Presently, there is no cure for Parkinson’s, but one should not lose heart as with proper care, a few changes in the lifestyle and medicines, it can be managed well and progression can be slowed down, says Dr. M V Padma Srivastava

The World Parkinson's Day is observed on April 11 every year to disseminate information about the health condition and understand the disease better. Parkinson's Disease (PD) or also called Parkinson's is a progressive nervous system disorder that affects movement. Currently, it afflicts more than 10 million people worldwide. India is home to nearly 0.58 million persons living with PD as estimated in 2016, with an expected major increase in prevalence in the coming years. This is expected to cause enormous strain on the economy as well as the already overburdened healthcare services in the country.

The PD symptoms usually emerge slowly, and as the disease worsens, non-motor symptoms become more common.

Presently, there is no cure for this neuro-generative disease, but one should not lose heart as with proper care, a few changes in the lifestyle and medicines, it can be managed well and progression can be slowed down, says Dr. M V Padma Srivastava, Chief, Neurosciences Centre, AIIMS, Delhi.

Talking to The Pioneer Health, she said that since PD majorly impacts those above 60 years old and given that the life expectancy is on increase, the disease is projected to affect over 12 million people by 2040.

Younger people — aged below 40 — are also reporting the disease Early-onset forms of PD are often, but not always, inherited, and some forms have been linked to specific gene mutations, she pointed out.

Dr. Srivastava explains that the disease occurs when nerve cells in the basal ganglia, an area of the brain that controls movement, become impaired and/or die. Normally, these nerve cells, or neurons, produce an important brain chemical known as dopamine. When the neurons die or become impaired, they produce less dopamine, which causes the movement problems of PD. Various researches are going on to know what causes cells that produce dopamine to die, she adds.

There’s more. People with PD also lose the nerve endings that produce norepinephrine, the main chemical messenger of the sympathetic nervous system, which controls many functions of the body, such as heart rate and blood pressure. The loss of norepinephrine might help explain some of the non-movement features of Parkinson's, such as fatigue, irregular blood pressure, decreased movement of food through the digestive tract, and sudden drop in blood pressure when a person stands up from a sitting or lying-down position.

She points out that symptoms start gradually, sometimes starting with a barely noticeable tremor in just one hand. Tremors are common, but the disorder also commonly causes stiffness or slowing of movement.

In a nutshell, there are over 40 symptoms, from tremors and pain to anxiety and every individual's experience is different.

 “Tremor in hands, arms, legs, jaw or head, small handwriting, loss of smell, trouble sleeping, dizziness or fainting,  stooping or hunching over, trouble moving or walking, constipation, a soft or low voice. For instance, sometimes you might think other people are losing their hearing when really you are speaking more softly, or masked face is some of the major signs.”

Also, PD can change the way a person walks. One may experience motor symptoms like freezing and trouble balancing. So if one sees more than two signs, it’s time to consult the doctor.

Dr. Srivastava says that like any other disease, management of PD is very similar — to exercise, a disciplined lifestyle, a healthy diet, and stress-free life. As we know exercise is an important part of healthy living for all, but for people with PD exercise and diet are like medicine, helping them live a fuller — maintain and improve mobility, flexibility, strength, and gait speed. It is advised that people with PD should perform exercises 45 minutes to one hour after medications when they are at their best.

Surgery to place microelectrodes for deep brain stimulation (DBS) has been used to reduce motor symptoms in severe cases where drugs are ineffective, says Dr. Srivastava, who has been conferred with the prestigious Padma Shri award for her significant contribution to the medical science.  

She also suggested that patients with PD try building a few hobbies into their routine that will give them a break from dwelling on the disease. Or find some activities to keep themselves busy. On our part as a society, she said, it's time people start a discussion to demystify and humanize the disease. More the people understand the PD, the more dignified the people with Parkinson’s will feel, Dr. Srivastava concluded.