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Parkinson’s Disease: Two Diseases Rather Than One?

Updated: Oct 4, 2020

Written By: Mayukha Kashyap



Parkinson’s disease is characterized as a brain disorder that usually older people suffer from. Though it affects 50% more men than women, those who have early-onset Parkinson’s have a higher risk of developing the full-fledged disease. Research has shown that early-onset Parkinson’s is often inherited and linked to specific gene mutations. The disease is known for developing over time, or in other words, “killing a person slowly.” As Parkinson’s progresses, the patient has trouble walking and talking, and their body begins to degenerate. So what causes this progression?


According to the National Institute of Health, “Parkinson's disease is a brain disorder that leads to shaking, stiffness, and difficulty with walking, balance, and coordination” (NIA 2020). It occurs when neurons get damaged or die in areas that control movement, caused by the protein alpha-synuclein. Neurons produce dopamine, which helps with movement. When the neurons are unable to produce sufficient dopamine, the movement problems associated with Parkinson’s occurs. Patients also lose nerve endings, which make norepinephrine. Norepinephrine controls functions, including heart rate and blood pressure. Due to the loss of norepinephrine, patients experience fatigue-like symptoms and irregular heart pressure. Scientists are also unsure of what causes Parkinson’s; while some cases have proven to be hereditary, most cases seem to occur randomly. Many researchers believe that it arises from a combination of genetic and environmental factors, similar to epigenetics.


Parkinson’s symptoms include trembling in the arms, legs, hands, head, or jaw, stiffness, slow movement, and a decrease in balance and coordination. Patients often also experience behavioral and emotional changes due to physical impairments. These changes include depression, sleeping problems, skin problems, and difficulty swallowing, chewing, and speaking. Since everybody is unique, Parkinson’s progresses differently in each patient. There are no medical tests to diagnose Parkinson’s accurately, and many doctors dismiss early symptoms of Parkinson’s due to aging. There is also no treatment for Parkinson’s; however, therapies are available to improve movement, and drugs re given to increase dopamine levels in the brain. Additionally, many patients develop a hunch-like posture, where they lean forward and take smaller steps due to lack of movement.


New research at Aarhus University has discovered information vital to understanding Parkinson’s. Because of Parkinson’s complexity, scientists have struggled with finding why Parkinson’s occurs and how to cure it. A new study led by Professor Per Borghammer and Medical Doctor Jacob Horsager from the Department of Clinical Medicine at Aarhus University and Aarhus University Hospital, Denmark, has shown that Parkinson’s is split into two diseases. Patients can either have Parkinson’s originating in the brain or intestines. The researchers claim that Parkinson’s can be divided into two diseases, depending on where it starts. If a patient has Parkinson’s originating in the brain, it then spreads to the organs and intestines and vice versa. This study is critical because it helps scientists understand the spread of symptoms associated with Parkinson’s. Since the disease is not homogenous, the diagnosis and progression of Parkinson’s are puzzling.


The next steps for scientists are determining why Parkinson’s may originate in the brain or body and the differences. Per Borghammer believes that examining the bacteria in the intestines called microbiota may help scientists learn more about Parkinson’s in the body. Patients with Parkinson’s have different microbiota compared to healthy people. Figuring out ways to combat the microbiota in Parkinson’s patients may help scientists discover a potential treatment plan. For patients whose Parkinson’s originated in the brain, finding a treatment plan may be more difficult. According to Per Borghammer, people cannot pick up that a person has Parkinson’s until they start exhibiting movement troubles. By that time, the disease has progressed too far, making it difficult to treat. Once researchers can understand the progression of the disease depending on where it originated from, potential treatment plans will be more successful.




Sources:

Aarhus University. "Parkinson's disease is not one, but two diseases." ScienceDaily.

ScienceDaily, 22 September 2020.

<www.sciencedaily.com/releases/2020/09/200922092156.htm>.


Jacob Horsager, Katrine B Andersen, Karoline Knudsen, Casper Skjærbæk, Tatyana D

Fedorova, Niels Okkels, Eva Schaeffer, Sarah K Bonkat, Jacob Geday, Marit Otto, Michael

Sommerauer, Erik H Danielsen, Einar Bech, Jonas Kraft, Ole L Munk, Sandra D Hansen,

Nicola Pavese, Robert Göder, David J Brooks, Daniela Berg, Per Borghammer. Brain-first

versus body-first Parkinson’s disease: a multimodal imaging case-control study. Brain,

2020; DOI: 10.1093/brain/awaa238


“Parkinson's Disease.” National Institute on Aging, U.S. Department of Health and Human

Services, 16 May 2017, www.nia.nih.gov/health/parkinsons-disease.


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