Parkinson’s disease is a progressive disease of the central nervous system caused by cell loss in the particular area of the brain (called the substantia nigra) that produces dopamine, a neurotransmitter that helps to regulate movement. The disease is most often diagnosed in people in their 60s, but can affect people at younger ages. Those diagnosed before the age of 50 are said to have early-onset Parkinson’s disease, and constitute between 10%-20% of all Parkinson’s cases. Half of all early-onset Parkinson’s patients are diagnosed before the age of 40.
Around 60,000 new cases of Parkinson’s disease are diagnosed each year in the U.S., meaning that between 6,000 to 12,000 newly diagnosed patients are early-onset patients.
Symptoms of early-onset Parkinson’s disease
Nonmotor symptoms are often the first symptoms experienced by people with early-onset Parkinson’s disease. They may include:
- loss of smell
- depression or anxiety
- orthostatic hypotension, or a drop in blood pressure when standing up
- trouble sleeping
- bladder problems
- change in sex drive
- increased saliva production
- fluctuations in weight
- visual disturbances
- cognitive issues
Causes of early-onset Parkinson’s disease
For most people with Parkinson’s, the disease is thought to be caused by a combination of underlying genetic predisposition and environmental exposures. Genetics is thought to play a more important role in early-onset Parkinson’s disease.
People who have both early-onset disease and a family history of Parkinson’s are more likely to carry mutations in certain genes associated with the disease. These include:
- Alpha-synuclein (Park1). A mutation in one copy of the Alpha-synuclein gene, which is rare, is known to cause early-onset Parkinson’s.
- Parkin (Park2). Inheriting two copies of the mutated Parkin gene causes early-onset PD; inheriting one copy increases the risk.
- Pink1; onset and risk are identical to Park2.
- Leucine-rich repeat kinase 2 (LRRK2). Many different mutations can occur in the LRRK2 gene, increasing a person’s risk of early-onset disease.
Treating early-onset Parkinson’s disease
Although no cure exists, identifying symptoms and determining a proper course of treatment helps many Parkinson’s patients to remain active and lead fulfilling lives. Carbidopa/levodopa is usually prescribed for Parkinson’s disease. However, early-onset Parkinson’s patients are more likely to develop side effects from this treatment, such as or involuntary movements (dyskinesias) at the medicine’s peak effect, and cramping (dystonia) as the effect wears off.
For this reason, physicians often treat movement symptoms in people newly diagnosed with early-onset Parkinson’s disease with other types of drugs, such as anticholinergics, monoamine oxidase B (MAO-B) inhibitors, and dopamine agonists.
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