Bay Biosciences provides high quality, clinical grade, cryogenically preserved sera (serum) and matched K3-EDTA plasma specimens from Parkison’s disease (PD) patients.
The sera (serum) and K3-EDTA plasma specimens are processed from Parkinson’s disease (PD) patient’s peripheral whole-blood using customized collection and processing protocols.
Parkinson’s Disease (PD) Overview
Parkinson’s disease is a progresssive movement disorder that affects the nervous system. The first signs are problems with movement, it causes unintended or uncontrollable movements, such as shaking, stiffness, and difficulty with balance and coordination..
Symptoms usually begin gradually and worsen over time. As the disease progresses, patients may have difficulty walking and talking. They may also have mental and behavioral changes, sleep problems, depression, memory difficulties, and fatigue.
The symptoms occur because of low dopamine levels in the brain.
Experts do not know why Parkinson’s disease develops, but they currently believe that genetic changes and exposure to environmental factors, such as toxins, play a key role.
In Parkinson’s disease, the cells of the substantia nigra start to die. When this happens, dopamine levels are reduced. When they have dropped 60 to 80 percent, symptoms of Parkinson’s start to appear.
Research studies suggests that Parkinson’s disease affects more men patients than women patients.
Most patients with Parkinson’s disease first develop the disease after the age of 60. Around 5% to 10% of the PD patients experience onset before the age of 50. Early-onset forms of Parkinson’s disease are often, but not always, inherited, and some forms have been linked to specific alterations in genes.
Stages of Parkinson’s Disease (PD)
Doctors use five stages to describe the progress of Parkinson’s disease. Each stage presents new or changing symptoms that a patient is likely to encounter.
It is worth noting that not everyone will reach the advanced stages. Some patients find that the symptoms remain mild and that they can continue to live independently and be mobile.
Dividing the disease into stages helps doctors and caregivers understand and address some of the challenges a patient is experiencing as it progresses.
Stage-1
During the initial stages, the symptoms are not typically severe. A patient can perform everyday tasks with minimal difficulty.
Some signs and symptoms of this stage include changes in:
- Facial expressions
- Posture
- Tremors, which are usually more pronounced on one side of the body than the other
- Walking
A patient may not seek or receive a diagnosis at this stage, as the signs and symptoms may not be very noticeable. If someone has received a diagnosis of PD, a doctor might prescribe medication to help control the symptoms.
Stage-2
Tremors, trembling, and stiffness affect both sides of the body and become more noticeable.
As stiffness increases, the person may find that daily tasks are harder to carry out and take longer than before.
Walking, speech, and posture problems are often more noticeable in stage-2 of Parkinson’s disease.
Stage-3
During stage-3, a patient will experience most or all of the symptoms of stage-2 plus some others, including:
- Slow reflexes
- Problems with balance
- Slow movements
There is also a higher risk of falling due to coordination problems. Dressing and other self-care tasks may become more difficult.
Medication and occupational or physical therapy may help patients manage the symptoms and daily living.
Stage-4
At stage-4, daily activities become even more challenging. A patient will likely need some form of daily care, as independent living is not usually possible.
The patient may be able to stand on their own but require a walker or another assistive device to walk.
Stage-5
At stage-5, a patient may not be able to stand or move around due to stiffness. Depending on their age and overall health, they may need a wheelchair for mobility.
The patient will need constant care to carry out daily activities and protect them from hazards, such as falling.
The individual may also experience the following:
Parkinson’s disease is not life threatening, but it can put a strain on the body. A patient may become more prone to certain types of infections, and there may be a risk of falling or choking.
Advances in treatment now mean that many people with Parkinson’s disease can expect to live for as long as a person without the condition.
Causes of Parkinson’s Disease (PD)
The exact cause of Parkinson’s disease is unknown. It may have both genetic and environmental components. Some scientists believe that viruses can also trigger Parkinson’s disease.
Low levels of dopamine and norepinephrine, a substance that regulates dopamine, have been linked with Parkinson’s.
Abnormal proteins called Lewy bodies have also been found in the brains of people with Parkinson’s. Scientists do not know what role, if any, Lewy bodies play in the development of Parkinson’s.
Parkinson’s disease occur when nerve cells in the basal ganglia, an area of the brain that controls movement, become impaired and/or die.
