Understanding Idiopathic Parkinson’s Disease

"Idiopathic" refers to a medical disease where there is no known aetiology. Idiopathic Parkinson's disease is the most common diagnosis. Being born with a male gender assignment and being older are risk factors.

Parkinson's disease is a neurological condition that worsens with time and impairs mobility. Non-motor symptoms can also be very varied in this disease.

The majority of Parkinson's disease diagnoses are idiopathic, meaning that the cause is unknown.

An expert in treating idiopathic Parkinson's disease (IPD) must thoroughly rule out other illnesses that might be causing the same symptoms.

A more thorough review of IPD is provided in this article, together with information on who is at risk, how to diagnose, and how to treat it.

Language matters

You'll see that the terminology used to present statistics and other information is largely binary, particularly when the word "male" is used.

It is important to be detailed when reporting on study participants and clinical findings, even though we often avoid using language like this.

Regretfully, neither the statistics nor the inclusion of transgender, nonbinary, gender nonconforming, genderqueer, agender, or genderless participants were reported in the source cited in this section.

What is idiopathic Parkinson’s disease?

IPD is the diagnosis made for Parkinson's disease when there is no known aetiology. It comprises the majority of Parkinson's disease diagnoses.

Only 10-15% of cases of Parkinson's disease have a documented hereditary aetiology. In comparison to those with IPD, these people frequently experience an earlier onset of Parkinson's disease.

Idiopathic Parkinson’s disease vs. Parkinsonism

The word "Parkinsonism" refers to a broad range of illnesses that cause movement issues akin to those caused by Parkinson's disease. Some of these diseases may also be referred to as "Parkinson's plus." Some instances are:

• Lewy body dementia
• progressive supranuclear palsy
• corticobasal degeneration
• multiple system atrophy

Furthermore, several established causes, including exposure to specific medications (drug-induced parkinsonism) and cerebrovascular illness (vascular parkinsonism), can result in secondary parkinsonism.

The Parkinson's Foundation claims that because of their comparable symptoms, it can be challenging to determine early on whether a person has IPD or whether there is a recognised cause of Parkinsonism. Other causes of Parkinsonism, as opposed to IPD, include:

• progress more quickly

Exhibit extra symptoms and indicators, such as:

• early onset dementia
• involuntary muscle twitching
• hallucinations

• first impact both sides of the body rather than just one
• not adequately respond to levodopa (Sinemet), a medication used frequently to treat Parkinson's illness

What causes idiopathic Parkinson’s and who’s at risk?

Brain nerve cells suffer damage and eventually die in IPD. This damage is thought to be facilitated by the accumulation of the protein alpha-synuclein in Lewy bodies inside nerve cells. It is unknown what causes Lewy bodies to form.

The brain region most frequently impacted by IPD is the substantia nigra. This region of the brain, which is home to many dopamine-producing nerve cells, is crucial for motor control. One neurotransmitter that aids in regulating muscle tone and action is dopamine. Parkinson's disease is characterised by a lack of dopamine.

The following are a few possible risk factors for IPD:

• previous exposure to pesticides
• older age
• being of the male sex

What are the symptoms of idiopathic Parkinson’s disease?

The following are the three primary signs of Parkinson's disease, including IPD:

• tremor
• muscle rigidity
• slow movements (bradykinesia)

Postural instability, a condition where IPD-related alterations in posture and gait impair balance and raise the risk of falling, may also develop over time.

Parkinson's disease can also cause a wide range of non-motor symptoms and indicators, such as:

• mood disorders like anxiety and/or sadness
• fatigue
• speech changes
• trouble sleeping
• constipation
• sexual dysfunction
• orthostatic hypotension
• urinary difficulties
• reduced sense of smell
• difficulty swallowing
• dementia

How is idiopathic Parkinson’s disease diagnosed?

IPD cannot be proved to be diagnosed with any degree of certainty by any test.

As part of the diagnosing process, a doctor will try to rule out other possible reasons for your symptoms, such as drug interactions or other neurological conditions. Typically, this procedure is carried out by:

Doing a comprehensive neurological and physical examination, where they will look at your:

• movement
• muscle tone
• speech
• mental status
• balance
• posture

Obtaining a thorough medical history that includes details about:

• information about your symptoms, including when they first appeared, how bad they are, and whether anything helps or worsens them
• whatever prescription drugs you already take
• any underlying medical issues
• specific medical issues that could run in your family

To help rule out other possible causes of your symptoms, other testing, including blood and imaging tests, may also be performed.

Parkinson's disease diagnosis can also be made based on response to levodopa medication. This is because this medicine usually has an adverse effect on other illnesses, such as other causes of Parkinsonism.

How is idiopathic Parkinson’s disease treated?

Medications are usually used to treat IPD. These drugs relieve the motor symptoms of IPD by altering dopamine levels in the brain. One of the most often prescribed drugs for IPD is levodopa.

You might also be prescribed additional drugs if you have IPD. These could be designed to lessen symptoms that aren't related to movement, such as sadness, constipation, or problems with sex.

A significant component of the therapy of IPD is nonmedical interventions. Among these therapies could be:

• either occupational therapy or physical therapy
• psychotherapy
• speech therapy

Deep brain stimulation may be a possibility if the symptoms of IPD are extremely severe or if the medicine isn't working. Electrodes that have been surgically implanted are used in this treatment to activate specific brain regions.

What’s the outlook for someone with idiopathic Parkinson’s disease?

IPD has no known treatment. Rather, the goal of treatment is to improve the quality of life and reduce symptoms.

IPD is progressive, meaning that with time, it progressively worsens. Most patients with Parkinson's disease are expected to have a recognised handicap within ten years.

Since each individual with IPD is unique, it might be difficult to anticipate with precision how each person's IPD will develop.

People with Parkinson's disease often have the same life expectancy as the general population.

A 2018 study found that those with idiopathic disease had a lower life expectancy, although it also pointed out that this conclusion depended on the particulars of the illness. For example, the life expectancy of those without cognitive impairments was average.

Takeaway

The majority of Parkinson's disease diagnoses are idiopathic, meaning that no clear cause can be found. The underlying cause of just a tiny percentage of Parkinson's disease diagnoses is believed to be genetic.

A physician must rule out other illnesses that have comparable symptoms, such as other causes of Parkinsonism, to diagnose IPD. They will closely examine your medical history and symptoms to complete this process.

Medication and possibly non-medical therapies like physical therapy or psychotherapy are used to treat IPD. IPD does not presently have a treatment. The course and results of IPD can differ from person to person.

FAQs

Can you live with Parkinson's without medication?

People with Parkinson's disease can maintain their physical function, improve their quality of life, and improve their overall health and well-being in a variety of ways.

Is Parkinson's painful at the end?

Pain can become more frequent and severe in a person with advanced Parkinson's

How long does it take to go from Stage 1 to Stage 4 Parkinson's?

most people go up one stage every two years

Can Parkinson's stay mild for years?

It is possible to live a full and active life with this condition.