Parkinson's disease, ranked as the second most common neurodegenerative disorder in the United States, frequently remains in the background of public awareness. Named after the English physician, Dr. James Parkinson, who recognized it in 1817, Parkinson's is a progressive neurological condition primarily impacting movement. It is characterized by the gradual deterioration of brain nerve cells, especially those responsible for producing dopamine—a vital neurotransmitter crucial for facilitating smooth and controlled muscle movements.
“As Parkinson's disease progresses, individuals may experience a range of symptoms, including tremors (shaking), bradykinesia (slowed movements), rigidity, and postural instability,” says Rebeka Sipma, M.D., instructor and fellow in the UAB Department of Neurology in the Division of Movement Disorders. “These symptoms often begin subtly and worsen over time, impacting a person's ability to perform everyday activities.”
Sipma provides further insights into the condition, emphasizing the significance of early detection and detailing how the UAB Comprehensive Parkinson’s Disease and Movement Disorders Clinic offers effective management strategies for Parkinson's disease.
Q: What are the key symptoms and signs of Parkinson's disease that patients and caregivers should be aware of?
Parkinson’s disease (PD) manifests uniquely in each patient. Motor symptoms typically initiate on one side of the body, gradually progressing to affect the other side. Key diagnostic indicators for Parkinson’s disease include slowness and decrements in movements known as bradykinesia, tremor, rigidity, and postural instability. Bradykinesia may present as smaller handwriting, reduced blinking and facial expressions, shuffling steps, difficulties with fine motor tasks, and drooling due to decreased swallowing. Rigidity can be sensed as stiffness or tightness, sometimes resembling frozen shoulder. Postural instability often results in falls, especially when maneuvering in confined spaces or moving backward. Additionally, Parkinson’s disease may impact other systems, leading to symptoms such as constipation, dream enactment, loss of sense of smell, lightheadedness upon standing, depression, anxiety, memory problems, and various other symptoms.
Q: How does Parkinson's disease progress, and why is early detection crucial for effective treatment?
Parkinson’s disease progresses at different rates for each patient, usually slowly over several years. Research indicates that exercise is the best way to slow the progression of the disease. Those who incorporate and sustain regular exercise early on are more likely to maintain mobility, reducing the risk of complications like falls. Although Parkinson's disease does not have a cure yet, symptomatic therapies exist. Addressing symptoms such as tremors and slowness not only aids in extending work capacity or the pursuit of enjoyable activities but also contributes to improved overall function and quality of life. Recognizing and addressing non-motor symptoms such as depression, anxiety, sleep disruption, and other symptoms early can help improve patient well-being.
Q: How does the UAB Comprehensive Parkinson's Disease and Movement Disorders Clinic contribute to the early detection and management of Parkinson's disease?
The UAB Comprehensive Parkinson’s Disease and Movement Disorders Clinic is the largest movement disorders clinic in Alabama, serving patients from Alabama, Mississippi, Florida, Georgia, Tennessee, and other states. Our team consists of 12 movement disorder neurologists, four nurse practitioners, a social worker, a team of nurses, research coordinators, and up to two new fellows annually. Diagnosis of Parkinson’s disease relies on clinical examination and history, emphasizing the importance of early detection through evaluation with a movement disorder specialist. If additional assessment is needed, our clinic provides comprehensive diagnostic services.
Our providers utilize a wide spectrum of treatment approaches, including physical, occupational and speech therapy, medications, deep brain stimulation, neuropsychologic evaluation and treatment, as well as clinical trials exploring innovative medical and surgical interventions for PD.
In addition, there is an alpha-synuclein seed amplification assay that has been developed to detect abnormal proteins in the cerebrospinal fluid. This test can pinpoint patients with Parkinson's disease, sometimes even before other symptoms emerge. Currently, it is exclusively utilized in research studies and is not yet available in clinical settings.
Q: Is there any groundbreaking research used by the clinic to enhance early detection methods?
Recently, the Syn-One skin biopsy has been developed to detect abnormal deposits of alpha-synuclein proteins in the skin, aiding in the differentiation of Parkinson’s disease, Dementia with Lewy Bodies, and Multiple Systems Atrophy from other diseases. This tool becomes particularly valuable when the clinical diagnosis is uncertain, providing patients at UAB with an additional diagnostic option. Our ongoing participation in research studies actively contributes to the development of such tests, advancing our understanding of Parkinson’s disease.
Q: What resources does the clinic offer to support individuals (and their families) in understanding and managing the challenges associated with Parkinson's disease?
Receiving a Parkinson’s disease diagnosis and adapting to the associated challenges can be overwhelming, but no patient needs to face it alone. Regular follow-ups with our nurse practitioners and physicians provide the necessary time to address questions and offer in-person counseling. In the event of unforeseen challenges, our phone line and messaging system are available to promptly address issues or schedule earlier appointments.
Established in 1978, The American Parkinson’s Disease Association (APDA) initiated The Parkinson’s Disease Information & Referral Center at UAB, offering educational, emotional, and political support to patients and their families. This includes a telephone helpline (205-934-9100) and support groups in major cities across Alabama, as well as some cities in Mississippi and the Florida panhandle. Our faculty actively contributes as guest speakers at small group meetings and larger educational events hosted by the APDA and the Parkinson’s Foundation. To further support patients, our health care professionals provide patients with materials and lists of reputable online resources during clinic visits. While follow-up appointments with nurse practitioners and physicians are regularly scheduled, additional phone calls or clinic visits can promptly address emerging challenges.
Learn more about APDA Parkinson’s Disease Information & Referral Center.