Parkinson's Disease

What is Parkinson's Disease?

Parkinson’s disease is a progressive disorder — meaning gets worse over time — that affects the nervous system and the parts of the body controlled by nerves. The disease develops gradually, sometimes with just a tremor in one hand, but as it progresses symptoms worsen.

Parkinson’s is caused when by the loss of nerve cells that make dopamine in the brain. Dopamine helps people regulate movements and emotional responses. Parkinson’s disease causes a range of motor symptoms that affect how you move. It can also lead to difficulty sleeping or mood changes.

At AHN’s Cahouet Center for Comprehensive Parkinson’s Care, an expert team of neurologists, neurosurgeons, therapists and support staff are dedicated to treating every symptom of the disease. Patients at the Center will have access to the latest treatments, therapies, and educational and community resources.

AHN Cahouet Center for Comprehensive Parkinson's Care

The AHN Cahouet Center for Comprehensive Parkinson’s Care is dedicated to treating and supporting patients with the disease. Using the latest, advanced Parkinson’s treatments, our experienced specialists provide care that is personalized to the unique needs of those with Parkinson’s. With a deep understanding of the challenges Parkinson’s patients face, our compassionate and expert staff provide comprehensive care designed to treat symptoms and improve quality of life.

AHN Movement Disorders Program

Parkinson’s disease is a movement disorder that causes involuntary shaking, motor issues, and other issues that can significantly impact everyday life. The AHN Movement Disorders Program, specializes in helping our patients find relief and coordinates care and treatment plans to help you lead more full and active lives. 

Why choose AHN for your Parkinson’s Disease

Our personalized, comprehensive care approach is designed for the unique needs of people with Parkinson’s disease. Patients will face a variety of challenges today and in the future. We’re prepared to treat their symptoms and improve their quality of life every step of the way.

At the AHN Cahouet Center for Comprehensive Parkinson’s Care, our specialists are experienced in some of the most effective and innovative Parkinson’s treatments, including deep brain stimulation, offering the potential for symptom relief. Treatments like deep brain stimulation can reduce tremors and improve motor skills. Patients, like a former sports reporter named Joe, have found decreased symptoms using the treatment.

Read more about Joe’s story.

Find us

Quick guide to Parkinson's Disease

Parkinson's Disease symptoms and signs

Parkinson's Disease screening and diagnosis

Types and stages of Parkinson's Disease

Parkinson's Disease treatment

Parkinson's Disease FAQs

Contact us

Parkinson's Disease symptoms and signs

People experience Parkinson’s symptoms differently. As nerve cell damage worsens, people may notice an increased severity of existing symptoms or new symptoms may occur.

People with Parkinson’s often experience symptoms that affect both motor skills and non-motor skills. These Parkinson’s symptoms include:

• Motor symptoms:
  • Slowness of movement
  • Problems moving, such as from stiffness in your arms or legs
  • Slight shaking of the hands or fingers, called a tremor, that happens when you’re sitting or resting
  • Loss of balance
• Non-motor symptoms:
  • Constipation or other bowel changes
  • Sleep problems, such as insomnia
  • Mood changes, such as depression or a general disinterest in things you used to love
  • Loss of smell

Causes and risk factors

Parkinson's disease is a complex neurodegenerative disorder, and its exact causes are not fully understood. However, a combination of genetic and environmental factors are believed to play a role. Genetic mutations are believed to be a contributing cause of Parkinson’s. In addition to the genetic mutations, there are risk factors that can increase a person’s chance of diagnosis.

• Exposure to toxins: Exposure to certain environmental toxins, such as pesticides (e.g., rotenone, paraquat) and heavy metals, has been associated with an increased risk of Parkinson's. These substances can damage dopamine-producing neurons.
• Head trauma: Some research suggests a link between repeated head injuries and an increased risk of Parkinson's.
• Rural living/well water: Some studies have indicated a higher incidence of Parkinson's in individuals living in rural areas or those who consumed well water, potentially due to exposure to agricultural chemicals.
• Age: Age is the most significant risk factor for Parkinson's disease. The risk increases substantially after the age of 60.
• Sex: Those assigned male at birth are slightly more likely to develop Parkinson's disease than women. The reasons for this difference are not entirely clear but may involve hormonal or genetic factors.

Parkinson's Disease screening and diagnosis

Currently, there are no definitive screening tests for Parkinson's disease that can be widely used in the general population before symptoms appear. Unlike some other conditions — mammograms for breast cancer, colonoscopies for colorectal cancer — there isn't a simple blood test, imaging scan, or other routine procedure that can reliably detect Parkinson's in asymptomatic individuals.

A diagnosis of Parkinson's disease is primarily a clinical diagnosis, meaning it's based on a careful evaluation of a person's medical history and neurological examination.

