Ask the expert

Ask the Expert

Q) How do I find a neurologist specializing in the diagnosis and treatment of Parkinson's disease?

A) The Parkinson's Disease Foundation maintains a referral list of qualified and experienced movement disorders specialists (the sub-category of neurology under which Parkinson's falls) that covers most areas in the United States and many major cities abroad. Please contact our office on (800) 457-6676 and our staff will be happy to check our lists for a specialist close to you. One caveat: Medicare and most other insurance plans do not accept the Parkinson's Disease Foundation as an official referral. To be evaluated by a movement disorders specialist approved and covered under the health plan, the patient may need a physician's referral first. This can typically be easily obtained from the patient's current neurologist or primary care physician.

Q) Is Parkinson's disease inherited?
A) For the vast majority of individuals, Parkinson's disease is not thought to be an inherited disease. Even when a second person within a family is diagnosed with Parkinson's disease, this is thought to be more of a coincidence than an emerging genetic pattern. This is because Parkinson's is a fairly common disorder among the older population.
For younger-onset patients (typically, less than 50 years old at the time when symptoms start), ongoing research is suggesting a possible, minor inheritance factor, but this is still a theory under scientific evaluation.
And finally, there is what is considered to be a very rare form of Parkinson's that is inherited. It has been found to affect only a very small percentage of Parkinson's disease patients worldwide (probably less than one percent of all patients). In these families there are multiple patients diagnosed in multiple, consecutive generations. Even for this form of Parkinson's disease, the inheritance patterns are still being worked out.
While research continues on all possible genetic aspects of Parkinson's disease, there is currently no way to predict one's risk of developing Parkinson's disease based on having other family members affected by this disease.
Q) Is Co-EnzymeQ-10 of benefit to Parkinson's disease patients?
A) Recent studies are suggesting that Co-enzyme Q-10 may help to slow the progression of Parkinson's disease. However, these findings were reached in a preliminary study of a very small number of patients over a short period of time. The findings have however, provided the justification to expand the studies (by increasing the number of patients involved and studying the effects over a much longer period of time) to prove or disprove the theory and to determine safety both short- and long-term.
At this time, PDF advisers, as well as the primary author of the most recent study on CoQ10, are not recommending that their PD patients take Co-Q-10 in the dosages suggested in this preliminary study. They are instead recommending their patients wait until further, more detailed studies are completed.
Q) How fast does Parkinson's disease progress?
A) For the vast majority of individuals, Parkinson's disease is a very slow-progressive disorder, measured in decades rather than in months or in just a few years. As the disorder does progress over the years, new symptoms may appear or older ones may become more noticeable. For this reason, regular evaluations by a movement disorders specialist are needed to maintain sufficient symptomatic control via adjustments to the medication regimen.
When a more rapid progression rate is observed, there are generally outside factors contributing to this increase that need to be identified and properly managed. These factors might include:
A need to adjust the timing and dosages of the prescribed antiparkinson medications
A new health issue that, by itself or through its treatments, is interfering with the disease or the PD drugs' benefits or
The diagnosis of Parkinson's disease was in error and a different diagnosis may need to be considered
Q) What causes Parkinson's disease to appear?
A) At this time, we do not yet know the cause(s) of classic (idiopathic) Parkinson's disease. Many different theories have been and continue to be under investigation in an effort to pinpoint the factor/factors that need to be involved for this disease to develop. Investigative areas include environmental exposures (to naturally-occurring or man-made toxins), past illnesses/disorders, trauma and even the inheritance of a slight genetic predisposition to develop this disorder (and combinations of any or all these possible factors).
Non-classic forms of parkinsonism can, for example, include drug-induced forms (caused by any number of pharmacologic agents that can produce, as side effects, symptoms similar to those seen as part of Parkinson's); vascular forms (caused, for example, by a stroke in specific brain structures), and atypical forms (such as multiple system atrophy, corticobasal degeneration and progressive supranuclear palsy). Most of these forms are very rare and can typically be differentiated from classic Parkinson's disease by different brain scans, blood tests and/or a thorough review of the patient's history.
Q) Are there any known vitamins or supplemental compounds that can be beneficial in limiting the severity of Parkinson's disease symptoms or that can slow or stop the progression of the disease?
A) At this time, there is no scientific evidence to prove any type of benefit to a patient with Parkinson's disease from vitamins and/or supplements.
The only vitamin that has undergone rigorous investigation with regard to Parkinson's disease is Vitamin E, which was originally thought to be neuroprotective because of its antioxidant properties. Five years of study, following almost 5000 patients, failed to show that Vitamin E has any neuroprotective properties in Parkinson's disease. The only suggested benefit may be in reducing constipation, which can be a common problem associated with Parkinson's disease. Vitamin E is a naturally oily substance that assists constipation by greasing the bowels.
Q) What is Parkinson's disease?
A) Parkinson's disease is a chronic, progressive, neurologic disorder. An important part of its mechanism is the loss of the neurotransmitter dopamine in a group of brain structures that control movements. Its major manifestations are variable but can include hand tremor, slowness of movements, limb stiffness, and difficulties with gait and balance.