Parkinson’s Disease

What is Parkinson’s disease?

Parkinson’s disease is a progressive neurological disorder characterised by brain and nervous system deterioration. It is Singapore's second most common neurodegenerative disorder, second to Alzheimer’s disease. It primarily impacts your ability to control movement, often resulting in tremors, slow movement, or stiffness. 

The brain is responsible for many functions, including movement. Movement is controlled by nerve cells in a section of the brain known as the substantia nigra. These nerve cells produce dopamine, responsible for several things, such as memory, motivation, mood, and movement. When nerve cells get damaged or destroyed, dopamine production reduces, resulting in Parkinson’s disease. 

parkinson’s disease
Deterioration of the substanti nigra results in a reduction of dopamine being released, causing Parkinson’s disease.

There are five stages of Parkinson’s disease:

  • Stage 1: the initial stage of Parkinson’s disease usually involves mild symptoms affecting one side of the body.
  • Stage 2: symptoms become more pronounced, affect both sides of the body, and begin to affect quality of life.
  • Stage 3: usually considered mid-stage Parkinson’s disease, there is a more pronounced loss of balance, and falls are more common. Disability is considered mild to moderate as the individual can still live alone but has a reduced quality of life.
  • Stage 4: symptoms are fully developed and pronounced, thus making independent living impossible and unsafe. 
  • Stage 5: advanced stage of Parkinson’s disease and is also the most debilitating. The individual is usually bed-bound and requires 24-hour care.

What causes Parkinson’s disease?

Although it is clear that reduced dopamine production due to a depreciated or deteriorated substantia nigra and nerve cells causes Parkinson’s disease, the exact cause is still not fully understood. However, several factors known to be linked to Parkinson’s disease include: 

  • Genetics: specific genetic mutations or variations are linked to Parkinson’s disease.
  • Environmental factors: although some gene variations have been linked to Parkinson’s disease, some individuals with these gene variations do not go on to develop the condition. This has led scientists to believe that environmental factors such as exposure to toxins may contribute to Parkinson’s disease.
  • Lewy bodies: researchers have also recently discovered that individuals with Parkinson’s disease have elevated levels of Lewy bodies (protein deposits) 
lewy’s body
Lewy bodies are higher in individuals with Parkinson’s disease.

What are the symptoms of Parkinson’s disease?

The symptoms of Parkinson’s disease can be broken down into two categories: motor and non-motor symptoms.

Motor symptoms include:

  • Tremors in the head, legs, arms, and jaw
  • Bradykinesia (slowness of movement)
  • Muscle rigidity where muscles can stay contracted for extended periods
  • Postural instability, often leading to falls

Non-motor symptoms include:

  • Cognitive changes which may result in difficulty thinking
  • Mood disorders, such as depression 
  • Sleep disturbances, insomnia
  • Autonomic dysfunction, such as constipation, urinary incontinence, sexual dysfunction

If you recognise any of the symptoms mentioned above, make an appointment with Chou Neuroscience Clinic today.

hand tremor
Parkinson’s disease is commonly characterised by tremors in the hands, legs, head and jaw.

Is Parkinson’s disease painful?

Parkinson’s disease itself is not typically characterised by pain. However, some associated symptoms and complications can cause discomfort or pain. For example, muscle stiffness and rigidity can lead to aching or soreness in your muscles. In some cases, individuals with Parkinson’s disease may experience pain related to falls or injuries due to balance issues.

While pain is not a primary feature of Parkinson’s disease, discussing any discomfort or pain you experience with your neurologist is important, as they can help address and manage these issues effectively.

Who is at risk of Parkinson’s disease in Singapore?

While Parkinson’s can affect people of all backgrounds in Singapore, some factors may influence the risk:

It is important to note that while these factors can influence risk, Parkinson’s disease can still affect you even without these risks.

How is Parkinson’s disease diagnosed?

Diagnosing Parkinson’s disease includes:

  • Clinical assessment: your neurologist will begin by discussing your medical history and symptoms. You will be required to describe the nature, onset, and progression of your symptoms.
  • Physical examination: a thorough neurological examination will assess your muscle strength, coordination, reflexes and movement.
  • Response to medication: one significant diagnostic criterion is your response to medicines used to treat Parkinson’s disease, particularly levodopa. If your symptoms improve with these medications, it is suggestive of Parkinson’s disease.
  • Imaging tests: while not always necessary, brain imaging scans such as magnetic resonance imaging (MRI) or computed tomography scans (CT scans) may be used to rule out other conditions.
  • DaTscan: single-photon emission tomography (SPECT) utilises a medication known as DaTscan to check for the loss of dopamine-producing cells.
  • Blood tests: these may be ordered to rule out other medical conditions with similar symptoms.

What are the treatment options for Parkinson’s disease in Singapore?

SPECT scans can be used to detect Parkinson’s disease.

Currently, there is no cure for Parkinson’s disease. In Singapore, Parkinson’s disease is managed through a range of treatment options to alleviate symptoms and enhance the quality of life for individuals affected by the condition.

  • Medication: usually prescribed for individuals with early-stage Parkinson’s disease. These medications typically work to increase or supplement dopamine levels or prevent dopamine from being naturally broken down by the body.
  • Surgery: procedures such as deep brain stimulation (DBS) can help alleviate Parkinson’s disease symptoms. 

Treatment plans are tailored to your individual needs and symptoms, and regular follow-up with a neurologist experienced in managing Parkinson’s disease is essential for optimising care and adjusting treatments as necessary.

Frequently asked questions  

Is there a cure for Parkinson’s disease?

Currently, there is no cure for Parkinson’s disease. Treatment for Parkinson’s disease is aimed at alleviating symptoms and improving quality of life.

Can Parkinson’s disease be prevented?

There is no known way to prevent Parkinson’s disease. While certain lifestyle factors may influence the risk, the exact cause of the disease remains unclear, making prevention strategies elusive. However, maintaining a healthy lifestyle can contribute to overall well-being.

What should I do if I suspect I have Parkinson’s disease?

If you suspect you have Parkinson’s disease due to experiencing its common symptoms, such as tremors or muscle stiffness, it is crucial to seek medical evaluation promptly. Consult a neurologist experienced in diagnosing and managing the condition for proper assessment and guidance.

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Copyright © 2023 Chou Neuroscience Clinic. All Rights Reserved
Copyright © 2023 Chou Neuroscience Clinic. All Rights Reserved