Parkinson's and the Basal Ganglia

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Parkinson's is the result of 80% loss of dopamine in the Basal Ganglia. The Basal Ganglia is hidden deep within the cerebral hemispheres of the brain. It is the responsibility of the basal ganglia to help coordinate movement in the body. 

 

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Diagnosing Parkinson's Disease

 

Clinically the diagnosis of PD is difficult as there is not a single test which can be used to let a person know they have PD. There are other diseases that share some features of PD such as cerebrovascular disease which makes diagnosis of PD harder. Diagnosis of PD will depend on the history of symptoms, and presentation

 

The diagnosis will be made by a neurologist who is specialised in diagnosing PD

which is usually a 3 step process as proposed by Parkinson Society Brain Bank Clinical Diagnosis Criteria

 

1. This includes slowness of movement (Bradykinesia) with either at least muscle rigidity, resting tremor (4-6Hz), and postural instability not caused by primary visual, vestibular, proprioceptive or cerebellar dysfunction

2. Step two excludes other possible diseases that share similar presentations to Parkinson’s

3. Step 3 requires supportive information

4. Symptoms of Parkinson's

 

 

Motor Symptoms

 

Rigidity- Stiffness of muscles can be experienced as muscular pain. Led pipe rigidity throughout movement and Cogwheel rigidity which has a Rachel like cogwheel effect.

 

Posture- Develops later with the disease. People with Parkinson's develop a stooped posture which can cause curvatures in the spine over time. Parkinson's also reduces spinal mobility required for turning the trunk. Postural changes in Parkinson's increases a person’s risk of falling.

 

Bradykinesia- is the slowness of movement and without Bradykinesia a diagnosis of Parkinson's cannot be made. Bradykinesia leads to slow mobility and slowness when performing activities such as personal care and dressing.

 

Non-motor symptoms

 

• Monotonous voice

• Sleeps disorders- lack of ability to turn at night

• Falls

• Drooling

• Muscle pain 

• Dystonia abnormal pattern of muscle contraction

• Bladder hyperreflexia

• Postural hypotension

• Sexual dysfunction

• Masked face

• Poor facial expressions

 

 

Risk Factors

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• Increases with age and of the population over 65 have Parkinson's

• Most of Parkinson’s have an unknown cause (idiopathic)

• May be linked to harmful substances in the environment