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No cure exists for Parkinson’s

DEAR DOCTOR K: My husband was just diagnosed with Parkinson’s disease. Can you discuss it in your column? I don’t know anything about it.

DEAR READER: Parkinson’s disease is a disease of the central nervous system. It causes problems with body motions and movement. PD worsens over time.

Brain cells “talk” to each other by making and releasing chemicals called neurotransmitters. When one cell releases a neurotransmitter, another picks up the signal. One type of neurotransmitter is dopamine.

Dopamine is made in an area deep in the brain called the basal ganglia. That is also where movements are coordinated. The dopamine made by cells in the basal ganglia is necessary for the basal ganglia to function properly.

PD develops when dopamine-producing nerve cells (neurons) in the brain die and not enough dopamine is produced. This affects movement.

There is no cure for PD, but symptoms can be treated with medications. Medication may not be necessary at first. Treatment usually begins when symptoms interfere with work or home life, or when it becomes difficult to walk or maintain balance.

Medications used to treat PD either boost levels of dopamine in the brain or mimic the effects of dopamine. The most commonly used medication is levodopa. It is usually prescribed in combination with another drug called carbidopa. Other medications can also be used, either alone or in combination with levodopa.

Nearly all patients improve after they start taking levodopa. But long-term use often causes side effects and complications.

Surgery is considered only when medications are no longer effective. Surgical options include deep brain stimulation in which electrical stimulation is delivered to targeted areas of the brain to control symptoms. Another option involves destroying precisely targeted areas of the brain that are responsible for the most troubling symptoms.