All about Parkinson's Disease with resident GP Dr Zak

It is a progressive disease and sadly, at present, there is no cure.

Around 150,000 are living with the condition in the UK. More men than women are affected. Most are over 60 at time of diagnosis.

READ MORE: Resident GP Dr Zak gets to the heart of the matter

Parkinson’s occurs due to a lack of the brain chemical dopamine. Over time the nerve cells that produce dopamine wear out and die. Dopamine is needed by another region of the brain, the basal ganglia, which coordinates movement.

Parkinson’s is also characterised by reduced production of the chemical noradrenaline. This is involved in the control of the autonomic nervous system.

The four most common symptoms associated with Parkinson’s are tremor, slow movement, rigidity and balance issues.

Tremor may start on one side of the body, typically the hand, before spreading to other areas and both sides of the body. Slow movements occur because commands in the brain take longer to process. Rigidity is due to lack of organised muscle contraction and relaxation. Balance issues may be a result of all the above.

However, Parkinson’s is much more complicated and in total there are at least 40 symptoms associated with the condition. It may present with agitation and reduced facial expression, being mistaken for depression initially. Constipation can be the first complaint.

There is no specific test for Parkinson’s. Diagnosis relies on taking a detailed history and performing a thorough examination. CT or MRI of the brain will be used, and the final diagnosis will be made by a neurologist, most likely one who has a special interest in movement disorders.

Treatment for Parkinson’s is based on medications which either get converted to active dopamine in the brain, or block enzymes involved in the breakdown of dopamine.

Deep Brain Stimulation involves placing electrodes in the brain which produce electrical impulses that block abnormal brain activity. Other procedures are aimed at destroying small portions of the brain to either reduce involuntary movements or severe tremors.

The aim is to keep anyone with Parkinson’s as independent as possible for the greatest amount of time.

Researchers in the US have engineered a bacterium that can produce a steady amount of L-dopa, which then gets converted to dopamine in the body.

This treatment would be given by consuming bacteria in capsules. This is a significant development any may offer hope to the many millions worldwide living with Parkinson’s and their families.