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Understanding Parkinson’s Disease
By Susan Locke, M.D.
Healthnetwork Medical Director
Parkinson’s disease (PD) affects the brain’s
ability to control movement. It is a progressive disease that worsens over time, although the
rate of deterioration greatly varies from person
to person. It is a common disorder that affects
more than 1 million people in the U.S., most of
whom are older than 60. It seems to be more common in men than women.
can cause difficulties in activities of daily
There are nerve cells (neurons) in the brain that
make the chemical dopamine which helps to
control movement. In patients with PD, these
progresses, the person can “freeze up”
neurons start to degenerate and lose their
ability to produce dopamine. This deterioration
• Rigidity causes stiffened movement of
is gradual which explains why the symptoms of
Parkinson’s worsen over time. It is not known
Approximately 10-15% of people with PD have
• Cognitive problems and dementia – this
at least one first-degree relative with the
disease. It is thought that PD is due to a
environmental causes. In patients with early
onset PD (diagnosed before age 50), it is
thought that genetic mutations play a role.
The symptoms of Parkinson’s disease can be divided into two categories: motor and non-
• Sleep disorders – difficulty falling and/or
Motor symptoms – these affect movement of
the body. Symptoms typically start on one side
of the body and spread to the other over a few
difficulty swallowing, abnormal sweating,
• Tremor – shaking is most noticeable
• Pain – reported in more than 40% of
called “pill-rolling.” Other body parts affected include the legs, lips, jaw or
There are no blood tests or imaging tests that
help to confirm the diagnosis of Parkinson’s
sleep disorders, dementia and psychosis and
disease. The diagnosis is made based on a
medications specific for these disorders.
reviewed during a thorough medical history and
careful general physical and neurological exam.
It is difficult to predict the outcome. There is
To make the diagnosis, one of the symptoms
great variation from one person to the next but
most do well with treatment for many years.
(bradykinesia) and then there should be either
Progression is usually slow. Parkinson’s disease
tremor or rigidity in addition to the bradykinesia.
is not fatal, but it increases the risk of dying
In additions, physicians will support the
from PD-related complications such as falls,
diagnosis with symptoms that begin on one side
of the body, the presence of tremors at rest and
that the symptoms can be controlled with PD medications. If the diagnosis of PD is uncertain,
a medication test challenge is commonly used – the patient is treated with PD medication for two months and if the symptoms improve, the diagnosis of PD is likely. Treating Parkinson’s Disease There are six main types of medication to treat
the motor symptoms of Parkinson’s disease which will be mentioned below, but not discussed in detail.
reduce side effects. In the U.S. this is
• MAO B Inhibitors – e.g., Eldepryl®,
• Dopamine agonists – e.g., Parlodel®,
If you would like more information about this
• Anticholinergics – e.g., benztropine,
disease or an appointment with a movement
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