Parkinson disease: Causes, symptoms and treatment strategies for this neurological disorder

Tremors in Parkinson's disease typically start in one hand or finger and are rhythmic, occurring when the limb is at rest. (Image: Canva)

Parkinson's disease is a progressive neurological disorder that primarily affects movement. It occurs when nerve cells (neurons) in the brain that produce dopamine, a chemical messenger that helps control movement and coordination, become impaired or die. Dopamine deficiency leads to abnormal brain activity, causing symptoms such as tremors, rigidity (stiffness), bradykinesia (slowness of movement), and problems with balance and coordination.

In addition to motor symptoms, Parkinson's disease can also cause non-motor symptoms such as changes in mood, sleep disturbances, cognitive changes, and problems with speech and swallowing.  Parkinson's disease can be challenging to diagnose early, but there are some signs that may indicate its onset. Here are five common signs to be aware of according to Mumbai-based senior neurologist Raghav Taneja.

Tremors: Tremors in Parkinson's disease typically start in one hand or finger and are rhythmic, occurring when the limb is at rest. These tremors may progress over time to affect other parts of the body, causing noticeable shaking that can interfere with daily activities like writing or holding objects.

Bradykinesia: Bradykinesia refers to slowness of movement, where tasks that once were automatic become challenging. Initiating movements such as rising from a chair or walking may become difficult. This slowness can extend to facial expressions, making expressions less animated.

Muscle rigidity: Parkinson's often causes stiffness and rigidity in muscles, leading to decreased range of motion and difficulty with smooth, fluid movements. This rigidity can cause discomfort, pain, and a feeling of heaviness in the affected limbs.

Impaired posture and balance: People with Parkinson's disease may develop a stooped posture, with shoulders hunched forward and head bent. Balance problems and coordination difficulties can make them appear unsteady or prone to falls, especially when turning or changing directions.

Changes in speech and writing: Speech in Parkinson's disease may become softer, slower, or slurred, making it harder to be understood. Handwriting can shrink and become cramped (micrographia), reflecting the decreased fine motor control characteristic of the disease.

Recognising these signs early and seeking medical advice promptly is crucial. A healthcare professional can conduct a comprehensive evaluation, including neurological exams and possibly imaging tests, to determine the cause of these symptoms and initiate appropriate management strategies.

Treatment options

Medications: Medications are often prescribed to increase dopamine levels in the brain or mimic dopamine's effects. These can help alleviate motor symptoms such as tremors, rigidity, and bradykinesia. Examples include levodopa (converted into dopamine in the brain), dopamine agonists, and MAO-B inhibitors, says Dr Taneja.

Deep brain stimulation (DBS): For some individuals with Parkinson's disease, especially those whose symptoms are not adequately controlled with medications, deep brain stimulation may be an option. This surgical procedure involves implanting electrodes in specific areas of the brain to help regulate abnormal brain activity and reduce motor symptoms.

Physical therapy: Physical therapy and exercise programs tailored to Parkinson's patients can improve flexibility, strength, balance, and overall mobility. These therapies can also help manage pain and prevent complications such as muscle stiffness and joint problems.

Speech therapy: Speech therapy can assist in improving communication abilities affected by changes in speech patterns, such as softness, slurring, or hesitation.

Occupational therapy: Occupational therapists can suggest strategies and devices to make daily tasks easier and more manageable despite motor impairments.

Lifestyle modifications: Adopting a healthy lifestyle, including a balanced diet, regular exercise, and sufficient rest, can help manage symptoms and overall health.

Supportive care: Psychological counseling, support groups, and education about the disease can help individuals and their caregivers cope with the emotional and practical challenges of living with Parkinson's disease.