Page 1

Parkinson’s Awareness  Association  

1

24 February 2014 Parkinson’s Awareness Association Chung Science Museum 126 Tompkins Hall Dear Ms.Chung, I.

Statement of Problem

Parkinson’s Disease, a common neurodegenerative disease, forms when particular neurons in the brain die preventing body movements from being regulated. Parkinson’s is more frequently diagnosed today than in past years. Therefore, more people must be educated on the symptoms of Parkinson’s in order to better recognize the disease. Education is essential on these symptoms because of the vast types and their variance among society. Each patient is affected differently by the disease, whether it be the symptoms themselves or intensity of those symptoms. As of now, there is no complete cure for this illness. Research has only been able to determine possible treatments for the symptoms associated with Parkinson’s. Even though there is no current cure for the disease, funding for research is essential in order for cure to one day be discovered. II. Purpose of Study


Parkinson’s Awareness  Association  

2

The goal of this study is to raise awareness about the multiple symptoms and the different treatment options available. This study will also reveal new treatment options that were discovered and are now accessible to those suffering from Parkinson’s. This is an important study because doctors are more knowledgeable on the disease due to the increasing number of patients who have identified these symptoms. Through the use of statistics and personal testimonies, we will show the importance of being knowledgeable and understanding the complexity of the illness. III. Research Questions / Hypothesis For the purpose of this study, the following question were addressed: i.

How does Parkinson’s affect the brain?

ii.

How have treatment methods developed over the years?

As part of this study, investigation included one research hypothesis: iii.

Recently, Parkinson’s Disease has been diagnosed more frequently, therefore

knowledge on the severity of the disease and possible treatment available is crucial. This is important because each case of Parkinson’s can affect people differently. Since it can affect patients differently, we must better understand the disease as a whole so we can assist those with the varying symptoms. IV. Conclusion (Impacts, Benefits) In today’s society, the number of people diagnosed with Parkinson’s has increased drastically. Making this research available to the public in the museum will increase awareness among society and promote more research on the topic. This opportunity will aid in raising money for the Parkinson’s Disease Foundation which would allow for


Parkinson’s Awareness  Association   future research to find a cure. Enclosed please find the literature review, body copy, reference list for the study, “The Parkinson’s Awareness Association.” Sincerely, Mackenzie Brewer Kaitlyn Ross

February 21, 2014 February 21, 2014

3


Parkinson’s Awareness  Association  

Parkinson’s Awareness Association Kaitlyn Ross and Mackenzie Brewer North Carolina State University English 101 (035) Professor May Chung March 18, 2014

4


Parkinson’s Awareness  Association  

5

Parkinson’s Awareness Association Literature Review Growth of Disease in Society The number of Parkinson Disease cases in the United States has progressively increased over the past couple of decades. Roughly 1.5 million Americans currently suffer from Parkinson’s Disease and around 60,000 more Americans will be diagnosed this year (Watson, 2013). The majority of patients identified with the illness are over the age of 60. However, around 15 percent are diagnosed before age 50 (Watson et al., 2013). According to the National Parkinson’s Foundation (2014), “The Center for Disease Control rated complications from Parkinson’s disease as the 14th leading cause of death in the United States.” Epidemiology There is no definite cause of Parkinson’s as of yet. One develops Parkinson’s disease when the specific neurons in the brain die. These neurons emit dopamine, which helps to send signals to regions of the brain that regulate body movement in a healthy person. In a patient with Parkinson’s, these neurons are dying, which delays the signals sent to parts of the brain that control body movement (“Parkinson’s Disease,” 1969). This delay is seen in the slow movement of patients who have been diagnosed with Parkinson’s. Due to the increase in the number of cases, research has discovered that some factors greatly increase the risk of developing Parkinson’s disease. Advanced age is a common factor that the majority of Parkinson’s patients share. However, 10% of patients with the illness are under the age of 45 (Lees, Hardy, and Revesz, 2009). Also, people who have lived in rural areas in their early life are more likely to the develop the


