Parkinson’s disease

James Parkinson is famous for publishing ‘An essay on Shaking Palsy’ in 1817, which made Parkinson’s Disease a recognised condition. He was the first to describe ‘Paralysis Agitans’, which was later named Parkinson's disease after him. Parkinson’s is a gradual degeneration of the brain. As many as one in every five hundred people are affected by it, which makes approximately 120,000 people in the UK. Generally people affected by this disease are aged 50 or above, however younger people can get it too. People with Parkinson’s don’t have enough of a certain chemical called ‘dopamine’ because some of their nerve cells have died. Without this chemical, movements in the body are considerably slower, hence taking a lot more time in doing general daily life things. The loss of the nerve cells cause the symptoms of Parkinson's to appear. Unfortunately, there is no cure for Parkinson's, nor do scientists yet know why people get the condition.

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The main symptoms of the condition are tremor, rigidity and slowness of movement. Not only does this affect movement, but other symptoms such as tiredness, pain, depression and even constipation, affect people’s daily lives. This all happens because of the decreased stimulation of the motor cortex normally caused by the insufficient formation and action of dopamine. Another problem in diagnosing this disease can be that the symptoms may differ from one person to the other. Some of the symptoms may be relieved my medicine, therapy or even surgery. As Parkinson’s continues to move down into its later stages, a lot more care and support will be needed by the patient. The symptoms of the condition develop slowly and in no specific order, which makes it even harder to diagnose. However the earliest signs of Parkinson's may be tiredness and weakness. Other symptoms may be poor hand co-ordination and sensations of tremors in various parts of the body.

Parkinson's, which is sometimes referred to as idiopathic Parkinson’s, is the most commonly diagnosed. The rate of degeneration and symptoms vary from person to person, this makes diagnosis considerably harder. If there isn’t a change in the symptoms then this may lead to another type of Parkinsonism. Whenever such a case happens the term ‘atypical parkinsonism’ is given. The term ‘early onset Parkinson’s’ is used when patients under 40 are diagnosed with the condition.

Vascular Parkinsonism is an atypical form of the condition. The most likely causes for this specific type of Parkinson’s is hypertension or diabetes. A stroke or cardiac disease may also lead to the condition. The main symptoms of vascular Parkinsonism are difficulty in eating, swallowing and making facial expressions. Other signs may be confused thoughts or problems with memory. This too is a progressive condition with varying symptoms changing over time.

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There is no solid evidence showing that Parkinson’s is hereditary except for a few very rare cases. It has been thought that the condition may not be inherited directly but some people may have genes that increase the chance of having Parkinson’s disease. At present, people with genetically inherited Parkinson’s disease may be as few as 5% in the world. Another type of Parkinson’s is called juvenile Parkinson’s as it affects people under the age of 20.

Although many types of Parkinson’s have been recognised the cause remains unknown. What causes the nerve cells to die? What causes dopamine to reduce? All this is currently undergoing a lot of research as to why all this happens in the hope that some sort of cure may come up. The task is made even more difficult as Parkinson’s occurs due to a loss of nerve cells and the symptoms of it appear after 70% of the nerve cells have died!

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The picture above is of a mouse’s brain, the left image shows us the image of a healthy mouse’s brain, with lots of nerve cells and the right image shows us the effected mouse and a lot less nerve cells!

Cures to Parkinson’s?

As I have mentioned before, there is no known cure for Parkinson's disease, however some medicines which restore some of the lost dopamine do exist such as levodopa which is a synthetic chemical that is converted into dopamine in the brain. Therapies such as physiotherapy helps maintain and restore maximum movement and function of their bodies throughout their lives. Occupational therapy may help patients perform meaningful and purposeful occupations; these may include work, leisure or even self-care.

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For later stages of Parkinson's, more serious steps may be taken such as a surgery called deep brain stimulation. This is done by placing electrodes in the areas important in the brain which control movement. These are then connected to a pulse generator which is placed under the skin of the chest as shown in the image above. Tiny electrical currents are sent from the pulse generator to the brain which may help in relieving some of the most distressing symptoms of Parkinson's disease.

There are many other ‘alternative’ cures or therapies that may slow down the degeneration of the brain. Recent research tells us that caffeine and Parkinson's disease may have a connection. A few large studies show that the intake of caffeine has reduced some of the symptoms of Parkinson's disease, this alone however, may not seem to be the answer to the cure itself. Many other things such as yoga or acupuncture are also considered beneficial to Parkinson's disease sufferers. This may help relieve one person’s symptoms but may not show change in another, therefore, many choose to try all these options.

