Parkinson’s Disease research by Tanner

What is Parkinson’s Disease?

In the late 1400’s Leonardo Da Vinci wrote about “people who shake without permission of the soul”.  In 1817, a British scientist named James Parkinson first described “the shaking palsy” in an essay.  This disease wasn’t understood much then, and there is still much we don’t understand today. 

Parkinson's disease is one of the most common diseases affecting movement in people over the age of 55. It affects approximately 1 in every 250 people over the age of 40, and around 1 in every 100 people over the age of 65. There are as many as 60,000 new cases each year and it is estimated about 1 million people in the U.S. are currently living with Parkinson’s.  The average onset is 57 years old, but younger people can get it.  There is even a case of a 3 ½ year old, who was diagnosed with Parkinson’s Disease.

Parkinson’s disease is a chronic, progressive neurological disease.  It belongs to a group of conditions called motor system disorders, which are the result of the loss of dopamine-producing brain cells.  Dopamine, a neurochemical that controls communication between brain cells, is responsible for control of motor function.  Parkinson’s disease is caused by the progressive impairment or deterioration of neurons (nerve cells) in an area of the brain known as the substantia nigra. When functioning normally, these neurons produce a vital brain chemical known as dopamine. Dopamine serves as a chemical messenger allowing communication between the substantia nigra and another area of the brain called the corpus striatum. This communication coordinates smooth and balanced muscle movement. A lack of dopamine results in abnormal nerve functioning, causing a loss in the ability to control body movements

Parkinson’s Disease is a disease of the central nervous system.  The CNS includes the brain and spinal cord, which are the control and coordination centers of the body. The spinal cord transports messages to and from the brain.  If certain parts of the brain are damaged and not functioning properly, messages cannot get through.  When messages aren’t sent effectively serious problems can result. 

Message that move muscles begin in the motor cortex of the cerebrum.  Most of this activity takes place of the cerebral cortex, the outer most layer of the brain.  This layer contains billions of neurons, which receive messages from different parts of the body, or different parts of the brain.  These neurons also send out messages to control the activities of the body.  Different groups of neurons have different jobs.  Motor neurons carry messages from the brain and spinal cord to muscles of the body, glands and various other structures.    These neurons help us walk, run, kick a ball, hold a fork, drink from a cup, chew your food, read, talking, etc.  Neurons connect like chains and transfer messages throughout the body with electrical signals.  Each neuron is made to either receive or send these signals.  Each neuron has a cell body with a lot of thread-like fibers extending from it.   The neuron sends information to the other nerve cells through a single long hair-like fiber, called an axon, which extends from the cell body.  The other thread-like fibers extending from the cell body are called dendrites.  The dendrites received information from other nerve cells.  Each axon ends with a cluster of little branches called terminals.  Each axon terminal can relay messages to another nerve cell.  There is a small fluid-filled gap between the axon terminals and neighboring dendrite, called a synapse and the nerve message needs to get across the synapse.

When a neuron is active an electrical charge travels along it to the axon terminals.  These terminals release a special fluid called neurotransmitters.  These neurotransmitters float through the fluid in the synapses to the dendrites of the next neurons in the chain.  With Parkinson’s Disease there is not enough dopamine (neurotransmitters) to get these messages across the synapse to the receiving neuron.  Because of this, the messages can’t travel and get to the muscles of the body therefore there can be little or no movement at all, even if the person wants to move.

What are some of the possible causes of the Disease?

Currently doctors and scientists are still trying to figure out what causes Parkinson’s Disease. Some possible causes include:

·         Virus - Some think a virus may be involved in causing Parkinson’s Disease. 

·         Drug induced – Some drugs have resulted in a drug-induced Parkinson’s Disease.

·         Head trauma – The disease can be produced by head trauma/brain injury and many boxers get this condition.

·         Genetic Factors – Scientist are discovering more about the genetic link.  They have isolated some genes that are more common in families that pass on Parkinson’s disease.  They believe a defective gene is making some people more sensitive to environmental toxins. 

·         Environmental Toxins – Some scientists believe that environmental toxins might be the cause for Parkinson’s disease.  Farmers are 7 times more likely to get Parkinson’s disease.  Pesticides and toxins in the environment are damaging the brain cells that produce dopamine.

What are the symptoms of the disease and the impact on the quality of life?

·         Tremors - uncontrollable shaking of their hands, feet, legs, lips and jaws.

·         Rigidity -  The have extreme stiffness in their limbs which can make it very hard to move..

·         Slowness of movement (bradykinesia).

