View
comments
Secretary Sharon Blight was diagnosed with Parkinson’s disease at just 49
Secretary Sharon Blight initially put the numbness and tingling in her right hand and foot down to a tennis injury.
‘I’d fractured my right collarbone after falling over on court 18 months before,’ she recalls.
Surgery
and physiotherapy restored full movement to her arm and shoulder, and
when she developed the numbness and tingling, she thought it was a
trapped nerve. But then her physiotherapist noticed a slight tremor in
her foot and recommended seeing a GP.
‘My GP said it was probably
nothing to worry about, but I should see a neurologist,’ says Sharon, a
married mother-of-two from Aldershot, Hampshire.
But after ten minutes of examining her, the neurologist said he was almost certain Sharon had Parkinson’s disease.
‘I
was in complete shock,’ she says. ‘I was only 49 and as far as I was
concerned, Parkinson’s was something that only affected the elderly and
mainly men.’
It’s a common misperception, which will only have been cemented by recent announcements about celebrity patients.
Comedian
Billy Connolly, 71, has recently been diagnosed with the disease. Sir
Roger Bannister, 83, the first man to run a four-minute mile and a
former neurologist, has been suffering from Parkinson’s for the past
three years.
Most sufferers are diagnosed later in life, on average
at 65. But scientists now believe the disease, which affects 127,000
people in the UK, begins to develop up to 20 years before the appearance
of the first symptoms, such as uncontrollable tremor, slow movements or
muscle stiffness. This means many people may have hidden Parkinson’s in
their 40s or earlier.
‘There’s a lot of debate about this but it’s
thought patients may start to lose nerve cells in the brain anywhere
between five and 20 years before symptoms appear,’ says Claire Bale,
research communications manager with the charity Parkinson’s UK.
Now
the race is on to develop new ways to identify patients during the
‘pre-onset’ years, and give them a better quality of life.
Parkinson’s
is caused by a loss of nerve cells in an area of the brain that
controls movement and feelings of reward and addiction. These cells
produce dopamine, a chemical that shuttles messages between the brain
and nervous system, helping to control body movement.
If these cells
become damaged or die, levels of dopamine are reduced. Symptoms of the
disease appear only when 80?per cent of the nerve cells have been lost.
Parkinson’s
is diagnosed by studying a patient’s symptoms and movement, often
followed by a DAT scan, which measures dopamine levels in the brain.
Scientists are trying to find ways to test for the condition in early stages. A most promising way is a blood test for raised levels of alpha-synuclein, which is released in clusters in the brain when the disease is setting in
Professor
Patricia Limousin, a specialist at the National Hospital for Neurology
and Neurosurgery in London, warns that the classic symptoms neurologists
instantly look for often go unnoticed by GPs.
‘We look for tremor,
especially when the arm is at rest, and slowness of movement, reduced
swinging of the arm when walking, and stiffness of muscles.
‘Most
patients have had some or all of these symptoms for months or years
before they see us.
Some may have noticed a slight tremor but didn’t
seek help, others have been to a GP but are told it’s down to stress.’
The disease has been known about since ancient times – it was referred to as ‘shaking palsy’ as early as AD175.
But
what triggers it is still unclear. The consensus seems to be that some
people may carry a mixture of genes that predispose them to damage by
toxins in the environment – such as from pesticides – and this sets
Parkinson’s in motion.
Men are 50 per cent more likely to get it than women. One theory is that oestrogen may have a protective effect.
For
most people, having Parkinson’s will not significantly affect life
expectancy. But in its advanced stages it can lead to chronic pain,
sleep disruption, anxiety and depression, and problems affecting
movement. Years of being ill can leave patients vulnerable to
infections.
The earlier Parkinson’s is treated, the better, as currently drugs can slow down – but not halt – the loss of brain cells.
So
scientists are trying to find easy ways to test for the condition in
the early stages. One of the most promising is a blood test for raised
levels of the protein alpha-synuclein. This is released in clusters in
the brain when the disease is setting in – but usually before symptoms
appear.
In 2011, scientists at Lancaster University discovered a way
to detect the protein in blood samples of Parkinson’s patients. Now
trials are looking at whether an alpha-synuclein blood test could be the
early warning sign doctors hope for
An Austrian team is even
testing a vaccine that could prime the immune system to attack and
destroy the clusters. First results are due in a few months.
