Diagnosis & Treatment of Parkinson's
Parkinson’s disease (PD) can be challenging to diagnose, particularly in early stages of the disease, and people who are suspected to have PD should be seen by a neurologist specially trained in movement disorders. Diagnosis of PD is generally made using a medical history and a physical exam or a neurological exam.1
Rating scales for Parkinson’s disease
Doctors use rating scales to assess the stage of PD in an individual. The two most commonly used rating scales are the Hoehn and Yahr scale and the Unified Parkinson’s Disease Rating Scale (UPDRS). The Hoehn and Yahr scale describes six stages to PD progression (Stages 0 through 5), while the UPDRS has four parts with multiple points in each section that are individually scored.2,3
Early diagnosis is important
Treatments for PD are more effective in early stages of the disease, so early detection of PD is important. In addition, physical therapy and exercise, which greatly improve symptoms and delay progression of the disease, are much easier to perform in the early stages.
One of the active areas of research in PD is the search for “biomarkers,” clinical markers in the blood, urine, or cerebral spinal fluid that reliably detect PD. Other research focused on early detection includes looking at brain imaging tests that have high sensitivity for detecting PD.4
Treating the symptoms of Parkinson’s disease
Current treatments successfully alleviate most of the motor symptoms of PD. However, there is no known cure for PD, and currently, there are no treatments that can slow the progression of the disease. Treatments for PD is focused on managing the symptoms to improve the individual’s quality of life. Symptoms can vary in severity among people with PD. Each person’s disease progresses at its own rate, and treatment is recommended based on the needs of the unique patient.
Treatment options for the motor symptoms of Parkinson’s disease
Treating the motor symptoms of PD—including tremor, rigidity, balance impairments, slowed movements (bradykinesia), difficulty swallowing, changes in speech, impaired fine motor dexterity, and muscle cramping—usually involves a combination of approaches, including:
- Medications, such as carbidopa/levodopa therapy, dopamine agonists, anticholinergics, COMT inhibitors, and/or monoamine oxidase-B (MAO-B) inhibitors
- Physical therapy
- Vocal exercises
- Deep brain stimulation surgery5
Treatment options for the non-motor symptoms of Parkinson’s disease
Treatment options for the non-motor symptoms of PD vary depending on the symptoms the person is experiencing. Treatment for non-motor symptoms of PD may include:
- Medications, such as those to relieve overactive bladder or those for pain relief
- Physical therapy
- Nutritional interventions, especially to help with constipation, support bone health, and improve brain health
- Complementary therapies, including acupuncture or massage1
Treatment for PD is focused on managing the symptoms to improve the individual’s quality of life. Although PD has some common features and symptoms, the disease can show up differently across different patients. Treatment is highly individualized to help each person manage his or her symptoms and maintain quality of life.