Parkinson’s disease: a complex enemy

By Michael Badejo

Parkinson’s disease is a disorder of the nervous system that affects movement. It starts gradually and worsens over time. It affects one in every 500 people in Canada. More than 6,000 new cases are diagnosed each year in Canada.

Tremors and shaking of the hands are the first symptoms most people think of when they hear the words “Parkinson’s disease”, but according to Mayo Clinic, other important signs and symptoms include:

  • Slowed movement. Over time, Parkinson’s disease may reduce your ability to move and slow your movement, making simple tasks difficult and time-consuming. Your steps may become shorter when you walk, or you may find it difficult to get out of a chair. Also, you may drag your feet as you try to walk, making it difficult to move.
  • Rigid muscles. Muscle stiffness may occur in any part of your body. The stiff muscles can limit your range of motion and cause you pain.
  • Impaired posture and balance. Your posture may become stooped, or you may have balance problems as a result of Parkinson’s disease.
  • Loss of automatic movements. In Parkinson’s disease, you may have a decreased ability to perform unconscious movements, including blinking, smiling or swinging your arms when you walk.
  • Speech changes. You may have speech problems as a result of Parkinson’s disease. You may speak softly, quickly, slur or hesitate before talking. Your speech may be more of a monotone rather than with the usual inflections.
  • Writing changes. It may become hard to write, and your writing may appear small.

Parkinson’s most commonly strikes people between 50 and 70 years old. While the disease can affect teenagers, only about 10 per cent of cases involve people under 45 years old. The youngest confirmed case of Parkinson’s disease was in a 3-year-old individual.

Meeting the Parkinson’s challenge

Although the disease has no cure, doctors and researchers are making strides in helping people live with Parkinson’s. When Parkinsonism is suspected, patients are generally referred to specialists for treatment through their neurologist or family doctor.

According to Dr. Doug Hobson, a movement disorder neurologist at the Movement Disorder Clinic (MDC) at Deer Lodge Centre, Parkinson’s hasn’t been beaten yet because of its complexity. “Typical Parkinson’s tends to progress more slowly than other less common ones. Medications are often designed for typical Parkinson’s, but people may need more input than medication alone. That’s where we come in.”

The Movement Disorder Clinic is home to a dynamic multidisciplinary team of specialists trained to treat Parkinson’s and other movement disorders. The clinic looks after more than 1,500 clients in Winnipeg and serves more than 5,000 affected individuals in its broader catchment area, which includes Manitoba, Saskatchewan, Northwest Ontario, and North Dakota.

Because Parkinson’s has a nasty tendency to affect every part of a person’s life once it takes hold, the Movement Disorder Clinic takes a decidedly multidisciplinary approach to treatment. The clinic’s partnership with specialists in the Allied Health Network make it a more effective weapon in fighting back against all aspects of the disease’s impact.

“The services and professionals we offer include physiotherapists, occupational therapists, speech therapy, dietitians, genetic counsellors, social workers, and more. Some of the movement disorders we treat in addition to Parkinson’s even have a role for surgeons. Overall, we try to have a very comprehensive approach,” says Hobson.

This comprehensive approach also makes it easier for clients, who can receive most of—and often all—the care they need in one visit.

One way people living with Parkinson’s can help themselves, says Hobson, is by embracing an active lifestyle.

“The only thing we’re convinced can slow down the progression of the disease is exercise. That’s three hours a week of cardio, and I mean actual cardio.” Hobson isn’t satisfied until he can see his patients climb a few flights of stairs without ending up out of breath. “If they can make the change, they have a much better outlook.”

Hope for the future

Dr Hobson finished his formal training in neurology in 1987 and has practiced at the MDC for 10 years. He has tracked the clinical trials of dozens of experimental medications. He says that over time, their effectiveness is improving.

“The Movement Disorder Clinic’s priority is patient care, but over the years we have been involved in over 40 clinical trials into new treatments and assist other research endeavours by recruiting patients with an interest in volunteering to advance the field. For instance, one study is exploring brain imaging as one path to determine new explanations of Parkinson’s and its effects on specific areas of the brain. Understanding this could be key to treating it and managing it more effectively.:

Hobson commends Allied Health’s continued research in the area, as well as the teaching they do out of the clinic to future doctors undergoing residencies in neurology. Additionally, organizations like the Michael J. Fox Foundation, equally committed to curing Parkinson’s, are employed in an abundance of research projects worldwide. All aspects of the disease—including possible causes, assessment techniques, and potential treatments and cures—are under investigation.

“We’re making progress,” says Hobson. “We know much more now than we did 30 years ago. For instance, we know which cells are affected, and there’s an abnormal protein involved. But no matter what we learn, our first commitment is to helping people live with disease today. And we’re getting better at that all the time.”