Parkinson’s Awareness  Association  

6

disease because they have been exposed to manganese, carbon monoxide, cyanide, and some pesticides and herbicides. However, many patients who have been diagnosed were not exposed to these types of chemicals (Watson, 2008). Other risk factors commonly found in Parkinson’s patients are family history, cigarette smoking, and caffeine use. These factors are suspected by researchers, but have not yet been proven (Tarsy, 2012). Symptoms Parkinson’s Disease has a wide variety of symptoms that affect one's body while suffering from the illness. The disease not only disturbs movement, but affects most aspects of the human body. “[Parkinson’s] has 4 cardinal manifestations: resting tremor, bradykinesia, rigidity, and gait disturbance,” (Tarsy, 2012). These symptoms restrict body movement and make it more complicated for patients to move about. “Depressive Symptoms in Parkinson’s Disease” (2012) states, when suffering from Parkinson’s it can be difficult for patients to express emotions because they begin to suffer from rigid and immobile facial expressions. The most troublesome of the symptoms would be the rigidity and bradykinesia (“Parkinson’s Disease,” 1969.) Not only does the illness affect body movements but it also affects the brain, “Parkinson disease also causes important nonmotor symptoms such as sleep disturbance, mood disorder, cognitive impairment, and autonomic dysfunction,” (Tarsy, 2012). According to “Depressive Symptoms in Parkinson’s Disease” (2012), Depressive Disorders can affect between 2.7% and 90% of patients suffering with Parkinson’s. They also proceed to say that 24.6% of patients with the illness experience moderate depression. Stages/Types


Parkinson’s Awareness  Association  

7

Once patients have been diagnosed with Parkinson’s Disease, doctors use the Hoehn and Yahr Staging and Unified Parkinson's Disease Rating Scale to determine which of the five stages of Parkinson’s that the diagnosed lies within. Stage one is diagnosed when the present symptoms are only found on one side of the body. Patients have progressed to stage two when symptoms are found on both sides of the body, but their balance has not became impaired yet. Disability and little balance impairment are said to be signs of stage three of Parkinson’s. The final two stages are much more severe than the first three. At the fourth stage, patients have developed severe disability, but are still capable of walking and standing on their own. The fifth and final stage is diagnosed when the patient is no longer able to walk or stand by themselves and have become reliable on a wheelchair or are bedridden. This scale helps doctors to follow the course of the illness by tracking intellectual impairment, depression, motivation, daily activities, and motor skills (Watson, 2008). The length of this scale and length of each stage varies among patients. There are a few different types of Parkinsonism that are commonly confused with Parkinson’s disease at first glance. Multiple System Atrophy is usually presented in the body around age 60. This form of Parkinsonism includes symptoms such as urinary incontinence and early erectile failure in men. Progressive Supranuclear Palsy is a second form of Parkinsonism, which usually presents itself in the body around 70 or 80 years of age and autonomic failure is absent. Similarly to Parkinson’s Disease, Progressive Supranuclear Palsy causes patients to develop axial and bulbar symptoms. However, these symptoms are much more striking in Progressive Supranuclear Palsy than in Parkinson’s Disease. Both of these types of Parkinsonism progress much faster than


Parkinson’s Awareness  Association  

8

Parkinson’s Disease. Due to the rapid progression of these types, doctors generally estimate “ a mean duration from onset of disease to death of about 9 years,” for patients who develop these progressive forms of Parkinsonism. (Lees, Hardy, and Revesz, 2009). Treatment Parkinson’s Disease currently has no confirmed cure, however there are treatments available to assist with the symptoms that are associated with the disease. Treatments can differ between patients because doctors simply aim to treat the symptoms associated with that particular case of Parkinsons (Tarsy, 2012). The most effective drug for symptoms involving motor skills is Levodopa. However, Levodopa can cause nausea, vivid hallucinations, and orthostatic hypotension so it is essential that patients also take medications such as Carbidopa or Benserazide in order to prevent these side effects. “These peripheral decarboxylase inhibitors block conversion of levodopa to dopamine in the peripheral circulation and liver,” thus preventing these side effects from occurring while the patient is on Levodopa (Tarsy, 2012). In recent years, surgical indications have been reintroduced and have become common among those diagnosed with advanced Parkinson’s Disease. This surgery known as Deep Brain Stimulation is performed by “implanting a stimulating electrode containing four electrical contacts.” The electrodes continue to stimulate the body and brain throughout the day, resulting in fewer side effects. Deep Brain Stimulation was commonly practiced on patients during the 1960’s before the discovery of Levodopa. However, DBS is being practiced again because, “motor fluctuations and dyskinesias began to limit the benefits of levodopa in patients with advanced Parkinson disease,” (Tarsy, 2012). According to Daniel Tarsy, MD, “As of 2010, approximately 60,000 DBS


