Parkinson’s Disease: Defining the Entire Spectrum

Overview
 Parkinson’s Disease (PD) is a complex neurodegenerative disorder where both motor and non-motor symptoms are present to a progressive loss of neurons in the brain. PD is the second most prevalent neurodegenerative disease after Alzheimer’s disease. PD effects approximately 0.3% of individuals within industrialized countries.
 
Symptoms: both Motor/Non-motor systems
 Within the public eye, it often comes across that symptoms associated with Parkinson’s Disease are exclusively limited to effecting the motor systems of PD patients. Personally, I fell within this category prior to investigating this neurodegenerative disease. Before diving into the relevance of the symptoms, I feel that a list may be helpful.
 
Motor Related Symptoms…

  • Tremors (both in movement and at rest)
  • Rigidity
  • Issues with posture
  • Bradykinesia
  • Difficulty with speech
  • Swallowing difficulties
  • Gait
  • Mask-like expression
  • Micrographia

 
Non-Motor related symptoms…

  • Depression
  • Sleep disturbance
  • Sensory abnormalities
  • Autonomic dysfunction
  • Cognitive decline

 
As alluded to earlier, the motor symptoms that come with PD are often seen as the sole effects seen within PD patients, and they also are how the disease is classically diagnosed. Although, this classical description of PD has more recently been to define to encompass a more complex dynamic to the illness to contain non-motor symptoms as well. Currently, the non-motor symptoms have called for the most clinical research and have been shown to be much more helpful in determining the disease outcome for PD patients. Overall, the symptoms associated with the disease impact the quality of life, progressive disability, and entry into long term care for PD patients.
Causation/Solutions
Death of dopaminergic neurons is prevalent in PD, although the pathological mechanism of these neurons fatality has not been clearly defined. One potential explanation for the death of neurons in PD is the accumulation of toxins such as dysfunctional proteins and mitochondria. The accumulation of the toxins is the result of the cell’s failed attempt to undergo ubiquitylation. The addition of ubiquitin to these malfunctioning cells/organelles would result in the degradation, and in turn, cease accumulation. Addressing this deregulation and finding an exact mechanism as to how this works could be a revolutionary treatment in PD
 
Another mechanism that we discussed in PD pathology was the irregular amounts of iron ions in the body. In PD, patients have been shown to exhibit a buildup of free Fe2+. The enzyme that oxidizes Fe2+ to Fe3+ doesn’t appear to be working, and in turn, induces cell death through improper binding with hemoglobin. Controlling this build up of Fe2+ could address this pathophysiological explanation of the cellular death in PD.
Therapeutics
A few therapeutics have been applied and positive outcomes have been noted. One is deep brain stimulation. In short, Deep Brain Stimulation is a surgical procedure that involves implanted electrodes within the brain. Although this seems risky, a control in symptoms has been seen. The Mayo Clinic shows a great video about how brain stimulation can be use.
 
Another therapeutic that has been looked at by the Mayo Clinic is the use of a laser to aid in simple tasks such as walking. The technology works by re-routing the way PD brains and avoids the complications that come with using a particular part of the brain where dopamine neurons are dysfunctional. Both of these two therapies can be found at the following link provided by Mayo Clinic Ventures. http://ventures.mayoclinic.org/news/video-library.php
 

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