Parkinsons Disease: Overview of Disease

The Regulatory Indication Module describes and explores the development of Parkinson disease, the pharmaceutical therapies, the symptoms, risk factors and the coverage of the disease regarding locality. Due to the future records and informing the future treatments of the disease, the research is going to be done with an intense focus on the effects of PD to all the daily activities. The coverage goes over to the European and the United States region which has got to have this information for indication purposes.

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1.2 Overview of Disease

Parkinsons disease is a disorder of a progressive movement which is said to limit the ability of the patient to perform the daily tasks over an extended period. The disease leaves the affected person bedridden and unable to do any activity on their own. The disease is considerably fatal, and when a person gets the news, he or she is confident that he will undergo an inexorable decline. The disease manifests itself like unnoticeable tremor which dilapidates over a period. Parkinson is classified as a neurodegenerative disorder together with Alzheimers disease. The cause of the disease is not well understood, but it is believed that the disease renders the neurons in the substantia nigra movement which is located in the center of the brain. The neurons are subjected as inoperative where they wither and finally die.

The degeneration route is, therefore, hard to fathom and identify, but the therapy of improving the systemic neuronal function would be appropriate and promising. The therapies are not what give the cure for the disease but with some deep implants electrotherapies and other curative treatments, the treatment of other symptoms could be an option. Approximately 1% of people over the age of 50 years are said to have been affected by the disease (Fereshtehnejad & Lokk, 2014). The cost that has been incurred directly and indirectly has conservatively been $ 25 billion per year in the United States only. More than 6 million today are reported to have suffered from the Parkinson disease. The onset of death can take much time making a medicine that meaningfully delays the progression and the benefit to the patient in the todays society.

Parkinson is has impacts like postural instability, rigidity, muscle slowed movement and often tremor. There are onset classifications which are unilateral and can include another abdominal movement which brings a different kind of tremor with action together with limb dystonia (Imai, Venderova, & Lim, 2012). The common non-motor findings may include depression, insomnia, anxiety, fatigue, rapid eye movement behavior, dysautonomia constipation, and anosmia. Parkinson disease is a disease with a disorder of non-Mendelian which occurs primarily in simple cases with the onset which is around the age of 60 years. The onset can, however, come earlier before the age of 20 years and can be considered to be very early-onset type, before the age of 50 it is deemed to be slightly early onset Parkinson disease and after 50 years it is considered as late Parkinson disease.

Many controversies have been made as to whether the disease frequency varies by race or gender. The resolution to these uncertainties has relied on the prevalence data or the clinical population which has rendered conclusions of these disputes. Parkinson disease is commonly considered to be a disease of the elderly whereby for survival o occur gender is usually the primary determinant. The data on Parkinsons disease has brought forth the main results of considerable difficulties in establishing the correct diagnosis (Khallaf & Fayed, 2015). Gender differences have been reported to be in most cases whereby men have been found to have the highest percentage rate more than the women. In the consideration of race or ethnicity, the rate of the disease was high in blacks compared to the whites in the North America.

On the study done on the membership of Kaiser Permanente Medical Care Program, Northern California, a comprehensive medical and health care services through 17 medical center hospitals and 21 medical office building to over 2.4 million members of primary located around San Francisco Bay and the Metropolitan areas. The comparison of data from KPMCP and Bay Area did an internal survey whereby it was identified that 91 % of the newly diagnosed Parkinson disease patients within five months of the primary care provider had a common time of 27 days. Race, gender, and age for the 86.5 percent of the known cases were obtained directly as part of the case-control study. The cases that have been investigated were around 588 in the northern California population. Men carried the mean age of diagnosis of 70.5 which means that the age ranges from 38-91. Women had an average of 70.5 where the range was between 31-93.

The overall annual incident rate was 12.3 per 100,000 while individuals over 50 years of age were 13.4 per 100,000 this means the overall percentage was 95. The ratio of female increases as their age increases going from 30-39 year category. The same pattern was observed when it came to men only that there was a slight drop in the incident rate for the 80-89 year age group among women.

According to the race, the event rates are reported to be high in Hispanics, non-Hispanic whites, Asians, and Blacks respectively. In the entire group apart from Asia, Parkinsons disease among men was two folds greater than the incident among women. In the Asians, the Parkinsons disease was found to be slower in men than in women (Allen, Schwarzel, & Canning, 2013). Men are said to have a high relative risk of Parkinson disease than men because of the toxicant exposure, head trauma, neuroprotection of estrogen, mitochondrial dysfunction and the X-linkage of the genetic risk factors. PD is more common in men more than women due to the studies of death rates that are done and the prevalence. Mortality rates are however not an indication for the incident of PD since there could be inaccuracy due to inaccurate diagnosis on the death certificate.

