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A Brief Introduction to Parkinson's, Alzheimers, Huntington's and MS

A walk-through of the basic causes, symptoms, and treatments of four of the most serious neurological disorders known today.

Parkinson's Disease

Parkinson's is a progressive disease, so symptoms present in a very mild fashion and progress as time passes. The disease affects the midbrain when nerve cells, called substantia nigra, die or are impaired (National Parkinson Foundation, N.d). Communication between the midbran and the corpus striatum (another section of the brain) is fostered by dopamine produced within the substantia nigra, thus when they are impaired or die, the brain's control over movement is as well. According to the National Parkinson Foundation, "when 80% of the dopamine-producing cells in the substantia nigra are depleted, symptoms of PD develop" (N.d)

Symptoms of Parkinson's, like the disease itself (and because of this characteristic of the disease), are progressive. Patients initially experience slight tremors in a limb, such as a leg or arm, or in extremities like the fingers. These slight tremors increase in severity over time to include full-blown tremors that occur during periods of rest, or inactivity.

Despite the midbrain nerve cell destruction cause of PD, few patients actually exhibit large scale cognitive symptoms. Dementia can be experienced, and the National Parkinson Foundation (N.d) notes the disorder DBL, or Dementia with Lewy bodies, as a possible complication for Parkinson's patients. This form of dementia is characterized by "prominent hallucinations, fluctuations over the day in cognitive status, and parkinsonism" (meaning the typical symptoms of PD).

Parkinson's is the most prominent form of neurodegenerative disease. According to Pinel (2020), it affects 0.5% of the population, and is 2.5 times more likely to affect males than females. Despite these rather large and alarming numbers, little is known about the cause of Parkinson's. Currently there are 10 gene mutations linked to the disease. Additionally, brain infections, stroke, tumors, and neurotoxins have also been blamed for the development of Parkinson's; and while some have looked into the idea of inheritance, the majority of cases see no link between the development of the disease and family history of it (Calne, et al., 1987).

Currently, treatments methods are available, but they are temporary and merely serve to ease the symptoms of the disease, there is no known cure. The most used medication attempts to replace the lost dopamine in order to relieve tremors, rigidity, and other movement issues associated with PD. Surgery can also be used to relieve Parkinson's symptoms temporarily. PD brain surgery is high risk and entails destroying the small abnormally active section of the brain in order to control tremors. There are also stimulation procedures that are used, but these too are only procedure used for severe cases in which medication has not worked.

Alzheimer's:

Alzheimer's is the most common and prevalent form of dementia today. It is best known as a disease of the elderly, as the disease commonly occurs during the later years of life; however it has been known to affect individuals as early as mid-life. According to Pinel (2020), approximately "10% of the general population over the age of 65 suffer from the disease, and the proportion is about 35% in those over 85.

Like Parkinson's, Alzheimer's is a progressive disease, so it moves in stages that can blur at times, but are generally readily identifiable. Early stages include symptoms of a decline in memory on a selective scale. Middle stages are characterized by confusion, irritability, anxiety, and deterioration of speech. Advanced stages include trouble with basic functions such as swallowing, controlling bodily functions, and inability or extreme difficulty with even the most basic speech. This last stage generally leads to expiration of the patient. These symptoms are caused by the death of brain nerve cells and the loss of tissue throughout the entire brain. According to the Alzheimer's Association (2020), the loss of nerve cells and brain tissue causes the shrinking of the brain, which in turn affects nearly all its functions, and why the disease is fatal.

More specifically, the portion of the brain responsible for thinking, planning, and remembering, the cortex, shrivels. The hippocampus, a key part of the brain for memory formation is also severely affected by shrinkage; and the fluid-filled spaces of the brain increase as the brain shrinks. Thus, more empty space is made, and less functioning space is present. Further brain functions are impaired by the presence and growth of plaque between the nerve cells which blocks signals from being passed between them, thus blocking different parts of the brain from communicating. Doctors examining a patient may notice this plaque, and the increase in fluid-filled spaces in the brain, which indicate the presence of Alzheimer's, although other dementia causes must be investigated.

At this point in time there is no cure for Alzheimer's; however, there are both drug and non-drug treatments available to Alzheimer's patients (Alzheimer's Association, 2020). Standard treatments for the disease include drugs to control cognitive symptoms. Additionally, non-drug and drug treatments are used to control the psychiatric and behavioral symptoms that may occur as a result of the disease.

