Parkinson disease is a type of movement disorder. It happens when nerve cells in the brain don't produce enough of a brain chemical called dopamine. Sometimes it is genetic, but most cases do not seem to run in families. Exposure to chemicals in the environment might play a role.
Symptoms begin gradually, often on one side of the body. Later they affect both sides. They include:
- Trembling of hands, arms, legs, jaw and face
- Stiffness of the arms, legs and trunk
- Slowness of movement
- Poor balance and coordination
As symptoms get worse, people with the disease may have trouble walking, talking or doing simple tasks. Other symptoms may include trouble chewing, swallowing or speaking. Individuals may also experience depression and sleep problems.
There is no lab test for Parkinson disease, so it can be difficult to diagnose. Doctors use a medical history and neurological examination to diagnose it.
Parkinson disease usually begins around age 60, but it can start earlier. It is more common in men than in women. There is no cure for the disease. A variety of medicines sometimes improve symptoms dramatically. Surgery and deep brain stimulation (DBS) can help severe cases. With DBS, electrodes are surgically implanted in the brain. They send electrical pulses to stimulate the parts of the brain that control movement.
Source: NIH: National Institute of Neurological Disorders and StrokeLearn more about brain and spine neurological conditions at The Ohio State University Wexner Medical Center.
Diagnosing Parkinson's Disease
Diagnosing Parkinson’s disease is sometimes difficult, since early signs may mimic other diseases. There is no blood or laboratory test to diagnose the disease. Sometimes, imaging studies, such as a computed tomography (CT) scan, magnetic resonance imaging (MRI) or a dopamine transporter SPECT scan (DaTscan), may be used to rule out other disorders with similar symptoms such as essential tremor.
Our movement disorders physicians will compile your comprehensive health history and conduct a thorough physical exam. Using internationally accepted criteria from the UK Brain Bank, we diagnose you based on the presence or absence of resting tremor, rigidity, slow movements and postural instability.
We have a genetic counselor who can answer your questions about genes and movement disorders. About 15 percent of people with Parkinson’s have a family history of the disease, although there is no genetic test to confirm who will get the disease.
Treating Parkinson's Disease
Your treatment plan is tailored to the assessment of your particular motor and non-motor symptoms. At our Madden Center for Parkinson’s Disease and Related Disorders, we offer a range of options to treat these symptoms, from medications to non-medication interventions. We can also refer you to other specialists for related issues such as sleep disturbances, urology concerns or depression and anxiety.
One of Ohio State’s strengths is our physical therapy program, which includes therapists who specialize in movement disorders. Our focus is on helping people maintain their highest level of function and movement. We work closely with all team members to help you manage motor, cognitive and psychiatric impairments that affect your ability to move.
We will assess you through a variety of tests and recommend the best therapies for your needs. These may include:
- Training you to walk with bigger steps and to walk faster to improve balance and prevents falls
- Working with you to safely transfer on and off of chairs and toilets to help you to be more independent
- Assessing you to recommend appropriate walking or assistive devices
- Teaching you exercises to improve strength, flexibility, coordination and balance, and maintain fitness and health
- Recommending exercises and strategies to cope with orthostatic hypotension (lightheadedness that sometimes occurs with standing)
Our movement disorders speech therapists can help you with difficulties swallowing and with slurred speech. A speech therapy technique known as LOUD focuses on increasing vocal loudness and enunciation so that you can be heard and understood during normal conversation.
Our occupational therapists assist you in performing work and leisure activities, as well as activities of daily living such as cooking, grooming and eating.
Deep Brain Stimulation
When medications cannot adequately treat Parkinson’s symptoms, deep brain stimulation (DBS) may be an option. We have a dedicated team of experts who can help assess you and help determine if DBS would be a beneficial treatment option for you.
DBS is performed through our Center for Neuromodulation. The procedure involves surgically implanting tiny electrodes into the brain and connecting them to a small pacemaker-like device (programmable battery) that has been implanted into the chest wall. The electrodes deliver tiny electrical signals that calm abnormal brain signals. The goal of these electrical signals is to alleviate disabling symptoms, such as tremors, rigidity and slow or uncontrollable movements.
Why choose Ohio State for treatment of Parkinson's disease?
Multidisciplinary Team of Experts: We have a team of experts dedicated to treating Parkinson’s disease at both our Madden Center for Parkinson’s Disease and Related Disorders and at our Center for Neuromodulation. They include:
- Movement disorders neurologists with fellowship training or extensive clinical experience in Parkinson’s disease
- Neuropsychiatrist who can address behavioral and mental health issues
- Social worker
- Physical, occupational and speech therapists
- Nurse practitioners and a clinic nurse
- Genetic counselor
- Speech therapists with expertise in training programs for speech difficulties common to Parkinson’s disease
- Coordinated efforts with a specialized team of neurologists, neurosurgeons and nurse practitioners experienced in assessing and treating those individuals with Parkinson’s disease who might benefit from deep brain stimulation (DBS)
Comprehensive Care: Our experienced team provides you with multiple options in three different clinic locations for managing the symptoms of Parkinson’s disease. We also work closely with other disciplines to address conditions that overlap Parkinson’s disease, such as sleep disturbances, urology concerns and depression.
Physical Therapy Expertise: Our physical therapists specialize in movement disorders and are known for our research and work in setting the standard of physical therapy care for Parkinson’s disease and related parkinsonian disorders such as Diffuse Lewy Body Disease (DLB), particularly in gait (manner of walking) and balance assessment and treatment.
Research: Our participation in national and international clinical research for Parkinson’s disease provides you with access to the latest options in medications, often long before they come to market.
Ohio State initiates clinical trials, participates in trials collaboratively with other institutions and networks with centers around the world to offer you the most effective treatments.
We are a member of the National Institutes of Health’s (NIH) NeuroNEXT: Network for Excellence in Neuroscience Clinical Trials. This collaboration results in more rapidly developing promising treatments, which provides patients like you more hope.
If you are interested in participating in a clinical trial, a physician and clinical research coordinator will screen you. If you are eligible for a trial, you will have access to some of the latest advances in Parkinson’s disease treatment.
Areas of focus include:
- Amantadine Medication Studies: Two industry-sponsored, multicenter trials are evaluating the effectiveness and safety of amantadine HCl extended-release tablets. This medication is used to treat abnormal, involuntary movements that are a side effect of levodopa, a drug of choice for treating the widest range of symptoms for Parkinson’s disease.
- Neurogenic Hypotension Study: Study of the effectiveness of the medication droxidopa for treatment of neurogenic hypotension (low blood pressure that occurs upon standing) in individuals with Parkinson’s disease and other neurological disorders.
- Isradipine Medication Study: Study to determine if the medication isradipine slows the progression of Parkinson’s disease symptoms.