As a regional leader in providing care for neurological conditions, Norton Neuroscience Institute is dedicated to offering the most advanced treatments and support for people with Parkinson’s disease.

Parkinson’s disease usually affects people between the ages of 55 and 75, but it can develop at an earlier age. Nearly 1 million Americans are living with the disease.

While a cure has yet to be found for Parkinson’s, Norton Neuroscience Institute offers advanced, leading-edge treatments to help control your symptoms.

Early detection and treatment can preserve quality of life and manage symptoms.

What is Parkinson’s Disease?

If you have a diagnosis of Parkinson’s disease, you may be wondering what it is, what you can expect or what kinds of treatments are available to manage the condition. Parkinson’s disease is a progressive neurological (brain) disorder that is caused by the breakdown of nerve cells (neurons) in the part of the brain that controls movement. These nerve cells die or become damaged, losing the ability to produce an important chemical called dopamine. Studies have shown that symptoms of Parkinson’s develop in patients with an 80% or greater loss of dopamine-producing cells.

Understanding Parkinson’s Disease

Parkinson’s disease is considered a movement disorder. The symptoms of Parkinson’s are caused by a loss of neurons that produce dopamine. When dopamine levels decrease, brain activity becomes irregular, which leads to issues with movement, speech and balance.

Doctors don’t know what causes Parkinson’s disease, but several factors appear to play a role, including:

• Genes: There are specific genetic changes that can cause Parkinson’s disease, but these are rare — except in some cases with many family members affected by Parkinson’s disease.
• Environmental triggers: Exposure to certain toxins or environmental factors may increase the risk of later Parkinson’s disease, but the risk is small.

Research has shown that the brains of people with Parkinson’s have certain changes, but it is not clear how those changes affect the disease. People with Parkinson’s have:

• Misfolded alpha-synuclein: Alpha-synuclein is a naturally occurring protein in the body, much of it in the brain. A mutation in this protein causes it to fold in on itself, forming a clump.
• Lewy bodies. These are abnormal microscopic clumps in brain cells. Lewy bodies are made up of several substances, but the main component is misfolded alpha-synuclein.

Researchers believe these Lewy bodies hold an important clue to the cause of Parkinson’s disease.

Risk factors for Parkinson’s include:

• Age: People typically develop Parkinson’s around middle age or later in life, and the risk increases with age.
• Genetics: Having a close relative with Parkinson’s disease increases the chances that you’ll develop the disease. However, your risks are still small unless you have many relatives in your family with Parkinson’s disease.
• Gender. Men are more likely to develop Parkinson’s disease than are women.
• Exposure to toxins: Ongoing exposure to herbicides and pesticides may increase your risk of Parkinson’s disease slightly.

Symptoms of Parkinson’s Disease

Most people think any shaking in the hands is a sure sign of Parkinson’s disease, but there are other conditions that make your hands shake, including essential tremor. A trained health care professional can tell the difference between Parkinson’s and essential tremor.

Other symptoms of Parkinson’s include:

• Shaking mainly on one side of the body
• Shaking that happens when the body is at rest
• Slowness of movement (bradykinesia)
• Muscle rigidity and stiffness
• Average age of onset: 60, typically with increased disability over time
• Shaking occurring in the upper and lower extremities, usually not in the head

Parkinson’s symptoms affect everyone differently, from the severity of symptoms to how quickly they get worse. Doctors use stages to describe how Parkinson’s disease progresses.

Stage 1: Symptoms are mild and do not interfere with daily life. Tremors and other movements happen only on one side of the body. Changes in posture, how someone walks and facial expressions are somewhat noticeable.

Stage 2: Symptoms get worse. Tremor, rigidity and other movement symptoms affect both sides of the body or the torso/neck areas. Difficulty walking, poor posture and balance issues also may be getting worse. Daily tasks become more difficult.

Stage 3: Mid-stage progression is when loss of balance is apparent. Falls become more common. Motor symptoms get worse. Daily activities are restricted, but the person still can be mostly independent.

Stage 4: Symptoms are fully developed and severely disabling. The person may be able to walk and stand by themselves, but may need a cane or walker to move safely. The person is no longer able to live alone.

Stage 5: Symptoms are seriously debilitating. Stiffness may make it impossible to stand or walk. The person may need to use a wheelchair to get around, or may be bedridden. Constant care and supervision are needed for all activities.

