Generally, as people tend to age, they are more likely to suffer from Parkinson’s disease. It is a brain disorder that makes the body of an individual become stiff and shaking. The condition comes as a result of poor coordination of motor movement leading to imbalance and walking difficulty. The illness affects both genders, with 50 percent dominance on males over females. Its signs and symptoms progress gradually and attain a critical level, which can alter the victim’s overall behavior. In some cases, Parkinson’s effect may be realized at the early stages of life before attaining the age of 50 years. The syndrome is linked to genetic mutation hence can be inherited from one generation to another (Blauwendraat et al., 2020). Early-onset of the disease, which has a low likelihood of occurring, is not connected to changes in gene thus not passed from one person to another. Critical analysis of Parkinson’s disorder that involves understanding its history, the process of pathology, clinical characteristics is important for proper comprehension of the condition and its implication on personal health.
History of Parkinson’s Disease
The history of Parkinson’s disease can be traced back to the ancient years of about AD 175. According to western medicine, a physician, Galen, described and named the condition “shaking Palsy.” Similarly, the early Indian medical system referred to the disorder as “Kampavata,” meaning tremor. In 1817, a London physician called James Parkinson developed an essay that entailed detailed information about the syndrome. The writing titled “An Essay on the Shaking Palsy” recognized the illness as a medicinal situation.
After some decades, a French neurologist called Jean-Martin Charcot improved the idea of James Parkinson and named the disorder Parkinson’s disease after evaluating and understanding the essential work done by the London doctor. In his role, Charcot and the students explained the clinical description of the illness. In the process of comprehending the disease, Charcot established two types of the condition. He categorized them into two distinct phases: the tremor and the rigidity stage (Li & Le, 2017). His work entailed a detailed explanation of the overall physical changes that an individual experiencing the sickness undergoes as the disease progress.
Furthermore, William Gowers contributed to understanding Parkinson’s disease were on his work “Manual of Disease of the Nervous System,” he outlined his comprehension of the disease based on the study on over 70 patients. He continued to elaborate on possible deformities associated with the syndrome on the patients in his studies around the year 1880. In addition, Gowers’ involvement confirmed that men are more susceptible to Parkinson’s illness than women.
The clear identification of the chemicals on a patient’s brain with Parkinson’s disease was discovered around the 1960s. During this essential finding, researchers detected nerve cell degeneration in the brain section known as the ‘substantia nigra’ and also realized a reduced level of dopamine. After the discovery, a possible treatment of the syndrome using the dopamine agonist becomes effective. In the year 1953, both Bosanquet and Greenfield examined changes in the brain, thus differentiating the effects of Parkinson’s sickness from other forms of illness.
Around the 1960s, the treatment of Parkinson’s disease symptoms involved administering levodopa. The control of the disorder still uses the same approach. In Parkinson’s essay, he recommended bloodletting and vesicatoria to manage the illness. The procedures induce inflammation and blistering of the skin, hence effective handling the condition. Similarly, Charcot suggested the use of an anticholinergic agent called hyoscyamine. Ordestein, a student of Charcot, also proposed the application ‘belladonna Alkaloids’ to treat the disease.
In 1910, Ewens and Barger discovered the dopa decarboxylase enzyme that was used to break down levodopa into dopamine. In the year 1961, Birkmayer injected the victim of Parkinson’s condition with levodopa for the first time. In his summary after the clinical trial, he concluded that people who had difficulty walking and those who could not stand were capable of engaging in the activities after receiving the injection. His work and discovery prompted modern involvement to determine dopamine agonists and associated enzymes that facilitate its activities, such as the monoamine oxidase inhibitors.
Description of Parkinson’s Disease
Parkinson’s disease is a condition caused by the disorder of the brain neurons responsible for the coordination of body movement. The syndrome occurs when the production of dopamine neurotransmitters is ineffective, thus causing unreliable signals that can be used to manage the overall functions of the cells. When the nerves fail to respond accordingly, then the signs and symptoms of Parkinson’s illness begin to appear progressively. Generally, at the early stages of the sickness, an individual will notice some slight tremors on the one hand. The patient, with time, will start realizing the difficulty in movement accompanied by stiffness of some joints. The effects are primarily visible on the arms, jaw, legs, face, and muscles. The associated impairments may cause sleep problems, tiredness, inability to write, speak, chew, and other essential activities. The condition is also referred to as shaking palsy or paralysis agitans. It occurs most frequently in about two percent of the people aged 60 years and above.
