More about Parkinson’s

What does Parkinson’s disease mean? Do you have Parkinson’s disease or are you a caregiver and want to know more about Parkinson’s. Below you will find more information about Parkinson’s. Parkinson’s disease is a neurodegenerative disease that is associated with damage and loss of neurons in the substantia nigra, the part of the brain which causes dopamine production (Dickson et al., 2009). How this loss of neurons comes about is still unknown. Dopamine is a neurotransmitter that is important for signal transmission between neurons and is mostly responsible for the signal transfer of the body (Homayoun, 2018). Typical Parkinson’s symptoms are tremors, bradykinesia and rigidity. These symptoms begin on one side of the body and later on spread to the other side, but always remains asymmetrical.

parkinson

Freezing

When the disease progresses there are more limitations, such as freezing. Freezing is a indecisiveness of the body when starting a movement or during a transition in type of movement. The patient has the feeling that their feet are nailed to the ground and it is no longer possible to take a good forward step, this can lead to falling (n-M. et al., 2011). In addition, Parkinson’s patients can also become unstable during movement and while standing still. There may also be cognitive problems such as confusion, concentration problems and difficulty in planning activities. In later stages of Parkinson’s disease, there may be more serious problems such as depression, anxiety and hallucinations (Deeaswran, & Shutter, 2011; Homayoun, 2018; Postuma et al., 2015)

Tremor
Tremor is an involuntary contraction and muscle release that creates a shaking motion. The tremor is often most visible in the upper extremities, has a frequency of 4 to 6 Hertz and take place when the patient is in rest (Postuma et al., 2015).

Bradykinesia
Bradykinesia is the phenomenon that a person shows slow movements and has difficulty repeating movements. Many patients describe it as “weakness” or “fatigue”. It can also prevent an impaired expression in the face, difficulty with fine motorial skills such as typing or a shirt button, trouble turning around in bed or coming from a chair, small short steps (shuffling) and dragging of the legs.

Rigidity
Rigidity is stiffness of the muscles and joints. This means that movement of the joint during the entire movement goes rusty. Rigidity can occur in any part of the body and can cause pain.

Treatment
Several physiotherapy treatments are effective to counteract balancing problems and freezing. Moving is advantageous for motoric functions and should be encouraged with every patient (Dickson et al., 2009). Regular movement is important as the benefits of the exercises are lost after a few months when the exercises stop.

Medicinal treatment may be prescribed when symptoms interfere with the patient’s daily life. There is no cure for Parkinson’s disease. The medication is to suppress the symptoms and also does not affect the progression of the disease. The medication mainly consists of Lepodova and dopamine agonists. These medications supplement the deficiency of dopamine or stimulate the dopamine receptors. Also, there are MOA-B inhibitors, this type of medication inhibits the breakdown of dopamine in the body. This leaves more dopamine in the body. However, Lepodova is the most effective medicine.

Levodopa has a number of side effects and should be prescribed with carbidopa, which blocks the conversion of Levodopa in dopamine into peripheral tissues. This reduces the side effects like nausea and orthostatic hypotension (light in the head when standing up) (Homayoun, 2018; Parkinsonnet, 2018).

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More information about Parkinson’s can be found on the website of

Bronverwijzing

den Oudsten, B. L. D., & de Vries, J. (2006). Kwaliteit van leven bij patiënten met de ziekte van Parkinson: Een kritische evaluatie. gedrag en gezondheid, 34(4), 164-173. doi:10.1007/BF03071133

Dickson, D. W., Braak, H., Duda, J. E., Duyckaerts, C., Gasser, T., Halliday, G. M., . . . Litvan, I. (2009). Neuropathological assessment of Parkinson’s disease: refining the diagnostic criteria. The Lancet. Neurology, 8(12), 1150-1157. doi:10.1016/S1474-4422(09)70238-8

Draijer, W., Eizenga, W., & Sluiter, A. (2011). NHG-standaard ziekte van Parkinson. Huisarts en Wetenschap, 54(7), 380-392.

Homayoun, H. (2018). Parkinson disease. Annals of Internal Medicine, 169(5), ITC33-ITC47. doi:10.7326/AITC201809040

Miyasaki, J. M. (2016). Treatment of Advanced Parkinson Disease and Related Disorders. Continuum (Minneapolis, Minn.), 22(4 Movement Disorders), 1104-1116. doi:10.1212/CON.0000000000000347

Nanhoe-Mahabier, W., Snijders, A., Delval, A., Weerdesteyn, V., Duysens, J., Overeem, S., & Bloem, B. J. N. (2011). Walking patterns in Parkinson’s disease with and without freezing of gait. 182, 217-224.

Parkinsonnet. (2018). Retrieved from https://www.Parkinsonnet.nl/Parkinson/

Postuma, R. B., Berg, D., Stern, M., Poewe, W., Olanow, C. W., Oertel, W., . . . Deuschl, G. (2015). MDS clinical diagnostic criteria for Parkinson’s disease. Movement disorders : official journal of the Movement Disorder Society, 30(12), 1591-1601. doi:10.1002/mds.26424