Parkinson's Disease: Symptoms, Risk Factors, and New Therapies
Learn about Parkinson's disease, including its symptoms, risk factors, and the latest therapies to manage and improve quality of life.
Written by Dr. J T Hema Pratima
Reviewed by Dr. Shaik Abdul Kalam MD (Physician)
Last updated on 11th Sep, 2025
Introduction
Parkinson's disease is a progressive neurodegenerative disorder that affects millions of people worldwide. While often associated with a tell-tale tremor, it's a complex condition with a wide range of symptoms that extend far beyond movement. Understanding the early signs and risk factors is crucial for seeking timely intervention, which can significantly improve quality of life. The landscape of Parkinson's treatment is also rapidly evolving, moving beyond traditional management to include groundbreaking therapies that offer real hope. This comprehensive guide will walk you through everything you need to know, from the first subtle symptoms you shouldn't ignore to the latest advancements in treatment. Whether you're concerned for yourself or a loved one, knowledge is the first step toward effective action and maintaining control over your health.
What is Parkinson's Disease?
At its core, Parkinson's disease is characterised by the loss of nerve cells (neurons) in a specific area of the brain called the substantia nigra. These neurons are responsible for producing dopamine, a crucial chemical messenger that facilitates smooth, coordinated muscle movement. As these cells deteriorate and dopamine levels drop, the brain's ability to control movement diminishes, leading to the classic motor symptoms of the disease. Additionally, the presence of abnormal protein clumps called Lewy bodies, primarily made of a protein called alpha-synuclein, is a key pathological feature. It's important to understand that Parkinson's is a progressive disorder, meaning symptoms gradually worsen over time, but the rate of progression varies greatly from person to person.
Consult a Neurologist for the best advice
Recognising the Early Signs and Symptoms
Early detection of Parkinson's can be challenging because symptoms often start gradually and may be mistaken for normal signs of ageing. However, recognising these early symptoms of Parkinson's disease is vital for early diagnosis and management.
Primary Motor Symptoms
The four cardinal motor signs are the hallmarks of a Parkinson's diagnosis.
1. Tremor
A slight shaking or tremor often begins in a limb, usually a hand or fingers. This is called a "pill-rolling" tremor because it looks like rolling a pill between the thumb and forefinger. It typically occurs at rest and may lessen when performing a task.
2. Bradykinesia
This refers to slowness of movement. Over time, Parkinson's disease may reduce your ability to move, making simple tasks difficult and time-consuming. Your steps may become shorter, or you might find it hard to get out of a chair.
3. Rigidity
Muscle stiffness can occur in any part of the body. This stiffness can be painful and limit your range of motion, making it difficult to swing your arms when you walk or turn over in bed.
4. Postural Instability (Balance Problems)
This symptom often appears in later stages but can be a significant risk factor for falls. It leads to impaired balance and coordination, causing a person to become unstable when standing or changing direction.
Non-Motor Symptoms: The Often-Overlooked Signs
Years before motor symptoms appear, individuals may experience several non-motor issues. These are critical early signs of Parkinson's that are frequently missed.
1. Loss of Smell (Anosmia)
A reduced ability to smell certain foods, like bananas, dill pickles, or licorice, is a very common early indicator.
2. Sleep Disorders and REM Sleep Behaviour Disorder
This involves physically acting out vivid, often unpleasant dreams with vocal sounds and sudden arm or leg movements during REM sleep, a strong predictor of neurodegeneration.
3. Mood Changes: Anxiety and Depression
Depression and anxiety are very common in people with Parkinson's, sometimes appearing years before motor symptoms. They are not just a reaction to the diagnosis but are part of the disease process itself.
Who is at Risk? Understanding Parkinson's Disease Risk Factors
The exact causes of Parkinson's remain unknown, but research points to a combination of genetic and environmental factors.
Uncontrollable Risk Factors
Age: The single greatest risk factor. The risk increases significantly after age 60.
Heredity: Having a close relative with Parkinson's slightly increases your risk. However, this does not mean Parkinson's is hereditary in a simple, straightforward way for most people. Specific genetic mutations are linked to only a small percentage of cases.
Sex: Men are about 1.5 times more likely to develop Parkinson's than women.
Potentially Controllable Risk Factors and Environmental Triggers
Exposure to Toxins: Ongoing research is looking at a potential link between prolonged exposure to herbicides and pesticides and a slightly increased risk of Parkinson's.
Head Trauma: Repeated blows to the head may be linked to a higher risk, as seen in some boxers.
How is Parkinson's Disease Diagnosed?
