Beyond the tremors: Understanding the impact of Parkinsons disease

By Shane Huntington

Neuroscientist and neurologist Prof Malcolm Horne discusses Parkinsons disease, and examines new technological developments and the prospects they offer for early diagnosis and treatment of the condition.

SHANE HUNTINGTON Im Dr Shane Huntington. Thanks for joining us. Among the many degenerative neurological disorders that can afflict us, Parkinson's disease is one such condition that can radically change the way we live and function. Second only to Alzheimer's disease in prevalence in the ageing West. Many of us have an image of the Parkinson's sufferer with increasingly debilitating tremors. But the symptoms of the disease go well beyond the visible. We don't know the cause, we don't have a cure, yet progress is being made.

Today on Up Close we discuss research into Parkinsons and what the future holds for sufferers and those who support them. With new genetic technologies improving by the day are we are on the verge of cracking this disease? Can we identify the risk factors and try to avoid them?

To answer these questions and more we are joined by Professor Malcolm Horne, Head of the Neurodegeneration Lab at the Florey Institute for Neuroscience and Mental Health, Consultant Neurologist at St Vincent Hospital and Conjoint Professor, Centre for Neurosciences at the University of Melbourne. Welcome to Up Close Mal.

MALCOLM HORNE Thank you.

SHANE HUNTINGTON Could you start with a brief description of what Parkinson's disease is like for someone with the condition?

MALCOLM HORNE It really depends on what stage of the disease. So when people first turn up to the neurologist and say look there's something not quite right here, they're actually talking about problems with movement. Often they come because they've got the tremor. But the factors that cause the disability is not so much the tremor but slowness of movement, loss of dexterity and as we've come to understand it this is not just a matter of being clumsy, but it's actually about being able to make goal directed and purposeful movements. And so actually carrying tasks with intent become increasingly difficult. But over time the disease progresses into becoming more than just about movement and eventually begins to affect cognitive functions so people find problem solving and this broad area of cognition we call executive function becomes impaired. As well they have disturbance of the parts of the nervous system that control processes such as blood pressure and gut function, swallowing and becoming increasingly affected by that.

And also there's an element of neuropsychiatry which is this process of dealing with thoughts and impulses so that impulsive behaviour such as gambling and overeating become common. People also get hallucinations and become depressed. So it's these latter stages of cognitive and psychiatric disturbances as well as the autonomic disease which really are the devastating components although it's the movement that is most prominent and often receives most of the attention.

SHANE HUNTINGTON When you describe all of these various symptoms I mean it's quite a swag of things that a person will end up with. But when they're first going through that process how do we go about making a diagnosis? Is there a blood test, a genetic test or is this all based just on looking at some of those movements and so forth and evaluating.

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Beyond the tremors: Understanding the impact of Parkinsons disease