Is Parkinson’s Disease genetic?
Only a small portion (< 5%) of people with parkinsonism have a purely genetic form. For most people, parkinsonism results from a combination of genetic and environmental factors. Epigenetics is the study of how the environment influences our genetic expression, for better and for worse.
Two of the most common genes associated with increased risk of developing parkinsonism are LRRK-2 and GBA. There has been an increased awareness of these genes in recent years, largely due to 23andme and other genetic testing companies making these genetic tests directly available to consumers. Research is underway to determine whether we can use specially-targeted strategies for one form of parkinsonism that may not necessarily work for other forms of parkinsonism.
Symptoms of Parkinson’s
Common motor symptoms of Parkinson’s disease include slowness (bradykinesia), trouble turning over in bed, difficulty rising from a seated position (especially after sitting for an extended period), shuffling steps, difficulty with fine motor skills (e.g. buttons, zippers), and difficulty with balance. Small handwriting and trouble typing can be one of the earliest symptoms. Late stage motor symptoms include freezing and frequent falls.
Nonmotor symptoms tend to precede motor symptoms by more than a decade. Early symptoms tend to include loss of smell (hyposmia), anxiety, apathy (lack of motivation), loss of pleasure, depression, fatigue, muscle pain, orthostatic hypotension (low blood pressure/dizzy when standing), poor balance, falls, temperature dysregulation, visual disturbances, myalgia (muscle pain or aching), muscle cramping (dystonia), slurred or soft speech/quiet voice, stopped or hunched posture, and drooling.
Sleeping symptoms can include disrupted sleep/frequent waking up/insomnia, frequent nighttime urination (nocturia), REM sleep behavior disorder (RBD)/ acting out your dreams at night/ kicking or yelling in your sleep, vivid dreams, restless legs syndrome (RLS).
Sexual impairment from Parkinson’s can include loss of libido, erectile dysfunction, and trouble with organsm. Urinary symptoms can include urinary urgency, incontinence, or frequent nighttime urination (nocturia).
While the cognitive decline of Parkinson’s disease is very different from the dementia seen in Alzheimers, there are still memory and concentration symptoms that patients must contend with. Sufferers of Parkinson’s disease will often have difficulty with executive function such as things that require following steps to complete a task. There can be problems with comprehension and confusion, all of which can be made worse with anxiety and poor sleep.