Parkinson’s Awareness  Association  

9

implants had been placed worldwide for Parkinson disease.” Though there is currently no complete cure for Parkinson’s scientist are working diligently to better understand the disease in order to one day find a cure. Conclusion Living with Parkinson’s Disease is a huge challenge to overcome. Not only is the illness difficult for the one diagnosed with it, but also for the family and the caregivers of the patient. In the final stages of Parkinson’s, patients begin to rely completely on others to help them in every aspect of their daily life. Due to the scarcity of the disease, little research has been conducted to better benefit patients and doctors. There is currently no cure for this disease but with more research, scientists will be able to better understand the disease in order to one day find a cure. However, over the past few years research has increased and will hopefully lead to better treatment options for the diagnosed patients.


Parkinson’s Awareness  Association  

10 Body Copy

Intro

Imagine one  day  finding  yourself  not  being  able  to  walk  or  move  your  arms  when  

you want.  How  frustrating  would  it  be  to  have  to  wait  on  your  brain  to  tell  your  feet  to   move  when  you  want  to  walk  somewhere?  This  feeling  is  a  daily  struggle  for  patients   who  have  been  diagnosed  with  Parkinson’s  Disease.  This  illness  is  the  second  most   common  neurodegenerative  disease  in  today’s  world.  Currently,  no  cure  has  been   found,  leaving  many  patients  hopeless  to  ever  getting  back  to  their  normal  condition.   Even  though  this  disease  normally  only  affects  older  people  it  is  essential  that  young   people  get  involved  in  helping  to  find  a  cure.  If  no  cure  is  found  young  people  today   could  still  suffer  from  this  disease  later  on  in  life. Growth  of  Disease  in  Society  

In today’s  society  Parkinson’s  Disease  is  becoming  a  more  and  more  relevant  

disease and  issue  growing  throughout  the  United  States.  Parkinson’s  Disease,  commonly   referred  to  as  PD,  was  first  discovered  by  physician  James  Parkinson  in  1817.    Since  the   first  reported  case  over  almost  200  years  ago,  the  disease  has  rapidly  become  a   household  name.  According  the  National  Parkinson's  Foundation  (2014),  around  1.5   million  Americans  are  currently  suffering  from  PD  and  roughly  60,000  more  people  will   be  diagnosed  each  year.  They  also  state  it  has  grown  to  become  the  14th  leading  cause   of  death  in  the  United  States.  According  to  the  FCA,  Parkinson’s  Disease  is  now,  “the   second  most  common  neurodegenerative  disease  after  Alzheimer's  disease,”  (2014).   Many  famous  celebrities,  such  as  Michael  J.  Fox  and  Muhammad  Ali,  suffer  from  the  


Parkinson’s Awareness  Association  

11

disease and  are  attempting  to  raise  awareness  about  the  illness  by  sharing  their  own   personal  stories. Epidemiology  

As of  2013,  researchers  have  found  no  cure  for  Parkinson’s  disease.  Most  people  

