Navigating Life with Parkinson's: Challenges, Triumphs, and the Quest for a Cure

-Katherine James

Introduction:

Imagine a world where 10 million stories play out in the delicate choreography of tremors, the silent war against stiffness, and the unseen struggles veiled from sight. Well, you don't need to imagine, as this is the reality, and it goes by the name of Parkinson's disease—a realm far more complex and enthralling than the superficial idea of a mere tremor suggests. This review will delve into the critical evaluation of Parkinson's disease, exploring its challenges, and navigating the numerical clinical trials in search of a cure.

What is it:

Parkinson's disease is a progressive neurological disorder that influences an individual's cognitive processes, behavior, and daily activities. This condition disrupts the normal functioning of the neurological system and impacts various nerve-controlled areas of the body.

History:

Parkinson's disease is a common and progressive neurological ailment that affects millions of people worldwide. It was named after the English physician James Parkinson, who first reported its symptoms in 1817. It's critical to comprehend the fundamentals of Parkinson's disease as we go deeper into its complex terrain. Parkinson's disease is more than simply a tremor illness; it involves a range of issues that go well beyond the obvious. We'll explore the complexities of this complicated illness in the upcoming parts, elucidating its effects on people and the continuous search for a treatment.

Symptoms:

Parkinson's disease frequently begins quietly, with mild symptoms that progressively worsen. A slight tremor in one hand could be the first sign, which could go unrecognized. But when the illness worsens, the symptoms worsen and affect many facets of day-to-day living.

Symptom	Symptom Description
Tremor	- Often rhythmic shaking of hands or fingers. - Thumb and forefinger rubbing back and forth, known as "pill-rolling tremor." - May occur during sleep but tends to decrease with movement.
Bradykinesia	- Medical term for delayed movement. - Gradual impairment of movement, making easy tasks more difficult and time-consuming. - Shortened steps for walking and challenges with daily tasks like getting out of a chair. - Perceptible dragging or shuffling of feet.
Rigidity	- Painful and movement-limiting stiffness in all body muscles. - Progressively worsens and varies in severity.
Impaired Balance and Posture	- Causes postural abnormalities, such as a hunched-over stance. - Increases the risk of falls due to balance problems.
Loss of Automatic Movements	- Reduced occurrences of smiling, blinking, or swinging arms when walking. - Exacerbates the overall impact on physical capacities.
Changes in Speech and Writing	- Altered speech characteristics like softness, speed, slurring, and hesitation. - Difficulty in writing, leading to smaller and more patterned handwriting.
Freezing of Movement	- Difficulty starting or maintaining movement. - Often described as a feeling of being "stuck" in one location.
Micrographia	- Handwriting becomes narrower and more confined.
Masked Face	- Reduced facial expression, sometimes referred to as a "mask-like" face due to the absence of movement or emotion.
Drooling	- Caused by increased salivation and difficulties swallowing
Dysphagia	- Swallowing difficulties, increasing the risk of aspiration or choking.
Decreased Arm Swing	- Decrease in the arms' normal swinging motion when walking. - Diminished or nonexistent arm swinging during gait.
Shuffling Walk	- Walking with short, shuffling steps.
Difficulty Turning in Bed	Challenges with turning or repositioning in bed.
Extra Symptoms	- Besides physical manifestations, Parkinson's can cause mild cognitive and memory impairments, sleep disorders, pain, and mental health concerns like sadness and anxiety

Mental Health of Parkinson's patients:

A study done by Mayo Clinic in 2007 discovered that a large number of Parkinson's patients have experienced mental health problems.

- 58% experience depression.

- 45% grapple with anxiety and panic.

- 63% face concentration challenges.

Surprisingly, only 11% seek support from mental health professionals, the lowest among available therapies.

Condition	Prevalence	Risk Factor	Onset
Depression	35%	Motor symptom severity, mainly women, dementia, sleep disturbance and psychiatric comorbidities	Depression Premotor stage to late stage of PD
Suicide	17%-30%	Mainly affects young age men, generalized onset of motor symptoms, depression, delusion and psychiatric disorder	Could occur at any stage
Dementia	83%	Affects mainly old age, old age at PD onset, severe motor symptoms, longer PD duration, depression, hallucination, confusion, disturbance, poor cognitive test scores and smoking.	Late stage of PD
Anxiety	60%	Mainly affects young women.	Premotor stage to late stage of PD.
Psychosis	40%	Mainly affects women, dopamine agonist therapy, anticholinergic drug and cognitive decline.	All spectrum of PD, typically later stage
Apathy	60%	Severe motor symptoms, and cognitive decline	Early stage of PD

Daily Challenges:

A person's quality of life can be greatly impacted by the many different daily challenges that come with having Parkinson's disease. People with Parkinson's disease (PD) have complicated duties that are simple skills that many individuals take for granted. Routine activities like eating, grooming, and dressing become increasingly difficult and physically draining due to the tremors, bradykinesia, and rigidity. Communication and interpersonal relationships may be impacted by the loss of reflexive movements and changed speech patterns.

