If you or someone you love has been diagnosed with Parkinson's disease, you may have many questions about what that means. To start with, what causes Parkinson's disease?

Parkinson's disease, often called PD, is the second most common neurodegenerative disorder among people in the United States. According to the National Institute of Neurological Disorders and Stroke, approximately 500,000 people have been diagnosed with the disorder. Still, it's likely that many others have the disease and simply haven't been diagnosed.

In addition to being a neurodegenerative disorder, Parkinson's disease is also often referenced as a "progressive" condition and a "movement disorder." It is both things — the condition affects the body's ability to move and gradually worsens over time, making it progressive.

What Is Parkinson's Disease?

Parkinson's Disease (PD) is a brain disorder that causes tremors, slowness, stiffness and unsteadiness. It occurs when nerve cells in a part of the brain called the substantia nigra become impaired or die off entirely.

Those same brain cells are responsible for producing a chemical messenger called dopamine, which helps stimulate the parts of the brain that control movement. When the body doesn't have enough dopamine, nerve and muscle cells are disrupted, causing the movement-related symptoms of Parkinson's disease.

PD also affects the norepinephrine, a chemical messenger in the nervous system. Depletion of this chemical is linked with the non-movement symptoms of Parkinson's disease.

What Causes Parkinson's Disease?

While we know that decreased production of important chemical messengers causes the symptoms of the disease, researchers are less certain about what causes people to develop Parkinson's disease.

The risk of developing Parkinson's disease is highest among older adults. The average age at diagnosis is 60, but an early-onset form of PD can affect people in their 40s or even younger. Other factors associated with an increased risk include being male and being white.

Beyond these risk factors, there seems to be a genetic component to some cases of Parkinson's disease, with up to 15% of the overall risk related to genetic factors. Researchers are currently investigating genetic markers that may increase the risk of developing Parkinson's disease.

In most cases, a combination of factors, including genetics and environmental factors, likely causes PD. Environmental factors that have been studied include exposure to toxic chemicals, such as pesticides and Agent Orange, or working with heavy metals or industrial solvents.

What Are the Symptoms of Parkinson's Disease?

Parkinson's disease affects the production of two chemical messengers — one associated with movement and one tied to nervous system functions. Because of that, people with Parkinson's disease can experience a wide range of symptoms that worsen over time.

Symptoms of PD may include:

• Cramping in hands and feet
• Difficulty initiating movement
• Difficulty walking
• Impaired balance and coordination
• Increased fall risk
• Muscle stiffness
• Slowing of movement (called bradykinesia)
• Tremor in the hands, arms, legs, head or jaw, particularly when at rest

Along with these noticeable movement-related symptoms, Parkinson's disease can also cause some seemingly unrelated symptoms, including acting out dreams and other sleep problems, difficulty maintaining blood pressure when standing up that leads to dizziness or fainting, constipation, urinary problems, skin conditions, difficulties swallowing, drooling, cognitive issues, or depression.

Other less-obvious symptoms? The Parkinson's Foundation notes that handwriting changes, a loss of smell, a newly breathy or hoarse voice, and facial masking can all be early signs of the disorder. The latter occurs when your face shows reduced emotions due to stiffness and rigidity in the facial muscles.

How Is Parkinson's Disease Treated?

While there is currently no cure for the disorder, many more Parkinson's disease treatments are available today than in the past. The goal of existing treatments is to alleviate symptoms.

Medications are often used to manage Parkinson's disease. Levodopa is the most common medication for Parkinson's disease, and it works by being converted to dopamine in nerve cells. Because levodopa can cause some intense side effects outside of the brain, such as nausea, it's often paired with a medication called carbidopa, which helps to prevent or limit many of those side effects by preventing its conversion to dopamine outside the brain and makes levodopa more effective.

As the disease progresses, each dose may not last as long, and other medications may be needed to help increase the duration of each dose's effect. Extended-release forms of levodopa can also be utilized. A subcutaneous levodopa infusion pump was recently approved for patients whose symptoms fluctuate throughout the day.

Other medications may also be used to treat movement-related symptoms, such as tremors or involuntary movements, as well as non-movement symptoms, including difficulty maintaining blood pressure, constipation, fatigue and sleep problems.

For those with Parkinson's disease who don't respond well to medications or who can't tolerate their effects, deep brain stimulation (DBS) may be an option. DBS involves implanting electrodes into part of the brain and connecting those electrodes to a device implanted in the chest.

Once in place, the electrodes painlessly stimulate the parts of the brain that control movement, which can help prevent the movement-related symptoms of PD. Deep brain stimulation doesn't help with the non-movement symptoms, so it may be paired with medications to treat those symptoms.

For those with tremor-dominant symptoms, focused ultrasound is another option. Unlike DBS, no surgery is required. However, because focused ultrasound produces a lesion, its side effects are irreversible.

In addition to these treatment options, other therapies may be used to help patients manage Parkinson's disease. While it can seem hopeless to have a progressive medical condition with no cure, the disease can now often be successfully managed for many years after a diagnosis.

Seeking Parkinson's Help

If you've been diagnosed, you may benefit from healthy lifestyle habits, including a healthy diet and regular exercise to strengthen muscles and improve balance. Your care team may also recommend you participate in outpatient rehabilitation, including physical therapy to improve gait and balance, occupational therapy to help you adapt daily activities as needed, and speech therapy to help you cope with any changes to your voice or abilities to chew and swallow.

Massage therapy and intentional exercise programs such as yoga and tai chi may also help reduce muscle tension and improve flexibility.

Have hope! Resources are available to help you manage your condition now, and research is being done to offer more treatment options in the future.

Visit our website to learn more about personalized treatment plans available at Methodist Le Bonheur Healthcare and meet our care team.