Parkinson’s disease is the fastest-growing neurological disorder in the world, affecting an estimated 10 million people.
Being diagnosed with Parkinson’s disease can be a shocking, despair-inducing experience. But UCI Health neurologist Dr. Claire Henchcliffe believes knowledge is power.
“Knowing more about what’s happening to you allows you to seek as much information as you wish, and to look for opportunities for optimal treatment now and in the future, including participating in clinical trials, if desired,” says the nationally regarded Parkinson’s specialist.
It also solves a mystery.
“It helps explain symptoms and signs that are worrisome,” she says. “It keeps people from having to go to multiple doctors in hopes of finding an explanation for what they’re feeling.”
A diagnosis also paves the way for intervention.
“Not getting the appropriate treatment for Parkinson’s in a timely way can lead to more disability,” adds Henchcliffe, part of a team of UCI Health neurologists who specialize in Parkinson's disease and other movement disorders, including Huntington's disease and essential tremor.
Hear the latest in diagnoses and treatment at the annual UCI Health Parkinson's Disease Symposium on Nov. 2, 2024 ›
How Parkinson’s progresses
Parkinson’s disease is the fastest-growing neurological disorder in the world, affecting an estimated 10 million people. Nearly 90,000 U.S. cases are diagnosed each year, according to a 2022 study.
The progression of the neurodegenerative disease cannot be stopped and there is no cure.
Characteristic symptoms of the disease — tremors, impaired coordination, slowing and imbalance — are caused by the loss of nerve cells that produce dopamine, a chemical involved in controlling movement.
Some patients with Parkinson’s disease progress faster than others. There appear to be a host of reasons, including:
- Age. “We know that on average, people with a younger age of onset seem to have slower progression,” Henchcliffe notes.
- Genetics. Some specific changes in the Parkinson's risk gene GBA1 lead to faster progression, while people with other genetic mutations linked to Parkinson’s tend to have slower progression.
- Lifestyle. Some diets, such as the Mediterranean diet, have been associated with slower progression.
- Medications. Certain types of drugs used to treat the disorder can indirectly affect progression by causing involuntary movements called dyskinesia.
Many of the symptoms of Parkinson’s are central to a person’s ability to move, including tremor, loss of coordination and rigidity.
“The vast majority of these problems arise because of the loss of neurons in the substantia nigra — a small area in the midbrain that produces dopamine,” explains Henchcliffe, chair of the UC Irvine School of Medicine's Department of Neurology.
The dopamine produced in the midbrain is delivered to another area of the brain called the the striatum, where it triggers networks that regulate movement.
Tremor symptoms are sometimes difficult to control using the usual anti-Parkinson’s medications because other networks are likely in action, too, she says.
Slowing progression
There are no proven ways to slow Parkinson’s disease. But there are strategies that may help.
“Following a healthy lifestyle with exercise and a good diet is a wise approach,” Henchcliffe says.
In addition, researchers are discovering new medications and therapies.
“There are a number of clinical trials that are testing potential disease modifiers and neuroprotectants,” she adds.
Those trials range from oral drugs to infusions that seek to “clear” alpha-synuclein, a key protein in Parkinson’s pathology. There are also clinical trials testing more invasive approaches using gene and cell therapy.
“None of these have been proven, so it’s important to make sure you’re in a well-run clinical trial.”
Henchcliffe is the principal UCI Health investigator for a clinical trial to test the safety of bemdaneprocel, a promising stem cell-derived therapy to restore dopamine production in the brain.
Coping with Parkinson’s disease
As Parkinson’s advances, simple activities become challenging.
“Things that used to be easy and fun, like playing with grandkids, become difficult and exhausting," Henchcliffe says. "Beloved hobbies and pastimes, like playing guitar, can suffer.”
Although Parkinson’s is known as a movement disorder, it’s so much more.
“Some of the most detrimental and scary changes can be in the Parkinson’s symptoms you don’t see,” Henchcliffe notes. “This includes not only depression and anxiety, but also cognitive changes.”
Such changes can be mild or severe, including dementia, hallucinations and paranoia. “These can have serious consequences, not least of which is making it difficult to keep living safely at home.”
Henchcliffe suggests several resources to find clinical trials, clinicians and support groups, including:
Loved ones also play an important role in a Parkinson's patient's well-being.
"Family and friends can be key in supporting the person with Parkinson’s, including showing patience.”
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