Millions of senior citizens around the world lead a painful life battling the ravages of Parkinson’s. The disease typically hits people over 65 and preys on their motor abilities, eventually turning them into trembling and infirm cripples. These elderly people exhibit a slow, awkward gait, even as their limbs turn rigid and become prone to tremors. Loss of balance turn their attempts to walk into a painful shuffle; they often lose facial expression and sometimes the ability to speak. In as many as half, the disease also comes with psychiatric complications of anxiety and depression. Though it is not clear what causes the disease, it is believed that at least some cases are hereditary. It is, however, known that cells in an area of the brain called the “substantia nigra” die off. These cells make a molecule called dopamine, which helps control muscle movement. Drug therapies have, therefore, focused on replacing the dwindling supply of dopamine or addressing specific symptoms associated with the disease. Thanks to the recent advances in the lab, including the pinpointing of several Parkinson’s genes, scientists are now uncovering new biochemical pathways involved in the disease and stripping open new targets for therapy.
There are no tests available to confirm Parkinson’s disease and, therefore, our specialists at BRAINS will examine your medical history, your signs, symptoms and your neurological and physical condition for making a diagnosis. Sometimes they may order tests to rule out other conditions that could be causing your symptoms. In addition to all these, your doctor may give you carbidopa-levodopa, the most effective Parkinson’s disease medication. Significant improvement with this medication often confirms the diagnosis.
Medications can help control the symptoms of the disease. In advanced stages of the disease, surgery may be considered. Your doctor also may recommend changes in your lifestyle, especially on going aerobic exercise. In some cases physical therapy focusing on balance and stretching too might be an important part of the treatment.
Problems with walking, movement and tremor can be mitigated quite effectively with medicines that are now standard for the treatment of the disease. Since Parkinson’s is caused by the deficiency of dopamine, a chemical messenger or neurotransmitter that helps in the transmission of signals in the brain, medicines typically attempt to either boost its supply or to suppress the production of an enzyme called MAO B that breaks down brain dopamine.
Formulations centered on Levodopa, a natural chemical that passes into your brain and is converted to dopamine, are thus far the most effective line of treatment. In certain situations, however, your doctor may opt instead for dopamine agonists which, unlike levodopa, don’t change into dopamine but mimic its effects in your brain. These may not be as potent in countering the symptoms of Parkinson’s but are known to remain effective over a longer run and may, therefore, be preferred in some cases, at times in combination with levodopa. Alongside or separately, depending entirely upon what each case demands, your doctor may prescribe medicines called MAO B inhibitors that prevent the breakdown of brain dopamine by going after an enzyme that metabolizes the neurotransmitter.
In some cases, your doctors at BRAINS may recommend a surgical procedure called deep brain stimulation (DBS) wherein electrodes are implanted into a specific part of your brain and connected to a generator in your chest that sends electrical pulses to your brain and may help improve many of Parkinson’s disease symptoms. DBS is most often a procedure to treat people with advanced Parkinson’s disease who have unstable medication responses. It can help stabilize medication fluctuations, reduce or eliminate involuntary movements (dyskinesia), reduce tremor and rigidity, and improve slowing of movement.
Deep brain stimulation (DBS): The surgical procedure involves implanting electrodes within certain areas of a brain. These electrodes produce electrical impulses that regulate abnormal impulses and (or) affect certain cells and chemicals within the brain. The amount of stimulation in deep brain stimulation is controlled by a pacemaker-like device placed under the skin in your upper chest. A wire traveling under your skin connects this device to the electrodes in your brain.
Deep brain stimulation is used to treat a number of neurological conditions, such as essential tremor, Parkinson’s disease and dystonia, a state of abnormal muscle tone resulting in muscular spasm and abnormal posture, typically due to neurological disease or a side effect of drug therapy