·         Impaired balance and coordination.  Parkinson’s patients have a hard time balancing and can fall a lot.  Overtime patients begin to lose their ability to walk.

·         Freezing – Patients can suddenly stop and freeze, being unable to move at all.  It can affect many things including speech and walking.

·         Dementia – Patients can get disoriented and can get very confused.  They also can have memory loss.

·         Depression – Patients often feel very sad . About 50% of patients need to be treated with antidepressant medications.

·         Facial Masking – The muscles of the face get stuck and frozen, so their face can have no expression on it.

·         Difficulty in swallowing and chewing.  They often have choking and drooling because they can’t use their swallowing muscles.

·         Speech problems – Speech is often spoken very softly and in a monotone voice, or they may speak too quickly.  They can slur their words making it very hard to understand them, and can lose their ability to speak at all.

·         Urinary & constipation problems

·         Skin problems

·         Sleep problems

·         Handwriting problems – Handwriting may appear small and very crowded.  Later in the disease they can lose the ability to write at all.

This disease is awful because it leaves people stuck in their own bodies.  Often their mind is fully working, but they are unable to control their own bodies.

Cure

Currently there is no cure, therapy, or drug to really slow or stop the progression of Parkinson’s disease.  While medication masks some symptoms for a while, it can be only four to eight years that it really works.  Unfortunately, there are many unpleasant side-effects from the medication.  Eventually the medications lose their effectiveness, leaving the person unable to move, speak or swallow.

Congress is taking up a bill to help learn more about Parkinson’s.  They will start to collect information about all the Parkinson’s patients in America. This will give scientists important information about the number of people with the disease, where they live, if there are clusters of the disease, etc., so they can discover more about Parkinson’s and hopefully find a way to prevent or cure it. 
Treatment 

·         Medication  - Commonly used medication is called L-dopa.  The medications help substitute for dopamine.  Medications work to replace the missing dopamine.
Medications work to replicate or replace the missing dopamine.

·         Physical Therapy

·         Nutrition and Exercise

·         Stem Cell research

·         Genetic Research

·         Brain Surgery - One includes deep brain stimulation, where they surgically put in something like a pace maker by your collar bone and a wire going up to your brain.  It puts a high frequency electric current into the brain and helps to paralyze parts of the brain causing tremors.

How Robotics help in the research & treatment of PD?

  It is a growing field with much to be discovered and a lot more research needed.  Some people are working on robot-assisted gait therapy in the rehabilitation of people with Parkinson’s Disease.  Other researchers are working on the development of MRI-compatible robotic systems which will hopefully assist in deep brain stimulation and surgery for Parkinson’s patients someday.

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Possible Solutions:

·         Nanobots could go in and get information about what areas of the brain are affected and would send a report to a computer to map out where the brain cells are dying.

·         Send in nano robots that are as small as cells to come in and study the human brain/body.  We could use this information to help make better medicine and treatment.

·         More nanobots would be placed in the brain with some artificial dopamine, which is continually released into the precise location needed and with the precise consistent amount.

·         Locate healthy brain cells in the area and the nanobots would take these brain cells.  Then scientists would put them into a petri dish and grow more. After removing the damaged or dying brain cells, the nanobots would replace them with the new healthy brain cells.

·         Make wireless connections with the brain and have the nanobots watch the brain from inside.  The nanobots would send signals to a computer and that way we could have a better idea of how Parkinson’s disease progresses.

·         Since people with Parkinson’s need physical therapy and usually don’t get enough, or can’t even get to the location where therapy is offered because they are homebound…a possible solution would be to have a life size robot that would mimic a physical therapist. 

·         Robots could also be very useful as helpful companions that offer support to those with advanced Parkinson’s.  The robot could be programmed to help them with many daily living skills.  It could help them hold silverware where they cannot, help with fine motor movements that they lose, opening things which they can’t, lift things, brush hair, help out of chair when stuck, could glide aside from them and help them gain balance, and protect them from falls, etc.

Meeting with Special Guests

Three ladies with Parkinson’s Disease joined us for the afternoon.  We got to each lunch with them and got to spend a few hours asking them questions and sharing.  We learned a lot more about the disease from them and how it affected their lives.  They shared information about their various treatments and their challenges.  We really appreciated how they all focused on what they were still able to do, and not what they were no longer able to do.  They all shared their hope that someday the medical field would not see them as a “disease”, but instead as “people with a disease.  Each of the speakers shared how the disease has helped them to really appreciate the little things in life. They all lit up and got really excited about our teams idea to create robots that could help them with daily living skills and to assist them with movement and protect from common falls.  I am thankful that they took the time to be with us.