have heard  of  the  disease  and  some  of  the  symptoms,  but  what  actually  causes  the   illness?  According  to  “Parkinson’s  Disease”  (1969),  Parkinson’s  is  caused  by  the  deaths   of  cells  in  the  brain  that  release  a  chemical  called  dopamine.  In  a  healthy  person,   dopamine  sends  signals  to  other  areas  of  the  brain  in  order  to  control  body  movement.   With  the  death  of  these  cells,  there  is  a  delay  in  the  recognition  of  the  signals  sent  to  the   brain.  Healthy  people  just  go  and  do  as  they  please,  but  Parkinson’s  patients  have  to   wait  for  their  body  to  catch  up  with  their  brain.  This  is  why  Parkinson’s  patients  move  at   a  slow  pace.  A  recent  increase  in  the  number  of  patients  diagnosed  with  Parkinson’s  has   sparked  researchers  to  find  out  if  there  are  things  in  our  lives  causing  the  disease.  Lees,   Hardy,  and  Revesz  (2009)  have  determined  some  common  factors  that  could  be   responsible  for  causing  the  disease.  Older  age  is  one  characteristic  that  most  Parkinson’s   patients  share,  however,  nearly  10%  of  patients  with  Parkinson’s  are  under  age   45.    Boxer  Muhammad  Ali  developed  the  disease  early  in  life  while  he  was  in  his  40s. Michael  J.  Fox  another  famous  person  with  the  illness  was  diagnosed  in  his  30s.  Watson   (2008)  discovered  that  another  common  factor  is  growing  up  on  or  near  farms  in  the   rural  areas  of  the  world.  By  living  in  these  areas,  people  are  exposed  to  higher  amounts   of  dangerous  chemicals  such  as,  manganese,  carbon  monoxide,  cyanide,  and  some   pesticides  and  herbicides.  On  the  other  hand,  there  are  many  patients  who  have  


Parkinson’s Awareness  Association  

12

Parkinson’s that  were  never  exposed  to  such  chemicals.  Tarsy  (2012)  found  that  other   factors  that  are  possible  causes  for  the  disease  are  family  histories  of  the  illness,   cigarette  smoking,  and  caffeine  use.  Although,  these  factors  have  been  suspected  by   researchers,  they  yet  have  been  proven  to  be  actual  causes.   Symptoms  

Parkinson’s is  commonly  known  to  affect  each  diagnosed  patient  differently.  

Each case  can  have  varying  symptoms  and  affect  the  patients  in  different  ways.   However,  it  is  common  for  patients  to  experience  certain  symptoms  such  as  stiffness   and  tremors  in  one’s  leg  or  arm.  According  to  Men’s  Health,  the  patients  also  suffer   from  slow  movements  which  can  eventually  prevent  them  from  performing  daily  tasks   such  as  walking,  bathing,  and  dressing  (1969).  These  slow  movements  and  stiffness  are   referred  as  bradykinesia  and  can  interfere  with  the  victims  balance  and  coordination.   Stephanie  Watson  reveals  that  these  symptoms  are  brought  on  by  the  disease   destroying  nerve  cells  in  the  brain  (2008).  

 


Parkinson’s Awareness  Association  

13

It is  also  stated  by  Men’s  Health  that  the  stiffness  affects  all  parts  of  the  body  including   the  patients  face  so  it  can  sometimes  be  difficult  for  these  victims  to  show  emotions   (1969).    

Not only  does  Parkinson’s  Disease  affect  the  physical  body  but  it  can  also  affect  

these patients  brain  and  mental  health  as  well.  It  is  extremely  common  for  many  of   those  suffering  from  PD  to  become  extremely  depressed  and  overwhelmed  by  the   disease  (Tarsy,  2012).  These  patients  become  depressed  because  of  their  sudden   inability  to  before  their  daily  activities.  A  once  simple  chore  of  getting  dressed  can  seem   like  a  marathon  for  those  suffering  from  PD.  This  realization  that  they  are  now   dependent  on  others  can  lead  many  patients  to  depressed  and  saddened  by  their   physical  state.  According  to  “Depressive  Symptoms  in  Parkinson’s  Disease”  (2012),   depression  can  affect  as  much  as  90%  of  those  with  Parkinson's  Disease.    


Parkinson’s Awareness  Association  

14

Stages

Types There  are  several  different  types  of  Parkinson’s.  These  two  types  of  Parkinsonism  are   very  similar  to  the  Parkinson’s  Disease,  however,  they  are  known  to  progress  much   faster  in  patients  than  the  general  form.  A  study  conducted  by  Lees,  Hardy,  and  Revesz  


Parkinson’s Awareness  Association  

15

(2009) defined  these  two  forms  of  Parkinsonism.  Usually  with  these  two  forms,  doctors   only  give  patients  9  years  to  live  from  the  time  they  are  diagnosed.   •

Multiple System  Atrophy  is  usually  discovered  in  patients  around  age  60.   Patients  will  usually  experience  difficulty  using  the  restroom.    Also,  other  general   symptoms  of  Parkinson’s  are  present  in  the  patient.    

