Parkinson's disease is a progressive neurodegenerative condition which affects various parts of the brain; however, most deleterious effects are observed in the substantia nigra – a part of the brain which is responsible for balance and movement control. According to latest statistics, this disease affects more than 4 million people globally with a little more than a million in North America alone. In United States, about 60,000 new cases of Parkinson's disease are identified each year with an incidence rate of 13 per 100,000 of the general population. It is imperative to mention that the risk of developing Parkinson's disease increases with physiological aging (also known as late-onset Parkinson's disease); but do genetics play a part in this?

Is Parkinson's Hereditary?

A simple answer would be, NO. It is, however, interesting that about 10% of Parkinson's patients have at least one relative with this neurodegenerative condition, yet experts believe that Parkinson's is not hereditary and there is no risk of passing it on to your offspring. It is believed that Parkinson's disease is a product of complex interplay between environmental and genetic factors.

How do Genes Play a Role in Parkinson's?

It is not completely understood how genetic factors can influence the development of Parkinson's disease and a lot of research is still in process to answer the question, "Is Parkinson's hereditary?" In the light of current research, experts suggested that Parkinson's is a result of degradation or impairment of neurons (nerve cells) in the substantia nigra region. These cells produce dopamine (a neurotransmitter) which helps in the smooth execution of physical movement by promoting the transmission of signals within the brain. When these cells are damaged, the co-ordination between brain and smooth muscle cells weakens due to which body balance and movement control is lost.

As discussed earlier, the complex interaction between genetic as well as environmental factors can influence the development of Parkinson's. All such cases are referred to as sporadic as the primary etiology remains unclear. However, some cases are familial as well (i.e. caused by mutation of genes such as, PARK2, PARK7, PINK1, LRRK2, OR SNCA genes). Needless to say that these genetic mutation can also play a role in some sporadic cases. In addition, mutation of GBA and UCHL1 genes are also believed to increase the risk of Parkinson's in some families.

Experts explain Parkinson's hereditary association with this mechanism. The mutations in certain genes can result in the accumulation of unwanted proteins that may alter the normal functioning of neurons (especially those that produce dopamine), ultimately leading to cell death or impairment of function. Likewise, some genetic mutations can also affect the functioning of mitochondria (the energy producers of cells). It is important to mention that free radicals are also produced as a by-product of energy generation processes and can cause mutations if not optimally neutralized; thus further aggravating the risk of Parkinson's.

How do Environmental Factors Contribute to Parkinson's?

So far, the exact mechanism of Parkinsonism is not clear; however, some research studies suggest that environmental factors such as chronic exposure to certain toxins like pesticides, insecticides (permethrin and beta-hexachlorocyclohexane), fungicide maneb and herbicides can aggravate the risk of developing Parkinson's disease. Likewise, MPTP is a synthetic neurotoxin which can cause permanent Parkinson's. The U.S Department of Veterans Affairs compiled a list of diseases that may occur secondary to Agent Orange exposure (another herbicide used by military), including Parkinson's. Besides toxic chemicals, consumption of well water or living in some rural locations may also contribute to Parkinsonism. It is important to mention that so far there has been no definitive evidence that these environmental factors alone can cause Parkinson's disease, which may explain why people ask, "Is Parkinson's hereditary?"

Is There a Cure for Parkinson's?

The treatment for Parkinson's is mainly symptomatic and so far there has been no cure. Fortunately, with appropriate pharmacological management, a dramatic improvement in the symptoms can be achieved to restore optimal quality of life. Surgery can also be performed in some cases.

1.    Medications

There are a number of pharmacological options that can help in controlling symptoms like tremors, improper balance and movement problems. Medical management for Parkinson's includes dopamine agonist, carbidopa-levodopa, carbidopa-levodopa infusion, amantadine, MAO-B inhibitors, anticholinergics, COMT inhibitors, etc. All these medications are either substitutes for dopamine or increase the levels of dopamine in the nerve endings. One drawback of these medications is tolerance (i.e. body becomes less responsive to the drug and ultimately needing a higher dose to produce same degree of relief).

2.    Surgical Procedures

People with advanced Parkinson's disease are often a good candidate for deep brain stimulation (DBS). It is a surgical procedure in which electrodes are implanted in the specific areas of brain while a generator is implanted near the collar bone. Electrodes are connected with generator and electrical pulses are sent to the brain in order to control symptoms of Parkinson's.

3.    Lifestyle and Home Remedies

Despite the answer to "Is Parkinson's hereditary?" changes in lifestyle are important as they can help to improve symptoms. Physical therapies and speech therapies are proven to be beneficial.

• Healthy eating

Certain foods can help in lessening the symptoms of Parkinson's disease. For example, constipation is a common symptom found in PD patients which can be reduced with intake of sufficient amount of fluid and eating highly fiber-rich food. Omega 3- fatty acids are also considered an excellent nutrient for Parkinson's patients.

• Exercise

Since balance and free movements are significantly affected in the Parkinson's disease; experts recommend physical exercises to improve your balance. Physical therapy that involves stretching and balancing the body posture are highly beneficial. It is a better option to work with a physical therapist to learn more about most appropriate exercises for you, such as walking, water aerobics, stretching or swimming. But one should do exercise with care and should not move quickly or abruptly. When walking, instead of looking directly down, you should look upfront. Moreover, if a person shambles, it is important to stop immediately.

• Avoiding falls

In advanced stage of illness, there is always a risk of getting injured as a result of sudden loss of balance. Few precautions can help a great deal from losing balance and preventing falls. For example, do not carry things while walking and do not walk in backward direction. While walking, weight should be evenly distributed between both feet. Also speak to your doctor to learn more about the illness and other preventive tips.