Tuesday, January 4, 2011

Parkinson's Disease

Parkinson's
  • What is Parkinson’s Disease?
  • Who gets Parkinson’s Disease?
  • What causes Parkinson’s Disease?
  • How is PD treated?
  • The Economic Impact of Parkinson’s Disease
What is Parkinson’s Disease?
Parkinson’s disease is a progressive, neurodegenerative, movement disorder.
Progressive - Parkinson’s disease gets worse over time. Neurodegenerative – Parkinson’s disease is caused by the degeneration of nerve cells in the brain. Movement disorder - the most prominent symptoms of Parkinson’s disease affect movement, although many other symptoms may also occur, some of which can be even more disabling than the movement symptoms.
Movement symptoms of Parkinson’s disease include:
Tremor: trembling in the hands, arms, legs, jaw and face
Rigidity: stiffness of the limbs and trunk
Bradykinesia: slowness of movement
Akinesia: difficulty in initiating movement
Postural instability: impaired balance
Other symptoms of Parkinson’s disease may include depression, anxiety, dementia (impaired thinking), difficulty in swallowing and chewing, speech changes, urinary problems or constipation, very oily or very dry skin, excessive sweating, and sleep problems. Not all these symptoms occur in everyone with Parkinson’s disease.
Other neurodegenerative disorders include Alzheimer’s disease , Huntington’s disease, and amyotrophic lateral sclerosis, or Lou Gehrig’s disease as well as many other mental diseases.
Who gets Parkinson’s Disease?
Parkinson’s disease affects both men and women. The average age of onset of Parkinson’s disease is 61, but it may begin as early as age 40 or even before. The number of people in the United States with Parkinson’s disease is estimated to be between 500,000 and one million, with about 50,000 to 60,000 new diagnoses each year. That number is growing every year as the American population ages.
The disease progresses at different rates in different people. A more severe course is often seen in people who develop Parkinson’s disease at an earlier age. Parkinson’s disease reduces life expectancy by an average of three to nine years. Parkinson’s disease is now the 14th leading cause of death in the United States.
What causes Parkinson’s Disease?
The neurons that degenerate in Parkinson’s disease are located in several areas of the brain, but most significant is the loss of dopamine-producing neurons in the substantia nigra. The dopamine produced by these neurons is crucial for another brain region, called the striatum (see diagram). Under the influence of dopamine, signals from the striatum regulate all forms of voluntary movement. The loss of dopamine in Parkinson’s disease accounts for most of the movement-related symptoms of the disease.
Dopamine neurons die over the course of many years. Parkinson’s disease symptoms begin when the loss of dopamine reaches a critical point, typically when 50 to 80 percent of dopamine neurons have died.
The question of why dopamine neurons begin to degenerate is being intensely investigated by scientists in our labs, and by scientists all over the world and in recent years, great strides have been made in solving this mystery. There is still no definitive answer, but it is now widely accepted that there is no single “cause” that triggers the disease. Instead, Parkinson’s disease likely results from a confluence of inherited (genetic) and environmental factors that interact in complex ways to set disease processes in motion. A small percentage of cases are hereditary in the classic sense that, if one or both parents have it, children are at higher risk. But in the vast majority of cases, no obvious familial link is present. Instead, it is believed that individuals may inherit a degree of susceptibility to the disease, which only causes Parkinson’s disease when other factors are present.
We are in the forefront of giving the scientific community the latest answers to these and many more vital questions. You can learn more about the latest developments at our website, www.parkinsoninfo.org.
How is PD treated?
Treatments are available only for the symptoms of Parkinson’s disease. The most effective treatment is levodopa, which makes up for lost dopamine. Other treatments mimic dopamine in the brain, or prolong its action. Brain surgery is also an option later in the course of P Parkinson’s disease. Unfortunately, all of these treatments become less effective as the disease progresses.
None of the currently available treatments can halt or even slow the loss of neurons in Parkinson’s disease. Our laboratories are dedicated to this vital task.
The Economic Impact of Parkinson’s Disease
The financial burden of Parkinson’s disease on individuals and their families is immense. According to the Parkinson’s Action Network, drugs commonly used to treat Parkinson’s disease cost between $1,000 and $6,000 per year per patient. Annual medical care, including doctors’ visits, physical therapies and treatment for co-occurring illnesses (such as depression) is estimated at $2,000 to $7,000 for people in early stages of the disease, and is probably much higher for advanced stages. Surgical treatments for Parkinson’s disease can cost $25,000 or more. As the disease progresses, institutional care at an assisted-living facility or nursing home may be required, and these costs can exceed $100,000, per person annually.
With up to one million people affected in the U.S., it is clear that Parkinson’s disease exacts a tremendous economic burden on the nation. Forty percent of people affected are under the age of 60, placing them squarely in the workforce. Experts say that about a third of employed individuals will lose their jobs within a year of a Parkinson’s disease diagnosis, making lost productivity a major factor in the societal impact of the disease. Moreover, the direct costs of treating and caring for people with Parkinson’s disease are placing a growing burden on the healthcare system, a burden certain to rise as the baby boom generation ages. Worldwide, the number of people with Parkinson’s disease is expected to double in the next 25 years.
Estimates of the overall cost of Parkinson’s disease range widely. The National Institute of Neurological Disorders and Stroke (NINDS) ADD LINK puts the figure in excess of $5.6 billion, including both direct medical expenses and indirect costs such as lost income, disability payments and medical costs. However, many experts say the number is much higher, as much as $25 billion or more.
What is clear is that investment in medical research that leads to better treatments for Parkinson’s disease can save millions of dollars each year. Studies have indicated that for every dollar spent on high quality research, $13 could be saved in direct and indirect costs. If new therapies could be found that could produce even a modest ten percent delay in the progression of Parkinson’s disease, hundreds of millions of dollars could be saved every year.
Despite these prospects, Parkinson’s disease continues to receive far less federal research support than most other disorders according to the Fair Allocation in Research Foundation. In 2007, the National Institutes of Health, the lead federal agency responsible for biomedical research on neurological disorders, committed $205 million to Parkinson’s disease research. On a per patient basis, this is far less than is spent on research on cancer or AIDS.
Privately funded research must fill these huge gaps in federal funding. At the Michael Stern Parkinson’s Research Foundation, at least 94 percent of contributions go directly to research aimed at finding a cure. Donations of any amount can help us make a difference for the millions of people affected by Parkinson’s disease directly or through a family member.
This page was last modified on 4 January 2011 at 07:05.