2.+Overiew+of+Parkinson's+Disease

**SYMPTOMS OF PARKINSON’S DISEASE** Parkinson’s disease symptoms develop over time, and most people do not develop all the symptoms associated with the condition. Primary symptoms include slow movements, tremor, rigidity and parkinsonian gait (Goldenberg, 2008). The ‘rolling pin tremor’ is the most common and recognizable symptom of Parkinson’s disease; the thumb and fingers move uncontrollably in a manner resembling the rolling of a pill between the fingers.

The early symptoms start usually on one side of the body and may progress gradually or quickly over the years. Some patients may become significantly disabled, while some may be able to function relatively well. Other symptoms are a reduction in facial expression, speaking in a soft voice, depression and handwriting difficulties (Goldenberg, 2008).



**WHAT PARTS OF THE BRAIN ARE INVOLVED?** The substantia nigra is the part of the brain that is affected by Parkinson’s disease when the nerve cells or the neurons die or become impaired. As more and more cells gradually become impaired and die, the amount of dopamine produced is reduced and nerve cell functioning progressively worsens. (Schmidt et al 2001).



[|http://www.michaeljfox.org/living.cfm#]

 //Parkinson's patient (top):// Dopamine neurons die off in the substantia nigra  fMRI scan comparing dopaminergic activity in the brain.

 //lllustration comparing dopamine release in Parkinson's patients and controls.//

STATISTICS Approximately 6.3 million people are affected by Parkinson's disease around the world, and in all cultures (Working Group on Parkinson’s Disease, 2003). In Canada, it is estimated that roughly 100, 000 people are affected by the disease (Health Canada, 1998).

Health Canada released information on the national costs of Parkinson's Disease (1998):
 * Total cost of Parkinson’s disease: $ 558.1 million.
 * Direct costs $87.8 million
 * Hospital care: $39.7 million
 * Drugs: $24.1 million
 * Physician care: $ 23.0 million
 * Research: $1.0 million
 * <span style="font-family: Arial,sans-serif; font-size: 17px;">Indirect cost: $470.3 million
 * <span style="font-family: Arial,sans-serif; font-size: 17px;">Premature mortality: $78.6 million
 * <span style="font-family: Arial,sans-serif; font-size: 17px;">Long-term disablity: $391.7 million
 * Citizens over the age of 65 account for approximately 90% of Parkinson's costs.

**<span style="background-color: #000000; color: #ffffff; font-family: Arial,sans-serif; font-size: 17px;">TREATMENT -- ** Much has been learned about the disease yet much continues to remain a mystery. Parkinson’s disease has no cure, but there are some drugs available to treat the symptoms. The symptoms are progressive and degenerative and tend to be more common in older individuals (NINDS, 1994). Dopamine deficiency in the brain is the root cause of this medical condition (NINDS, 1994). In 1960, the brains of patients with Parkinson’s Disease were studied and the chemical differences were identified between patients and controls. The first forms of pharmaceutical treatment was created based on this discovery (NINDS, 1994). The drug Levodopa was first administered to treat the symptoms of the disease and it has since become the gold standard in medication (NINDS, 1994). Despite the fact that there is still no cure for this disease, the symptoms can be effectively managed to reduce it severity. The Parkinson’s disease Foundation was established in America in 1957 to assist those suffering from the symptoms of this condition and to fund and promote further research.There are many other foundations that are assisting the cause; a notable recent addition is the Michael J Fox Foundation, named after a loved television and movie actor ("History of Parkinson's", n.d).

<span style="display: block; height: 1px; left: 0px; line-height: 16.5pt; margin-bottom: 0cm; overflow-x: hidden; overflow-y: hidden; position: absolute; text-align: center; top: 1043px; width: 1px;">** SYMPTOMS OF PARKINSON’S DISEASE **

<span style="color: black; display: block; height: 1px; left: 0px; line-height: 16.5pt; margin-bottom: 0cm; overflow-x: hidden; overflow-y: hidden; position: absolute; text-align: center; top: 1043px; width: 1px;">Parkinson’s disease symptoms develop over time, and most people do not develop all the symptoms associated with the condition. Primary symptoms include slow movements, tremor, rigidity and parkinsonian gait (Maraganore et al 2005).The ‘rolling pin tremor’ is the most common and recognizable symptom of Parkinson’s disease; the thumb and fingers move uncontrollably in a manner resembling the rolling of a pill between the fingersThe early symptoms start usually on one side of the body and may progress gradually or quickly over the years. Some patients may become significantly disabled, while some may be able to function relatively well. Other symptoms are a reduction in facial expression, speaking in a soft voice, depression and handwriting difficulties.



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