How Parkinson’s hides in plain sight and why early detection matters – Firstpost

Parkinson’s disease (PD) often creeps in unnoticed, its early symptoms mistaken for normal aging. With nearly 10 million people affected globally, this progressive neurological disorder demands greater awareness.

Firstpost spoke to Dr. Jaideep Bansal, Senior Director & HOD – Neurology at Fortis Hospital, Shalimar Bagh, to understand the early signs, causes and the wide spectrum of treatment options that now include cutting-edge technologies like Deep Brain Stimulation and nanotech-based diagnostics.

Excerpts:

What are the causes, risk factors and preventive options for Parkinson’s disease?

Dr. Jaideep Bansal: Early symptoms usually evolve slowly and are often mistaken for normal aging. These include slowness in daily activities, walking with short steps, a stooped posture, and a tendency to fall—especially while turning. People may also notice reduced facial expressions, less frequent blinking and tremors in one hand.

Other signs include soft, monotonous, and slurred speech. There may be slight stiffness and a decrease in the natural swing of one arm while walking, which family members often overlook.

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What are the causes, risk factors and preventive options for Parkinson’s disease?

Dr. Jaideep Bansal: Parkinson’s is multifactorial, involving both genetic and environmental components. Familial occurrence is seen in about 5–15% of cases. Some risk factors include:

*Certain drugs like antipsychotics, metoclopramide, lithium, flunarizine, and cinnarizine

*Viral encephalitis, paraneoplastic illness, head trauma, brain stroke, and hypoxia

*Exposure to toxins, especially pesticides, manganese, mercury, and synthetic neurotoxins like MPTP

*Air pollution—especially particulate matter (PM2.5) and nitrogen dioxide exposure—has also been linked to increased risk.

How does Parkinson’s affect speech, movement, and daily life as it progresses?

Dr. Jaideep Bansal: Speech becomes monotonous, low in volume, and often slurred. Over time, patients develop a short, shuffling gait and walk as if chasing their center of gravity—making them prone to falls. Handwriting becomes smaller (micrographia), and simple daily tasks like bathing or feeding take significantly longer. As the disease progresses, many patients become dependent on others for routine activities.

How are anxiety and depression linked to Parkinson’s disease?

Dr. Jaideep Bansal: Depression and anxiety are very common. They stem from the progressive loss of independence, difficulty in movement, and social withdrawal. Patients also struggle with tremors, sleep disturbances, and sometimes memory loss. These factors significantly affect emotional well-being and can lead to severe isolation if not addressed.

How effective is DBS in managing Parkinson’s symptoms?

Dr. Jaideep Bansal: Deep Brain Stimulation is a newer technique where electrodes are implanted in specific brain areas using stereotactic guidance. These are usually placed in the subthalamic nucleus or globus pallidus. It’s particularly useful for patients who no longer respond well to medication or suffer from severe dyskinesia (involuntary movements).

What new technologies are improving Parkinson’s diagnosis and treatment?

Dr. Jaideep Bansal: Some key advances include:

*DaTscan imaging (SPECT scans) for visualising dopamine transporters

*Biomarker tests, such as alpha-synuclein in CSF or skin biopsies

*Nanotechnology, which enhances drug delivery, improves imaging and enables more accurate biomarker detection

*These tools are helping doctors detect Parkinson’s earlier and personalize treatment more effectively.

Apart from medication, how can treatments like physiotherapy or surgery help people with Parkinson’s live better?

Dr. Jaideep Bansal: Several surgical and non-surgical options help:

*Ablative procedures like pallidotomy and thalamotomy create small lesions in specific brain areas

*Focused ultrasound (FUS) uses MRI-guided sound waves to destroy tremor-causing areas

*Radiosurgery uses targeted radiation for tremor control

*Neurotransplantation involves transplanting foetal dopaminergic tissue to improve motor symptoms

*Therapies like physiotherapy, occupational therapy, speech therapy, and cognitive behavioural therapy are essential to improving mobility, communication, and emotional resilience.

Is Parkinson’s disease hereditary and should family members consider genetic testing?

Dr. Jaideep Bansal: Our understanding of the genetics of PD has tremendously increased in the last few years.

We now know much more about the genetic side of Parkinson’s. Genetic testing can help identify individuals at higher risk but is not recommended routinely. It’s best used in the context of family history and other risk factors and should be interpreted by a genetic counsellor or neurologist.