Parkinson's Disease

A Brief Introduction

What is PD? 

PD is a disorder of the nervous system resulting in tremor, slow movement and stiff and inflexible muscles which get gradually worse.   More men than women get PD of which the symptoms usually appear after the age of 50 but in about 5% of cases they occur before age 40. At present there is no cure for PD but treatments are available which alleviate the symptoms.  Although everyday life can become more difficult as the disease progresses it usually has no impact on life expectancy.

Symptoms

The symptoms of PD vary from person to person both in their nature and severity.  Slight tremor in one hand might be the first sign.  As the disease progresses involuntary shaking increases and other characteristic problems arise including muscle stiffness, slower movements and difficulties with posture, balance, speech, writing and unconscious movements such as smiling and blinking.  Some people may experience other problems relating to swallowing, the sense of smell, sleep, fatigue, bladder control, depression, memory and pain.

What causes PD?

In the human body dopamine, which is produced in the midbrain’s substantia nigra area, plays an important transmission role in controlling and coordinating muscle movements. When a significant number (over 60%) of the nerve cells which produce it are damaged or die symptoms of Parkinson’s disease start to appear. It is not clear why the brain cells concerned degenerate but genetic and/or environmental factors might be involved.

Types of Parkinson’s Disease and Parkinsonism

Parkinsonism is an umbrella term for neurological conditions which have similar symptoms to PD – mainly tremor, muscle rigidity, slowness of movement and balance problems. The following classifications are sometimes used:-

  •  Idiopathic Parkinson’s disease – the most common diagnosis in people, who are mostly over the age of 60, where the cause is not known and the main symptoms are tremor, rigidity and slowness of movement. In early onset cases, below age 50, the disease progresses at a slower rate but there is an increased risk of persistent abnormal postures (dystonia)
  •  Vascular parkinsonism – caused by a restricted blood supply to the brain, as a result possibly of a stroke. Older people who have diabetes are sometimes affected. In addition to the main symptoms of PD difficulties may be experiences with various activities including speech, swallowing and thought.
  •  Drug-induced parkinsonism – A few of the people who are diagnosed with parkinsonism are found to have developed it as a result of taking medication often in the form of neuroleptic drugs. Most people recover within a short time after they stop taking the drugs which interfere with the production of dopamine in the brain.
  •  Inherited PD – It’s thought that up to 50% of early onset PD before the age of 50 may have a genetic cause but the parts played by genes and environmental factors are not yet clearly understood.
  •  Juvenile parkinsonism – Rare and often overlooked as a diagnosis PD like symptoms can occur in children and young people under the age of 20. Their involuntary movement disorders tend to be more pronounced
  •  Dementia with Lewy bodies – The main symptoms of PD are often present but there are other problems including difficulties with memory, thinking, language and

 Research

PD is a worldwide problem with a particularly high incidence in China and Europe. As a result research is being conducted in many countries to learn more about it, better ways of diagnosis, more effective treatments and hopefully a cure.  For many years the search has been on to identify biomarkers, early reliable signs of the disease, which will enable treatments to be developed to prevent or slow down the progression of the disease. Current research includes investigating the roles of iron and copper, the presence of a common protein alpha- synuclein in the spinal fluid and colon, the role of the LRRK2 protein in inherited PD and studies of the impact, if any, of over 1100 other proteins found in blood.  Another focus of research is the e possibility of using embryonic stem cells to make dopamine-producing neurons that could alleviate the symptoms of PD.

Research at the University of Nottingham & the Queen’s Medical Centre

The teams at Nottingham and Derby led by Dr Nin Bajaj were awarded ‘Centre of Excellence’ status in 2008 by the US-based National Parkinson Foundation in recognition of their research strengths and clinical expertise.  Substantial funding for research has been provided by the Medical Research Council, Parkinson’s UK, The Michael J. Fox Foundation and other organisations. Ancillary funding has been contributed by the NSG@QMC towards the costs of studentships, supplies and other items. Details of the work carried out by one of Management Committee members, Dr Lynn Hughes, are given on our Projects page.  Other examples of current or recent research at Nottingham are:

  • Professor Penny GowlandDr Stefan Schwarz and Professor Dorothee Auer   – A potentially useful test for PD was discovered in 2013/14. Using MRI scanners researchers discovered that a small cluster of dopamine producing cells known as nigrosome 1 in the midbrain of people with PD does not have the swallow tail appearance found in people without the disease.
  • Professor Dorothee Auer – “Developing better brain scans for Parkinson’s” – part of the largest ever in-depth UK study of PD funded by Parkinson’s UK

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