"Shaking Palsy"

handwriting of a parkinson patient

PARKINSON'S DISEASE

Parkinson's disease is a degenerative neurological disease. Basically, it is a disease of the nervous system that gets worse over time. Characteristic signs of a Parkinson's sufferer experience would be the tremor (involuntary trembling of limbs), rigidity (Stiffness of muscles), lack of movement/slowness and also postural instability (difficult to maintain balance and bending of body), as you can see from the life story of the young lady who has suffered from Parkinson disease when she was just 27 or 28 years.

The disease seems to eat up her lifestyle, she experiences involuntary shaking or jerking which is known as tremor, unable to lift things easily, or act or sleep normally. She becomes slow and rigid, unable to coordinate her movements such as walking and balancing. Sooner or later, communication might become a difficulty, as she wouldn't be able to stabilize her hand while writing, and facial expression is affected as the patient face may seem masked and staring, and the tone of voice may become monotonous, and frequent drooling may occur. As the disease progresses, she might require assistance even in the mundane things in life, such as applying make up, buttoning a shirt, rising from a chair, getting in and out of a car, using a keyboard etc..

   
      


As for the psychological impact on the Parkinson patient, it is rather obvious that they would be embarrassed by their state and feel frustrated with themselves. People around them would start to judge them, not being understanding as seen in the life of the young lady in the video earlier. The public may start to isolate these sufferers or view them as people with mental disability. Depression and anxiety are also very common among the Parkinson sufferers, and drug-induced hallucinations and delusions may occur as well. However, the lady in the video learns how to cope with her changed lifestyle and being positive is really the key to living on even with this disease.

So many may wonder what actually happens in Parkinson's disease. Let us fill this thirsting question.

Firstly let us look at the brain. (sideview)

Notice the very small area located deep in the brain called the Substantia nigra. That's the part where the neurons located there starts to degenerate, disrupting the brain's ability to generate body movements, and then you will get those symptoms characteristic of Parkinson's disease!

                                                                            

Here is another picture of the brain and the Substantia nigra. 

As you can observe, the autopsy of the brain of a Parkinson patient shows that the Substantia nigra has lost its usual black pigment. To add on, there are fewer cells in the Substantia nigra in Parkinson disease, in which that the remaining cells often are abnormal, and the presence of Lewy bodies (small substance) can be seen in the cells.









So.. what is so important about this small Substantia nigra we keep repeating?
Here is the juice of it:

It is the part that is important for control and regulation of motor activity (movement)!

Every movement in us is dependent on the complicated series of electrical and chemical events that occurs when a neuron (nerve cell) transmits information to the next neuron in the brain! These connections are vital and the chemicals involved are called neurotransmitters! They are like signals the brain cells use to communicate with one another. Yes, the Substantia nigra produces and use a specific neurotransmitter called DOPAMINE. And in this blog, you would come across this term later on! 

In Parkinson's disease, the cells of Substantia nigra degenerate and die, and there goes the Dopamine and the various dopamine-relayed messages to the other motor centers. When Dopamine concentration declines, the concentrations of other neurotransmitters such as Serotonin and Norepinephrine decline as well as other parts of the brain are affected.  The central nervous system (brain) can no longer control the muscles as well as it should be, the muscles start to act strangely.... giving rise to those symptoms of Parkinson's sufferers.