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.

(http://www.parkinsonsdise
The image on the top left shows
us a PET (Positron Emission
Tomography) scan of a healthy
brain, the image on the top right
shows us a PET scan of a
Parkinson's disease brain. The
three images below shows us the
dopamine activity throughout
the stages of Parkinson's disease

asecme.com/images/subnav/module2/figuresLRG/fig2-fdopa-pet-scan-
imaging.jpg)

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.
 The graph on the
left shows us the
link between age
and risk for
Parkinson's
disease. We can
see that at a
general level men
are more likely to
develop the
condition than
women, especially
after the age of 55-
59 onwards; men
are exposed to a
considerably higher

(http://www.hesonline.nhs.uk/Ease/servlet/EaseImageRetriever?
siteID=1937&uid=237688&table=site_category_items)

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!
 (http://www.sciencedaily.com/releases/2010/04/100406172644.htm)

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.

(http://biomed.brown.edu/Courses/BI108/BI108_2008_Groups/group07/DB
Ssrc-wiredblod.jpg)

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.

BIBLIOGRAPHY

http://news.softpedia.com/news/Marijuana-Against-Parkinson-
46701.shtml

http://www.nap.edu/openbook.php?record_id=9586&page=116

http://news.bbc.co.uk/1/hi/health/303438.stm

http://www.ninds.nih.gov/disorders/parkinsons_disease/parkinson
s_disease.htm

http://news.bbc.co.uk/1/hi/health/303438.stm

http://news.bbc.co.uk/1/hi/health/991965.stm