Pathology Process
Parkinson’s disorder is caused mainly by the continuous loss of the neurons that secrets dopamine and the lack of it in the brain. The deficiency of dopamine contributes to the irresponsibility to effectively coordinate body balance and movement. Based on an autopsy of the affected tissues, Parkinson’s disease is associated with the accumulation of Lewy bodies. The aggregation results in the inability to produce dopamine cells in the substantia nigra.
The distribution of Lewy bodies in the affected brain normally varies amongst the patients making the individuals experience varied signs and symptoms. Despite the variation, the density of alpha-synuclein protein influence the level of indicators of Parkinson’s disorder in sick individuals (Fanning et al., 2020). The excessive existence of Lewy bodies causes the death of nerve cells in both the ventral and basal ganglia. In some cases, the alpha-synuclein is not present in the indicators of the illness; thus, it is not a factor causing the function of the body to decline. However, Lewy bodies show a reduction of activeness over a period of time.
Another cause of the disorder is connected to the chemical MPTP (1-methyl-4-phenyl-1, 2, 3, 6-tetrahydropyridine). Based on the developmental finding of the possible origin of the disease in 1982, a positive response associated with contaminated opiate was detected. This discovery was made in California, where individuals who took heroin showed symptoms of Parkinson’s sickness after taking opiate contaminated by the MPTP. Exposure to the type of chemical leads to the development of signs that are similar to the ones of Parkinson’s disorder.
Similarly, activities such as welding are hypothesized to cause the sickness. The continuous and involvement in the events exposes an individual to heavy metal particles such as copper, lead, aluminum, iron, manganese, whose accumulation in the substantia nigra increases the chances of developing Parkinson’s illness. This is because aggregation of the elements in the brain will temper the oxidation process, thus impacting the function.
Moreover, Parkinsonism can also be caused by head trauma. For instance, most boxers have shown the effects due to severe injuries they obtained when engaging in fights.
Diagnosis of Parkinson’s Disorder
A close association between Parkinson’s symptoms and other disorders makes it confusing to distinguish between the illness and other diseases that cause similar signs. Conducting various tests is effective in enabling to detect and differentiate them from Parkinson’s sickness. Generally, there are no laboratory tests that can be performed to diagnose the disorder. The examination and judgment of the problem are based on the patient’s medical record history and subjection into the neurological analysis (Marsili et al., 2018). In the process of diagnosis, levodopa can be used in cases where impairment has occurred on one side of the victim. Upon realization of relief from the pain, then the presence of Parkinson’s disease can be justified.
Another testing can be conducted through an imaging system that involves the use of magnetic resonance imaging (MRI) and computed tomography. The scanning of the brain of individuals with the disorder will indicate normal appearance, thus enabling physicians to rule out other sicknesses such as hydrocephalus, vascular pathology, and substantia nigra tumors. The technique is effective in separating between strange and typical Parkinsonism in the patients.
Treatment of the Disorder
There is no specific cure for Parkinson’s sickness; therefore, physicians have formulated various ways to manage the symptoms and prevent the gradual effects of the illness. This makes the control and management differ from one patient to the other (Raza & Anjum, 2019). The treatment is aimed at managing the motor signs, which makes the handling change as the indicators progress. Some of the antiparkinson medicines include dopamine agonists, levodopa, and MAO-B inhibitors. The drugs are used during the early stages to reduce motor symptoms.
In some cases, varieties of foodstuffs are consumed to facilitate management of the disease. Furthermore, stimulation of the deep brain and surgery has been effective in controlling the indicators of Parkinson’s disorder. These practices are mainly applicable in situations where the drugs have become futile and cause several side effects (Ryan et al., 2018). For instance, as the sickness progress, they become ineffective and cause dyskinesia complications resulting in struggling movement.
Anatomy of the Affected Area
Generally, Parkinson’s disease affects a part of the brain called the basal ganglia. It is located deep in the central location of the forebrain. Basal ganglia contain several nuclei that have strong connectivity with both the thalamus and the cerebral cortex. They form large communication systems that enable them to involve in different functions such as routine conduct, motor movement, and emotional involvement (Zeighami et al., 2019). Basal ganglia have a complex nuclear called the striatum, which is made up of putamen and caudate. Several inputs from the cerebral cortex are transferred to the striatum. Furthermore, the striatum receives physical input from dopaminergic. There are two types of spiny projections that accept nigral and cortex inputs.
