Research Paper On Parkinson's Disease

Parkinson’s disease is a neurodegenerative brain disorder. This disease is both chronic and progressive in nature. In this disease, the brain slowly stops producing dopamine, a neurotransmitter that regulates body movements and emotions. This disease can present itself in many different symptoms, but the four main motor symptoms are: tremors at rest, slowness of movement, stiffness in arms and legs, and trouble with balance. Other symptoms like depression and anxiety often accompany Parkinson’s. Parkinson’s is diagnosed by a series of tests one including a DAT neuroimaging scan of the brain to identify the dopamine transporters and their functionality. A physician may record the results of a physical exam on the United Parkinson’s Disease Rating Scale. This universal scale is used to document the patient’s disease progression from year to year.

There are a couple causes and risk factors researchers have identified that can increase susceptibility to Parkinson’s.

Age, sex, and heredity all play a part in developing the disease. Young people, women, and those without Parkinson’s in their immediate family are less likely to develop the disease. Research has shown that people who do have high risk factors for Parkinson’s may be able to reduce their risk with regular aerobic exercise. However, once a patient has developed Parkinson’s disease their prognosis depends on the severity of their disease. Each patient has different symptoms and different intensities of those symptoms. Those with a more severe case of the disease will have a poor quality of life as opposed to those who are high functioning whom will have a higher quality of

life.
There is no cure for Parkinson’s Disease at this time. However there are multiple forms of treatment that can help with the disease. Medicinal and therapeutic treatments are able to help many aspects of the disease. One therapeutic form of treatment is called dance therapy. Research conducted by Gammon Earhardt studied the effects of dance used as therapy for patients with Parkinson’s disease. In this study, patients were put into a dance class where they learned the tango. Patients met five days a week for two weeks for 90 minute lessons. Patients that participated in the dance class had improved balance and improved gait. The tango helped patients maintain their ability to turn and to walk backwards. The social nature of the classes increased their perceived quality of life as well. The dance therapy was used in addition to their medication, but the research showed continuation of the dance may decrease the need for utilization of other health care services.
Medicinal treatment’s for patients with Parkinson’s can vary between patients. Some of the time the patient’s symptoms specifically are what are being treated. For example those with an increased amount of pain will be prescribed pain medication. Those with increased depression and anxiety will be prescribed anti-depressants or anti-anxiety medication. Drugs that can solve the dopamine problems within the brain, are what are mostly prescribed to those with this disease. There are two different kinds of drugs that can do this. One drug called levodopa was the first medication that was effective in treating patients with Parkinson’s disease. Levodopa is a pill which crosses into the brain through the blood brain barrier. Once it crosses into the brain it is converted into dopamine. The dopamine is stored in the neurons until it is needed for movement. This drug is almost always given in addition with carbidopa. This medicine allows for a lower dose of levodopa and reduced side effects. The other form of treatment is a dopamine agonist. These drugs mimic the effects of dopamine, rather than actually being converted into it. These are typically the first drug that is prescribed to treat Parkinson’s disease, but they can be used in later stages of the disease in addition to the levodopa.
Recent research has shown that Parkinson’s has the qualities of an autoimmune disease. In these studies it was proposed that people with a long term illness, developed functional problems with their receptor sites. These impaired receptor sites made it impossible for the essential neurotransmitter, dopamine, to bind to them correctly. This caused a decrease in dopamine binding creating the inability to control body movements, and ultimately leading to Parkinson’s disease. More research was done at Columbia University College of Physicians and Surgeons. In this research, a doctor named Dr. Sulzer was examining healthy, postmortem brain tissue. He discovered MHC-1 proteins were present on two types of neurons; one of these affected neurons being dopamine in the substantia nigra. He began research with a fellow doctor to be sure that these MHC-1 proteins displayed antigens, and served no other purpose. From their research, Dr. Sulzer and Dr. Cebrian concluded that in circumstances that accompany Parkinson’s disease, neurons used MHC-1 proteins to display antigens.
This was a completely foreign concept because it has been believed that neurons did not display antigens on their cell surfaces, so they were immune from attacks from the immune system. When the immune system sees antigens as foreign, T cells are sent to attack and kill the cell. With this new information, it appeared that the neurodegeneration of the substantia nigra was due to these T cells attacking and killing the dopamine neurons. More research needs to be done to ensure that this is in fact happening to patients with Parkinson’s, but if this is the case, defensive measures can be taken to prevent the death of these neurons. Once this is determined, more research will need to be done to see if people will still develop Parkinson’s disease, or if the prevention of neurodegeneration will still leave the patient with symptoms of the disease.
Parkinson’s disease as an autoimmune disease is a very new concept, and leaves researchers with many questions. Does this mean the disease will become easier to treat? Will the ability to prevent previous long term illness assist in the elimination of receptor problems leading to difficulty in dopamine binding? Are there antigens present on dopamine neurons, causing T cells to attack and kill these neurons? What are the treatments for neurodegeneration? How effective will they be in combating the disease as opposed to dopamine antagonists or levodopa? All of these questions and more need to answered by a significant amount of research that is yet to be done. This research will determine the validity of the hypothesis as well as the repercussions of this diagnosis.

References
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