Parkinson’s, a progressive disease which affects nerve cells in the brain, is a relatively well-known condition. Many people will be familiar with the physical aspects of Parkinson’s to some extent. These include symptoms which can affect motor function, such as tremor, stiffness and slow or restricted movement.
But fewer people might be aware of the ‘non-motor’ symptoms associated with the condition, such as anxiety, depression, problems with memory and sleep disruption; which can have a profound effect on emotional and mental well-being.
While there is no cure for Parkinson’s at present, there are treatments and therapies available that can help to manage and relieve these symptoms.
Research into new and more advanced treatments is being undertaken; and scientists hope that this will yield better medicines in the coming years (and, in time, a cure).
In addition to this, new technology is being harnessed to develop solutions, such as devices and apps, to assist people living with Parkinson’s in their everyday lives, and counter the effects of motor associated symptoms.
Recently, we spoke to Claire Bale, Head of Research Communications and Engagement at Parkinson’s UK, to discuss the above in more detail.
In this, the first of two posts on the subject, with Claire’s help we’ll examine the therapies and support currently available for Parkinson’s, the technologies being developed to help those living with the condition, and the research being undertaken to advance treatment.
How common is Parkinson’s?
Parkinson’s is actually more common than many people may suspect.
‘Every hour, someone is diagnosed with Parkinson’s.’ Claire tells us. ‘It is one of the most common neurological conditions in the UK, affecting an estimated 127,000 people.’
This is roughly equivalent to one in every 500.
‘Although the majority of people start to develop symptoms when they're over 50, younger people can get it too. Studies suggest around 3-5% of people with Parkinson’s experience symptoms before the age of 40.’
What symptoms can Parkinson’s cause?
As we’ve already mentioned, tremor is the single characteristic most people will tend to associate with Parkinson’s disease. However, as Claire illustrates, this is only one possible symptom of several:
‘Parkinson’s is characterised by tremor, slow movement and rigidity, but also includes a host of other non-motor symptoms such as depression, anxiety and pain. These symptoms occur when the brain stops producing a chemical neurotransmitter called dopamine, which normally relays messages to the parts of the brain that control movement, cognition, motivation and reward.’
And this loss of dopamine levels, Claire explains, leads to a reduced capacity to control movements and emotions.
‘The symptoms of Parkinson’s only begin to appear when a large proportion of the brain’s dopamine-producing cells have already been damaged. There is currently no way to restore these cells and – as it is a degenerative condition – they continue to be lost over time. This means the condition continues to progress, as do the symptoms.’
One factor which can make Parkinson’s difficult to identify is that symptoms can differ from one individual to another.
‘Because every person’s brain is different, so is a person’s experience of Parkinson’s.’ Claire tells us. ‘No two people with the condition will have the exact same Parkinson’s ‘journey’, so some people may develop a severe tremor, others may not – which makes the condition particularly difficult to diagnose and treat.’
A PET scan to find signs of Parkinson’s. (Image provided by Parkinson's UK)
What treatments and therapies for Parkinson’s do we have?
In many cases, a combination of various therapies and medicine may be used to help relieve Parkinson’s symptoms, and support quality of life.
‘There are a number of therapies that can help people with Parkinson’s to manage their symptoms, including occupational therapy, physiotherapy, speech and language therapy, dietary therapy and other complementary therapies.’ Claire explains.
At present though, there are no medical options which can halt the progression of the disease.
‘There is no cure or treatment that can stop, slow or reverse the damage caused by Parkinson’s, leaving those affected with limited options.’ Claire tells us.
‘Drug treatment is the principal method used to control the symptoms of Parkinson's and the main drug relied on – levodopa – hasn’t changed in over 50 years. Medication aims to increase the levels of dopamine in the brain and stimulate the parts of the brain where dopamine works.’
Dopamine agonists and monomase oxidase-B inhibitors are other medicines sometimes issued either alongside or instead of levodopa.
‘However, some of the medications used to treat the condition can have severe side effects. Also, as people need to take increasing doses to treat their symptoms as the condition progresses, these side effects can worsen over time.’
Furthermore, because Parkinson’s is progressive, medicinal treatments may gradually begin to lose their efficacy as time goes on.
