By Fred Cicetti
Q. Is it true that pesticides are responsible for people getting Parkinson’s disease?
Although genetics is very important in Parkinson’s disease (PD), environmental exposures also increase a person’s risk of developing it. Scientists have known for some time that farm workers who used pesticides, or people who lived or worked near fields where they could inhale drifting pesticides, have an increased risk of PD.
History of Parkinson’s Disease
First described in 1817 by British physician Dr. James Parkinson, PD affects 1 in 100 people over the age of 60. (It can also affect younger people, although the average age of onset is 60.) The progression of symptoms may take 20 years or more, but in some people, the disease progresses much more quickly. PD affects at least half a million people in the United States, including 62-year-old actor Michael J. Fox (“Family Ties,” “Back to the Future,” “Stuart Little”).
PD is a complex disorder of the central nervous system. After Alzheimer’s, PD is the second most common neurodegenerative disease in the United States. Its defining symptoms include tremor, slowness of movement, rigidity, and impaired balance and coordination. As these symptoms become more pronounced, patients may have difficulty walking, talking, or completing simple tasks. They also may experience depression, difficulty sleeping and other problems.
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In the early 1960s, scientists determined that the loss of brain cells was causing PD. The cells that were depleted produced dopamine, a chemical that helps control muscle activity. Today, PD is treated with drugs and surgery.
Medications for PD fall into three categories: 1) drugs that increase the level of dopamine in the brain; 2) drugs that affect neurotransmitters in the body to ease some of the symptoms; 3) medications that help control the non-motor symptoms such as depression.
Surgical treatments for PD include pallidotomy and thalamotomy, procedures involving removing or destroying parts of the brain that are “misfiring” – in some cases, symptoms of PD can be alleviated.
Because these procedures are invasive, they are usually reserved for severely afflicted Parkinson’s patients who do not get adequate relief from medications and are rarely used today.
A third option is deep brain stimulation (DBS). Scientists have found that they can mimic the effects of pallidotomy by implanting an electrode in the brain in a way that calms the abnormal neuronal firing.
A fourth option is focused ultrasound, a non-invasive procedure. Guided by magnetic resonance imaging (MRI), high-intensity, inaudible sound waves are emitted into the brain. Where these waves cross, they create high energy. This high energy creates heat, destroying a very specific area in the brain connected to tremor.
A wide variety of complementary and supportive therapies are also used for PD. Among these are rehabilitation techniques to help with gait and voice disorders, tremors and rigidity, and cognitive decline. Exercise may help people improve mobility.
Looking at the Future of Parkinson’s
While Parkinson’s is a complex disease, research has progressed a great deal in recent years. Halting the progression of PD, restoring lost function, and even preventing the disease are now considered realistic goals. For more information, visit the Michael J. Fox Foundation for Parkinson’s Research at www.michaeljfox.org.