According to Parkinson’s UK, around 145,000 people live with Parkinson’s disease in the UK, and it’s also the fastest growing neurological condition in the world.

In this article, we attempt to explain the symptoms and available treatments for Parkinson’s disease, to help you get a better understanding of the condition.

What is Parkinson’s disease?

Classed as a neurodegenerative disorder, Parkinson’s disease affects the nerve cells in a specific part of the brain called the substantia nigra. This causes a reduction in the level of a chemical called dopamine, which helps to control body movement.

While the precise causes of the disease are still unknown, symptoms typically include the following:

  • Hand tremors, although other tremors can also occur
  • Slow movement (known as bradykinesia)
  • Stiff limbs and muscles
  • Balance problems.

These symptoms take a long time to develop, usually over several years. The precise progression of the disease differs from person to person. While Parkinson’s disease itself is not fatal, disease complications can be serious.

It is now known that sufferers experience symptoms in an advanced stage of the disease, when a significant number of neurons have been affected.

According to the NHS website, around one in 500 people in the UK are affected by Parkinson’s disease. Most people begin to develop symptoms over the age of 50, although around one in 20 sufferers show early signs under 40. Men are slightly more at risk than women.

Currently, there are no blood or laboratory tests available to diagnose Parkinson’s disease. Diagnosis is based on a person’s medical history and a neurological examination. Improvement after initiating medication is another sign of Parkinson’s disease.

What are the non-motor symptoms of Parkinson’s disease?

As well as movement, or motor, related problems, people with Parkinson’s disease are often affected by non-motor symptoms. According to the Parkinson’s Foundation, these non-motor symptoms can have the biggest impact.

Non-motor symptoms can include a wide range of physical and psychological conditions, including:

  • Depression and anxiety
  • Loss of sense of smell (anosmia)
  • Sleeping problems (insomnia)
  • Constipation
  • Memory problems.

According to research, managing these symptoms is vital for the long-term quality of life of the sufferer. Carers and loved ones might not see evidence of non-motor issues, but they need to be aware that symptoms are common and can be more serious than motor symptoms.

In fact, issues such as losing a sense of smell or becoming depressed can often arrive years before a diagnosis of Parkinson’s disease.

Parkinson’s disease treatment

Although there is no cure, it is possible for Parkinson’s disease sufferers to continue to enjoy a good quality of life. Medication and support from a doctor and other healthcare professionals, such as a Parkinson’s nurse, are essential for effective treatment.

Parkinson’s disease treatment may not be required during the early stages, as symptoms are usually mild.

Available treatments include:

  • Physiotherapy and occupational therapy
  • Medication
  • Brain surgery (in some cases)

Physical, occupational, and speech therapies can help with movement and voice disorders, tremors, stiffness and cognitive decline. Other supportive techniques include a healthy diet and exercises to strengthen muscles and improve balance.

Parkinson’s disease medication

Medication is commonly used to improve the main symptoms of Parkinson’s disease, such as tremors and movement problems. However, medication is not right for everyone, and each type has its own short- and long-term effects.

The purpose of Parkinson’s disease medication is to do one or more of the following:

  • Increases the amount of dopamine in the brain
  • Acts as a dopamine substitute, stimulating the parts of the brain where dopamine works
  • Blocks the action of other factors (enzymes) that break down dopamine.

According to Parkinson’s UK, the types of medication used to treat Parkinson’s disease include:

  • Levodopa (co-beneldopa and co-careldopa): the main Parkinson’s disease medication, it is a chemical building block that your body converts into dopamine in the brain.
  • Dopamine agonists (pramipexole, ropinirole): these trick your brain into thinking they are dopamine. This means they can mimic the way dopamine works, which can reduce your symptoms.
  • MAO-B inhibitors (rasagiline, selegiline, safinamide): these can help your nerve cells make better use of the dopamine available.
  • COMT inhibitors (entacapone, opicapone): COMT inhibitors can block an enzyme that breaks down levodopa medication.
  • Amantadine: used to treat involuntary movements (dyskinesia) if other Parkinson’s medication has not been effective.
  • Anticholinergics (procyclidine, trihexyphenidyl): these treat tremors by blocking a chemical messenger called acetylcholine.
  • Apomorphine: this tricks your brain into thinking it is dopamine.
  • Rotigotine skin patch (Neupro): releases dopamine agonist medication slowly over 24 hours.

Scientists are currently trying to find ways to identify biomarkers for Parkinson’s disease that can lead to earlier diagnosis and more tailored treatments to slow the symptoms. Currently, all Parkinson’s disease treatments improve symptoms, without slowing or halting the disease.

Approved by Dr Darren Cotterrel MBBCh, MRCPsych, MSc, FRCPS