Natalie’s Goldstein Book Titled "Parkinson’s Disease"

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Parkinson’s Disease (also known as Shaking Palsy) is a neurological condition that affects the nervous system and people’s ability to function accordingly. Parkinson’s was first discovered by a physician named James Parkinson in 1817 while examining a gardener in his early 50’s. Eager to learn more about an unknown condition Parkinson, interviewed many people in London with Parkinson’s Disease. He spent countless amount of time on research and wrote “An Essay on the Shaking Palsy” a report which detailed the different symptoms of patients (Goldstein et al, 2008).

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Parkinson’s is one of the most prevalent and most rising diseases of the 20th century. It affects mainly people aged 60 or older, but a majority are tested positive for Parkinson’s as early as aged 40. In Natalie’s Goldstein book titled, “Parkinson’s Disease”, researched showed that, “About 1.2 million Americans have Parkinson’s disease and about 50,000 new cases are diagnosed every year (Goldstein et al, 2008). Every year this number is expected to grow because, “life expectancy is 77.2 years, up from 50 years in 1900.” Although rare ‘About 5%’ , develop parkisons in their early to late 30’s.

The substantia nigra plays a very important role in the creation of dopamine. The production of dopamine allows individuals to control movement and maintain balance within the body. According to Natalie’s Golstein’s book “Parkinson’s Disease” there is a connection between the substantia nigra and neurotransmitter acetylcholine that work together in a brain without Parkinsons. The corpus striatum is a part of the brain that acts as a signal for movement and body position in order for the body to be in control. 

Acetylcholine is signaled towards the corpus striatum to process a person’s movement. In a person with parkinson’s the substantia nigra does not function properly. Acetylcholine can get a person to move but since there is not enough dopamine the individual can not keep it in control. As stated by Goldstein, “In the brain of an individual with Parkinson's disease, more and more of the dopamine-producing neurons in the substantia nigra stop functioning and die. As the disease progresses, less and less dopamine is produced and transmitted to other neurons. Yet the same amount of acetylcholine continues to be present. With less of the inhibiting chemical available, body movement becomes increasingly uncontrolled.”

A process in the body that causes parkinsons is called oxidation. Oxidation happens when iron forms with air to create rust. When too much Oxidation happens within a cell it can damage it. Researchers are still questioning whether oxidation can cause the substantia nigra to stop functioning. According to Goldstein Researchers have found that an important enzyme that is required for a cell’s mitochondria to function is insufficient in a person with Parkinson’s disease.

Some environmental factors that can lead to the development of Parkinsons are illegal substances, pesticides, and Brain Injuries. Some of these toxins include mercury, carbon disulfide, and polychlorinated biphenyls. These chemicals that are still used in some water and is even included in soil has been found to create symptoms that mimic that of parkinsons. According to Mosley and Romaine (2017) signs that can be detected at the early stages consist of lightly shaking of one hand, unable to stay at a steady balance, hesitating while walking, a loss in the sense of smell, and changes in writing . Often these symptoms happen in one side of the body.

One of the most prominent symptoms of Parkinson’s are tremors. Tremors are movements that happen unintentionally. According to Silverstein, 75% of people diagnosed with Parkinson's say tremors are the first symptoms that they encounter. Bradykinesia is the slowest of movement that progresses usually after tremors. Bradykinesia leads to postural instability that affects a person’s ability to maintain balance. For example, a person might lean forward and start to exhibit signs of tremors and lose balance. Rigid movements is when muscles become stiff and makes it difficult for a person with parkinson’s to move.

A patient with Parkinson's disease may have other symptoms like depression, an unusual voice tone and a hard time speaking, an abnormal sleep pattern, slow blinking, a desire to urinate frequently, and constipation. Parkinson’s can be difficult to diagnose at its early stage. Physicians often mistaken signs of Parkinson with other conditions such as progressive supranuclear palsy, and Multiple system atrophy. When a patient complains about signs of Parkinsons, a doctor may ask for any medication the individual is taking to see if that is the cause of the symptoms the patient reports. if an outside source was not the issue the individual would be referred to a neurologist. A neurologist would start by asking the person’s medical history such as if the person takes any medication, and if they were involved in any contamination. Then, the neurologist would ask several questions that determine if the person has other conditions like alzimers.

To perform a test on a patient a neurologist would perform a series of activities with the patient. The neurologist would ask the person to walk for a short amount of time, assemble a puzzle to see if the patient has a decent coordination skills, eye reflex movement, sign his or her name, stand on one foot, examine their posture, and inspect any insufficient arm movement. 

Often to determine other possibilities other than parkinsons, neurologist perform brain scans specifically MRI scans and CT scans to evaluate if the patient’s symptoms are relied on other factors. In people with earlier signs of parkinson's these scans would not directly show signs of parkinsons in the brain. Doctors use a PET scan to observe the brain’s chemical level. It would show a better photograph of the person’s dopamine levels.

Within the last few years of ongoing research there have been many effective discoveries for treating parkinsons. Levodopa is a powerful decarboxylase inhibitor medication that is used to help increase the production of dopamine in the brain of those with parkinson's disease. Levodopa helps those with parkinsons because the chemicals inside the drug acts as a similar substance to that of dopamine. It tricks the neurotransmitters into acting as if though it was real dopamine. It therefore, binds itself to the neurotransmitter and continues to work normally. 

Other effective treatment are vitamin C, vitamin A, vitamin D, and vitamin E. Research shows that a large amount of these vitamins would slow down the development of parkinsons. An important nutrient that individuals with parkinson's lack in the mitochondria is coenzyme Q-10. This supplememant is not sold prescribed anymore but can be bought in certain food and over the counter. Deep brain-stimulation is also a possible treatment with those who suffer from parkinsons. The procedure involves controlling the action of neurons in the brain. A high dose of electricity would decrease the activity of brain cells and once it disintegrates the cells would come back to its normal state. Thalamotomy is a specific type of surgery that neurosurgeons use to destroy parts of the thalamus in order to control involuntary movements in those with parkinsons.

Research has shown that Parkinson’s itself is not the main cause of death but the conditions that develop as a result of Parkinson’s. Parkinson’s may lead to heart disease, diabetes, pneumonia, asphyxiation, and accidental injuries. A person might end up with different results according to the specific treatments and medications. Treatments may last years up to even a lifetime (Mosley & Romaine 2017).  

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