Aside from the listed symptoms related to movement, the patient may have other symptoms, which may be treatable. Those include:

• Thinking difficulties: Cognitive issues, such as dementia and thinking difficulties, usually occur in later stages of Parkinson’s. Such cognitive issues usually aren’t helped by medicines.
• Depression and emotional changes: Depression, fear, anxiety and loss of motivation are common. These are all potentially treatable.
• Swallowing issues: As the condition progresses, patients may develop difficulties with swallowing. Saliva may accumulate in the mouth due to slowed swallowing, leading to drooling.
• Chewing and eating issues: Late-stage Parkinson’s disease affects the muscles in the mouth, making chewing difficult. This can lead to choking and poor nutrition.
• Sleep issues and sleep disorders: People with Parkinson’s disease often have sleep issues, including waking up frequently throughout the night, waking up early or falling asleep during the day. Medication may improve sleep.
• Bladder issues: Parkinson’s disease may cause bladder issues, including being unable to control urine or having difficulty in urinating.
• Constipation.: Many people with Parkinson’s disease develop constipation, mainly due to a slower digestive tract.
• Blood pressure changes: Patients may feel dizzy or lightheaded when standing, due to a sudden drop in blood pressure (orthostatic hypotension).
• Smell dysfunction: Patients report issues with their sense of smell. They may have trouble identifying certain odors or the telling the difference between odors.
• Fatigue: Many people with Parkinson’s disease lose energy and experience fatigue, especially later in the day.
• Pain: Some people with Parkinson’s disease experience pain, either in specific areas of their bodies or throughout their bodies.
• Sexual dysfunction: Some people with Parkinson’s disease notice a decrease in sexual desire or performance.

Diagnosis and Early Signs of Parkinson’s Disease

It is important to diagnose Parkinson’s disease as soon as possible. The symptoms of Parkinson’s are very similar to other conditions. In order for doctors to treat your specific disease correctly, testing is key.

There is no one test for Parkinson’s, but a new skin test may help doctors diagnose this disease. In addition to this test, doctors will ask about your family history. They also will perform a physical and neurological exam and look at your symptoms.

Your health care team may use other tests if needed.

Very early symptoms of Parkinson’s easily may be overlooked. They also can mimic many other conditions, so it is important to have an experienced health care provider evaluate you. Some early symptoms include:

• Sleep issues, such as insomnia or restless leg syndrome
• Losing your sense of smell
• Handwriting getting smaller
• Having to go to the bathroom more often
• Depression or anxiety
• Fatigue
• Tremor or other uncontrollable movement
• Slower movements

Parkinson’s Disease Treatment

While there is no cure for Parkinson’s, there are effective ways to manage symptoms so you can live a full and comfortable life. It is important to work with a multidisciplinary health care team so your Parkinson’s treatment experience is fully tailored for your needs.

Treatment for Parkinson’s may include medication, surgery or lifestyle changes. It typically will include all three, depending on your unique symptoms. Parkinson’s symptoms vary from person to person, in severity and response to treatment.

There is some evidence that aerobic exercise prevents the progress of Parkinson’s disease.

Early-onset Parkinson’s and Prognosis

It is unusual for people under age 60 to be diagnosed with Parkinson’s disease. About 5% to 10% of those diagnosed with Parkinson’s disease are under age 50, and about half of those are diagnosed before age 40. Approximately 90,000 new cases of Parkinson’s are diagnosed each year in the United States, meaning somewhere around 9,000 to 18,000 are young-onset patients.

Diagnosis between ages 21 and 50 is called early-onset or young-onset Parkinson’s disease (YOPD). While symptoms are mostly the same at any age, people with YOPD experience the disease differently from their older counterparts. YOPD symptoms may go overlooked for years due to age, meaning you could go undiagnosed or misdiagnosed for a long time. YOPD patients tend to have fewer other illnesses and generally are more capable during physical therapy treatments.

The disease progression looks different in younger Parkinson’s patients. The commonly used medication treatment levodopa can cause more involuntary movement issues in younger people. Other typical symptoms of Parkinson’s disease are less common or less severe in younger patients, including memory loss, confusion and balance issues.

YOPD patients need lifelong Parkinson’s care. It is important to have a multidisciplinary health care team to tailor a complete care plan.

Effects of Parkinson’s Disease

Parkinson’s disease doesn’t just affect your body and mind. It impacts your entire life, including relationships and mental health. It also can affect those around you — family, friends and co-workers. As human beings, social interaction is crucial to our overall well-being, so it is important to maintain that as long as possible.