Incidences of the PD represent new cases diagnosed on a particular interval within a predefined population risk; the impact measurement is, therefore, more direct and more ambiguous epidemiological estimates of risk for developing PD than the rate of prevalence.

Parkinsons disease history dwels on the separation of the other neurological conditions and the evolution of the therapy from the empirical observations to the treatment which is of rational design. The history is based on the knowledge of anatomy, biochemistry and the physiology of the basal ganglia. Parkinson disease is by the conclusions obtained from the clinical results in rigidity, bradykinesia and tremor. Use of imaging techniques that are functional like the single photon computed emission tomography or fluoro-dopa position emission tomography is a useful document in the occurrence of dopamainergic dysfunction although it is not specialized to differentiate between Parkinson and the other typical diseases. The imaging modalities can be relevant in verification of the symptoms that individual has to make out if it is indeed Parkinson. The feature of the cardinal of the non-mendelian Parkinson disease is what brings about dopaminergic neurons loss in the nigra substantial with the outstanding intact neurons of the nigral. The Neuropathology of Parkinsonism which are genetic may significantly be at variance from the outcomes which could be recorded in the non-Mendelian Parkinson disease.

The appearance of the Lewy bodies was more needed by the verification of pathology due to the diagnosis of the Parkinson disease. It has been identified however that the nigral pathology can occur even when the Lewis body are absent. After the diagnosis of the Parkinson disease, it can only be acknowledged through verification that the prominent characteristics potrayed by the clinic and post-mortem certification of Lewy bodies could be done. The conclusion of doubt is usually avoidable (Ozdilek & Kenangil, 2014). There are others neurologic entities which can act as a mimic Parkinson disease and they are: Multiple system atrophy, essential tremor, Alzheimer disease, Progressive supranuclear palsy, Lewy body dementia, among others. Parkinson can be a distinctcharacteristic of a number of dominant autosomal with neurologic situation like the frontotemporal dementia with parkinsonism-17, spinocerebellar ataxia, Familial prion disease, dopa-responsive dystonia and Hunting disease.

Risk factor

Although it has been identified that the primary cause of the Parkinson disease is yet to be named, some risk factors can be identifiable. These factors can be evident as:

Advancing age- it is believed that the disease is occasionally developed as a young adult since it can manifest itself in the middle to late years of life ("Parkinsons disease," 2014). The risk advances and some researchers assume that the people with Parkinson are which have neural damage from the genetic or the environmental factors that get worse as they age.

Sex- the most individuals who are more likely to be affected by the disease are males more than female. What contributed to this may be the fact that males have got greater exposure to the other risk factor such as toxin exposure or the head trauma ("Parkinsons disease", 2014). It has been identified in several theories that the estrogen hormone might have neuroprotective effects or rather the genetic predisposing; a gene predisposing someone to Parkinsons may be linked to the X chromosome.

Family history- if there are more than one close relative with the disease, the likelihood that one might get the disease increases although it is to the minimum degree. The clue, therefore, indicates that there is a genetic link in the development of the Parkinson disease.

Declining Oestrogen Levels- women at their post-menopausal cannot use hormone replacement therapy, and they pose a greater risk of being infected with the disease. The post-menopausal women suffer the same fate as those people who have had hysterectomies.

Agricultural work- due to the exposure to the environmental toxin such as pesticides and herbicides people around the area becomes susceptible to the Parkinson. Some of that toxic inhibit the dopamine production and is able to promote the free radical damage ("Parkinsons disease", 2014). The people who are involved in farming are therefore exposed to the toxins that are very prevalence of the symptoms of Parkinson.

Genetic factors- in the consideration of a study that was done in the clinic of Mayo, it was evident that the alpha gene-synuclein is what play a greater role in the development of the disease. The studies done were able to indicate that the individuals with the more active gene had time increased risk of developing Parkinson. The findings were able to support the development of the alpha-synuclein suppressing therapies which could have been able to run slow or even halt the occurrence of the disease ("Parkinsons disease", 2014). It has been identified that individuals who have got more active gene are 1.5 times at risk of acquiring the disease more than the person with an inactive gene.

Low levels of B vitamin foliate- it has been discovered that mice which have a deficiency of vitamin are prone to develop severe Parkinsons symptoms while the one who have got a reasonable level of vitamin B are regarded as safe.

Head Trauma- the research done indicate that the link between the damage to the head, neck or the upper cervical spine and the Parkinson. The study that was done on 2007 revealed that some 60 patients indicated evidence of having trauma-induced high cervical damage. In this case, the patient could remember certain incidents while the others...