Types of Parkinson's Disease: A Comprehensive Classification Guide

Parkinsonism is an umbrella term that is used to describe health conditions which impact mobility and balance and often are chronic. Parkinson’s is a specific condition within this larger umbrella term that is characterised by motor issues, tremors and balance. It can present itself in different forms, so understanding it can help in getting the right treatment and care. Understanding the Parkinson's disease classification can help in getting the right treatment and care.

Parkinson’s is of several classifications based on symptoms and conditions that all need specific treatment and care. It is important to understand how to manage the condition, and a comprehensive guide can ease stress, and provide you with information that can help make informed and safe choices. A clear Parkinson's classification system helps doctors tailor treatment approaches based on the specific type and severity of symptoms, ensuring better patient care.

What is Parkinson's Disease?

Parkinson’s disease is a disorder that affects movement when brain cells and neurons that make dopamine start to die. This leads to tremors, stiffness, and slow movement. Over time, it gets worse and can affect balance and coordination. It often results in body balance issues, weakness of the muscles and poor hand eye coordination that puts the person at high risk for falls and injuries.

Importance of Understanding Different Types of Parkinson's Disease

Parkinson’s is the most common form of Parkinsonism, and it affects motor functions. This can have a serious impact on physical health as poor body coordination makes the person more prone to risks of injury. Understanding the Parkinson's disease classification can help in identifying symptoms and in seeking the right treatment plan and care when needed. It can help in getting treatment at the right time and educate the person and their caretakers on the condition and how to support the individuals.

Primary Parkinsonism

Primary parkinsonism is the most common form and includes idiopathic Parkinson’s disease. It happens without a clear cause and mainly affects movement. Tremors, stiffness, and slow movement that gradually worsen are some common symptoms. It’s different from secondary parkinsonism, which can be caused by medications, strokes, or other health conditions. Doctors use Parkinson's classification to distinguish between primary and secondary parkinsonism, helping in accurate diagnosis and treatment planning.

Idiopathic Parkinson's Disease

Idiopathic Parkinson’s usually starts with tremors, stiffness, and slow movement that get worse over time. It mainly affects older adults. Since the exact cause is unknown, diagnosis is based on symptoms and ruling out other conditions. It falls under Parkinson's classification based on its unclear origins and progressive nature. It can have many reasons for the cause, which the medical professional will help understand.

Familial Parkinson’s

Familial Parkinson's is an inherited disorder where such mutations occur within the family. It is less common than idiopathic Parkinson's. Symptoms are similar to others: tremors and stiffness. However, familial Parkinson's may present a little earlier in life. Family history increases the risk of developing Parkinson's, although not everyone who has the genes is at any risk of getting the disease.

Early-Onset Parkinson’s

Early-onset Parkinson's begins before the age of 50. Symptoms such as tremors and muscle stiffness begin earlier but can progress more slowly. It is often associated with genetic factors and may respond differently to treatment. Younger people with early-onset may face different challenges, such as feeling tired, having motor issues and difficulty moving around. Understanding Parkinson's disease classification helps in identifying the specific type and progression of the condition, allowing for more personalised treatment and management strategies.

Secondary Parkinsonism

Secondary Parkinsonism is conditions that cause Parkinson's based on external factors that affect the neurons, such as exposure to drugs, pesticides and other toxins.

Drug-Induced Parkinsonism

Some drugs, such as antipsychotics, which affect dopamine levels, can cause symptoms that mimic Parkinson's, such as tremors and stiffness. The symptoms usually go away once the drug is stopped, but it may take some time. It is different from Parkinson's because it does not worsen over time and can often be regulated.

Vascular Parkinsonism

Vascular parkinsonism happens when small strokes or reduced blood flow affect movement in the body or impact neural connections and coordination. It usually causes stiffness and trouble walking, often more in the legs than the hands. To treat it, it's recommended to look at the overall condition rather than treating it with Parkinson's medications. 

Toxin-Induced Parkinsonism

Substances like pesticides, manganese, or carbon monoxide can damage brain cells over time as they are toxins and impact the brain's function. This can, over time cause tremors, slow movement and even cause imbalance. It’s different from regular Parkinson’s because it’s linked to exposure, not gradual cell loss.

Post-Traumatic Parkinsonism

Repeated head injuries can lead to symptoms that look like Parkinson's, for instance, slow movement and tremors. It has been observed in people who have a history of multiple concussions, like athletes. The symptoms might take years to appear and, at times, may stay the same and not get worse.

Normal Pressure Hydrocephalus

Normal pressure hydrocephalus occurs when there is excessive fluid in the brain, leading to issues with movement, memory, and the inability to control urine. It is unlike Parkinson's since it results from fluid accumulation in the brain and not the death of brain cells. In some instances, people improve if the excess fluid is drained.

Atypical Parkinsonism (Parkinson’s Plus)

Atypical parkinsonism has additional symptoms such as trouble with speech and change in thinking and often has an impact on brain functions beyond movement control.

Multiple System Atrophy (MSA)

In the case of MSA, the body's involuntary functions like heartbeat, digestion, blood pressure and even bladder control are affected. It is often characterised by severe neurodegenerative disorders that affect both movement and coordination and internal body processes of the person.