Normally, these nerve cells, or neurons, produce an important brain chemical known as dopamine. When the neurons die or become impaired, they produce less dopamine, which causes the movement problems associated with the disease. Scientists still do not know what causes the neurons to die.
Low Dopamine Levels
Parkinson’s disease symptoms mainly result from low or falling levels of dopamine, a neurotransmitter. It happens when cells that produce dopamine die in the brain.
Dopamine plays a role in sending messages to the part of the brain that controls movement and coordination. Therefore, low dopamine levels can make it harder for people to control their movement.
As dopamine levels continue to fall, symptoms gradually become more severe.
Low Norepinephrine Levels
Parkinson’s disease may also involve damage to the nerve endings that produce another neurotransmitter, norepinephrine, which contributes to blood circulation and other automatic body functions.
Low levels of norepinephrine in Parkinson’s disease may increase the risk of both motor and non-motor symptoms, such as:
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Difficulty focusing
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Postural instability
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Tremor
This may explain why patients with Parkinson’s disease commonly experience orthostatic hypotension. This refers to when a person’s blood pressure changes when they stand up, leading to lightheadedness and a risk of falling.
Lewy Bodies
A patient with Parkinson’s disease may have clumps of protein known as alpha-synuclein, or Lewy bodies, in their brain.
The accumulation of Lewy bodies can cause a loss of nerve cells, leading to changes in movement, thinking, behavior, and mood. It can also lead to dementia.
Lewy body dementia is not the same as Parkinson’s disease, but people may have both as the symptoms are similar.
Genetic Factors
Experts have identified changes in several genes that appear to have links with Parkinson’s disease, but they do not consider it a hereditary condition.
Genetic factors appear to cause only 10% of cases, mostly among people with early onset disease.
Autoimmune factors
In a 2017 study, scientists found a possible genetic link between Parkinson’s disease and autoimmune conditions, such as rheumatoid arthritis (RA).
In 2018, researchers investigating health records in Taiwan found that people with autoimmune rheumatic diseases had a 1.37-higher chance of also having Parkinson’s disease.
Signs and Symptoms of Parkinson’s Disease (PD)
Parkinson’s disease is a neurological condition with a wide range of effects, including problems with movement, blood pressure and thinking, and mood, sensory, and sleep difficulties.
The symptoms of Parkinson’s disease (PD) usually begin gradually, and they affect each person differently. The symptoms a person has will vary widely, regardless of how severe they are or how quickly they develop.
Early Symptoms
The symptoms of PD affect every patient differently, following can be an early sign of the disease.
- A smaller size of handwriting
- Constipation
- Difficulty moving or walking or a stooping gait
- REM sleep disorder and other sleep problems
- Loss of the sense of smell
- Tremor, especially in one hand
- Low or soft voice
- Loss of facial expression, that may make the person look emotionless
Primary Motor Symptoms
The four main signs and symptoms include the following:
- Muscle stiffness, or rigidity
- Problems with balance and coordination, known as postural instability
- Slow physical movements, known as bradykinesia
- Shaking, or tremor
Symptoms often start on one side first.
Slow Physical Movement
The patient finds it hard to start moving. Starting to get up from a chair can become more difficult, for example. It takes longer than before to do physical tasks. A lack of coordination can cause the person to fall or drop things.
The difficulty is not only with carrying out the movement itself, but also with planning and starting it.
Many people may experience slower movements and attribute these to older age, but sometimes they are a sign of Parkinson’s disease (PD).
Tremor
In most Parkinson’s disease patients tremor is a familiar symptom. The shaking usually starts in one hand.
It may start in one foot, or the person may begin rubbing their forefinger and thumb together, back-and-forth. Less commonly, it starts in the jaw or face. Many people do not have a severe tremor.
Usually it is more likely to happen when the affected part of the body is resting. Anxiety or stress may make the tremors more noticeable.
Other conditions that may lead to tremor include:
- Alcohol use disorder
- Encephalitis an inflammation of the brain
- Multiple sclerosis (MS)
The presence of tremor is not necessarily a sign of PD. However, according to the Parkinson’s Disease Foundation, around 70 percent of patients with Parkinson’s disease experience a slight tremor at some time during the disease.
