movement-. Ability to act in everyday life is important. For patients with speech disorders speech therapy help.
What you can do yourself with Parkinson's disease?
If Parkinson's disease is diagnosed at an early stage, the symptoms can be treated well. Therefore, it is recommended to consult a doctor at the slightest suspicion of Parkinson's disease. Affected persons and their relatives can also get help and support in dealing with the disease from a counseling center for Parkinson's patients. This also advises the affected person on options for home or inpatient care. In addition, support groups offer an opportunity for Parkinson's patients and their relatives to exchange ideas and experiences.