It is estimated that up to 120,000 people in Britain have Parkinson’s disease and that up to seven million people are touched by it – but many people are still unaware of the symptoms and how it is managed. Rob Mair reports.

In addition, about 10,000 people are newly diagnosed with Parkinson’s each year in Britain. About 4 million people worldwide are estimated to have the disease.

While most people are diagnosed at around age 60, younger people can also develop Parkinson’s. Indeed, it is estimated that one in 20 people with Parkinson’s is less than 40 when first diagnosed.

What is Parkinson’s disease?

 
Parkinson’s is a progressive, neurological disorder. It can affect all activities including talking, walking, swallowing and writing.

Parkinson’s occurs when cells in the part of the brain that controls movement die. These cells produce dopamine, a chemical messenger that enables people to perform smooth co-ordinated movements. It is not known why these cells die.

The three main symptoms are tremors, muscle stiffness and slowness of movement. But not all sufferers experience all three.

Other symptoms may include; altered posture, difficulties with balance, speech and writing, sleep difficulties, bladder and bowel problems, swallowing difficulties, depression, anxiety, excessive sweating, and memory problems. People with Parkinson’s also have an increased risk of falling.

How is Parkinson’s treated?

At present there is no known cure for Parkinson’s, but a range of treatments are available to help control the symptoms and maintain quality of life.
Drugs are the main treatment for Parkinson’s, which work to restore dopamine levels in the brain. While medication helps to alleviate some symptoms, there can be side effects, including abnormal involuntary movements.

Other treatments include Deep Brain Stimulation, a form of brain surgery, which involves implanting electrodes deep inside specific regions of the brain that are connected to a small battery under the skin in the person’s chest. This generates electrical signals and stimulates the brain. If successful, DBS can provide significant improvement in an individual’s symptoms and quality of life. However, this operation does not work for all sufferers.

Physical therapies such as physiotherapy, speech and language therapy and occupational therapy also have an important role to play in managing Parkinson’s.

In addition, Parkinson’s Disease Nurse Specialists provide healthcare support and advice to people living with the condition, working alongside other healthcare professionals, from GPs to continence advisers.

Research into future treatments

Studies are ongoing to investigate novel ways of replacing dopamine that will complement or provide an alternative approach to current drug therapies.

Gene therapy is an emerging approach to treating medical conditions, which basically uses genes as drugs. It introduces normal genes into specific cells of people with certain disorders to overcome the effects of defective genes that may cause or have a part to play in the development of the condition.

Unlike other treatments for Parkinson’s aimed at modifying the symptoms, gene therapy would treat the underlying progression of the disease. This therapy may also be used to reverse the process of cell death in people who do not have defective genes and would help the remaining cells to operate more efficiently or even regrow. With gene therapy, it is hoped that the progression of Parkinson’s will eventually be delayed, halted and ultimately a cure developed.

Initial studies in this area have shown some benefit, although more research is required.

More controversial is stem cell research, which uses the inner cell mass from an embryo or cells derived from adult tissue. These cells can be transformed into nerve cells that can then be implanted into the brain to replace those dopamine-producing cells that have died, thereby reversing the progress of the disease.

This may ultimately lead to a breakthrough in treatment for Parkinson’s disease, but such therapies are unlikely to be available in the near future.

Information from the Parkinson’s Disease Society. For more information go to www.parkinsons.org.uk.