Parkinson’s disease (PD) is a degenerative disease associated with progressive nerve disorders. It affects two specific regions of the central nervous system – the brain and the spinal cord.Parkinson’s disease on spinal cord cause primary motor symptoms like
- Tremors even on resting muscles
- Stiffness and rigidity due to increased muscle tone
- Slowness of physical movements
- Postural instability issues due to impaired balance and coordination
Additionally, there may be secondary motor symptoms like fatigue, involuntary movements, speech problems, handwriting variations and swallowing difficulties. In severe cases, PD impacts the thinking process and causes dementia (loss of memory) in many patients.
Causes of PD
PD is caused by the destruction or degeneration of certain brain nerve cells called dopaminergic cells. These cells produce dopamine, a neurotransmitter, which aids in transmitting messages for controlling and coordinating body movements. In PD cases, there is a decline in dopamine production. This in turn makes it harder for the brain and spinal cord to control and coordinate muscle movements.
Risk Factors for PD
- Age – With increasing age probability of getting PD is higher
- Genetics – People whose close relations have PD history are likely to develop it themselves than others
- Gender- Males are more prone to PD risks than their female counterparts
- Exposure to toxic chemicals-People who are exposed to harmful chemicals like carbon monoxide, pesticides or herbicides may develop PD
- Antipsychotic medications – Some medicinal drugs used to diseases like paranoia and schizophrenia can cause PD
There also seems to be a relation between Spinal Cord Injury (SCI) and Parkinson’s disease (PD). Some research studies have found out that patients who have SCI are at an increased risk of PD.
Treatment of PD
Various treatment approaches for PD include medicines, physical exercises, therapies like physiotherapy, occupational and speech therapy, alternative therapies and surgical procedures.
Spinal Cord Stimulation (SCS) in the treatment of Parkinson’s disease is used in advanced PD cases when medications fail. This surgical route improves gait and postural instability in patients enabling them to walk independently. SCS is a mid-thoracic procedure that involves placing electrodes on either side of the spinal column. Electric impulses are sent from a neurotransmitter to the spinal cord via these electrodes. These impulses interfere with the electric signals causing the PD symptoms and subsequently block them effectively. With SCS, dramatic improvements in minimizing dynamic gait characteristics like step length, stride width, stride velocity, stance, and swing time are seen .It usually has no side effects.
Likewise Deep Brain Stimulation (DBS) may be done for treating several disabling disorders due to PD. DBS treats neurological symptoms like tremors, rigidity and stiffness, slowed movement and walking impairments.
Impact of Parkinson’s disease
PD impacts various body functions and interferes with daily life tasks. PD complications include
- Difficulties in chewing and swallowing occur, especially at later PD stages.
- Feelings of anxiety and depression are experienced by patients at some stage of PD.
- Sleep disturbances are common. Waking up during night, difficulties in falling asleep and drowsiness during the day may also be experienced.
- Sexual dysfunctions may be seen (more in case of men).
- Patients may also experience urinary incontinence or retention.
- PD medicines can also cause the following side effects
- Hypotension(decrease in blood pressure) when standing up from seated or lying positions
- Involuntary movements including twitching and jerking of the arms and legs
- Obsessive Compulsive Disorders (OCD)
PD patients can have widely varying symptoms and severity levels. So application of standard treatment procedures may not beneficial .However, customised therapies and treatment with focus on addressing the underlying symptoms can significantly improve the patient’s quality of life.