As Claire explains, surgery may be an option in a small percentage of those whose symptoms cannot be controlled with medication.
‘Deep Brain Stimulation (DBS) involves implanting electrodes in the brain. This treatment can help to control movement symptoms, but the effects of this are temporary and DBS is only suitable for 10% of people with Parkinson’s.’
With such a limited range of treatment options available then, searching for and perfecting new and more effective treatments for Parkinson’s is vitally important.
Physical therapy for people with Parkinson’s. (Image provided by Parkinson's UK.)
What other support is available to those affected by Parkinson’s?
Besides treatment and therapy, other help is available from support groups and charities, such as Parkinson’s UK.
‘Parkinson’s UK offers advice and support through a network of local advisers, self-management groups, Parkinson's nurses and a helpline.’ Claire explains. ‘The charity also has around 350 volunteer-led local groups throughout the UK, offering local support to people with Parkinson's, their carers and families.'
‘Anyone who would like more information about Parkinson’s UK and the support that is offered can find out more on our website.’
What assistive technology is there for people with Parkinson’s?
Assistive technology as a whole (as we’ll touch on in more detail in our sequel to this post) is an area of research which is receiving more attention from developers; particularly so as the population gets older.
Part of the focus on improving quality of life for those living with the physical symptoms of Parkinson’s, is on creating tech that improves mobility and maintains dexterity.
As Claire illustrates, new technology is also being harnessed in care delivery, for use by practitioners:
‘There are many devices, apps and living aids available or in development for those living with Parkinson’s. These range from medical devices designed for use in a clinical setting (such as apps for health professionals to help calculate correct dosage of medication), devices to measure symptoms (such as bracelets or patches that monitor the progression of motor symptoms like tremor) and aids to help make daily tasks easier (such as walking sticks and pill timers).’
Perfecting new technology though is a process which takes time. When new apparatus is developed to, for instance, assist healthcare professionals in monitoring Parkinson’s symptoms, the need for reliable and accurate readings is paramount.
‘There is also currently a lot of interest in using devices, for example wearable technology to assess and measure the progression of symptoms, in clinical trials.’ Claire explains. ‘However, quality control is incredibly important in the development of any new devices and tech for people with Parkinson’s, and it needs to go through rigorous testing before being approved for day to day use.’
A woman takes part in research to assess motor coordination. (Image provided by Parkinson's UK)
What does the future hold for Parkinson’s treatment?
As mentioned earlier, the go-to treatment for Parkinson’s, levodopa, has been the same for several decades. Considerable advancements in understanding Parkinson’s have been made in recent years, but unfortunately these haven’t yet translated into new medicines.
But experts believe the future for Parkinson’s treatment holds great promise; and that, given the right investment, new treatment options could be possible in the near future.
Parkinson’s UK plays a prominent role in funding research, so far putting £80m into the study of new treatments. But, as Claire illustrates, there is still work to be done.
‘What is needed are treatments that do more than mask the symptoms of Parkinson’s. Over the last decade there have been great advances in our understanding of what’s happening inside the cells affected Parkinson’s, which has opened the door for treatments that may slow or stop the progression of the condition. The challenge now is to take the best new scientific findings forward through drug discovery, and give new treatments the best chance of succeeding in clinical trials by improving the way they are tested.’
‘To help achieve this, Parkinson’s UK launched its first ever public fundraising campaign – We Won’t Wait – earlier this year to help direct money towards developing research for the condition and to deliver better treatments in years, not decades.’
As part of this initiative, scientists are now considering new strategies, including looking into existing medicines licensed in the care of other conditions, to see whether they could be useful in tackling Parkinson’s. But the pursuit and investigation of new treatments remains a key focus.
‘At the moment, researchers are most interested in treatments that correct problems with dopamine-producing cells, target inflammation and prevent the spread of the condition from one cell to another.’ Claire tells us. ‘There is also ongoing research into harnessing naturally-produced protective substances, such as GDNF, that could be used to create successful therapies.’
You can read more on research over on the Parkinson’s UK site, as well as a wealth of informative videos about the condition, and details on how and where to find support.
Next week, we’ll be discussing the subject of assistive technologies for Parkinson’s further, with Benjamin Gottemoller, developer of Steady Mouse.