A Neurologist Debunks The Top 3 Myths About Parkinson's Disease

Parkinson's disease occurs when nerve cells in the brain that control motor skills begin to die, according to the National Institute on Aging. This typically causes impaired movements such as tremors, stiffness, slow movement, and problems with balance and coordination. Parkinson's progresses slowly and can cause difficulties in walking and talking. People with Parkinson's could also experience symptoms such as sleep problems, fatigue, depression, and problems with memory. However, not every person with Parkinson's has the same symptoms.

Although scientists don't know what causes Parkinson's, they do know that a mix of genetic and environmental factors can increase or decrease the likelihood of developing this brain disorder, according to the Parkinson's Foundation. About 10% of all Parkinson's cases are linked to genetics, even though a family member with Parkinson's doesn't guarantee a diagnosis in their children. Environmental factors such as head injuries, occupation, and exposure to metals, solvents, and polychlorinated biphenyls (PCBs) have inconsistent associations with Parkinson's Disease. The commercial herbicide paraquat, which is banned in 32 countries, is associated with Parkinson's Disease.

Dr. Guy Schwartz, co-director of the Parkinson's and Movement Disorders Center at Stony Brook Medicine, says there are some common myths surrounding Parkinson's that are worth clarification — and in an exclusive interview with Health Digest, he debunks those myths.

You can die of Parkinson's disease

Schwartz says that Parkinson's is incurable, and the scientific community hasn't found a way to stop or reverse the disease's progression in the body. However, Schwartz adds, it's a myth that you die from the disease. "With onset after a certain age, it does not impact the life expectancy of an individual," Schwartz said. "Oftentimes, our patients succumb to some other illness."

Because the symptoms progress over time, Schwartz says the disease is treatable, and the symptoms can be controlled. One way to control the disease's progression is through exercise.

"There are multiple publications about the benefits of aerobic exercise," Schwartz said. "The mechanism of aerobic exercise is thought to be increased brain blood perfusion and oxygenation. Those who do it consistently were shown to have a better long-term outcome." A 2018 review in Mayo Clinic Proceedings found that aerobic exercise and cardiovascular fitness can slow the progression of Parkinson's disease.

Taking levodopa is harmful in the early stages of the disease

According to the National Institute on Aging, levodopa is often prescribed for people with Parkinson's Disease. Levodopa helps brain cells produce dopamine, which declines with Parkinson's. Schwartz says that it's a myth that taking levodopa too early in the disease's progression is harmful.

"As far as harmful, many years ago it was shown that individuals taking levodopa had a faster disease progression as compared to those who were not on the drug," Schwartz explains. "This was based on imaging findings used as part of a clinical trial. This was an unexpected finding and could not be clearly explained. The hypothesis at the time was that the levodopa may be neurotoxic to cells of the brain (neurons)."

Schwartz says that many studies now have debunked this myth, finding that treating people in the early stages of Parkinson's does not impact long-term motor functioning. A 2022 systematic review and meta-analysis in the Journal of Neurology looked at 23 articles and concluded that levodopa-alone therapy has more benefits for early Parkinson's disease patients than levodopa-sparing strategies.

Levodopa stops working in later stages

Schwartz also said that another common Parkinson's myth surrounds the use of levodopa in the later stages of the disease. Some people believe levodopa becomes ineffective in advanced Parkinson's. Schwartz says this isn't true. "Levodopa does not ever stop working," he said. "However, its benefit becomes increasingly shorter-lived in sync as the disease progresses."

According to the Michael J. Fox Foundation, the progression of Parkinson's might require higher doses, which can increase side effects such as involuntary movements. If the doctor reduces the dose of levodopa, some tremors could occur, leading people to believe the drug has stopped working. Parkinson's Therapeutics adds that some people taking levodopa experience "on-off" fluctuations where symptoms might reappear, but this can be attributed to the progression of the disease. According to a 2022 article in The Lancet Neurology, treating these fluctuating symptoms is challenging to researchers, so they are looking for better ways to administer levodopa, such as a levodopa-carbidopa intestinal gel, to help treat Parkinson's Disease.