Health Occupations Students of America, or HOSA, is a career and technical organization for high school students interested in health professions.
Why Parkinson’s Disease?
Good friends, Sahasra Charkam and Tejaswini Pitchuka, are both interested in pursuing careers in health care. Charkam would like to become a surgeon, and Pritchuka has her sights set on becoming a biomedical engineer.
Charkam’s grandmother passed away from Parkinson’s disease, so they decided to focus their efforts on raising awareness of Parkinson’s. This is their report.
Our Objectives:
- Our primary objective is to eliminate the stigma surrounding PD. Many people are embarrassed by the symptoms of their Parkinson’s diagnosis: tremors, difficulty moving, and, for some, difficulty talking.
- Our secondary goal is to create hope and community for individuals living with PD. Recent advances in Parkinson’s disease treatment focus on managing motor and non-motor symptoms and exploring disease-modifying therapies.
So, what is Parkinson’s Disease?
Many attribute minor tremors or occasional difficulty getting up or sitting down to growing older. However, these slight tremors (and difficulties) can indicate the onset of Parkinson’s Disease (PD). With over 1 million people in the United States affected, PD is expected to surpass Alzheimer’s and Dementia by 2027.
Parkinson’s Disease is a progressive disorder of the central nervous system that primarily affects movement. The gradual loss of dopamine-producing neurons in the brain causes it. Dopamine is a key neurotransmitter responsible for controlling movement and motivation, often referred to as the “feel-good” chemical.
Because dopamine does not reach the brain at normal levels in PD patients, communication between the mind and body becomes impaired.
How does the brain control movement?
Movement in the human body is controlled through a complex connection between the brain, spinal cord, and muscles. The motor cortex plays a key role in processing sensory information about the body’s position in space. However, another part of the brain, the Extrapyramidal System (EPS), is critical in regulating and refining motor movements. The EPS integrates signals and sends feedback to the motor cortex, helping us move smoothly and purposefully.
Amazingly, a significant part of the brain is dedicated to motor control despite the numerous other functions it manages simultaneously.
The Substantia Nigra and Dopamine Production
One essential structure within the EPS is the substantia nigra, located in the midbrain. This region contains neurons that produce dopamine and melanin, giving the area its darker color in a healthy brain. A darker substantia nigra generally indicates a higher concentration of functioning dopamine neurons.
Dopamine is synthesized in neurons from a precursor called L-DOPA, also known as levodopa. Over time, these neurons can be damaged or destroyed due to several factors:
- Toxin exposure (which poisons mitochondria)
- Genetics (PD can run in families)
- Brain trauma
- Viral infections
Remarkably, individuals can lose many dopamine-producing neurons before motor symptoms manifest.
Why is Parkinson’s more common in men?
Research shows estrogen, a hormone more prevalent in women, may protect against neuronal death. As women age and estrogen levels decline, their risk of developing Parkinson’s disease increases, thus narrowing the gender gap in older age groups.
Symptoms of Parkinson’s
PD symptoms can be broken into two categories: motor and non-motor.
Motor Symptoms:
- Tremors
- Muscle rigidity
- Bradykinesia (slowness of movement)
- Balance and coordination issues
Non-Motor Symptoms:
- Depression
- Anxiety
- Tremors
- Cognitive decline
- Decreased sense of smell
- Constipation
- Low blood pressure
- Sexual dysfunction
- Urinary problems
- Sleep disturbances
- Sweating problems
- Hallucinations
How is Parkinson’s Disease Diagnosed?
There is no single test that can definitively diagnose Parkinson’s Disease. Doctors consider a combination of factors:
- Medical history
- Physical and neurological exams
- Blood and lab tests to rule out other conditions
- Genetic testing (especially with a family history)
- Trial medications (to see if symptoms improve)
A new and promising development is the alpha-synuclein test. Alpha-synuclein is a protein that forms toxic clumps in the brains of individuals with Parkinson’s Disease. In a 2023 study, this test accurately identified individuals with PD 87.7% of the time. However, further research is needed before it becomes standard practice.
How is Parkinson’s Disease Treated?
While there is no cure, several treatments aid in managing symptoms and enhancing quality of life.
- Medication:
- Levodopa (L-DOPA) is extremely common and helps relieve motor symptoms.
- Therapy:
- Physical therapy improves mobility and balance. Speech therapy helps with speech and swallowing difficulties.
- Occupational therapy teaches strategies to maintain independence in daily life.
- Lifestyle Changes:
- Regular exercise (like walking or yoga) helps slow progression.
- A balanced diet, stress reduction, and good sleep habits are also essential.
- Deep Brain Stimulation (DBS):
- DBS involves implanting a device in the brain that sends electrical impulses to areas that regulate movement.
- It doesn’t cure PD, but it can significantly reduce symptoms in advanced cases.
Parkinson’s Disease is complex, and although it often begins subtly, its impact grows over time. With ongoing research and academic progress in diagnosis and treatment, there is hope for earlier detection, better symptom management, and a cure.
Humans build support systems, whether family, friends, or strangers. Parkinson’s Disease has impacted not only those diagnosed with the disease but also the people who surround them.
Parkinson’s Strength
Parkinson’s Strength is an initiative we created to increase awareness and knowledge about Parkinson’s Disease. Through our initiative, we have tried to debunk some of the myths about Parkinson’s Disease.
Editor’s note: Sahasra and Tejaswini presented at a state-wide competition in April, where they came in second place and earned a silver medal. They will next compete at the international competition in June. Additionally, they have had a stall at the MetroWest YMCA and presented at TEDx in January.
Thank you for writing a clear and thoughtful explanation of Parkinson’s disease. As you point out, its effects on patients and their families are widespread. And based on the work of young scientists like you, improvements in care and prevention may be in our near future. Congratulations to you both and good luck in the international competition.