Medical history and symptom review

The doctor will ask about the onset and progression of symptoms. They will ask you about your family history of Parkinson's and exposure to certain medications or toxins will also be discussed.

Neurological examination

Following your medical history and symptom review, your doctor will perform a thorough physical and neurological exam to assess:

• Muscle strength and tone
• Reflexes
• Coordination and balance
• Gait (walking pattern)
• Facial expressions
• Speech
• Presence and characteristics of tremor

Many other conditions can mimic Parkinson's disease (e.g., essential tremor, drug-induced parkinsonism, other atypical parkinsonian syndromes, strokes, normal pressure hydrocephalus). The doctor will consider these possibilities and may order tests to exclude them.

Response to levodopa

Often, a key part of the diagnostic process is observing how symptoms respond to medication, particularly levodopa (a precursor to dopamine). A significant improvement in motor symptoms after taking levodopa strongly supports a diagnosis of Parkinson's disease.

Imaging

An MRI scan of the brain is primarily used to rule out other conditions that might cause similar symptoms, such as tumors, strokes, or hydrocephalus. It typically looks normal in early Parkinson's disease.

Types and stages of Parkinson's Disease

Parkinson's disease presents in various forms, ranging from the most common Idiopathic Parkinson's Disease to Atypical and Secondary Parkinsonism, each with distinct characteristics. Regardless of the form, it is typically understood to progress through five stages, indicating the severity and impact of symptoms over time.

Types of Parkinson's Disease

The different types of Parkinson's Disease are often grouped under the umbrella term parkinsonism. These are distinct types but share some similar symptoms.

• Idiopathic Parkinson's Disease (PD): This is the most common form, accounting for about 80–85% of cases*. It is characterized by the gradual loss of dopamine-producing neurons.
• Atypical Parkinsonism (Parkinson-plus Syndromes): These are conditions that resemble Parkinson's disease but have additional types, a different prognosis, and often don't respond as well to standard Parkinson's medications like levodopa. Examples include:
  • Progressive Supranuclear Palsy (PSP): Characterized by early falls, problems with eye movement (especially looking down), and difficulties with balance.
  • Multiple System Atrophy (MSA): Involves dysfunction in multiple body systems, leading to severe problems with blood pressure regulation, bladder control, and coordination (ataxia), in addition to parkinsonian symptoms.
  • Corticobasal Syndrome (CBS): Often presents with asymmetric symptoms, severe stiffness, alien limb phenomenon (feeling a limb act independently), and cognitive issues.
  • Lewy Body Dementia (LBD): Characterized by fluctuating cognition, recurrent visual hallucinations, and parkinsonian motor symptoms, often appearing close together.
• Secondary Parkinsonism: Parkinson-like symptoms that are caused by another identifiable factor. Examples include:
  • Drug-induced Parkinsonism: Caused by certain medications, especially antipsychotics, anti-nausea drugs, and some calcium channel blockers, that block dopamine receptors. Symptoms usually improve or resolve if the offending drug is stopped.
  • Vascular Parkinsonism: Caused by small strokes or blood vessel damage in the brain, often affecting the lower body more and presenting with a shuffling, hesitant gait.
  • Post-encephalitic Parkinsonism: A rare form that can occur after a severe brain infection.
  • Toxin-induced Parkinsonism: From exposure to certain neurotoxins (for example, MPTP, carbon monoxide).

Stages of Parkinson's Disease

Parkinson's stages are often described using the Hoehn and Yahr Scale staging system. Staging primarily focuses on motor symptoms and their impact on daily function.

• Stage 1: The tremor, rigidity, or slowness of movement affects one side of the body, and symptoms are mild and generally do not interfere with daily activities.
• Stage 2: Symptoms worsen and affect both sides of the body. Daily tasks become more difficult and take longer. Posture and gait problems may be more noticeable. Most people can still to live independently.
• Stage 3:  Loss of balance is a significant symptom, leading to impaired reflexes and an increased risk of falls. Movement is considerably slower. At this stage people can begin to experience limitations in daily activities.
• Stage 4: Symptoms become severe and disabling. Individuals are able to stand and walk unassisted to a limited extent, but often require assistance leaving many to be unable to live alone.
• Stage 5: The most advanced and debilitating stage. Individuals are typically confined to a bed or wheelchair unless assisted and require full-time nursing care.

Parkinson's Disease treatment

Our neurologists have extensive training in the diagnosis and treatment of movement disorders such as Parkinson’s disease. Treatments today largely focus on improving symptoms, however, researchers continue to explore what exactly causes Parkinson’s disease so they can find a cure.  We also participate in clinical trials that study new ways to treat this condition.

After a thorough evaluation of your symptoms, our care team provides a treatment plan that addresses your unique, individual needs. You may find that a combination of therapies helps ease your symptoms. Because the condition is progressive, we meet with you regularly to address any symptoms that worsen or change over time.

