Parkinson’s Disease vs. Multiple Sclerosis

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Multiple sclerosis (MS) and Parkinson’s disease (PD) often seem alike and have many instances where one condition may be misdiagnosed as the other. But does this mean the two medical conditions are linked? What are their similarities against their differences?

Multiple sclerosis and Parkinson’s disease are neurodegenerative conditions that affect the normal functioning of the brain and spinal cord. Both conditions are lifelong diseases that affect the patient’s movements but also have distinct features that allow designated specialists to differentiate one from the other.

Similarities Between Multiple Sclerosis and Parkinson’s Disease

Some symptoms of PD and MS are similar, making diagnosing and distinguishing one condition from the other challenging. Both conditions start out with relatively mild symptoms but progress and become more severe over time.

Common Symptoms

The following are some common symptoms typically shown in both conditions:

  • Depression
  • Numb or weak limbs
  • Shaky fingers, lips, and limbs
  • Poor balance
  • Uncontrollable spastic limb movements
  • Changes in cognitive functioning
  • Slurred speech that other people cannot easily understand
  • Loss of muscle control (often affects one side of the body at first before progressing to both sides)
  • Erectile dysfunction
  • Loss of bowel or bladder control

Causes

MS and PD both affect the patient’s central nervous system (the brain and spinal cord), which is why they affect movement, sleep, sensory, and speech.

Multiple Sclerosis

MS occurs when the patient’s immune system attacks myelin cells in the brain and spinal cord. Myelin cells surround and create a protective layer around the nerves. They also increase the speed at which nerves transmit electrical information.

Over time, repeated attacks on the myelin can cause nerve inflammation and permanent nerve damage. While it’s not yet clear what causes multiple sclerosis, some more pronounced risk factors increase the chances of developing the condition, including:

  • Genetics: people with a parent or sibling with MS have about a 2-3% chance of developing the condition
  • Smoking: smoking increases your risk of developing MS
  • Teenage obesity: people who had obesity when they were teenagers are also at a higher risk of developing MS later in life
  • Biological sex: female bodies are four times more likely to develop MS than male bodies
  • Viral infections: studies have shown that certain infections, particularly ones caused by the Epstein-Barr virus, might trigger immune activity and lead to MS in some people
  • Lack of sufficient vitamin D and sunlight: MS is more prevalent in countries farthest away from the equator. This could mean the lack of sufficient sunlight and low vitamin D levels play a role in the condition. However, it is not yet clear if vitamin D supplements can prevent MS progression.

Parkinson’s Disease

PD is caused by the loss or death of cells that produce dopamine in the substantia nigra. Dopamine acts as a neurotransmitter that coordinates all bodily motor functions.

Studies suggest that genetic and environmental factors play a role in the development and progression of PD:

  • Genetics: genetic are linked to about 10-15% of Parkinson’s disease cases
  • Chemical exposure: prolonged exposure to certain chemicals like pesticides, fungicides, and herbicides are thought to increase the risk of developing PD
  • Age: Likelihood of Parkinson’s increases with age
  • Occupation: it’s possible that people in certain occupations like agriculture and welding are at a higher risk of developing PD, but research in this area is ongoing

Differences Between Multiple Sclerosis and Parkinson’s Disease

While MS and PD seem to share several similarities (symptoms and causes), the two neurodegenerative diseases differ in other situations.

For example, both conditions start to affect the patient at different ages. MS mainly affects people between 20 and 50 years, but children can also get it. On the other hand, PD often starts at age 60 and older, but some younger adults (30 years) may begin to show signs.

Some symptoms can also help medical specialists to distinguish between MS and PD, including symptoms that appear in only one condition or the other.

Common MS Symptoms

  • Pain or tingling in some parts of the body
  • Dizziness or vertigo
  • Feeling of electric shock or sharp pain in the neck when moving
  • Seizures
  • Headaches
  • Itching
  • Hearing loss

Common PD Symptoms

  • Poor posture
  • Slowed movement
  • Stiff, rigid muscles
  • Feet drag or shuffle
  • Small, cramped handwriting
  • Loss of control over certain motor functions like blinking, swallowing, or swinging arms when walking

Diagnosing Parkinson’s Disease vs. Multiple Sclerosis

To make a PD or MS diagnosis, a designated team of experts will carefully review your medical history and use this data to run several targeted tests to rule out one condition for the other.

These tests include:

  • Physical exam
  • Neurological exam
  • Blood tests
  • Imaging

Diagnosing Multiple Sclerosis

Medical experts use multiple tests to diagnose MS, including:

  • Finding evidence of damage in multiple parts of the central nervous system like the brain, spinal cord, and optic nerves
  • Finding evidence that the damage resulted from different times
  • Ruling out all other possible conditions

Your doctor may perform specific tests to diagnose MS, including:

  • MRI scan
  • Blood tests
  • Spinal fluid analysis
  • Examining your medical history
  • Performing a neurological and physical exam

Diagnosing Parkinson’s Disease

PD can be diagnosed clinically based on the patient’s signs and symptoms during the neurological and physical exam. A proper diagnosis of PD is likely if the patient meets at least 2 of the following symptoms:

  • Shaking or tremor in parts of the body where they don’t usually occur
  • Muscle stiffness
  • Slowness of movement

If symptoms improve after taking medications like levodopa, it may be an indicator that a patient has PD.

A dopamine transporter scan (DaTscan) can also help doctors to identify the loss of dopaminergic neurons in the basal ganglia (part of the brain that produces dopamine).

Treating MS vs. PD

Neither multiple sclerosis nor Parkinson’s disease currently has a cure. The treatment and outlook of both conditions vary depending on several factors like the speed of progression, treatment method used, and other concurrent medical conditions.

The treatment of multiple sclerosis focuses on slowing down the disease’s progression. On the other hand, treatment for PD focuses on managing the disease’s symptoms. There are no current methods of stopping or reversing either disease.

Treating Multiple Sclerosis

Your physician will typically prescribe disease-modifying drugs for treating multiple sclerosis.

These medications help:

  • Prevent new disease activity
  • Slow disease progression
  • Prevent relapses

MS medications are available in the form of:

  • Injectable medications like Avonex, Betaseron, Copaxone, Extavia, Glatopa, Rebif, and Plegridy
  • Oral medications like Aubagio, Bafiertam, Dimethyl Fumarate, Mayzent, Gilenya, and Zeposia
  • Infusions like Lemtrada, Ocrevus, Novantrone, and Tysabri

A treatment plan for multiple sclerosis may also include therapies to help patients maintain or regain physical functions. Physical therapy and plasma exchange can also help stretch and strengthen the patient’s muscles to improve their strength, mobility, and balance.

Treating Parkinson’s Disease

Currently, there are no available treatment options to reverse the effects of Parkinson’s disease. But the following treatments should help manage its symptoms:

Medications, such as:

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