There are more optimistic solutions but because of ethics and morals, not many see the benefits of stem cells. It has been a controversial topic ever since dolly the sheep was cloned. Some believe that it may be the answer to all problems, even genetic disorders, it may even be able to restore sight to the blind, but on the other hand, people are concerned that this may be abused. Organs may become a normal commodity, or it may even become ‘normal’ to harvest foetus farms. Economically, it could cost a fortune, but on the other hand, the use of stem cell isn’t unheard of. In bone marrow transplant, stem cells are used, so if stem cells can be used there, why not to cure Parkinson's disease? This is an undergoing debate. Stem cells being formed from an embryo do raise a lot of morals which may cause uproar amongst people who believe that embryos are an existing life and to take away that opportunity from that embryo to live is equivalent to committing murder. The debate about the pros and cons of using stem cells seems never ending but the problem still remains, how can we cure Parkinson's?

Stem cells may be used for Parkinson's but a lot of tests must be run by scientist to ensure that patients receive full potential of the treatment and that the treatment is long lasting and does not prove to be dangerous for the patient being treated. The idea of this treatment would be to replace the cells that have died with other dopaminergic nerve cells, obtained from stem cells. So by this we can see it can take many years in research, let alone testing. Many lives will be changed, but until then one has to remain hopeful that there will be some breakthrough from which many sufferers will benefit from one of the harshest genetic disorders known.

There are many benefits of using stem cells in Parkinson's, not only Parkinson's but many other genetic disorders. By curing those using stem cells we may be able to restore the quality of life for that certain individual. And by using stem cells, the embryo which was to be wasted, would be put into good use. Using up embryos, which were to be wasted anyway, to improve a living person’s life is not unethical from my point of view, however many may disagree. There are no such disadvantages to the environment by the technology used, it’s only using the things we already have, if anything, then it may be that people may start abusing this technology for money and to ‘make’ organs and sell them will just become another everyday business. Organs and other parts of the body are not just parts, they are truly priceless, but if something like this does ever happen, we will be putting a price on ourselves which is against many religions. This may be the cause of some outrage amongst people, but if this technology is used in a controlled manner then everyone can maintain quality of life without compromising on the treatments they can get. There is no such permanent cure to this disease, but as I have mentioned before, Parkinson's itself is not the cause of death directly, but may be a factor. Stem cells could reduce this factor and help improve life. The only other alternatives to this may be therapies or the surgery as mentioned above. A few sites say that they might just have found the answer to Parkinson's disease. This site says that they may have found a medicine that will stop the dopamine making cells from dying in the first place.

"We believe this work represents a very significant breakthrough in understanding the complicated chemical process that results in Parkinson's disease," said William J. Burke, M.D., Ph.D., professor of neurology at the Saint Louis University School of Medicine and the study's lead author.

On a different note, there is another alternative treatment, marijuana. This may not be seen as a medical treatment by many, but on the other hand, many people did say that the symptoms were temporarily relieved and they felt more relaxed after using the drug.

How marijuana works? Well here I have it all explained. Diseases related to movement disorder are caused due to defects in the basal ganglia, clusters of nerve cells which control muscle movement. Even the slightest of injury to this area causes muscles in the limbs and face. In the brain, there is a certain chemical called ‘endocanninoids’ which are very similar to the chemicals found in cannabis, which ultimately could improve symptoms in Parkinson's disease. "We have identified a new way of potentially manipulating the circuits that are malfunctioning in this disease" says senior author Dr. Robert Malenka. This newly discovered treatment was then experimented on mice, a mixture of drugs were given to rise the levels of endocanninoids to mice suffering from the condition, within fifteen minutes, the mice who were in a more or less vegetative state started moving about freely. “They were basically normal” exclaimed Dr. Anatol Kreitzer at seeing this remarkable recovery in the mice. "It turns out the receptors for cannabinoids are all over the brain, but they are not always activated by the naturally occurring endocannabinoids" said Malenka. Also in 1999 the BBC news had a report telling us about how natural marijuana can treat brain disorders. This site also explains to us how marijuana has similar chemicals to that present in the brain, and how their experiments showed positive results. This alternative cure to Parkinson's does seem effective, not long lasting, but it may temporarily relieve some of the most distressing symptoms.

Some sites did seem slightly biased about marijuana, however looking at a few other sites did confirm that the claims made about marijuana’s effect on Parkinson’s are true. Some of the sites were slightly out-dated but had valid information in them such as the BBC one, the link is given below in the bibliography. The sites which discussed about Parkinson's and how it affects the human body, almost all of them discussed the same thing about dopamine not being sufficient enough for muscular activity.

However as a conclusion to this topic, we must remain hopeful of a scientific breakthrough from which everyone can benefit from, especially people who suffer from this incurable disease. An article from BBC shows us that scientists were able to reverse the spread of Parkinson's in monkeys. Scientists raised hopes that they may soon be able to cure humans in the near future. If they are able to reverse the disease in monkeys, it won’t be too long before they will be able to successfully reverse the effects of Parkinson's on a sufferer. In this age and day the possibilities are endless in terms of research, but at the moment hang in balance with the burden of ethics versus scientific breakthrough.

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