Parkinson’s disease is a progressive neurodegenerative condition affecting more than a million people in North America and more than 7.5 million people worldwide. Dr. Bernardo Rodrigues directs the Parkinson’s Disease and Movement Disorder Center at UConn Health, and shares his expertise during this Parkinson’s Disease Awareness Month.
What does Parkinson’s disease do to a person?
Parkinson’s disease (PD) is associated with loss of dopamine neurons in the brain. It can lead to resting tremors, stiffness, slowing down of movements, and balance problems. Other symptoms of Parkinson’s disease are decreased facial expression, softer voice, smaller handwriting. Some people have noticed loss of sense of smell and constipation years before the onset of classical PD symptoms.
It’s more common among the elderly, and the incidence increases with age. The risk of PD rises from 1 percent at age 60 to 4 percent at age 80. Men are a little more affected than women.
What role do genetics and lifestyle have in Parkinson’s disease?
Many genes have been associated with Parkinson’s disease. Around 15 percent of people with PD have a first-degree family member affected. PD seems to be a condition where genetic and environmental factors seem to combine to predispose someone to develop the symptoms. Many environmental factors have been described ranging from pesticides, to Agent Orange and heavy metals, to dietary preferences.
How do you manage Parkinson’s disease?
The management of PD starts with exercise programs and diet changes, then progresses to medication use, and finally, surgical options are considered.
It is important for a patient with PD to maintain a healthy and balanced diet, rich and fibers and probiotics, and keep well hydrated. Multiple exercise modalities (walking, biking, swimming, dancing and boxing) have been associated with better motor function and increased quality of life in Parkinson’s disease.
Medications for PD are focused on replacing the deficiency of dopamine in the brain. Dopaminergic medications can improve the tremors, the speed of movements and gait and relieve the stiffness and tightness the patient may feel. They are considered safe and highly effective in most cases.
Many new surgical techniques have been developed to help the symptoms of Parkinson’s disease. Deep brain stimulation (DBS) surgery can help improve the symptoms of PD and allow for decrease in the dose of medication. Other surgeries include thalamotomy [precise destruction of a tiny area of the brain] with Gamma Knife® [highly focused beams of radiation] or magnetic resonance imaging-guided focused ultrasound (MRgFUS) for the tremors.
What enables UConn Health’s Department of Neurology to provide the best care for Parkinson’s patients?
UConn Health’s Movement Disorders clinic has a team dedicated to the care of patients with Parkinson’s disease. Our doctors are fellowship trained in the care of patients with Parkinson’s disease and can offer an array of treatment options. Our clinic offers all FDA-approved medications for PD, DBS programming and analysis, and injections of botulinum toxin (Botox) for drooling or muscle spasms.
Where are we with treatments or a potential cure?
The focus of the study of Parkinson’s disease has been on the factors that can lead to the condition many years ahead. Multiple epidemiologic studies have been trying to understand the relationship between genetic factors and environmental exposure.
Scientists are studying the changes that happen in the gut bacteria that lead to constipation and have been associated with development of PD years later. Probiotics could lead to a change in the population of bacteria and help patients.
A common asthma medication has been recently associated with lower risk of PD. New studies will test if these medications could be used to slow down or prevent PD.
