What You Need to Know About Parkinson's Disease
In the below article from Women's Health Magazine, NPF's National Medical Director, Dr. Michael S. Okun, comments on Parkinson's disease (PD) in the wake of news reporting that actor Robin Williams was in the early stages of PD.
It was recently revealed that Robin Williams was suffering with the early stages of this neurodegenerative condition.
A week ago today, the unforgettable, award-winning actor Robin Williams passed away at the age of 63. While family, friends, and innumerous fans worldwide mourn the loss this beloved star, much needed awareness about depression—and just how serious an illness it can be—is rapidly spreading.
Additionally, on Thursday, August 14, Robin's widow Susan Schneider revealed to the press that the comedian had been recently diagnosed with Parkinson's disease:
"Robin's sobriety was intact and he was brave as he struggled with his own battles of depression, anxiety as well as early stages of Parkinson's disease, which he was not yet ready to share publicly. It is our hope in the wake of Robin's tragic passing, that others will find the strength to seek the care and support they need to treat whatever battles they are facing so they may feel less afraid."
In light of this news, we wanted to take this opportunity to focus on the realities of Parkinson’s disease and what you need to know about the illness. While you're probably familiar that actor Michael J. Fox has been living with the disease since 1991, chances are there's a lot you still don't know about Parkinson's disease (PD).
For one, experts believe it's a commonly misunderstood disorder. “One of the things that many people mistakenly believe is that Parkinson’s is like Lou Gehrig’s disease (ALS), Alzheimer’s, or a brain tumor–that it is an extremely fast-progressing disease and an immediate death sentence,” says Michael Okun, M.D., medical director of the National Parkinson Foundation and professor of neurology at the University of Florida Health. “Parkinson’s is an extremely livable disease if the patient seeks the right help; there are many very good therapies available including drugs, behavioral therapies and, in some cases, medical procedures like brain stimulation.”
So what is it, exactly? “Parkinson’s disease is a very slowly progressive neurodegenerative condition affecting multiple circuits in the brain," says Okun. "Because the brain is part of the central nervous system, there are numerous complex and interrelated neural pathways involved that affect every aspect of human functioning. Therefore, the disruption of neural circuitry in the brain can lead to a wide range of deficits of varying severity. With Parkinson’s, the specific circuits affected result in a range of motor manifestations such as tremors, stiffness, and disrupted walking.”
In the United States alone, between 50,000 and 60,000 new cases of PD are diagnosed each year, and it is currently the 14th leading cause of death in our country. The cause of the disease remains uncertain, though research suggests genetics and environmental factors could play a role, and men have a somewhat higher risk than women, says Okun.
When one suffers from Parkinson’s disease, brain cells die in various parts of their brain, including a region called the substantia nigra, or “black substance,” explains Okun. Degeneration in this part of the brain causes neurons to fire without normal control, leaving Parkinson’s patients with motor symptoms like tremors and rigidity. Potential early symptoms that precede actual motor disruptions include vivid dreams, constipation, and loss of smell.
Parkinson’s patients also experience non-motor symptoms, which studies have shown may be even more disabling. These symptoms may include depression, anxiety, and sexual dysfunction.
Interestingly, until recently, depression among Parkinson’s patients has been largely misunderstood, says Okun. “For many years it was thought that patients’ tremendous sadness about their Parkinson’s diagnosis caused depression. But several large, extremely reliable studies in recent years have shown that, for many Parkinson’s patients, depression is not just a reaction to their diagnosis.” In fact, there may be biological changes in the brain that underpin a Parkinson’s disease diagnosis. These come from both the degenerative process and changes in brain chemicals such as dopamine, serotonin and norepinephrine, which may be depleted in the Parkinson’s brain. When dopamine drops, so does serotonin, a neurotransmitter responsible for mood regulation.
“Due to these recently revealed biological changes in the brain, we now believe there is a biological basis for why depressive symptoms occur in the majority of people diagnosed with Parkinson’s,” explains Okun.
While depressive symptoms can seriously affect quality of life, Okun stresses the importance of realizing that Parkinson’s is a very livable disease with many treatments available. “If symptoms are identified and addressed as soon as possible, there are many ways we can help people live long and happy lives."
The most effective Parkinson’s treatments available include medications (like dopamine replacement therapies, dopamine agonists, and MAO-B inhibitors), behavioral therapies like exercise (tai chi and specific forms of weight training and walking have been shown to be particularly beneficial), and, in some cases, surgery such as deep brain stimulation.
“Every Parkinson’s patient is different,” says Okun, “Which is why at the Parkinson’s Outcomes Project, which is the first and largest data-driven study of outcomes in Parkinson’s disease, we do everything possible to personalize treatments and take an interdisciplinary approach with multiple professionals working together to find the right combinations of medications, behavioral treatments and potentially surgeries for each patient.”
So, if you or a loved one demonstrates early Parkinson’s symptoms or receive a Parkinson’s diagnosis, remember to remain hopeful and engage in medically-prescribed treatments as soon as possible.
More information on Parkinson’s disease, symptoms, and treatments can be found at the National Parkinson Foundation, as well as the Michael J. Fox Foundation for Parkinson’s Research.
— Leah Fessler
© 2014 Rodale Inc. All Rights Reserved.