Rigidity
The muscles feel stiff, and this can make some everyday tasks troublesome, such as getting out of a chair, rolling over in bed, using body language appropriately, or making fine finger movements.
Stiffness is most common in the limbs and neck. Severe stiffness can reduce a person’s range of movements. Sometimes there is pain.
Posture and Balance
Problems with balance and coordination, especially if the person feels stiff, can increase the risk of falling.
Secondary Motor Symptoms
In addition to the primary motor symptoms, the patient may also:
- Experience muscle cramps
- Feel tired
- Have difficulty with fine finger movements
- Experience drool
- Lose facial expression, which can make the person appear uninterested when speaking or cause them to stare fixedly with unblinking eyes
- Have difficulty coordinating movements
- Make involuntary movements and have prolonged muscle contractions
- Experience sexual dysfunction
- Have difficulty swallowing
- Not swing the arms when walking
- Speak more softly, slur or repeat words, use a monotonous voice, or speak with varying speeds, either faster or more slowly
- Stoop or lean forward, as if they are walking quickly
- Walk with the arms held stiffly by their side
- Write with a small, cramped hand
Automatic Nervous System Changes
Parkinson’s disease affects the brain and the CNS, and specifically the parts that control movement. Movement does not happen only in the hands, feet, and other parts of the body that we can see. It is also responsible for essential functions such as digestion and the circulation.
For this reason, the following symptoms may occur:
Constipation: This is a common problem for patients with Parkinson’s disease. There may also be leakage of stool.
Changes in urinary control: The patients may have some inconinence or difficulty passing urine.
Blood pressure problems: A person’s blood pressure can vary as the circulatory system cannot control the blood flow as well as it used to.
People commonly experience low blood pressure, and this can make them dizzy as they stand up, for example, or lead to fainting.
Wide variations in blood pressure are also possible. In the long term, this can have an impact on the cardiovascular system.
Emotions, Thinking, and Senses
The main cause of symptoms in PD is a fall in dopamine production in the brain. This affects movement, but it can also affect a person’s thinking and sense of well-being.
This can lead to the following:
Dementia: This is common in the later stages of the disease. The patient may have difficulty remembering things and thinking clearly.
If clumps of protein, Lewy bodies form in the brain, dementia is more likely. Some patients with Parkinson’s disease also have the tangles of protein that occur with Alzheimer’s disease.
Sleep problems: These are a core feature of Parkinson’s disease. Contributing factors include REM sleep disturbances, the use of some medications, restless leg syndrome, pain, and difficulty turning over in the night.
A person may have difficulty sleeping or staying asleep at night, and they may also be excessively sleepy during the day.
Tiredness: Fatigue and a lack of energy can happen because of sleep problems and also because of the way Parkinson’s disease affects movement.
Depression: This is a common problem. It can result from the changes in brain activity and from how the person feels about their condition. Anxiety is another common problem.
Psychosis: This is common in the later stages, and it can affect nearly 1 in 3 patients with Parkinson’s disease. It can range from minor illusions and vivid dreams to hallucinations, confusion, and paranoia. Hallucinations are usually visual, but some people hear and feel things that are not there.
Sensory changes: Patients with Parkinson’s disease often lose their sense of smell. This can happen long before other symptoms appear. Experts consider it a predictor of PD. Some patients experience a numbness, tingling, and prickling in the skin.
Pain: Pain is a common problem with PD, affecting over 60 percent of patients with the disease, according to one study. Some patients also experience a reduced sense of pain.
Diagnosis of Parkinson’s Disease (PD)
Parkinson’s disease diagnosis is made based on health history, a physical and neurological exam, as well as a review of signs and symptoms.
Some diagnostic and lab tests are possible, but these are usually needed to rule out other conditions or certain causes. However, most lab tests aren’t necessary unless you don’t respond to treatment for Parkinson’s disease, which can indicate you have another condition.
Diagnostic Tests
When healthcare providers suspect Parkinson’s disease or need to rule out other conditions, various imaging and diagnostic tests are possible. These include the following:
- Blood tests (these can help rule out other forms of Parkinsonism
- Computerized Tomography (CT) Scan
- Genetic testing
- Magnetic resonance imaging (MRI)
- Positron emission tomography (PET) scan
New Lab Tests for Parkinson’s Disease
Researchers have found ways to test for possible indicators or Parkinson’s disease. Both of these new tests involve the alpha-synuclein protein but test for it in new, unusual ways.
