Diagnosis and Treatment of Parkinson's

Parkinson’s disease (PD) can be challenging to diagnose, especially in the early stages of the disease. People who are suspected to have PD should be seen by a neurologist who is trained in movement disorders. Diagnosis of PD is generally made using medical history and a physical exam or neurological exam.¹

Rating scales for Parkinson’s disease

Doctors use rating scales to assess the stage of PD in person. The 2 most commonly used rating scales include:^2,3

• Hoehn and Yahr scale – This scale describes 6 stages of PD progression (stages 0 through 5)
• Unified Parkinson’s Disease Rating Scale (UPDRS) – This scale has 4 parts with multiple points in each section that are individually scored.

Early diagnosis is important

Treatments for PD are more effective in the early stages of the disease, so early detection is important. Physical therapy and exercise, which greatly improve symptoms and delay the progression of the disease, are also much easier to perform in the early stages.⁴

One of the active areas of PD research is the search for “biomarkers.” These are clinical markers in the blood, urine, or cerebral spinal fluid that reliably detect PD. Other research focused on early detection includes brain imaging tests that have high sensitivity for detecting PD.⁴

Treating the symptoms of Parkinson’s disease

Current treatments successfully reduce most of the motor symptoms of PD. However, there is no known cure for PD or treatments that can slow the progression of the disease.

Treatments for PD are focused on managing the symptoms to improve quality of life. Symptoms can vary in severity among people with PD. Each person’s disease progresses at its own rate. Treatment is recommended based on the specific needs of each person.

Treatment options for motor symptoms of Parkinson’s disease

The common motor symptoms of PD include:⁵

• Tremor
• Rigidity
• Balance impairments
• Slowed movements (bradykinesia)
• Difficulty swallowing
• Changes in speech
• Impaired fine motor dexterity
• Muscle cramping

Treating these symptoms usually involves a combination of approaches, such as:⁵

• Medicines like carbidopa/levodopa therapy, dopamine agonists, anticholinergics, COMT inhibitors, and/or monoamine oxidase-B (MAO-B) inhibitors
• Physical therapy
• Vocal exercises
• Deep brain stimulation surgery

Treatment options for 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 may include:¹

• Drugs like those to relieve an overactive bladder or pain
• Physical therapy
• Exercise
• Nutritional interventions, especially to help with constipation, bone health, and brain health
• Complementary therapies, including acupuncture or massage

Treatment for PD is focused on managing the symptoms to improve quality of life. Although PD has some common features and symptoms, the disease can show up differently in different people. Treatment is highly specific to help each person manage their symptoms and maintain quality of life.