Glossary

A-B

A

Acetycholine

A neurotransmitter that sends messages between nerve cells, or between muscles and nerve cells.

Acupressure

A form of touch therapy that utilizes the principles of acupuncture and Chinese medicine. In acupressure, the same points of the body are used as in acupuncture, but they are stimulated with pressure from the fingers rather than with the insertion of needles.

Acupuncture

A technique of inserting and manipulating ultra-fine needles into acupuncture points on the body, with the aim of restoring health and wellbeing.

For more information, see: Acupuncture

Adeno-associated virus

A group of DNA-containing viruses, of which the ‘wild’ type can cause conjunctivitis and upper respiratory tract infections in humans

Adjunctive

A treatment or preparation that supports the main therapy.

Adverse Event

Side effects to a medication that are unintended, generally of a harmful or unpleasant nature.

Akathisia

A sense of restlessness and a desire to move the limbs that makes people unable to sit still and can be painful. 

A common symptom of Parkinson’s, particularly at night, and may be a side effect of the medication used to treat the disease. Can also occur as a side effect of psychotropic medicine, including tranquillisers and antipsychotics.

Akinesia

Lack of movement.

Alexander technique

A practice concerned with changing movement habits in everyday activities and thus eliminating or reducing harmful tension in the body, particularly in the head, neck and back.

For more information, see: Alexander Technique

Alzheimer's disease

A progressive, neurodegenerative disease that attacks the cells, nerves and transmitters in the brain.

This gradually destroys the connections between the brain cells that are essential for normal mental activity, which results in loss of cognitive function including attention, memory and language.

Alzheimer's disease is the most common cause of dementia

For more information, see: Dementia

Amantadine

A type of medication used to treat Parkinson's disease.

For more information, see: Types of medication

Amino Acid

Molecules that form the basic building blocks of proteins [LINK to protein glossary item.]

Dietary proteins need to be broken into their amino acid components before they can be used by the body.

Amplitude

The measure of something's size, such as the wideness in range or extent of a movement.

Anaesthetic

Substances that cause temporary loss of feeling or sensation used in medical, surgical and dental procedures to prevent pain and/or make a patient unconscious.

There are two types: 'local', which affects a particular part of the body, and 'general', which affects the whole body by making a person unconscious.

Anhedonia

The inability to experience pleasurable emotions from normally pleasurable activities.

Anticholinergic medications

Also known as Anticholinergics.

See also Anticholinergics

Anticholinergics

A class of older medication used to treat Parkinson's disease that works by reducing the amount of acetylcholine in the body and thereby facilitating dopamine cell function.

Also called antimuscarinics.

For more information, see: Classes of medication

Antidepressant

A medication or other substance, such as a nutrient or herb, used to alleviate depression.

Anxiety

An unpleasant feeling of uneasiness, fear, apprehension or concern about some uncertain event.

For more information see: Anxiety.

Apathy

Apathy or apatheia, from the Greek απάθεια meaning "absence of feeling", is a philosophical term describing a state of having no interest, enthusiasm or emotion.

For more information see: Apathy.

Aphasia

A condition in which the ability to communicate verbally or in written words is partially or fully lost. Difficulty speaking, reading, writing, or understanding what others have said may also be experienced.

Apomorphine

A dopamine agonist medication used to treat Parkinson's disease, usually administered by injection. 

Dopamine agonists have structures similar to dopamine.  Rather than replacing, it imitates the action of dopamine, in the same way levodopa does.

Aromatherapy

An ancient practice that uses essences from aromatic plants, called essential oils, to improve physical and emotional wellbeing.

For more information, see: Aromatherapy

Arterioles

The small ‘twigs’ or divisions of arteries that end in capillaries.

Artery

The muscular, elastic tubes that form a branching system and carry blood from the heart through the body.

Artificial hydration

Introducing additional fluid into the body to ensure adequate hydration levels, usually necessary when a person is too unwell to drink enough water or eat enough food.

Aspiration

Inhalation of a foreign matter or substance, such as food, into the trachea (windpipe) and lungs.  

This can lead to aspiration pneumonia, an often-serious infection in the lungs.

Aspiration pneumonia

Inflammation of the lungs caused by inhaling or choking on foreign matter such as food or saliva.

Asthenia

A lack of strength or energy.

Ataxia

Loss of muscle coordination.

Attenuate

To weaken or become weak, or to decrease in level.

Autonomic dysfunction

Term used when the autonomic nervous system (ANS) does not function as it should.  The ANS is part of the peripheral nervous system that controls functioning largely below the level of consciousness, e.g. heart rate, digestion, salivation, perspiration, diameter of the pupils, urination and sexual arousal.

For more information see: Autonomic dysfunction.

Autonomic nervous system

Part of the peripheral nervous system that controls functioning largely below the level of consciousness, e.g. heart rate, digestion, salivation, perspiration, diameter of the pupils, urination and sexual arousal.

