Effective Treatment of Parkinsons Disease - Essay Example

Effective Treatments of Parkinson’s Disease Name Institutional Affiliation Parkinson’s is one of the diseases that currently have no cure. Nevertheless, there has been considerable progress that has been made in the last 50 years in Parkinson’s disease (PD) treatment. Advancements in experimental therapeutics have resulted in the emergence of many promising and encouraging therapies for treating PD. However, Levodopa still remains the main therapy used in controlling PD symptoms (Jankovic, 2008). However, its side effects have led to the use of deep brain stimulation as an alternative method for treating PD in patients suffering from drug-related complications. This essay discusses levodopa and deep brain stimulation as effective methods in treatment of PD. Other methods are also briefly discussed including methods used to treat advanced PD. PD is a disease that normally targets the brain and is progressively degenerative neurologic. Degenerative, in this case, means to decline in quality. Therefore, the severity of PD increases over time (Weiner, Shulman, & Lang, 2013). Neurologic refers to the nervous system. It is, therefore, true to assert that PD is a nervous system disease that worsens over time. PD can also be described as a chronic and progressively neurologic disease (Weiner, Shulman, &Lang, 2013). Chronic can be interpreted to mean long duration and progressive means that the disease is ‘proceeding in steps’. The neurons of the people who have PD are injured in a slow and progressive manner. They then degenerate or die selectively. This process in turn causes the typical symptoms of PD. Many of these symptoms are caused by loss of a certain group of nerves in a person’s brain that lead to a lack of dopamine (Caslake et al., 2009). Despite several years of research, the exact cause of PD has not been known yet. It is still not understandable what kills dopaminergic neurons. In treating PD, doctors use characteristic symptoms of the disease. Trembling involuntarily is a feature that may occur in people that have PD (Weiner et al., 2013). Muscles become rigid and stiff and making of spontaneous and rapid movements are subsequently lost. The body of a person having PD is bent or flexed as one is walking and difficulty in maintaining balance may be experienced. Other early signs of PD are reduced facial expression, soft voice and smaller handwriting (Parashos & Wichman, 2013). It is important to note that not all people who have PD exhibit all these symptoms. In order for one to be diagnosed with PD, there are cardinal symptoms that must be present and are different from the above. PD is a neurodegenerative disorder that impairs motor functioning (King & Mody, 2010). In diagnosing PD, a person needs to exhibit at least two of the four symptoms that characterised the disease. Tremor, rigidity, bradykinesia and postural instability are symptoms strongly associated with PD (Brichta, Greengard, & Flajolet, 2013; Jankovic, 2008; Parshos & Wichmann, 2013). It is a disease that is difficult to diagnose and it has been proposed by some specialists that PD cannot be diagnosed if bradykinesia is not one of the two symptoms. It is a disease that is so much individualised. For instance, a certain person may experience tremor at an early stage of PD while another one experience it at a later stage of PD or not experience it all. Moreover, in other people, tremor may be replaced by other symptoms as the disease progresses. It is true in patients having PD that the disease progress over time and early diagnosis may be crucial in treating these symptoms. There are various treatment methods that have been identified in treating PD. In order to treat the disease and institute medical therapy, correct diagnosis needs to be established (Jankovic & Aguilar, 2008). Furthermore, the level of impairment of mental, autonomic, sensory and motor must be determined. In treating PD, individualisation of each patient’s therapy is carried out and various drugs apart from levodopa are currently available. It includes nondopaminergic agents, catechol-o-methyl-transferase (COMT) inhibitors and dopamine agonists (DA) (Jankovic & Aguilar, 2008). Levodopa is a prescription medication that has been widely used in treating PD. Nevertheless, it is accompanied by side-effects that include hallucinations and dyskinesia- involuntary movements (King & Mody, 2010). Deep-brain stimulation has been recently proposed as an alternative method of treating PD in patients that suffer drug-related complications. Levodopa and deep-brain stimulation are among the methods used in effectively treating PD. Levodopa is a drug that has been widely used to control PD symptoms although it is often associated with complications of the motor system. It is an amino acid that naturally occurs and it acts as an intermediary in the way of dopamine synthesis (LeWitt, 2008). Levodopa is actively circulated from the upper small intestines after it is orally ingested by a patient. A small fraction of Levodopa reaches the brain after crossing the blood-brain barrier because of the continued metabolism process in the body. Moreover, this is also because the drug is distributed throughout the body. Once in the brain, levodopa rapidly forms dopamine through aromatic L-amino acid decarboxylase (AAAD) (LeWitt, 2008). The effectiveness of levodopa can be improved by co-administering levodopa with other drugs. The combination of AAAD inhibitor with levodopa is carried out in order to inhibit the conversion of levodopa to dopamine in places that are