There is no single definitive test for Parkinson's. A diagnosis is primarily made by a neurologist based on your medical history, a review of your signs and symptoms, and a neurological and physical examination. A significant improvement in symptoms after starting levodopa medication is often a strong confirming indicator. In some complex cases, a DaTscan (a specific type of brain imaging) may be used to help differentiate Parkinson's from other conditions with similar symptoms, like essential tremor.
New and Emerging Therapies Offering Hope
While there is no cure yet, the field of Parkinson's disease treatment is advancing rapidly, focusing on better symptom control and slowing disease progression.
Advanced Drug Therapies and Formulations
Newer formulations of levodopa, such as inhaled levodopa (Inbrija), are designed to quickly manage "off" periods, times when medication wears off and symptoms return. Continuous subcutaneous infusion pumps are also being developed to provide a steadier dopamine level.
Focused Ultrasound (FUS)
This is a non-invasive procedure that uses sound waves to target and destroy specific brain areas responsible for tremors. It's an alternative to Deep Brain Stimulation (DBS) for some patients, performed without any incisions.
Gene Therapy and Cell Replacement Therapy
These are the frontiers of research. Gene therapy aims to deliver genes to the brain that instruct cells to produce dopamine themselves. Cell replacement therapy involves transplanting lab-grown, dopamine-producing neurons into the brain to replace those that have been lost. While still largely experimental, these approaches hold immense promise for altering the course of the disease. If you are considering these new treatment options, it's essential to consult a neurologist online with Apollo24|7 to discuss their suitability for your specific condition.
Living Well with Parkinson's: Management and Support
A comprehensive management plan is multi-faceted. Physical therapy helps improve balance, flexibility, and strength. Occupational therapy assists with daily activities, and speech therapy can address voice softness and swallowing difficulties. Support from family, friends, and Parkinson's support groups is invaluable for mental and emotional well-being.
Conclusion
If you or a loved one are experiencing persistent symptoms beyond typical ageing, such as a slight tremor, changes in handwriting, or loss of smell, it is crucial to seek professional evaluation. Consulting a neurologist is the critical first step. You can book a convenient online consultation with an expert neurologist on Apollo24|7 to discuss your concerns and determine the best path forward.
Consult a Neurologist for the best advice
Consult a Neurologist for the best advice
Dr. Aditendraditya Singh Bhati
Neurosurgeon
18 Years • MBBS(2004), DNB Neurosurgery(2014); MNAMS; Fellow Neuroendoscopy
Delhi
Apollo Hospitals Indraprastha, Delhi
(100+ Patients)
Dr. Ganeshgouda Majigoudra
Neurologist
10 Years • MBBS, MD ( GENERAL MEDICINE) DM (NEUROLOGY)
Bengaluru
Apollo Clinic, JP nagar, Bengaluru
Dr. E Prabhakar Sastry
General Physician/ Internal Medicine Specialist
40 Years • MD(Internal Medicine)
Manikonda Jagir
Apollo Clinic, Manikonda, Manikonda Jagir
(125+ Patients)
Dr Rajashekar Mummadi
Neurologist
3 Years • MBBS, DNB General Medicine, DRNB Neurology
Hyderabad
Dr Ram's Neuro Clinic, Hyderabad
Dr S Selvin
Neurologist
10 Years • MBBS, MD, DM (Neurology), FINR fellowhsip in Interventional Neuro Radiology
Chennai
Apollo Speciality Hospitals Vanagaram, Chennai
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Frequently Asked Questions
1. Is Parkinson's disease fatal?
No, Parkinson's disease itself is not fatal. However, complications from the disease, such as pneumonia or falls, can be serious. With modern treatment, most people have a normal or near-normal life expectancy.
2. Can Parkinson's be prevented?
Since the exact cause is unknown, there is no proven way to prevent it. However, some research suggests that regular aerobic exercise and a healthy diet may have a protective effect on brain health and could potentially reduce risk.
3. What's the difference between Parkinson's and Alzheimer's?
Both are neurodegenerative disorders, but they affect the brain differently. Parkinson's primarily affects movement due to a loss of dopamine-producing cells, while Alzheimer's primarily affects memory and thinking due to a buildup of amyloid plaques and tau tangles.
4. Do all people with Parkinson's get a tremor?
No. While tremor is a common symptom, about 30% of people with Parkinson's do not have a noticeable tremor at onset. Their disease may be dominated by slowness and stiffness (bradykinesia and rigidity).
5. How does deep brain stimulation (DBS) work?
DBS involves surgically implanting electrodes in specific areas of the brain. These electrodes are connected to a device (like a pacemaker) implanted in the chest that sends electrical pulses to the brain. These pulses can help block the abnormal nerve signals that cause tremors and other motor symptoms.