Around 200, 000 people in Germany are affected by the nerve disease Parkinson's disease. On average, the disease is recognized one year after the onset of the first signs. The reason is that the symptoms in the early stages are very unspecific and do not directly think of Parkinson's. However, the earlier you can start therapy, the better the long-term course of the disease.
Skin test offers hope for early detection
In February 2017 researchers were able to prove for the first time that an examination of the nerve cells of the skin can detect Parkinson's disease. In Parkinson's disease, deposits of proteins (proteins) in certain regions of the brain are known to occur. The protein "alpha synuclein" is deposited not only in the brain, but also in the skin nerve cells. Even years before the onset of obvious motor symptoms. When this Parkinson's test can be routinely used is still unclear.
Transcranial ultrasound - certainty in the early stages?
Another method that researchers are working on is brain ultrasound, transcranial sonography. Through a natural bone window on the temple, the doctor can determine the reflection of the sound waves of the brain region Substantia nigra. An amplified signal is indicative of cell degeneration in this area, as is typical of Parkinson's disease.
The test could help diagnose Parkinson's disease in the early stages, but also shows abnormalities in nine percent of healthy volunteers.
A first indication: the sense of smell disappears
The decline and disappearance of the sense of smell (hyposmia or anosmia) is a common symptom in the early stages of Parkinson's disease.
The affected person first noticed a loss of taste, which is closely linked to the sense of smell. The basic flavors sweet, sour, salty, umami and bitter can often still be perceived.
The cause of this are degradation processes in the olfactory center of the brain. These occur about four to six years before the motor symptoms. A smell test with a neurologist can provide information. The subject will be presented with different odor samples.
Unspecific pain as an early symptom
Pain can be an early sign of Parkinson's disease. They often affect shoulders and arms or other parts of the musculoskeletal system. Also burning, pulling or tingling pain is reported. They are similar to complaints from the rheumatic type and are rarely directly associated with Parkinson's disease.
In the late stage, orthopedic problems arise as a result of bad posture. Since many diseases are associated with pain, the diagnosis without further Parkinson's symptoms is very difficult to make. Most patients are first examined by orthopedics or rheumatology before being referred to a neurologist.
Sleep disorders in the initial stage
In a more advanced stage of the disease, the so-called Schenck syndrome can occur. It is a behavioral disorder during sleep, characterized by jerky, often violent movements.
The reason for this is the absence of the flaccid paralysis that normally occurs during the REM sleep phase. The affected people live out what they dreamed about physically as well. In addition to a neurological examination, the diagnosis is usually done in a sleep laboratory.
Depression in Parkinson's disease
Sometimes a depressed mood, including depression, is an early symptom of Parkinson's. Listlessness, lack of interest and joylessness are manifestations of this. If there are no motor abnormalities, Parkinson is rarely suspected.
In later stages of the disease, the depressive mood is aggravated by the progression of the disease and the concomitant everyday limitations.
Dementia and Parkinson's disease
Often Parkinson's patients in the late stage develop an additional dementia disease, ie a slowing of memory performance to memory loss. The personality changes too. Those affected are disoriented, confused and often in need of care.
Delineated is this dementia caused by the breakdown of dopaminergic cells from other dementia diseases, such as Alzheimer's dementia.
Tremor, Rigor, Akinese - the typical Parkinson's triad
A classic symptom of Parkinson's disease is the tremor of parts of the body, most commonly the hands. Doctors speak of tremor. Typical of Parkinson's disease is a tremor that is dormant and disappears when focused on movement. Every new tremor should be treated with Parkinson's disease. However, it is usually observed only in the advanced stage of the disease.
Striking is also the generally reduced mobility of the person concerned. Parkinson's patients are moving slowly and need more time for many everyday things. One speaks of Akinese. In the further course, "dyskinesia" can also occur. These are jerky, unwanted movements.
Another classic phenomenon is the so-called rigor, a muscle stiffness, which complicates the movement even more.
The role of the eyes in the early detection of Parkinson's
Only in recent years, researchers have found that even the eyes start to shake, so develop a "tremor". That can go unnoticed by the environment. The patients themselves rarely detect this eye tremor.
If Parkinson's disease is suspected, an ophthalmologist's eye examination may reveal possible eye tremor.
Symptoms in the late stages
The gait pattern of a person with Parkinson's disease is always similar: small steps without swinging of the arms, of which often only one side of the body is affected in early stages. A clear change of the image occurs only in later stages of the disease.
Disorders of muscle functions
In Parkinson's patients, fine motor skills are limited during the course of the disease. Accessing, opening bottles, combing hair or closing the trouser button is becoming more and more difficult for sufferers.
Due to the decreasing controllability of the hand and finger muscles also changes the typeface of those affected. Many people with Parkinson's are very short and scrawly.
Since the facial muscles can be moved less, the face looks stiff and expressionless, the facial expression is frozen ("mask face"). Even the language can be impaired and sound monotonous and washed out.
How is Parkinson's disease still announcing?
In addition to the motor symptoms, there are also changes in the autonomic nervous system. This controls numerous involuntary processes of the body.
So for example the blood pressure. Many Parkinson's suffer from low blood pressure - dizziness and fainting may result. Due to a dysfunction of the sweat glands they produce too much secretion and increased sweating is the result.
Another affected organ is the intestine, which can become sluggish and thus cause blockages. Likewise, the bladder muscles may be weakened and result in urinary incontinence.
Who can get Parkinson's?
Everyone can get Parkinson's disease. Cause is a lack of a messenger in the brain, the dopamine. Consequence is a disturbance of the motor control and thus malfunctions of the arbitrary and involuntary muscle cells.
The first signs usually appear from the age of 55 to 65 years, but earlier or later breakouts are possible. Only after the death of about 50 percent of the dopaminergic nerve cells symptoms are visible.
Various forms of Parkinson's
There are several forms of Parkinson's disease, the most common is no cause recognizable (idiopathic Parkinson's syndrome). However, there are also hereditary forms that underlie a mutation in the genes of a parent. However, these forms are much rarer than idiopathic Parkinson's disease and usually occur in younger years. A genetic test can provide certainty.
Other Parkinson's forms are secondary and atypical Parkinson's syndrome.
How do I recognize Parkinson's disease?
The problem of the individual early symptoms of the disease is that they are very nonspecific. There are many signs of the environment first, such as the altered typeface, the lack of facial expressions or the one-sided swinging of the arms.
If pain or depression leads to a doctor's visit, Parkinson's disease is rarely suspected first and foremost. On the other hand, in advanced stages with motor symptoms such as rigor, tremor, and akinesia, eye diagnosis is often possible.
13 possible early warning signs for Parkinson's in overview
- Protein deposits in the skin (alpha synuclein)
- Cell depletion in the brain region Substantia nigra
- Loss of the sense of smell
- Non-specific pain, especially of the musculoskeletal system
- Sleep disorders ("Schenck syndrome")
- Tremor, rigor and akinesia
- Tremor of the eyes
- classic gait
- changed typeface
- rigid facial expressions (mask face)
- low blood pressure, increased sweating, constipation, urinary incontinence due to disorders of the autonomic nervous system
Our parkinsonian screening test can help to detect possible symptoms at an early stage.