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Parkinson's Disease - why early diagnosis and treating it right from the start matters?

Parkinson's Disease (PD) is a chronic neurodegenerative disease affecting over 1 million people in the US. Earlier it used to be a disease of old age, but more and more young patients in their 30s and 40s are being diagnosed with PD. The lack of early markers for detection of the disease makes it difficult to identify the ones that will be at risk. with increasing number of genes discovered, we may have to change the way we think about the disease. A combination of genetic susceptibility and environmental toxins may be responsible for causing the disease.

Since the 60s, Levo dopa has been the corner stone of therapy for patients with PD. As we learn more about the disease, we realize that its not all about correcting the dopaminergic dysfunction since there are so many non-motor syptoms of PD which are minimally responsive or unresponsive to dopaminergic therapy. Therapy of PD needs to focus beyond the dopaminergic theory and look at other neurotransmittor systems which may be involved based on Braack's neuropathological staging.

Therapies focused on correcting dopaminergic deficiency and protective agents directed only at Substantia Nigra may only address half of the story of what constitutes PD in its full element.

It is critical that we develop detailed insight in to what causes a person to be susceptible to insults which result in loss of dopaminergic and other nerve terminals. Also we need to chanellize our energies towards finding early biomarkers for PD. Hence a person with a family history of PD or exposed to known environmental toxins can take a lab test and know his risk of future PD. The final common pathway most likely terminates at the level of the mitochondria, hence newer therapies are focusing on mitochondrial protectants to slow down the progression of the disease. NIH directed NET-PD initiative is targetted towards studying new therapies for neuroprotection in PD.

Imagine a day when one could predict who is susceptible to developing the disease with the help of early biomarkers and imaging studies, then starting them on neuroprotective therapy which would slow the progression of the disease. Essentially you could have a high risk of developing PD but due to critical neuroprotective therapy, you could slow down the rate of nerve terminal loss to the extent that a person would be spared from being symptomatic in their life time. You would have a lot of at risk people, walking around, leading productive lives and careers with no symptoms what so ever of the dreaded disease. That would be the day when you could say, " a new dawn is here"!

The fight against PD continues as researchers and clinicians alike toil day and night to develop insight into pathogenesis, genetics and management of PD.

To quote a little story..

A man walks in the park and finds a bird with skinny little legs lying on the back with the feet raised towards the sky. The man asks, ' may I ask why you are lying down like that"? And the bird responds, " I just heard the sky is falling down on us and I want to try to stop that from happening". The man laughs and says, " even if that were to be true, you realize that you wouldn't be able to support the sky on your skinny little legs"? To which the bird responds, "yeah probably so, but you do what you can"!

Let it be known that there are people out there, doing "whatever it is that they can" to find solutions to address difficult problems in science and medicine.
Whether it be Parkinson's, Alzheimer's, MS, ALS, cancer or AIDS, the fight continues.

Join the fight against PD; if you or your family member has been diagnosed with Parkinson's disease, ask questions, make sure you tell your doctor about every little symptom, problem, because it is only through you researchers and doctors learn more about your disease and can think towards addressing critical problems.

Good luck and hang in there because help is on the way!

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Parkinson's Disease - why early diagnosis and treating it right from the start matters?

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