New Treatment Modalities for Parkinson’s disease


Q1. What is Parkinson’s disease? Are hand tremors a sign of Parkinson’s disease?
Most people may associate hand tremor with Parkinson’s disease upon first impression. While it is common in patients with Parkinson’s disease, there are also other symptoms such as muscle stiffness, slow movement and fall propensity. Hand tremors may have causes other than Parkinson’s disease.

Parkinson’s disease is a progressive neurological disease. Degeneration in substantia nigra can result in inadequate production of dopamine, causing a series of functional movement disorders. Other non-functional movement disorders include loss of smell, constipation and postural hypotension.  While old people are more likely to suffer from Parkinson’s disease due to degeneration, young people may also suffer from this as 1 out of 10 patients has early onset. The causes of early-onset Parkinson’s disease can be hereditary. Drugs and other diseases are also other causes of early-onset.

Q2. Can Parkinson’s disease be cured?
Currently, there is no cure for Parkinson's disease. As mentioned earlier, degeneration is the major cause of Parkinson’s disease. While there is still no way to slow down or stop the degeneration, other treatments can relieve the symptoms significantly and help patients resume normal lives. As a major treatment of Parkinson’s disease, medication can alleviate most symptoms such as hand tremors, limb stiffness and slow movement. Proper treatment can minimise motor impairment, help patients resume normal lives and improve the quality of life. Many patients can continue to work for years despite the condition.

Q3. Is medication effective in the long run since Parkinson’s disease cannot be cured?
Although Parkinson’s disease is incurable, medication can greatly control the symptoms. We encourage patients to start taking medication once the symptoms begin to affect their lives. Medication can help maintain the quality of life and control the condition in the long run. If the symptoms get worse despite optimal medication and become debilitating, patients may consider surgical treatment to control the disease.   

Q4. When should I have the surgery?
In surgery for Parkinson’s disease, two electrodes with wires will be inserted into both left and right sides of the inner brain areas. As a complicated and major surgery, it will only be considered when medications fail to control the symptoms and patients can no longer function properly. Not all patients are suitable to undergo surgery due to other comorbidities. 

Q5. Besides surgery, are there any other non-medication treatments?
Conventionally, treatment for Parkinson’s disease is a major surgery. It may not be suitable for some patients. Nowadays, there are alternative treatments to improve motor functions. One of them is High-intensity Focused Ultrasound (HIFU) ablation, which uses ultrasound to create a lesion in the brain without incision or craniotomy or electrode implantation. Transcranial magnetic stimulation is a relatively new treatment, in which the brain is stimulated by magnetic field while one is sitting in a chair. It helps improve brain function and relieve the symptoms.

Q6. Patients with Parkinson’s disease are prone to fall. Can they do exercise? 
Exercise is essential to patients with Parkinson’s disease. Aerobic exercise can alleviate the symptoms and slow down disease progression. Tai Chi and yoga can also enhance patients’ balance.

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