Fall risk and potential injuries rise when maintaining balance and posture becomes a continual concern. Basic mobility becomes more difficult due to the freezing of movement and shuffling walk, which makes turning in bed and traveling through places difficult. Furthermore, the psychological burden of coping with these physical restrictions, in addition to any cognitive deficits, underlines how challenging living with Parkinson's disease is. The ability to bounce back and adjust to these obstacles on a daily basis emphasizes how crucial supportive conditions and comprehensive healthcare are to improving the general well-being of people with Parkinson's disease.

Treatment Approaches:

Treatment	Definition
Medication	All medications addressing Parkinson's disease target the underlying dopamine deficiency. Levodopa, a key component, replenishes depleted dopamine levels, effectively alleviating core motor symptoms such as bradykinesia and rigidity. Monoamine oxidase-B (MAO-B) inhibitors regulate dopamine levels by inhibiting its breakdown. The selection of medications is customized to individual needs, often employing a combination approach. Close collaboration with healthcare professionals is crucial to determine the most suitable regimen.
Deep Brain Stimulation	DBS is a surgical therapy for specific aspects of PD, mainly addressing movement symptoms of parkinsons and the side effects of medication. In some cases DBS may improve some non-motor symptoms which includes sleep, pain and urinary urgency. DBS is used to relieve symptoms not cure PD. The FDA approved DBS surgery in 1997 to treat Parkinson's tremor. After the development of levodopa DBS is considered as the most important therapeutic advancement.
Therapies	There are 3 main therapies for PD patients: physiotherapy, occupational therapy and speech and language therapy. The definition of physiotherapy is physical therapy that helps with movement and function after an injury, illness or disability. In particular for PD.
Exercise	Frequent exercise helps people with Parkinson's disease (PD) by enhancing posture, movement, and balance as well as lowering symptoms including slowness and stiffness. Additionally, it improves mental health by reducing common PD-related anxiety and sadness. Leading an active lifestyle can enhance cognitive performance and enhance the benefits of medication.
Diet change	Research suggests that making targeted nutrition the focal point of your meals may help slow down the progression of Parkinson's disease (PD). Consuming a plant-based, whole-food diet has several advantages. There is no PD diet, but it can be beneficial if it includes a range of nutritious grains, fruits, vegetables, and protein-rich foods because they contain healthy fats, including nuts, seafood, eggs, and olive oil in your diet.

Research Advances:

Treatment Approach	Description
Immunotherapy Targeting Alpha-Synuclein	A revolutionary method for Parkinson's disease (PD) treatment, aiming to neutralize harmful forms of alpha-synuclein. Anticipated benefits include delaying disease progression and preventing its spread in the brain, potentially lessening symptom severity.
LRRK2 Inhibitors	Investigated as a potentially productive option in the quest for PD treatment advances. Targets the LRRK2 gene associated with higher PD incidence. Aims to modify underlying disease mechanisms and develop precise, individualized medicines, offering hope for specialized and potent therapies.
Gut-Brain Axis Research	Explores the relationship between changes in gut microbiota and the onset of PD. Unveils possibilities for creative treatments through the bidirectional gut-brain communication channel, emphasizing the stomach's role in neurological health and marking a paradigm shift in PD research.

Case Study:

To conclude this article, I'd like to share a real-life story featuring Harlee Abromson-Kuth.

For four years, her neurologist assured her that her tremors were nothing to worry about. However, during a routine haircut, her hairdresser, drawing a comparison to her own father who had Parkinson’s disease (PD), suggested she get evaluated. This unexpected comment prompted her to seek a second opinion. The new neurologist confirmed that her challenges with tremors, coordination, slowness, and rigidity were indeed indicative of Parkinson’s.

The diagnosis cast a shadow on her usual upbeat mood, and she initially grappled with fear and isolation. Seeking information and support, she reached out to the Parkinson’s Foundation Helpline, delving into research and posing numerous questions. Discovering the Rock Steady boxing program for PD, she decided to take up boxing and water aerobics, viewing them initially as necessary tasks for managing her condition. Surprisingly, she found genuine enjoyment and a sense of social connection in both activities, eventually adding a regular boxing class.

A recent visit to her neurologist brought positive news—remarkable improvement. Her tremors were less frequent and intense, rigidity had diminished, and coordination had notably improved. She attributed this progress not only to medication but also to the newfound joy in boxing, water aerobics, and walking, all recommended by PD professionals emphasizing the benefits of vigorous exercise.

Understanding the importance of a comprehensive approach, she incorporated additional resources into her routine. A supportive and compassionate network, socialization, a mostly healthy diet, meditation, rest, and yoga became integral parts of her life. Her advice is simple: find what works best, embrace the 3 P’s—Positivity, Peace, Proactivity—and remember that living a full life with Parkinson’s is possible with the right support and resources.