Parkinson's Disease

A doctor talks with a mature African American male patient in a clinical setting.

Parkinson's disease is a degenerative neurological disorder that breaks down the brain cells that are responsible for normal movement. It causes tremors in the hands and legs, slowness of movements, rigidity or stiffness, and changes in the ability to balance and walk. Symptoms can change throughout the stages of Parkinson’s disease, affecting mood and memory.

While there is not yet a cure for this progressive condition, early diagnosis is key to managing symptoms. MedStar Health has the only hospital in Washington, D.C., designated as a Parkinson’s Foundation Center of Excellence. Our team of Parkinson’s disease specialists offers individualized services designed to maximize function and independence.

Parkinson’s occurs when an abnormal form of a protein called alpha-synuclein causes brain cells that produce dopamine to degenerate. Dopamine is a chemical messenger that helps us move normally. As dopamine levels decrease, it can lead to changes in movement and other Parkinson’s symptoms.

Signs and symptoms of Parkinson's disease

Parkinson's disease symptoms and the onset of symptoms vary among patients and change over time. Some symptoms may not occur until a later stage or might never occur. Patients and families may notice some or all of these symptoms:

Bradykinesia: Slowness in voluntary movement caused by loss of dopamine, which delays the transmission of signals from the brain to the skeletal muscles. Bradykinesia causes difficulty in initiating and completing movements and an expressionless, mask-like face.
Tremors: Shaking in the hands, forearms, or feet when a limb is at rest but not when performing tasks. Tremors can also occur in the mouth and chin.
Rigidity: Stiff muscles that can produce muscle pain. Stiffness tends to increase during movement.
Poor balance: Shuffling steps and unsteadiness caused by losing the reflexes that manage posture.
Speech problems: Hypophonia appears as reduced voice volume and loss of tone or emotion. Patients may develop slurring, stuttering, or stammering, with slower or faster speech.
Difficulty swallowing: Dysphagia occurs as the throat muscles lose function. This can cause choking, coughing, or excessive throat-clearing. It might feel like food gets "stuck" on the way down.

Parkinson's disease can also causes non-motor symptoms, such as:

Mood changes: Anxiety, depression, or apathy.
Constipation: Lost ability of muscle control in the digestive tract can cause difficulty with bowel movements.
Loss of smell: Reduced sense of smell can affect your ability to enjoy food.
Sleep disturbances: Patients may have trouble sleeping or act out their dreams during deep sleep.

Some medications cause side effects that mimic Parkinson’s disease symptoms. Talk with a doctor about any concerning signs of disease. A specialist can diagnose Parkinson’s or determine another cause of your symptoms.

Diagnosing Parkinson's disease

There is no blood test to screen for Parkinson’s disease, and symptoms may mirror other disorders. The first step of diagnosis is to get a comprehensive neurological exam from a specialist. Your care team will also evaluate your complete medical history.

Research and technology innovations are streamlining diagnosis:

A new type of skin biopsy can detect the presence of the problematic alpha-synuclein protein.
A dopamine transporter scan (DaTscan) is a special nuclear medicine imaging test. A technician injects a radioactive tracer called Ioflupane into a vein. It attaches to dopamine transporting enzymes, allowing your doctor to see if there is a loss of dopamine in the brain.

Your neurologist might also use a CT scan or MRI to rule out disorders that cause similar symptoms.

Facebook Live: Movement Disorders and Parkinson's Disease

Dr. Gary Volkell, a board-certified neurologist fellowship trained in movement disorders, discusses Parkinson's Disease. Learn about movement disorders and Parkinson’s disease symptoms, diagnosis, and treatment.

Treatment Options for Parkinson's Disease

Medication

Some medications can help to manage symptoms impacted by reduced dopamine levels. One example is carbidopa-levodopa. This small pill converts to dopamine in your brain to improve symptoms.
Physical therapy

PT can help you move around safely, at home and in your community. Practicing specific small and large motor tasks will help you maintain your independence. MedStar Health offers a special PT program called LSVT BIG®. You'll work one-on-one with a certified therapist to "recalibrate" your brain for daily tasks. It's an intensive four-week course that requires a referral from your doctor.
Speech and swallowing therapy

Speech-language pathologists provide treatment for vocal and swallowing challenges. These specialists will help you strengthen the muscles in your face, neck, and throat to improve communication and safety. MedStar Health therapists practice LSVT LOUD®, a program to teach you how to use your voice at a "normal loudness."
Fitness and exercise

Aerobic exercise may slow the progression of Parkinson's disease while improving balance, mobility, and mental health. Aquatic therapy is a great way to reduce rigidity, stiffness, and pain. The buoyancy of water allows you to move safely, even if you have balance issues. A regular regimen of exercise can build confidence and independence while providing socialization.

Procedures for Parkinson's disease

Deep brain stimulation (DBS) is a surgical procedure in which electrodes implanted in the brain deliver controlled stimulation to targeted areas. The electrical charge interrupts the brain's faulty signals to reduce rigidity, tremors, and slow movements. DBS is adjustable—as Parkinson’s disease progresses, the device can be reprogrammed to improve new or increasing symptoms.

Focused ultrasound is a newer non-invasive treatment for Parkinson's disease. Guided by MRI, a neurosurgeon uses tiny ultrasound beams to destroy a part of the brain to improve symptoms of tremor.

Research and clinical trials

MedStar Health patients may have access to clinical trials, which offer early-stage investigative Parkinson’s disease therapies before they are widely available elsewhere.

Explore clinical trials at MedStar Health

Patient resources

Videos

Art Moves! Event for Parkinson's Patients

Bill's Story of Hope

Rita's Second Chance

Movement Disorders: Ask Dr. Fernando Pagan

Movement Disorders and Deep Brain Stimulation (DBS): Ask Dr. Chris Kalhorn

Helpful Links

Parkinson's Foundation

Michael J. Fox Foundation for Parkinson's Research

American Parkinson Disease Association

Related services

Emergency Medicine

Movement Disorders

Neurosurgery

Pharmacy

Primary Care

Urgent Care

Parkinson’s Disease

Parkinson's Disease