Smooth Movements: Treatments for Parkinson's Disease

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Photo source: Nicholas Rougier/Wikimedia Commons

My typical morning almost always begins with a cup of coffee. I add my favorite Columbian coffee grounds and water into my coffeemaker, heat up some milk, and pour them both into my coffee mug. As simple as that sounds, there are actually a lot of individual steps that go into making my morning coffee. Imagine what would happen if my hand started to shake uncontrollably while I was adding the grounds or if I was unable to smoothly pour my coffee from the pot to my mug.

Being unable to control my movements seems intolerable to me. And yet, that’s the reality for the more than 1 million people living with Parkinson’s disease (PD) in the United States. PD is a debilitating movement disease that causes uncontrollable shaking of the hands, slowing of movements, and loss of proper body posture. In addition, there are many non-motor symptoms including mood disorders, cognitive changes, and sleep disturbances.

PD is caused by the death of a group of neurons that release a chemical, dopamine, in a region of the midbrain known as the substantia nigra pars compacta. These neurons are crucial in regulating proper, smooth movements. Their deterioration causes the shaking and tremors seen in PD. It may seem obvious that one way to treat PD is to provide the brain with more dopamine. Indeed, one of the classic methods of treatment does involve enhancing dopamine production in the brain with a drug called levodopa. Levodopa is a compound that can easily enter the brain and be converted to dopamine. However, this isn’t a perfect solution for all patients, as some patients respond better than others. More recently, a promising treatment has been introduced, called deep-brain stimulation (DBS). As the name implies, this is a treatment option whereby an electrode and a device called an implantable pulse generator (similar to a pacemaker) are implanted into the brain. Often, the electrode is placed in an area of the brain called the subthalamic nucleus. The mechanism by which DBS works is unclear. While it does not directly change levels of dopamine in the brain, it is thought to work by correcting abnormal electrical signals that are responsible for many of the symptoms seen in PD.

DBS is becoming an increasingly alluring treatment option for many patients, as it can significantly reduce motor symptoms. However as with any treatment, there is still much research to be done for improving it and fully understanding it. There are labs at Northwestern University, such as those of Drs. Bevan, Krainc, and Mazzullithat are dedicated to understanding the mechanisms by which dopamine-producing neurons die and how to improve existing treatment options. Hopefully with time and promising results, we’ll all be able to see the day when making a cup of coffee becomes an effortless task for everyone.

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