Huntington's Disease:

Huntington's is another progressive motor disease occurring during the middle and elderly years of life. However, luckily, it is quite rare, unlike the two aforementioned diseases. Huntington's disease is an inherited disease, passed on through family genes, and the disease is often passed to the child unknowingly since "...the first symptoms of the disease do not appear until the parent is well past the peak reproductive years" (Pinel, 2020). Early symptoms of the disease include mood swings, depression, irritability; trouble driving, learning new things, remembering facts, and making decisions (National Institute of Neurological Disorders and Stroke, 2020). Progression of the disease plagues the patient with difficulty with concentration and other intellectual tasks (including recognizing faces), as well as difficulty performing basic activities of daily life (eating, swallowing), and controlling bodily functions. Motor symptoms are also present in Huntington's patients including increase fidgetiness, and jerky movements in the entire limb.

This serious condition is a fatal one, according to Pinel (2020) the patient typically dies of the disease 15 years after the first symptom appears. Unfortunately this means there is no cure as of yet, and like Alzheimer's and Parkinson's, Huntington's patients can only treat the symptoms of the disease. Medications are used to help control the emotional and motor problems associated with the disease; however, the National Institute of Neurological Disorders and Stroke (2020) note that some bothersome side effects are common including, fatigue, restlessness, or hyperexcitibility.

Multiple Sclerosis:

Multiple Sclerosis, or MS as it is generally called, is another progressive disease; however, this particular disease that attacks the central nervous system (made up of the brain, spinal cord, and optic nerves). Damage to the nerve fibers and the myelin cause disturbances in the transmission of signals between the central nervous system (CNS), which in turn lead to the symptoms of MS. According to the National MS Society (N.d), the most common symptoms of the disease include fatigue, numbness, coordination and balance problems, bladder dysfunction, bowel dysfunction, vision problems, dizziness and vertigo, sexual dysfunction, pain, impaired cognitive function, emotional changes, depression, and spasticity. Additionally, each of these can cause secondary problems of their own that must be managed. Furthermore, less common symptoms are also listed as: speech disorders, swallowing problems, headache, hearing loss, seizures, tremor, respiration problems, and itching (National MS Society, N.d).

MS is considered an autoimmune disease, which means that the body's own immune system attacks the CNS and myelin due to an inability to distinguish "friend from foe," per se. Despite this fact, the disease is often well dealt with by patients. Additionally, unlike most other neurological diseases, MS patients generally exhibit one of four disease courses: Relapsing-Remitting MS (clearly defined attacks and worsening neurologic function. Recurring flare-ups, frequently followed by complete or partial recovery periods), Primary-Progressive MS (slow progressive worsening of neurologic function), Secondary Progressive MS (follows an initial period of relapsing-remitting MS, disease worsens steadily with or without flare-ups and with only minor recovery), Progressive-Relapsing MS (a rare course, steadily worsening from initial symptoms, disease progresses without remission) (National MS Society).

Studies on MS have shed light as to its epidemiology, exhibiting signs of environmental and genetic factors in disease development. Current research indicates that a large number of genes contribute to MS development, with each playing a small part in the disease. Additionally, genetic research has narrowed down specific races that are more prone to the disease than others. According to Pinel (2020), Africans and Asians have less of a chance of being diagnosed with MS, while Caucasians have an incidence of 0.15%, with the disorder being twice as common females. Environmental studies indicate higher incidence in people raised in cool climates, versus those raised in warm climates.

Current treatments to MS slow the progression of the disease, yet there is no cure. Medication, self-care techniques, and rehabilitation, are all used to treat the symptoms of MS. Additional medications are prescribed to treat flare-ups that generally severely affect the individual's functioning.

References:

Alzheimer's Association. (2020). Alzheimer's Disease. Retrieved 6, 2020, from

National Parkinson Foundation. (N.d). About Parkinson Disease. Retrieved April 6, 2020, from

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National Institute of Neurological Disorders and Stroke. (2020). NINDS Huntington's Disease Information Page Retrieved April 5, 2020, from National MS Society. (N.d). About MS. Retrieved April 5, 2020, from

Pinel, J., P.J. (2020). Biopsychology, 6th Edition. University of British Columbia. Pearson.