Parkinson's disease

Parkinson's disease is a progressive disorder of the nervous system in which the dopamine-producing nerve cells in the brain's substantia nigra gradually deteriorate. It is the second most common progressive neurological disease after Alzheimer's disease. In Finland, about 14,000–18,000 people have Parkinson's disease. The disease most commonly begins after the age of 60, although younger people can also be affected.

Typical motor symptoms are resting tremor (shaking of the hands or feet at rest), muscle stiffness, slowness of movement, and impaired balance. The walking stride becomes shorter and the arms stop swinging during walking. Non-motor symptoms are often just as troublesome: constipation, sleep disturbances, depression, reduced sense of smell, and cognitive changes may precede motor symptoms by years.

Parkinson's disease is caused by a disturbance in the dopamine system, the exact cause of which is not known. Age is the biggest risk factor. Environmental factors, such as exposure to pesticides, may play a role. Certain genetic changes are linked to the onset of the disease, especially in juvenile-onset Parkinson's disease.

Diagnosis is clinical: a neurologist assesses the motor symptoms and rules out other causes of tremor and movement disorders. A DaTSCAN brain imaging study can support the diagnosis. Early diagnosis is difficult because symptoms develop slowly.

Drug treatment is the cornerstone of Parkinson's disease treatment: levodopa is the most effective symptomatic medication and is often used for a long time. Other medication options include dopamine agonists and MAO-B inhibitors. In advanced disease, deep brain stimulation (DBS) may be considered; it is an effective functional surgical treatment.

Neurological physiotherapy is, alongside medication, a key treatment method: it helps maintain mobility and balance and helps prevent falls. Strength training, dance, and especially tai chi have been shown to be beneficial. Speech therapy helps with problems in voice and swallowing. Assessment by a professional is important already in the early stages of the disease so that treatment can be tailored individually.