Stiffness and slowness: the onset of Parkinson’s disease

Parkinson’s disease is the most common neurodegenerative disorder after macular degeneration and Alzheimer’s disease. It affects, regardless of the race of the subject, 31 to 200 people per 100,000 population over 60 years of age, with an incidence of 20 new cases per 100,000 population per year, which increases with age.

What causes this disease?

Dr. Victor M. Campos Arillo explains that Parkinson’s disease is caused by the progressive death of neurons located deep in the brain, the basal ganglia. Unknown mechanisms set in motion the neurodegeneration with accumulations of synuclein in the bodies of the neurons. As a consequence, symptoms appear, which include stiffness and slowness of movement.

What symptoms does Parkinson’s disease produce?

In half of the patients, the symptoms with which Parkinson’s disease begins are stiffness and slowness in the performance of voluntary movements; in the other half it is usually tremor, but not the usual tremor, but a very specific and characteristic one: the so-called “rest” tremor. This last symptom makes people with other diseases that produce tremor, much more frequent than Parkinson’s disease, consult the specialist in Neurology thinking that they suffer from this disease.

With the evolution of the pathology and the treatments established, changes appear in the motor situation which, initially, usually corrects itself well. There are also other types of symptoms, such as cognitive, behavioral, stability, affective, vegetative… which, in the long term, make these patients complex and difficult to manage. This disease also places an important emotional, economic and even physical burden on the patient and his or her caregivers.

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We distinguish between initial or intermediate situations, in which the aforementioned “motor complications” appear, and advanced ones, in which treatment strategies based on external devices are already necessary.

Can it be prevented?

There are currently no neuroprotective treatments available, so, as with other neurodegenerative diseases, the main recommendations are aimed at a healthy lifestyle that includes a Mediterranean diet, physical exercise and control of cardiovascular risk factors (avoiding alcohol, tobacco, controlling blood pressure, sugar, cholesterol, etc.). Likewise, early detection is the key to a better evolution of the disease, favoring a faster and better control of the symptoms of the disease.

How is this disease treated?

Unfortunately, there is no definitive cure. Current treatments do not aim to stop the disease, but to reduce the symptoms; this aspect allows us, at least, to provide a better quality of life to our patients for many years.

In terms of pharmacological treatments, levodopa is the most ‘effective’ drug; however, the choice of treatment depends on age, the clinical manifestation of the patient, the aforementioned lifestyle and the individual preference of each person after informing them of the benefits and risks of each of the drugs.

Over the years, other non-pharmacological strategies have been developed (preferably surgical) that constitute an important support to existing therapies with oral or parenteral drugs. In the near future, techniques will probably be developed to eliminate or avoid the accumulations of the altered intracellular protein, Alphasynuclein, which seems to be at the basis of neurodegeneration, which will directly affect the evolution of the problem and bring us closer to a cure.