Parkinson's Disease - What you need to know

It all started on a Saturday morning. I woke up, said my prayers and went to take my bath in preparation for work. I went downstairs where my Dad was already sitting at the dining table. We exchanged greetings as I helped myself to a cup of coffee and fried eggs. As I gulped down some coffee, Grandpa walked in. He was in his 80s at the time. He reached for a glass of water on the table, and I noticed something strange. His hands were trembling and minutes later, we tried getting into my car but his legs were stiff. Hours later, a middle-aged neurologist informed us that my grandpa has been diagnosed Parkinson's Disease. This prompted me to research about the disease.

What I found out about Parkinson's Disease

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Parkinson's disease is a neurological condition caused by the decreased secretion of dopamine by the dopaminergic neurons of the basal ganglia, especially that related to a nigrostriatal pathway. The basal ganglia (or basal nuclei) constitute masses of gray matter located within the cerebral hemispheres (the largest part of the brain). The basal ganglia are made up of the corpus striatum, the amygdaloid complex, and the claustrum. Through connections with other parts of the brain and spinal cord, the basal nuclei help control voluntary muscle activities. It carries out its function through a number of neurotransmitters but the most notable is dopamine. Dopamine is an inhibitory neurotransmitter which inhibits excitatory neurons which if not otherwise inhibited, would cause the release of spontaneous impulses which could lead to uncoordinated muscle contractions.

Causes of Parkinson's Disease

Parkinson's disease can be caused by a variety of factors.

• Accidents: A fatal accident which affects the brain can lead to damage in the connections of the basal ganglia and hence cause Parkinson's disease.

• Old Age: Parkinson's disease is usually more common in older people. Thus, it is thought of that the secretion of dopamine decreases with age.

• Idiopathic: Parkinson's disease sometimes is caused by unknown factors.

• Drug-induced: Parkinson's disease can also be caused by the use of some drugs such as Sodium valproate.

Signs and Symptoms of Parkinson's Disease

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As the basal nuclei is mainly concerned with coordination of voluntary muscle function, Parkinson's disease is mainly manifested as a wide range of muscle defects. Some of which are explained below;

• Tremor: Tremor is the involuntary contraction of muscles. The muscles contract involuntary and cause “shivering-like” movement of the body especially in the hands, leg, feet, and jaws. The tremor in Parkinson's disease occurs usually at rest.

• Rigidity: Rigidity simply means stiffness of muscles. Patients with Parkinson’s disease usually suffer from stiffness of voluntary muscles due to sustained contraction of this muscles.

• Difficulty in Movement: An individual with Parkinson's disease usually finds it hard to initiate movement. When these moments are finally initiated, they are often very difficult to bring under control. There is also slow movement (bradykinesia) or sometimes inability to move (akinesia).

• Stamping Gait: Patients with a chronic form of Parkinson's disease usually develop a special kind of gait (walking step) called stamping gait. In this gait, the patient raises his foot up with difficulty and stamps it on the ground. It is also called festinating gait.

L-dopa To The Rescue

Though Parkinson's disease cannot be cured, it can be managed effectively. Parkinson's disease by the administration of dopamine. L-dopa is injected into the bloodstream. In the bloodstream, it is converted to dopamine. Dopamine then moves to the brain where it performs its inhibitory functions and help control muscle action. L-dopa is often administered with carbidopa and/or L-deprenyl. Carbifopa inhibits the conversion of L-dopa to dopamine. Dopamine when in excess in the bloodstream leads to the damage of organs like the liver and kidneys. L-deprenyl inhibits monoamine oxidase which degrades dopamine hence it increases the duration of action of dopamine.

Conclusion

We were able to get our hands on L-dopa, though expensive, it has helped to manage grandpa's condition and he is now doing pretty fine.

References

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