What Is Juvenile Parkinson’s Disease?

Before discussing Juvenile Parkinson’s Disease (or JPD) in detail, we must consider what is PD itself? 

If the symptoms develop before the age of forty (or fifty), it is referred to as ‘Early-Onset’ Parkinson’s Disease (EOPD). 

This EOPD is further classified into two groups. If the symptoms show between the age of twenty-one to forty, it is known as ‘Young-Onset’ Parkinson’s Disease.

But if they appear even before the age of twenty-one, experts call it Juvenile Parkinson’s Disease (JPD).

We have a related article for you, you can read What Is Parkinson’s Disease Life Expectancy?

What Is Juvenile Parkinson’s Disease? What Is Parkinson’s?

PD or Parkinson’s disease is a neurodegenerative disorder. What happens is that a substance called Lewy body develops in a specific part of the brain, which is known as ‘substantia nigra’. This development hampers dopamine production, leading to various PD symptoms.

Diagnosis of Juvenile Parkinson’s Disease

Now, Parkinson’s disease usually develops or gets diagnosed at or after the age of sixty. However, sometimes the symptoms appear earlier. If the symptoms develop before the age of forty (or fifty), it is referred to as ‘Early-Onset’ Parkinson’s Disease (EOPD). 

This EOPD is further classified into two groups. If the symptoms show between the age of twenty-one to forty, it is known as ‘Young-Onset’ Parkinson’s Disease. But if they appear even before the age of twenty-one, experts call it Juvenile Parkinson’s Disease (JPD).

Causes

PD is usually associated with genetic mutations, environmental influences, or both. The symptoms differ in different people, and their development stages also vary. This diversity makes Parkinson’s Disease a somewhat unusual disorder with diverse conditions. 

But there is an underlying line of commonalities that characterize Parkinson’s in all the patients. Over ten million people worldwide are affected by Parkinson’s Disease every year. 

The leading cause identified in almost all the patients is the lack of dopamine due to the development of the Lewy body in the affected part of the brain. However, the precursor to such a development in ‘substantia nigra’ remains, as discussed above, either:

• genetics, or 
• environmental factors

Let us visit both of these in a bit more detail.

Genetics

About 10-15% of all patients are the ones who develop PD symptoms due to genetic mutations. This number has been charted by years and years of medical research on the DNA of affected patients. 

The research has brought into light various genetic mutations that are causative of Parkinson’s-related symptoms over the years. There are institutes in the world like PD GENEration, which help the patients identify genetic PD and offer them help through genetic counseling. 

Environmental Factors

The environmentally-induced PD is even more complex to regulate and monitor. The environment can sometimes cure the symptoms, while at other times, it can worsen them. The PD impact factors of the environment may include:

• an injury on the head
• the area where one lives
• pesticide or insecticide exposure

Sometimes both of these factors, i.e., genetics and environmental factors, combine to contribute to Parkinson’s disease.

Almost four percent of every one million people are affected by Juvenile Parkinson’s Disease. The symptoms are usually the same as those appearing after fifty or sixty years of age. But the challenges these symptoms pose at a younger age are far more severe and complicated as those are the most active years of one’s age. 

Thus such individuals are not only affected in terms of health, but they also suffer monetarily, family-wise, and in their professional lives.

Although very little in number, there are such cases where PD symptoms develop in toddlers and teenagers. Such cases come under the rubric of Juvenile Parkinson’s Disease or Juvenile Parkinsonism. 

The most common causes of such developments which scientists have noticed and identified are genetic mutations.

Symptoms

The symptoms of Juvenile Parkinsonism include:

• tremors or rhythmic shaking in hands, arms, legs, jaws, and face
• rigidity in the limbs
• bradykinesia
• faulty gait and loss of balance in the posture

Alongside these movement-related symptoms (also known as motor symptoms), there are ‘non-motor’ symptoms. These include:

• depression
• apathy
• constipation
• disorderly sleep patterns
• cognitive disability
• loss of sense of smell, and so on.

How Is JPD Different?

Juvenile Parkinsonians usually have a family history of PD. They tend to suffer longer than those who develop PD at an average age range of the fifties or sixties. The usual experiences of Juvenile Parkinsonians may include:

• Relatively slow development and progression of both ‘motor’ and ‘non-motor’ symbols.
• Prolonged and intensified reactions and side effects from medicines that help sustain dopamine levels in the body
• More abnormal body postures, twisting, and stiffening of limbs.

Why Is Distinguishing Young-Onset Parkinson’s Important?

The people who come across PD at a younger age have their life influenced in several ways. Their response to these symptoms may be affected by their career trajectory, energy levels, reflexes, etc. 

They may also be socially awkward due to their condition if they are at a stage where they are planning to have kids. They may also be apprehensive about transferring these genes to their kids.

The doctors, in such cases, have to be extra careful and devise novel ways of treatment. JPD is mostly genetically-induced. Therefore, genetic testing and counseling can be provided to such patients. 

The factor of neuroplasticity in the younger brains also plays an essential role in the reception of specific modes of treatment in a different way than older ones.

Causes and Theories Pertaining to “Juvenile” Parkinsonism

In most instances, the root cause of PD is a combined factor of genetic mutation and environmental influences. But the former is more significant when it comes to JPD. Thus, by investing years of research and millions of dollars, scientists have discovered the possible genetic mutations that can trigger PD at a relatively younger age.

The individuals who have JPD along with a family history of PD can have the following types of genes, among others:

• SNCA
• PARK2
• PINK1, and
• LRRK2. 

Studies have brought out the statistics which highlight genetic mutation in:

• 65% of patients who are under twenty years of age
• 32% of patients who are between the ages of twenty and thirty

But there is also a great possibility that there is no development of Parkinson’s disease even in the presence of these genes. Developed countries like the USA have active institutes and facilities to conduct rapid genetic testing to identify and trace the factors that cause the genes to mutate. Along with mapping out the genetic mutations, these studies and research will also be a benchmark in finding modern and effective ways to treat PD and perhaps even find a permanent cure someday.

As per the trends and studies up to this point, the researchers and experts believe that JPD has more to do with genetics than with the environment. But there is still less evidence to claim this ‘observation’ as final, as scientists collect more diversified data each day.

Therapy and Treatment

Treatment may include a range of possibilities, including therapies, oral medicines, and surgeries. However, the treatment for JPD also follows a symptom-oriented approach. This approach means that the symptoms are treated through various medicines, most commonly carbidopa or levodopa. 

Also, you have to check out my post on Parkinson Disease and Protein Intake – A Complete Guide.

These medicines can reduce motor symptoms, but excessive use can also lead to dyskinesia. Along with these medicines, other possible treatments may include different types of speech therapies, physiotherapies, biological therapies, etc.

Advanced treatment is that of neurosurgery, i.e., deep brain stimulation.

Furthermore, following changes in the lifestyle can also be instrumental in treating and better dealing with PD:

• adopting a diet that contains rich amounts of antioxidants
• cutting dairy items from the diet
• exercise
• yoga
• boxing (without contact)
• Pilates, etc.