Parkinson's is more than just tremors
US-President Joe Biden likely does not suffer from Parkinson's disease - contrary to over 8.5 million people worldwide. The disease often begins subtly, and it can take years before a diagnosis is made. But what causes Parkinson's disease, and what treatment options are available?
Recent visits of a Parkinson's specialist to the White House in the US have sparked speculation in the US about Joe Biden's health. Rumors have emerged that Biden might have Parkinson's disease. However, Biden's personal physician has now dismissed these rumors. While Biden apparently does not have the condition, over 8.5 million people worldwide do. So, what causes Parkinson's disease? What are its symptoms? And how can it be treated?
Parkinson's disease is the second most common neurodegenerative disorder after Alzheimer's disease. According to the World Health Organization (WHO), the number of affected individuals has doubled in the past 25 years. Currently, there are approximately 400,000 people affected in Germany alone. There is no cure.
What causes Parkinson's disease?
There are various forms of Parkinson's disease. The most common is the so-called idiopathic Parkinson's disease (IPD). "Idiopathic" means that no cause can be identified. The disease originates from a specific brain region, known as the substantia nigra in the midbrain. This area contains specialized nerve cells that produce and communicate with the neurotransmitter dopamine. Dopamine is essential for motor control. Through the Parkinson's disease process, more and more of these nerve cells die, leading to a dopamine deficiency and an imbalance of neurotransmitters in the brain, resulting in the typical symptoms of Parkinson's disease, as the German Parkinson and Movement Disorder Society explains on its website.
The cause of cell death in Parkinson's disease is still not definitively proven. In the affected nerve cells, Lewy bodies form, primarily consisting of clumps of the protein Alpha-Synuclein, which are discussed as a cause of the neurodegenerative process.
Parkinsonian symptoms can also be the result of other nervous system disorders, such as dementia. Inflammations, tumors, or medications like psychotropic drugs can also cause such symptoms.
How does Parkinson's disease manifest?
The symptoms of Parkinson's disease develop gradually. In most cases, they begin unilaterally and become more pronounced over the course of the disease, significantly impairing the daily lives and self-sufficiency of those affected. The typical symptoms, according to health information from gesundheitsinformation.de, include:
Motor symptoms (Akinesia): Affected individuals can only move slowly. Their gait becomes very hesitant, with short, small steps. Fine motor skills, such as tying shoelaces, become increasingly difficult. Facial muscle tone decreases, making the face appear mask-like. Speech becomes soft and monotone, and swallowing becomes difficult.
Rigidity (Rigor): The arms, legs, and neck can be rigid and tense in Parkinson's patients. Arms and legs can usually only be moved with great effort or not at all, and they stiffen even more during attempts to do so. The excessive tension often leads to muscle pain.
Quivering at Rest (Rest Tremor): The rest tremor occurs when muscles are at rest. An arm or leg quivers, even when the person is completely relaxed. The tremor is less noticeable or disappears when the person moves the affected muscles.
Possible further consequences are for example bladder and digestive problems, circulatory problems, speech problems, increased sebum production of the skin, concentration problems, and depressions.
Parkinson's disease is most often diagnosed between the ages of 55 and 60, but in one out of ten patients even before the age of 40. The first signs can occur long before a diagnosis. They are often not noticed or attributed to normal aging. Typical symptoms include a decline in fine motor skills and handwriting. Sometimes the sense of rhythm is lost, or the arms no longer swing while walking. In many cases, the facial expression becomes stiff. There is often constipation, sleep problems, or mood swings. Many experience a decrease or complete loss of the sense of smell.
How is Parkinson's treated?
Although there is no cure, symptoms can be treated. Medications can help replace the missing dopamine. However, these medications cannot stop the progression of the disease, so their effectiveness decreases over time. Therefore, the type and dosage of medication must be constantly adjusted. To ensure even effectiveness, a medication pump can be used. It administers the active ingredient either under the skin or directly into the intestine.
In some cases, a brain surgical intervention, called Deep Brain Stimulation (DBS), may be meaningful. Electrodes are implanted in the brain, which positively influence certain brain regions through electrical impulses. Studies have shown that young patients and patients with early-onset Parkinson's disease benefit most from early DBS application. In combination with physiotherapy, logopedics, and ergotherapy, these measures enable patients to maintain a good quality of life for many years.
Despite rumors suggesting otherwise, Joe Biden's personal physician has categorically denied any Parkinson's disease diagnosis for the US President. This medical condition, known as the second most common neurodegenerative disorder globally, affects approximately 400,000 individuals in Germany alone. The cause of Parkinson's disease remains elusive, with the formation of Lewy bodies and the protein Alpha-Synuclein being discussed as potential contributors.
In response to the progressive loss of dopamine-producing cells in the substantia nigra, individuals with Parkinson's disease exhibit a range of motor symptoms including akinesia, rigidity, rest tremor, and impaired fine motor skills. Although medication can alleviate these symptoms, there is currently no cure for Parkinson's disease, and treatment strategies must be regularly adjusted to maintain effectiveness.