Progressive Supranuclear  Palsy  is  usually  found  in  patients  who  are  around  the   ages  of  70  or  80.  These  patients  typically  have  difficulty  moving  their  arms  and   legs.  They  also  often  have  difficulty  with  their  lungs.  This  makes  it  challenging  for   some  patients  to  swallow,  chew,  etc.  

Treatment  

There is  no  complete  cure  for  Parkinson’s  Disease.  There  are  only  options  

available to  help  and  ease  the  symptoms  of  the  disease.  There  are  two  main  sources  of   treatment  for  the  symptoms,  medication  and  Deep  Brain  Stimulation.  According  to  Dr.   Tarsy,  the  most  common  and  effective  medication  for  motor  skill  symptoms  is   Levodopa.  However  Levodopa  may  cause  side  effects  so  it  must  be  taken  with  a  mix  of   other  medications  as  well.  A  second  source  of  treatment  is  Deep  Brain  Stimulation,   commonly  referred  to  as  DBS.  During  a  DBS  operation,  two  electric  metal  rods  are  put  in   the  brain  to  constantly  provide  stimulation.  This  operation  helps  to  stop  many  side   effects  of  Parkinson’s  such  as  tremors  and  shakes.  DBS  has  just  recently  been   reintroduced  into  the  field  of  treatment  for  Parkinson’s  Disease  (2012).  


Parkinson’s Awareness  Association  

16

Conclusion

Today, living  with  Parkinson’s  Disease  is  a  daily  struggle.  Patients  in  the  early  

stages wonder  when  their  ability  to  do  for  themselves  will  deteriorate.  Those  in  the  final   stages  rely  on  hired  help  or  loved  ones  to  care  for  them  and  help  out  with  their  daily   routines.  Diagnosis  of  Parkinson’s  is  one  the  rise,  but  the  disease  is  still  unknown  or   misunderstood  by  many  in  the  world  today.  Throughout  the  past  few  year  there  has   been  an  increase  in  research  with  a  goal  of  finding  a  cure,  rather  than  just  medication  to   control  the  symptoms.  More  research  is  encouraged  and  needed  in  order  to  provide  a   cure  to  the  many  helpless  patients  already  diagnosed.  To  learn  more  about  Parkinson’s,   watch  our  video  at   http://www.youtube.com/watch?v=5uSBeTE6OwY&feature=youtu.be


Parkinson’s Awareness  Association  

17

References

Lees, A., Hardy, J., & Revesz, T. (2009). Parkinson's disease. The Lancet, 373(9680), 2055-2066. Retrieved February 17, 2014, from http://www.sciencedirect.com/science/article/pii/S014067360960492X Parkinson Disease Overview. (n.d.). National Parkinson Foundation. Retrieved February 17, 2014, from http://www.parkinson.org/parkinson-s-disease.aspx Parkinson's Disease. (n.d.). Men's Health Magazine : Men's Guide to Fitness, Health, Weight Loss, Nutrition, Sex, Style and Guy Wisdom. Retrieved February 17, 2014, from http://www.menshealth.com/health-conditions/parkinsons-disease Piccinni, A., Marazziti, D., Veltri, A., Ceravolo, R., Ramacciotti, C., Carlini, M., et al. (2012). Depressive symptoms in Parkinson's disease. Comprehensive Psychiatry, 53(6), 727-731. Retrieved February 17, 2014, from http://www.sciencedirect.com/science/article/pii/S0010440X11002136 Tarsy, D. (2012). Treatment of Parkinson Disease A 64-Year-Old Man With Motor Complications of Advanced Parkinson Disease. The Journal of American Medical Association, 307(21), 2305-2314. Retrieved February 17, 2014, from http://jama.jamanetwork.com/article.aspx?articleid=1153854&author=Tarsy Watson, S. (n.d.). Parkinsons Disease Overview. HowStuffWorks. Retrieved February 17, 2014, from http://health.howstuffworks.com/diseasesconditions/musculoskeletal/parkinsons-disease1.htm

Parkinson's Awareness Association  
Advertisement