Parkinsons

Parkinson’s is a progressive neurological condition that affects movement and coordination. Symptoms of Parkinson’s usually take many years to develop. The first sign of Parkinson's is sometimes a tremor or slowness of movement. There is currently no cure for Parkinson’s, but its symptoms can be treated with medication, surgery and lifestyle changes.

What is Parkinson's?

Parkinson’s is a progressive neurological condition caused by an insufficient quantities of dopamine – a chemical in the brain. Dopamine enables quick, well-coordinated movement. When dopamine levels fall, movements become slow and awkward.

A person does not suddenly develop Parkinson’s. The nerves in a part of the brain called the substantia nigra degenerate or die slowly, so the condition comes on gradually.

Parkinson’s has both motor and non-motor symptoms:

  • motor symptoms include control of coordination, movement and mobility
  • non-motor symptoms include things such as your senses, energy levels, mood and cognitive abilities (perception, memory, judgement, reasoning etc).

With good medical treatment, Parkinson's generally has only a minor effect on life expectancy.

How common is Parkinson's? 

About 1 in 500 people have Parkinson’s disease.

  • It is most common in older people, with an estimated 1% of people over the age of 60 being diagnosed with Parkinson’s.
  • There is a very small increase in Parkinson’s risk in people with family/whanau who have Parkinson’s.

Parkinson's has possibly always affected humans:

  • Descriptions of Parkinson’s-like symptoms can be found in some accounts from Roman times.
  • The first authoritative description was by Dr James Parkinson in 1817 in a paper called the ‘An Essay on the Shaking Palsy,’ describing many features of the condition.
  • Since that time, many doctors and scientists have taken an intense interest in Parkinson’s and more is known  about it now than any other degenerative condition of the brain.

What causes Parkinson's?

Doctors currently do not know what causes Parkinson’s. However, there are a variety of treatments for symptoms of Parkinson's and researchers around the globe are constantly searching for new treatments. 

Parkinson’s is often called ‘Parkinson’s disease’, however, it is not contagious and can't be spread from one person to another.

Symptoms of Parkinson's

Motor symptoms

  • Tremor
    • About 70% of people with Parkinson’s experience a tremor.
    • Tremor is characterised by shaking, particularly when resting, which often occurs initially in one hand or arm.
  • Stiffness
    • Muscle rigidity can make tasks like turning in bed, getting out of a chair, or delicate movements like doing up buttons, difficult.
    • Stiffness can also affect posture and facial expressions and can lead to muscular aching.
  • Slowness of movement (also known as bradykinesia)
    • People with Parkinson’s often find initiating movements difficult, or it might take them longer to perform a task than someone without Parkinson’s.
    • This can affect things like repetitive limb movements, handwriting and getting dressed.

Non-motor symptoms

  • depression, anxiety or loss of interest in life
  • disturbance of normal sleep
  • extreme tiredness 
  • lack of sense of smell
  • constipation
  • trouble swallowing or speaking
  • skin sensations and pain.

Diagnosis of Parkinson's

Early onset

People diagnosed with Parkinson’s below 60 years of age are said to have early-onset Parkinson’s. Although Parkinson’s is generally thought to be an older person’s condition, about 10% of all people diagnosed with Parkinson’s are younger than 40 years old.

Juvenile Parkinsonism

In rare cases, Parkinson’s-like symptoms can occur in children and teenagers, this is known as ‘Juvenile Parkinsonism’ and is considered to be a separate condition to Parkinson’s. 

Parkinson's symptoms are generally the same regardless of age. However, with early-onset Parkinson’s, medical, psychological and social management (ie, raising children and managing full-time employment) can be more difficult.

Treatment of Parkinson's

Drug treatments

In most people recently diagnosed with Parkinson's, improvements can be made with medication. You will need to work together with your doctor to discover the right combination of medications to best manage your symptoms. 

The main aim of drug treatments for Parkinson’s is to:

  • Increase the level of dopamine that reaches the brain.
  • Stimulate the parts of the brain where dopamine works.
  • Block the action of other chemicals that affect dopamine.

However, sometimes if a person has mild symptoms of Parkinson’s, their doctor might choose to delay medications, focusing instead on lifestyle improvements such as exercise and relaxation.

Learn more about drug treatments for Parkinson's:

Medication used in the treatment of Parkinson's: a guide for people with Parkinson's and those who care for them (PDF) Parkinson's NZ

Deep brain stimulation (DBS)

DBS is a therapy aimed at treating multiple symptoms of Parkinson’s.

  • DBS stimulates a specific part of the brain with mild electrical pulses.
  • The DBS treatment leads to better symptom management and often allows for a 30% to 40% reduction in the amount of medication needed by the patient.
  • In New Zealand less than 20 patients receive DBS treatment annually (because it is only effective in some patients).
Learn more about DBS:

Deep brain stimulation factsheet criteria, assessment process and surgical procedure used for DBS in New Zealand, Parkinson's NZ
People’s experiences of undergoing DBS The Parkinsonian, September 2013

Exercise

Exercise is vital for people with Parkinson's.

  • It improves overall health and well-being, and appears to improve the body's reaction to dopamine.
  • People with Parkinson's should try for a minimum of 20-30 minutes of daily exercise, including stretching exercises (these are especially helpful).
  • Always consult your doctor/GP before starting any new exercises. 

Support

Parkinson's New Zealand Support and information for all people with Parkinsonism conditions – not only those with Parkinson's. So people with an alternative diagnosis can join the society.
UPBEAT – Parkinson's New Zealand A special interest group for people with early-onset Parkinson's, their whanau/family and friends. 
Carers & families Parkinson's New Zealand 
Local services & support Parkinson's New Zealand 
Links to other organisations Parkinson's New Zealand

Learn more

About us Parkinson's New Zealand 
News & research Parkinson's New Zealand

References

Parkinson’s New Zealand

Credits: Editorial team.