Neuromuscular Issues and Parkinson\'s Disease

Anatomy: Parkinson's Disease

Parkinson's disease is a central nervous system disease that is degenerative. It disrupts normal functioning at the cellular level by reducing the activity of cells that secret dopamine (Davie, 109). That happens through the death of cells, as well, in a couple of different regions of the brain. The two regions most affected are both related to movement and learning. They also affect how a person reacts to something, and whether he or she feels like a particular behavior was rewarding. The pathways that connect the basal ganglia of the brain to other areas are all affected in people who have Parkinson's disease (Shulman, De Jager, & Feany, 196). The symptoms are based on the ways in which those pathways are disrupted by the disease process and the death of the cells. As these cells die, they are not able to stop the body's systems from activating at times that are not appropriate. That causes involuntary movements that would otherwise be avoided by brain cells providing proper levels of chemicals (Davie, 115).

When a person makes a decision to do something, such as move a part of the body, the inhibition that is given to that motor system is reduced. That allows the movement or action to take place more easily, and it is dopamine that allows for this release of inhibition (Davie, 117). When the cells that secret dopamine are affected, there is either too much or not enough. That can mean that a person has trouble making movements, or that he or she has movement that is not desired. When dopamine levels are low, such as would be seen with Parkinson's disease, it is more difficult for a person to move properly, resulting in extra effort to create motion (Shulman, De Jager, & Feany, 205). That can result in jerky motions and constant jiggling or shaking, as well as movements that are seemingly involuntary. Unless cells are able to produce enough dopamine, movement will continue to be problematic and will continue to degrade, making it more difficult for the afflicted person to handle daily activities.

There are a number of treatments that can be used in people who have Parkinson's disease. Medications are a common option, and they work to alleviate symptoms by forcing the body to produce more dopamine. The problem with these medications is that they often mean too much dopamine ends up in the brain cells. That results in movements that are unwanted, along with other side effects. Levodopa is the standard medication used, and has been for three decades (Davie, 121). It is important to know what stage of the disease a person is in, though, in order to understand which medication will work best. In the first stage of the disease, there are problems with motor control and the person needs treatment with medication. In the second stage of the disease, adjustments have to be made because of the side effects of the medication provided. Treatment is usually delayed as long as possible, because when a person is on Levodopa, he or she has to be very careful of getting too much dopamine and having trouble adjusting to that (Davie, 122). There is a balance to be found between symptom control and side effects.