At AHN, our specialists have a deep knowledge of the most effective Parkinson’s treatments available today:

• Medication: Your physician will help determine which medications would benefit you most, based on your symptoms and specific challenges. The medications you take (or the dosage) may change as the condition progresses.
• Physical therapy: Certain exercises or activities, such as boxing, may improve Parkinson’s symptoms.
• Speech or occupational therapy: Our specially trained speech and occupational therapists can help you relearn how to complete daily activities that have become difficult due to symptoms.
• Surgery: Certain patients experience significant symptom relief from neurosurgical procedures, such as deep brain stimulation (DBS). Our specialists have performed hundreds of these innovative procedures, which involve surgically implanting electrodes into the brain to regulate impulses. 

Parkinson's Disease FAQs

AHN is here to help in providing clear, reassuring, and informative answers to common questions is crucial for people navigating a Parkinson's diagnosis. Your AHN care team is available to talk with you about any of your questions or concerns, and will help you feel more confident in your overall treatment plan.

What is the best thing to do for Parkinson's Disease?

The best thing to do for Parkinson's Disease is unique to each person. It begins with seeking care from compassionate, expert health care providers like those at AHN’s Cahouet Center for Comprehensive Parkinson’s Care to get an early and accurate diagnosis. This can be  followed by a comprehensive, individualized treatment plan managed by a specialized care team. While there's no single magic cure, proactive management offers the best quality of life. This includes:

• Adhering to treatment plans: This often involves medication, primarily to manage Parkinson's symptoms like tremor, stiffness, and slowness. Your care team will tailor these Parkinson's treatments to your specific needs and adjust them as you progress through different Parkinson's stages.
• Maintaining an active lifestyle: Regular exercise (aerobic, strength training, balance exercises) is incredibly beneficial for motor skills, mood, and overall well-being. Physical therapy, occupational therapy, and speech therapy are also vital components.
• Healthy diet: A balanced diet can help manage non-motor symptoms like constipation and maintain overall health.
• Emotional and social support: Connecting with support groups, family, and friends can significantly help in coping with the emotional challenges of living with Parkinson's.
• Educating yourself: Understanding your condition helps you be an active participant in your care.

Can you live a long life with Parkinson's Disease?

Yes, many people with Parkinson's Disease can live a long and fulfilling life. While it is a progressive condition, it is generally not considered a rapidly fatal disease. Advances in Parkinson's treatments, including medications and lifestyle interventions, have significantly improved life expectancy and quality of life for individuals living with Parkinson's.

With proper management, individuals can effectively control their Parkinson's symptoms for many years. The disease progression and its impact vary greatly among individuals, depending on factors like age at onset, the types of Parkinson's they have, and their response to Parkinson's treatments. Focusing on a healthy lifestyle and maintaining consistent communication with your care team are key to living well with the disease through its different Parkinson's stages.

How long can you live a normal life with Parkinson's Disease?

The concept of a normal life can be subjective, but many individuals with Parkinson's Disease can maintain a good quality of life and continue with many of their usual activities for a significant period after diagnosis. The timeline varies greatly from person to person. For some, Parkinson's symptoms may progress slowly, allowing them to remain highly independent for decades. For others, the disease might progress more quickly.

Effective Parkinson's treatments, including medications and therapies, play a crucial role in managing Parkinson's symptoms and extending the period of independence. People often adapt their routines and activities as they move through different Parkinson's stages, finding new ways to engage with their lives. While there might be adjustments required, the goal of modern care is to maximize independence and well-being for as long as possible. Understanding your specific types of Parkinson's and working closely with your care team will help set realistic expectations for your personal journey.

Is Parkinson's Disease curable?

Currently, there is no cure for Parkinson's Disease. However, this does not mean there's no hope or effective management. Significant progress has been made in understanding the disease and developing Parkinson's treatments that effectively manage Parkinson's symptoms. Medications like levodopa can dramatically improve motor symptoms, and other therapies can help with non-motor issues.

What do people with Parkinson's struggle with?

People with Parkinson's Disease can struggle with a wide range of challenges, impacting both their physical abilities and overall well-being. These struggles often evolve as the disease progresses through different Parkinson's stages. The physical symptoms people often struggle with include:

• Balance and gait issues
• Muscle rigidity
• Tremors
• Difficulty swallowing
• Pain

The emotional and mental health issues can include:

• Cognitive issues
• Fatigue
• Sleep problems
• Mood disorders

Contact us

If you or a loved one has been diagnosed with Parkinson’s disease, know that you don’t have to face the challenges alone. To schedule an appointment or learn more about services at the AHN Cahouet Center for Comprehensive Parkinson’s Care, call 412-359-8850 in Pittsburgh or 814-452-7575 in Erie.

If you're an existing patient, you can also call (412) DOCTORS 412-362-8677 in Pittsburgh or request an appointment with AHN neuroscience services.