Parkinson’s is a chronic degenerative disease that is generally manifested by uncontrollable tremors. Still, other symptoms can help detect it early, know them, and manage them.
Parkinson’s disease or Parkinson’s (PRK) is a disease of the central nervous system, chronic, degenerative, affecting an area of the brain called the basal ganglia, whose function is to act as a support system in the production and control of movements, both voluntary and involuntary.
Parkinson’s develops in an insidious, slow way, with a progressive, although variable, evolution, generally between 55 and 60 years of age. However, the lower age limit for developing the disease is 35 years. As indicated by the Spanish Society of Neurology (SEN), 15% of the people diagnosed are under 50 years of age. It is not a fatal disease, but to this day, it is still incurable.
SEN experts also explain that Parkinson’s is often underdiagnosed. In the next 30 years, the detected cases will triple, partly due to the aging population and advances in its diagnosis and treatment. According to data from the SEN, there are currently approximately 150,000 patients with Parkinson’s disease in our country.
Causes of Parkinson’s disease
In an area of the brain called the substantia nigra there are a series of neurons (nerve cells) of a darker color than the rest, whose function is to produce and secrete an essential substance for controlling movements: dopamine.
At the “gateway” to these basal ganglia, called the Striated Nucleus (EST), are the receptors on which dopamine will act. When dopamine receptors have been activated, a series of biochemical changes allow the adequate connection with the rest of the basal ganglia components, regulating their activity. This complex function is only carried out correctly when there is a perfect balance between all the components.
When this process is developed appropriately, the individual can keep voluntary movements under control – that is, those that he “wants to do”-and allows him to stay involuntary movements inhibited. Out –, and thus prevent its appearance.
When Parkinson’s develops, the black neurons responsible for releasing dopamine degenerate and, consequently, stop producing the neurotransmitter or do so in lesser amounts. When this happens, the regulation of the basal ganglia is not adequate.
The rest of the components and substances of the ganglia do not work in the necessary way, which translates into uncontrolled movements: voluntary movements are not carried out in the desired shape, which implies the appearance of one of the most striking signs of Parkinson’s: hypokinesia (decreased voluntary activities).
Some of the symptoms that occur in this disease are intensified by acetylcholine, a dopamine antagonist neurotransmitter that intensifies its effects by decreasing the level of this.
Among the symptoms of Parkinson’s, we can highlight those that affect movement, balance control, or the patient’s posture; and other partners, not motors, which we will see later.
Motor symptoms of Parkinson’s
- Hypokinesia: due to decreased dopamine. The slowness of voluntary and automatic movements. Lack of facial expression. Small and slow writing (micrograph). Clumsiness when handling objects.
- Tremors: slow and rhythmic. They predominate in a state of rest and decrease when making a voluntary movement. It is a symptom that not necessarily all Parkinson’s patients present. However, its presence is significant since the diagnosis of Parkinson’s disease is very difficult when there is no tremor.
- It is known as ‘cogwheel’ stiffness because, although the member presents resistance to being moved, from a point on, the resistance disappears, and the movement is effortless. The lack of dopamine allows the exaggerated action of another substance contrary to it, acetylcholine, which stimulates the muscles and supposes a difficulty in the movements.
- Postural abnormalities: the tilt of the trunk and head forward. Elbows and knees are hunched over.
- Anomalies when walking: the gait is slow, with a tendency to drag the feet, and alternates with rapid and short steps (festination) with difficulty stopping. The Parkinson’s patient suffers from blockage episodes in which the feet appear to be glued to the ground as if they were frozen or magnetized.
- Balance disorder: altered reflexes, accessible falls.
Other symptoms of Parkinson’s that do not affect movement
Although indeed, the symptoms and signs related to movement, posture, and balance are the most frequent and easy to identify, they are not the only ones that a person diagnosed with Parkinson’s disease can develop:
- Depression and anxiety: many patients diagnosed with Parkinson’s can develop depression or anxiety, as well as sudden mood swings.
- Cognitive disorders: memory loss, confusion, difficulty concentrating.
- Decrease in some senses, such as smell.
- Dull pain and discomfort in the extremities.
- Sleep disorders: daytime sleepiness and frequent naps. Stiffness and hypokinesia can make it difficult to sleep at night, especially when getting out of bed, turning around, or changing posture.
- Gastrointestinal problems.