‘Although
we know alpha-synuclein is involved in nerve-cell death in the brain,
there are many types of the same protein, and we are still some way off
having a readily available blood test,’ says Claire Bale.
There are other, perhaps slightly surprising, clues that Parkinson’s may be developing.
One
is a loss of smell. As brain cells die off, one of the areas of the
brain affected fairly early is the olfactory bulb, which processes and
identifies odours. Up to 80 per cent of patients recall losing some or
all of their sense of smell months or years before the onset of other
symptoms.
Another potential early warning sign is constipation. As
dopamine-producing cells die off, muscles controlling contractions in
the bowel also seize up, because dopamine is produced by nerve cells in
the enteric nervous system – which controls digestion. Around 60 per
cent of sufferers experience constipation early on.
‘We think these
nerve cells outside of the brain are affected earlier, or start to show
symptoms earlier than those in the brain,’ says Claire Bale.
Scottish actor Billy Connolly is a sufferer
A third
indicator is vivid dreams, or acting out nightmares. At least five
years before patients suffer stiffness, many have REM sleep behaviour
disorder.
Rapid eye movement sleep is the stage where we have vivid
dreams. To stop us acting them out, the brain temporarily paralyses us.
But the damage to brain cells in Parkinson’s switches off this
mechanism.
Individually, none of these indicators are strong enough
to confirm that Parkinson’s has set in. But it may be that a collection
of such warning signs could justify further investigation.
It’s hoped
new drugs could stop the progression of the disease altogether. Current
treatments, such as levodopa – a drug which has been around for nearly
50 years – address only the symptoms by replacing some of the missing
dopamine.
A more extreme treatment is deep-brain stimulation, where
electrodes are implanted into the brain to ‘deactivate’ affected areas.
It
can ease symptoms, and patients are often able to reduce their drug
dosage. This is vital: dopamine-replacing drugs have been associated
with severe behavioural side-effects, such as gambling or sex addiction.
One of the most promising new treatments could be a relatively cheap drug already widely and used for type 2 diabetes.
At
£18 per injection, exenatide helps lower blood sugar levels. But a
study with 20 patients last year at University College London found it
appeared to slow down, or in some cases halt, the progression of
Parkinson’s. Bigger trials are planned.
Meanwhile, Sharon, now 54, takes a daily cocktail of drugs, including levodopa and up to five paracetamol.
‘I
hate bedtime because I know in the morning I will be so stiff I can’t
get up,’ says Sharon, who fundraises in her spare time for Parkinson’s
research.
‘I’ve had to give up my beloved tennis and now play bowls.
I’m determined to not let my illness beat me. I may have Parkinson’s
disease, but it doesn’t have me.’
For more information, see parkinsons.org.uk
or comment on this article
Miley Cyrus lets homeless man accept her award at 2014 VMAs
Graphic: Venomous snake head severed as chef prepares dish
Patrick Stewart does his version of the ALS Ice Challenge
ARCHIVE: Women’s rights activists celebrate ‘Go Topless Day’
Mini Bruce Lee shows off his formidable martial arts skills
Gunshots captured on video at party hosted by Chris Brown
‘Jihadi John’: Abdel-Majed Abdel Bary raps as Lyricist Jinn
Watch the Knee Defender in action during a flight
Turtles returned to sea after being illegally snatched for…
Captain Jack prank calls live CNN broadcast
Cats take control in bizarre Pizza Hut marketing campaign
Drunken behavior filmed outside New York brunch spot Pranna
Outrage over Kardashian sisters ‘TEXTING’ and chatting at…
Who is the homeless youth who went to the VMAs with Miley…
Bare-breasted women parade through New York for seventh…
Could James Foley have been murdered by ISIS a YEAR ago? New…
Singer Chris Brown ‘shot at’ and hip hop boss Suge Knight…
‘We’ve had enough of the senseless killings’: Michael…
‘He didn’t wanna give up and run on home to mommy’: Mother…
Passengers who had mid-air brawl over ‘knee defender’ device…
‘I don’t know how long I can take this’, sobs pregnant…
Ex-sheriff’s deputy with ALS kills wife and sister-in-law…
Family of two Amish girls who were kidnapped and sexually…
‘I’m dying:’ Horrifying final moments of the jogger killed…
Comments (0)
what you think
No comments have so far been submitted. Why not be the first to send us your thoughts,
or debate this issue live on our message boards.
Find out now