outside the patient’s central nervous system (LeWitt, 2008). It also limits the systemic side effects of the drug. Several years of thorough research and investigations led levodopa to be recognised as an effective drug for treating PD. It was subsequently accepted and preferred method for treating PD. It is an effective drug in relieving the PD motor signs and symptoms. Levodopa can also be utilised in confirming the diagnosis of PD (LeWitt, 2008). A patient is capable of recovering from the earlier speech, gait and dexterity impairments after an oral dose of levodopa is administered. This occurs in about 15 to 30 minutes. However, levodopa does not always assist all the characteristics of PD. For example, tremor in some cases does not improve after the drug is given to a PD patient while retropulsive imbalance does not occur at all. Additionally, the patterns associated with levodopa response can change after 2 years since the treatment was initiated (LeWitt, 2008). In this case, PD experts recommend that levodopa should be combined with dopaminergic agonist because it lowers the risk of this kind of problem. Most PD patients have been effectively treated with levodopa at least during the infant stages of the disease. However, dopaminergic drugs have frequently not capable of controlling the PD symptoms in a reliable manner. Limitations associated with dopaminergic therapy have led to the emergence of surgical methods for treating PD. One of these methods is deep-brain stimulation. Deep Brain Stimulation (DBS) is a current therapeutic technique that has been widely accepted for treatment of various PD disorders. PD disturbs the motor function and is also capable of producing non-motor deficits such as limbic and cognitive (Dostrovsky, Hutchison, & Lozano, 2002). DBS is being utilised to treat these kinds of disorders, and essentially, in treating tremor and dystonia. It is a surgical treatment that is used in treating patients with advanced PD and those having symptoms that cannot be very well managed with medications (Matias, Gostkowski, & Machado, 2015). Before DBS procedure can be carried out, magnetic resonance imaging (MRI) is used by a neurosurgeon in identifying and locating the exact target in the patient’s brain that needs surgical intervention. The DBS result in neural elements excitation that surrounds the electrode tip hence leading to increasing output from the structure that is stimulated (Dostroksky et al., 2002). A surgical procedure such as DBS is an effective method in treating PD. For many years, lesions had been made in the motor thalamus in the treatment of tremors. A successful and positive experience that was realised in treatment of tremor by using thalamic high-frequency stimulation, DBS has been applied in alleviation of motor disturbances in patients that have PD (Dostroksky et al., 2002). In alleviating pain, the DBS in either ventro-posteromedial or tactile thalamic relay nucleus is used ((Dostroksky et al., 2002). Moreover, electrical stimulation is used in treating pain by stimulating the central or peripheral sensory nerves. The electrical impulses that are sent into the brain of PD patients block the abnormal electrical signals hence alleviating the motor symptoms. Apart from the widely used levodopa and DBS methods, there are also other treatment options for PD patients. Zhang et al., (2014) systematically reviewed and analysed various random trials that evaluate traditional Chinese medicine (TCM) as an adjunct therapy for PD. They found out that there is enough evidence indicating potential TCM superiority as an alternate therapeutic for treating PD. Olcucu, Ozen, and Kurui (2014) reviewed various studies on how exercises can be used in treating PD. They found out that exercise improves mobility, strength, balance, gait and rates of falling among patients having PD. Moreover, positive results are provided by exercise among patients that are in depression and fatigue (Olcucu et al., 2014). Kim et al., (2015) concluded in their study that adding rotigotine transdermal system to low-dose dopamine receptor agonist in patients that have advanced PD represented a promising approach in treating the disease. Advanced PD can be difficult to treat, but there are new pharmacological options that can be used in treating it. It is a serious disease that mostly affects old people. In fact, PD affects one per cent of people that are over 60 years (Devos et al., 2013). Although there is no specific method for treating the disabling disorders of PD that has reached an advanced stage, there are some new symptomatic treatment options. One of them is by inhibiting dopamine transporter (DaT) and norepinephrine transporter (NeT) by potentiating transmission of noradrenergic and dopaminergic transmission (Devos et al., 2013). Others include modulating glutamatergic system and potentiating cholinergic system by inhibiting acetylcholinesterase. These methods have all be tested and tried in treating advanced PD patients that are undergoing subthalamic nucleus stimulation (STN) although large clinical trials are needed to ascertain their efficacy. Nevertheless, STN deep brain stimulation has been a useful method in effectively treating severe PD (Romito, & Albanese, 2010). PD is a neurodegenerative disorder that is progressive in nature and it manifests itself through the various motor and non-motor characteristics. Despite various advances that have been made in treating PD and notwithstanding its limitations, levodopa still remains the preferred method for treating PD. 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