Implication on Radiographic Technique
The most effective radiographic technique to be used is nigrosome imaging. In this process, microsomes can be grouped into five calbindin-scarce zones, where the largest one is nigrosome 1. Generally, in Parkinson’s disorder, the gradual loss of dopaminergic cells in basal ganglia majorly occurs in microsomes, with the first one experiencing the highest depletion followed by the second, third, fourth, and fifth, respectively. Using high-resolution MRI facilitates easy and direct visualization of the nigrosome in the substantial nigra. The technique makes it easier to observe and distinguish the atypical from the typical Parkinson’s disease characteristics.
Studies and Radiographic Utilized in Diagnosis of Parkinson’s Disorder
Functional and Structural Imaging
Different studies have been conducted to evaluate and find the practical radiographic approach that can be used to diagnose Parkinson’s disease. Amongst the research, MRI has proven operative since it can identify the structural injuries that come as a result of other underlying conditions of Parkinsonism, such as neoplasm (Atkinson-Clement et al., 2017). It is also essential in determining the degree and distribution level of brain degeneration. Furthermore, structural MRI enhances higher sensitivity and specificity compared to other forms of diagnosis. The application of the improved MRI modalities such as arterial spin labeling (ASL), diffusion-weighted imaging (DWI), and spectroscopy has indicated the ability to distinguish Parkinson’s illness from other diseases. The usage of the technique is significant because it makes it easier to identify the problem.
Clinical Features of Parkinson’s Disease
The disorder’s clinical features are inconsistent, and patients may show completely different signals of the sickness. In most cases, during the beginning of the disease, it indicates mild symptoms that cannot be noticed by the victim. The illness indicators start from one part of the body then spread out, while the initially affected part gets worse as it progresses on other sides of the body.
The symptoms include tremor, which is majorly the initial sign of the disorder where the patient begins shaking on a limb, especially a hand or a finger. Sometimes, the shaking happens while an individual is at rest. Another indicator is slowed movement, as the condition progress, an individual develops difficulty in doing activities such as walking hence taking more time to finish a given duty. It may also involve having a small stride while walking or dragging of feet in order to move from one point to another. The disease is associated with rigid muscles, which limit the motion of a person. The stiffness results in pain when forcing the nerves to respond. Furthermore, Parkinson’s illness causes improper body balance of the victim.
In summary, Parkinson’s disease is a paralysis disorder that affects the overall activities of patients. It shows early symptoms such as tremors in the hands, legs, and other parts of the body. The condition majorly affects individuals who have attained an age of about 60 and above. It is a progressive sickness that spreads through various parts. The sickness is caused by the malfunction of the basal ganglia section of the brain that is responsible for coordinating physical movement. There is no exact cure for the illness, but physicians have adopted different ways to manage and delay its symptoms. Various diagnosis techniques are used to detect the presence of the syndrome. Currently, methods such as the use of structural MRI have proven to be effective in identifying and distinguishing the disorder from other sicknesses that show similar signs and symptoms. The studies and application of different radiographic procedures are useful in managing the impacts of the disorder
References
Atkinson-Clement, C., Pinto, S., Eusebio, A., & Coulon, O. (2017). Diffusion tensor imaging in Parkinson’s disease: Review and meta-analysis. Neuroimage: Clinical, 16, 98-110. Web.
Blauwendraat, C., Nalls, M. A., & Singleton, A. B. (2020). The genetic architecture of Parkinson’s disease. The Lancet Neurology, 19(2), 170-178. Web.
Fanning, S., Selkoe, D., & Dettmer, U. (2020). Parkinson’s disease: Proteinopathy or lipidopathy?. NPJ Parkinson’s Disease, 6(1), 1-9. Web.
Li, S., & Le, W. (2017). Milestones of Parkinson’s disease research: 200 years of history and beyond. Neuroscience bulletin, 33(5), 598-602. Web.
Marsili, L., Rizzo, G., & Colosimo, C. (2018). Diagnostic criteria for Parkinson’s disease: From James Parkinson to the concept of prodromal disease. Frontiers in neurology, 9, 156. Web.
Raza, C., & Anjum, R. (2019). Parkinson’s disease: Mechanisms, translational models and management strategies. Life sciences, 226, 77-90. Web.
Ryan, M. B., Bair-Marshall, C., & Nelson, A. B. (2018). Aberrant striatal activity in parkinsonism and levodopa-induced dyskinesia. Cell reports, 23(12), 3438-3446. Web.
Zeighami, Y., Fereshtehnejad, S. M., Dadar, M., Collins, D. L., Postuma, R. B., Mišić, B., & Dagher, A. (2019). A clinical-anatomical signature of Parkinson’s disease identified with partial least squares and magnetic resonance imaging. Neuroimage, 190, 69-78. Web.