Causes of Parkinson's disease

Written by: Dr Anke Hensiek
Edited by: Laura Burgess

Parkinson’s is a degenerative neurological disease, which affects a part of the brain that is responsible for coordination. People living with the condition usually have movement problems. Here, one of our leading neurologists Dr Anke Hensiek explains everything that you need to know about Parkinson’s, from symptoms and risk factors, to the support that is available if you or your loved one have been diagnosed with the condition.

How does Parkinson's disease affect the brain and the body?

The typical symptoms of Parkinson’s disease may include:

  • Tremor - this is most prominent at rest and improves when people move and do things. It often just affects one side.
  • Stiffness – which commonly is associated with the slowness of movement.
  • Stooped posture
  • Slow shuffling when walking
  • General feeling of tiredness

Other symptoms that can occur include sleep disturbances and in some cases, patients may lose their sense of smell. At least a third of people with Parkinson’s have memory disturbances. Some may suffer from constipation or dizziness when they get up.

Is Parkinson's disease hereditary?

Parkinson’s is caused by a combination of multiple genetic and environmental factors, many of which are yet unidentified. In most cases, those with Parkinson’s disease do not have an affected family member but the risk for a family member of someone who does have Parkinson’s is slightly increased. The chances of developing Parkinson’s by the age of 85 is around 4%, but if you have a relative with the disease, this increases to 8%.

There is a small proportion of around 10% of people with Parkinson’s who have a purely genetic cause of the disorder, which is the result of a single faulty gene. These individuals may have a strong family history of the condition or slightly unusual symptoms, which would then prompt the neurologists to organise genetic tests.

What are the risk factors for developing Parkinson’s?

Many environmental factors are not identified but there are others that we do know about. The most important risk factor for Parkinson’s is ageing as the likelihood of developing Parkinson’s disease increases with age. Furthermore, men are more likely to develop the disease than women.

Other known risk factors include living in a rural area and exposure to pesticides and solvents. It has been shown that there is an infection that causes Parkinson’s, which is extremely rare. Parkinson’s has also been linked to repeated head injuries, such as in the case of the boxer Muhammad Ali who developed the disease.

There are some factors that are protectors from Parkinson’s. Research shows that people who smoke, take anti-inflammatory medications or who drink a lot of coffee are at a lower risk. However, there are many dangerous diseases linked to smoking and one clearly should not smoke in order to prevent Parkinson’s disease.

Are there any other medical conditions that are linked to Parkinson’s disease?

People with Parkinson’s have a slightly increased risk of diabetes and melanoma. There is also a condition called Gaucher disease, which is very rare but linked to Parkinson’s.

There are many disorders that look very similar to Parkinson’s because they cause very similar symptoms, although they often don’t respond well to treatment for Parkinson’s disease. These conditions include vascular disease of the brain and other neurodegenerative diseases such as multiple system atrophy, progressive supranuclear palsy, Lewy body dementia or rare metabolic and genetic conditions.

There is a rate of misdiagnosis of Parkinson’s disease. Sometimes it is only possible to confirm that someone definitely had the disease after they have died and when a pathologist makes an examination of their brain.

How is Parkinson’s managed?

Parkinson’s is caused by degeneration in a part of the brain where the nerve cells that degenerate produce a substance dopamine. Many of the symptoms of Parkinson’s disease are the result of the subsequent lack of dopamine in the brain. Medications that replace dopamine are usually very effective in treating the symptoms of Parkinson’s disease and drug treatment is therefore usually the mainstay for managing the disease.

It has been increasingly shown that exercise is a very useful treatment for people with Parkinson’s. Physiotherapy and balance exercises can really improve the symptoms. It is also important to stay as fit as possible by training your memory. You should make sure that you tell your neurologist about all of your symptoms, as many can be treated with medication or other interventions, such as mood and sleep changes. Please be alert of these symptoms and be sure to report them.

Are there any support groups available?

It is important to have regular follow-ups with your neurologist and to work with a multidisciplinary team, which includes a speech and language therapist, occupational therapist and a physiotherapist.

We often refer patients to the charity Parkinson’s UK which is community-based. Many patients find it helpful to meet other patients and families with the condition and the charity also provides practical support and educational meetings.

Dr Hensiek specialises in the treatment of headaches, multiple sclerosis, epilepsy, Parkinson’s and memory disorder. You can book an appointment to see her via her Top Doctor’s profile here.

By Dr Anke Hensiek

Dr Anke Hensiek is an accomplished consultant neurologist at Cambridge University Hospitals with extensive experience in the management of common and rare neurological disorders.

With over 20 years expertise, she is highly skilled and knowledgeable in a wide range of conditions, including headache, peripheral neuropathy, epilepsy, Parkinson Disease, dizziness, muscle disorders, memory disorders and motor neuron disease. She also has great experience in the management of multiple sclerosis and was awarded a PhD for her work in the genetics of multiple sclerosis from the University of Cambridge. With a subspecialist interest inneurogenetics she conducts several clinics for hereditary neurological disorders, including ataxia, movement disorders and spastic paraparesis. Furthermore, Dr Hensiek is the neurology lead for the national clinics for neurofibromatosis and ataxia-telangiectasia based at Addenbrookes Hospital.

Having graduated from the University of Dusseldorf, Germany, she underwent her neurology training at renowned institutions such as Addenbrooke's Hospital in Cambridge, the Norfolk and Norwich University Hospital and at the National Hospital for Neurology in London.

As well as providing care of the highest quality to her patients, she is an educational supervisor for the neurology trainees in Cambridge and regularly teaches medical students. She has a strong academic background with continuing clinical research involvement, including the conduction of clinical treatment trials for neurological disorders and supervision of PhD students. Being a member of the Ataxia Telangiectasia Society scientific advisory board, she regularly reviews articles for medical and scientific journals. Dr Hensiek has co-authored several book chapters and published more than 30 articles on a variety of neurological topics. She has medicolegal experience since 2009 including personal injury, medical negligence and reports for the GMC.

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