Progressive Supranuclear Palsy (PSP)

Progressive Supranuclear Palsy affects the person's balance and eye movements, where they may find it difficult to look up or down and have stiffness in their neck and trunk. In some cases, their speech, ability to swallow and ability to focus is affected.

Corticobasal Degeneration (CBD)

Corticobasal Degeneration (CBD) affects movement and thinking. One side of the body might be more affected, with stiffness, jerky movements, or trouble using a hand or leg. People might also have trouble speaking or understanding things.

Dementia with Lewy Bodies (DLB)

Lewy Body Dementia is a type of Dementia that is a result of abnormal protein deposits in the brain, which causes behavioural changes and issues with movement and speech. People may experience memory issues, confusion, and visual hallucinations. People diagnosed with this condition are prone to severe motor function issues that are akin to Parkinson’s.

Juvenile Parkinsonism

Juvenile parkinsonism is caused by genetic mutations and is found in young adults under the age of 21. The symptoms are similar to Parkinson's, with tremors, stiffness in movement, and loss of balance. It can be particularly hard for young children as it makes being socially difficult in school settings or when they want to play.

Early-Onset Parkinson’s Disease

In most cases Parkison’s is usually identified in older adults above the age of 60. In situations where it is found in younger crowds below the age of 50, it is classified as Early- Onset Parkinson’s. This often progresses slower in terms of how the symptoms show but can get worse later on. Most Early- Onset Parkinson’s are idiopathic in nature, so it is important to get help and diagnose the condition early on.

Genetic Factors in Juvenile Parkinsonism

Juvenile parkinsonism is often linked to inherited genetic mutations. Changes in specific genes, like PARK2, can lead to early symptoms. These genetic factors can run in families or happen randomly. However, there is no major link that establishes it to be hereditary, so the possibility of it being inherited is quite low.

Symptoms Across Different Types of Parkinson's Disease

Different types of Parkinson’s share common symptoms like tremors and stiffness but can also have unique signs. Some types affect balance more, while others impact thinking or body functions.

Motor Symptoms

Parkinson’s often affects movement and includes tremors, stiffness, slow movement, and balance problems. Walking may become harder, with smaller steps and freezing. Tasks like buttoning clothes or writing can be challenging. Symptoms usually start on one side and gradually spread to the other over time.

Non-Motor Symptoms

Non-motor symptoms affect things beyond movement, like sleep, mood, and thinking. People may have trouble sleeping, feel anxious or depressed, and experience memory problems. Digestive issues and low blood pressure when standing up are also common. Over time, speech may become blurry.

Diagnosis and Differentiation of Parkinson's Disease

There are no tests that can confirm if it is Parkinson's, so medical professionals will conduct several tests such as motor functions, balance tests, MRIs and scans that can help understand the nerve functions and brain functions. This is related to the symptoms being exhibited by the person, and the doctors will rule out any other underlying condition. They may inquire about environmental factors to understand if there is any exposure to toxins and may run blood tests to determine any other issues.

Available Treatment Options for Parkinson's Disease

Treatment options for Parkinson’s focus on managing motor and balance issues. Physiotherapy can help strengthen muscles and in some cases, doctors will prescribe medication to manage tremors and other neural functions. 

• Medications for Symptom Management
  Medications help to regulate movement disorders through the levels of dopamine in the brain. Some medications can reduce tremors and stiffness, whereas others help with movement coordination. The dosages might have to be altered periodically as symptoms progress. Different types and stages of Parkinson's may respond better to different medications.
• Physical Therapy and Exercise Programs
  Exercises focus on improving flexibility and coordination to make daily tasks easier. Regular activity can help people stay mobile for longer. Therapists can create routines based on individual needs and the progression of symptoms.
• Occupational and Speech Therapy
  Occupational therapy helps with everyday tasks like dressing and eating by finding easier ways to do them. Speech therapy focuses on improving speaking and swallowing, which can become difficult over time. Both therapies help people stay independent and communicate better.
• Personalised Treatment Plans for Different Types of Parkinson’s Disease
  Each type of Parkinson’s affects people differently, so treatment plans are tailored to specific symptoms and progression. Plans may include medications, therapies, and lifestyle changes to address movement and non-movement challenges. A personalised approach is important to manage symptoms effectively.

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FAQs

Can certain types of Parkinson’s be reversed?

Parkinson’s disease can't be reversed. Some conditions that look like Parkinson’s, such as drug-induced parkinsonism, might improve when the cause is removed. But neurodegenerative types of Parkinson’s, like idiopathic Parkinson’s, keep progressing over time.

Is Parkinson’s disease hereditary?

Most cases aren’t hereditary, but genetics can play a role. Some gene mutations increase the risk, especially in early-onset Parkinson’s. A family history might raise the chances, but environmental factors often contribute more to the disease.

What are the three main types of Parkinson's disease?

The three main types are idiopathic Parkinson’s, which is the most common; vascular parkinsonism, caused by reduced blood flow to the brain; and atypical parkinsonism, which includes conditions like multiple system atrophy and progressive supranuclear palsy.

What are the 4 pillars of Parkinson's disease?

The four pillars refer to the key symptoms: tremors, slowness of movement (bradykinesia), muscle stiffness (rigidity), and balance problems (postural instability).