While these tests can’t tell you what conditions you have because of misfolded alpha-synuclein proteins, that information can still help doctors make a diagnosis.
The two tests use the following methods:
- Spinal Tap: One of these tests looks for misfolded alpha-synuclein proteins in cerebrospinal fluid, which is the fluid that surrounds your brain and spinal cord. This test involves a spinal tap (lumbar puncture), where a doctor inserts a needle into your spinal canal to collect some cerebrospinal fluid for testing.
- Skin biopsy. Another possible test involves a biopsy of surface nerve tissue. A biopsy includes collecting a small sample of the patients skin, including the nerves in the skin.The samples come from a spot on the back and two spots on the leg. Analyzing the samples can help determine if the alpha-synuclein has a certain kind of malfunction that could increase the risk of developing Parkinson’s disease.
Treatment of Parkinson’s Disease (PD)
There is no cure for Parkinson’s disease. However, treatment can help relieve the symptoms.
The treatments can also vary from person to person, depending on their specific symptoms and how well certain treatments work. Medications are the primary way to treat this condition.
The treatment options include:
- Medications: A patient can take medications to increase their dopamine levels and control non-motor symptoms. The main medication to treat Parkinson’s disease is levodopa. A doctor may also prescribe carbidopa to prevent or reduce some of the side effects of levodopa.
- Deep brain stimulation (DBS): A doctor may suggest deep brain stimulation (DBS) if medications prove ineffective. A surgeon will implant electrodes into a part of the brain and connect them to a small electrical device. This painlessly stimulates the areas of the brain that control movement.
- Therapies: A patient with Parkinson’s disease may benefit from:
- Massage therapy
- Occupational therapy
- Physical therapy
- Speech therapy
A patient should aim to eat a nutritious diet and exercise regularly. They may also benefit from practicing yoga and tai chi to increase their flexibility.
Medications for Parkinson’s Disease
Medicines can help treat the symptoms of Parkinson’s by:
- Increasing the level of dopamine in the brain
- Having an effect on other brain chemicals, such as neurotransmitters, which transfer information between brain cells
- Helping control non-movement symptoms
The main therapy for Parkinson’s is levodopa. Nerve cells use levodopa to make dopamine to replenish the brain’s dwindling supply. Usually, patients take levodopa along with another medication called carbidopa. Carbidopa prevents or reduces some of the side effects of levodopa therapy, such as nausea, vomiting, low blood pressure, and restlessness and reduces the amount of levodopa needed to improve symptoms.
Patients living with Parkinson’s disease should never stop taking levodopa without telling their doctor. Suddenly stopping the drug may have serious side effects, like being unable to move or having difficulty breathing.
The doctor may prescribe other medicines to treat Parkinson’s symptoms, including:
- Amantadine to help reduce involuntary movements
- Anticholinergic drugs to reduce tremors and muscle rigidity
- Dopamine agonists to stimulate the production of dopamine in the brain
- Enzyme inhibitors (e.g., MAO-B inhibitors, COMT inhibitors) to increase the amount of dopamine by slowing down the enzymes that break down dopamine in the brain
Deep Brain Stimulation
In years past, surgery was an option to intentionally damage and scar a part of your brain that was malfunctioning because of Parkinson’s disease. Today, that same effect is possible using deep brain stimulation (DBS), which uses an implanted device to deliver a mild electrical current to those same areas.
The major advantage is that deep-brain stimulation is reversible, while intentional scarring damage is not. This treatment approach is almost always an option in later stages of Parkinson’s disease when levodopa therapy becomes less effective, and in patients who have tremor that doesn’t seem to respond to the usual medications.
Experimental Treatments
Researchers are exploring other possible treatments that could help with Parkinson’s disease. While these aren’t widely available, they do offer hope to people with this condition. Some of the experimental treatment approaches include:
- Stem cell transplants. These add new dopamine-using neurons into your brain to take over for damaged ones.
- Neuron-repair treatments. These treatments try to repair damaged neurons and encourage new neurons to form.
- Gene therapies and gene-targeted treatments. These treatments target specific mutations that cause Parkinson’s disease. Some also boost the effectiveness of levodopa or other treatments.
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