Some of the ways Parkinson’s affects your life include:

• Socializing: You may not reach out to friends as often, as your symptoms may be unpredictable, or you may be more tired than usual. You may feel some embarrassment as your symptoms become more apparent. Parkinson’s also can affect your voice.
• Physical activity: While physical activity is beneficial for Parkinson’s patients, you may not feel like getting out and about like you used to do. You may need accessible facilities when you are at places like restaurants, theaters or other areas, for example, if you have mobility issues.
• Mental health: Depression and anxiety are common symptoms of Parkinson’s. These may keep you from your typical activities.

What to do about the social impacts of Parkinson’s:

• Communicate: Share with people how you are feeling, and what your limits are. You can also share information about the disease.
• Stay active: As your symptoms allow, stay involved. Accept invitations to go out or do things with friends. Check to see if venues are accessible.
• Join a support group: Being around other people with Parkinson’s can help you meet people who share your situation. These groups also can connect you to Parkinson’s resources in your area.

Prevent Parkinson’s Disease

Some recent studies show two ways to prevent the progress of Parkinson’s: aerobic exercise and limiting exposure to some chemicals. There has been some evidence that dietary changes can slow the symptoms of Parkinson’s.

Resources for People with Parkinson’s

Early detection and treatment of Parkinson’s is key. There are many ways to manage symptoms, especially if they are caught early.

Care That’s Focused on You

It’s part of Norton Neuroscience Institute’s goal to care for the whole person, not just the condition.

• Norton Neuroscience Institute Resource Centers offer ways to improve your access to care, provide valuable information on managing your disease and address your quality of life issues. The Norton Healthcare Foundation funds this important service, so patients don’t need to pay.
• Dedicated patient navigators can help schedule follow-up appointments, coordinate prescription assistance, create customized diet plans and provide guidance on disability benefits, housing, financial and employment concerns and more.
• Patients can access support groups, exercise classes and other educational events to connect with others and learn how to make the most of life while managing a neurological condition. 
• Access an on-demand video library of educational content across a variety of condition-related topics is available.
• We want to help prevent illness. Get help quitting smoking and learn the signs of stroke.
• Communicate with your provider, manage appointments, refill prescriptions and more anytime from a computer or mobile device with a free Norton MyChart account.

A Louisville Leader in Neurological Care

More patients from Louisville and Southern Indiana seek their neurology and neurosurgery care from Norton Neuroscience Institute’s nationally recognized specialists than any other providers in the area.

Your Norton Neuroscience Institute medical provider has the expertise, experience, diagnostic tools and sophisticated treatments to provide care tailored to your needs.

• More than 75 medical, surgical and research specialists are dedicated to providing innovative care to those with brain, spine and nervous system conditions.
• Advanced, minimally invasive neurosurgery equipment can speed your recovery and minimize pain.
• Multidisciplinary clinics provide easy access to care in one convenient appointment for your neurological condition, with specialists in oncology, cardiology, orthopedics and behavioral health.
• Norton Healthcare’s four adult-service hospitals in Louisville are certified by DNV, recognizing excellence and expertise in stroke care.
  • Norton Brownsboro Hospital is recognized as a Comprehensive Stroke Center.
  • Norton Audubon Hospital and Norton Hospital are Primary Stroke Centers.
  • Norton Women’s & Children’s Hospital is an Acute Stroke Ready Hospital.
• Norton Neuroscience Institute is at the forefront of neuroscientific research. As investigators on numerous trials, our physicians contribute to groundbreaking studies and publications in peer-reviewed journals. Also, patients may be eligible to take part in these experimental treatments.
  Learn more about current neuroscience clinical trials and studies.

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• The American Heart Association Get With the Guidelines stroke care program has recognized all four of Norton Healthcare’s adult service-hospitals in Louisville for exceeding national averages in getting patients in the door and administering lifesaving treatment to restore blood flow to the brain.
• Norton Neuroscience Institute’s multiple sclerosis (MS) program has been designated a Center for Comprehensive MS Care by the National Multiple Sclerosis Society.
• The National Association of Epilepsy Centers has recognized Norton Neuroscience Institute as a Level 4 Epilepsy Center, providing the highest level of medical and surgical evaluation and treatment for patients with complex epilepsy.
• Norton Neuroscience Institute Resource Center navigators help educate patients and their families about new diagnoses, available treatments and ways to manage their disease.
• We are listed by Becker’s Hospital Review as one of 100 great neurosurgery and spine programs.