Autosuggestion

The influence of the mind on the body, whereby positive or negative thoughts and beliefs can affect physical symptoms.

B

Basal ganglia

The part of the brain that is responsible for controlling movement.

Dopamine, the neurotransmitter that is in short supply in the brains of people with Parkinson's disease, is made in a section of the basal ganglia known as the substantia nigra.

Benzhexol

An anticholinergic used to treat Parkinson's disease. Also known as trihexyphenidyl.

For more information, see: Types of medication.

Benzodiazepines

A type of medication known as tranquillisers and sedatives.

Benzodiazepines work by slowing down the transmission of nerve signals in the brain to the central nervous system.

Benzotropine

An anticholinergic used to treat Parkinson's disease.

For more information, see: Types of medication

Biofeedback

A technique using electronic monitoring equipment to obtain information about an involuntary function of the central or autonomic nervous system. Biofeedback can be used to train an individual to gain control over bodily functions which are normally automatic.

Biomarker

A measurable substance that is introduced into an organism whose presence is indicative of some phenomenon such as disease, infection, or environmental exposure

Bladder

The part of the urinary tract that receives urine from the kidneys and stores it until it is expelled via urination.

For more information, see: Bladder Problems

Blastocyst phase

This occurs four to five days after the union of a sperm and egg, before an embryo plants in the uterus.

Blepharospasm

Involuntary closure of the eyelid caused by muscles contracting. This is often experienced as excessive blinking, intolerance to light, a burning feeling in the eye or irritation.

For more information, see: Dystonia

Blog

Short for WeB LOG, a blog is a journal kept on the internet.  This is generally updated daily or on a frequent basis by the person wishing to share the information (a blogger).

Botulinum Toxin

A neurotoxin used in minute doses as a treatment for muscle spasms and dystonia.

Bowel

The part of the digestive system below the stomach especially the large intestine.

The large bowel is sometimes used to describe the colon and rectum. The upper part of the intestine, which includes the duodenum, jejunum and ileum is often referred to as the small bowel.

For more information see: Bowel problems

Bradykinesia

The slow execution of movement and impaired ability to adjust the body's position.

The word bradykinesia is derived from Greek roots: brady (slow) and kinesis (movement).

For more information, see: Bradykinesia

Bradyphrenia

Slowness of thought processes.

Bromocriptine

A dopamine agonist used to treat Parkinson's disease.

For more information, see: Types of medication

Burn out

A physical or psychological condition often induced by overwork or overexposure to stress in the workplace.

This causes feelings of being worn out and having diminished interest in performing an activity, resulting the person feeling tired, defensive, frustrated, cynical, bored, and generally pessimistic about the job.

C-D

C

Cabergoline

A dopamine agonist used to treat Parkinson's disease.

For more information, see: Types of medication.

Calculus

A hardened or calcified plaque that forms from mineral salts in the saliva and deposits on the teeth.  A cause of tooth decay and gum disease, it requires scaling by a dentist or dental hygienist to remove.

Also known as tartar.

Capillaries

The tiny blood vessels that connect arterioles.

Carbidopa

A medication used in combination with levodopa which prevents levodopa from being metabolised in the body, therefore allowing more levodopa to reach the brain.

For more information, see: Types of medication

Carbon dating

A technique used to determine the age of carbon-bearing minerals, including wood and plant remains, charcoal, bone, peat and calcium carbonate shell.  

When an organism dies, it stops absorbing radiocarbon and the amount already within it starts to decay and reduce. The rate at which this occurs is a known quantity: it takes 5,730 years for half of the radiocarbon available in the organism to decay. By comparing the amount left in a dead organism to the available radiocarbon levels in the atmosphere, it is possible to estimate when that organism died.

Also known as radiocarbon dating or carbon-14 dating.

Cardio-pulmonary

Associated with the heart (cardio) and the lungs (pulmonary).

Cardio-respiratory

Associated with the heart (cardio) and the lungs (respiratory).

Cardiovascular

Anything associated with the heart (cardio), lungs, blood vessels (vascular) and/or circulatory system.

Caregiver

The term used to describe people who look after or provide support - usually voluntarily and without payment - to relatives, partners or friends who are ill, aged or disabled.

Also known as carer.

Carer

The term used to describe people who look after or provide support - usually voluntarily and without payment - to relatives, partners or friends who are ill, aged or disabled.

Also known as caregiver.

Cataracts

Literally means waterfall, and is when the crystalline lens of the eye clouds over and loses transparency, becoming opaque and making it difficult to see.

Cataracts usually occur in elderly people, but can also be caused by injury or through inheritance.

Catechol-O-methyltransferase inhibitors

A class of medication used to prolong the duration of the effects of levodopa.

They block an enzyme called catechol-O-methyl transferase (COMT) that breaks down levodopa. This slows the destruction of levodopa in the body.

For more information, see: Classes of medication

Catheter

A thin, flexible tube inserted into the body to inject or remove fluids.

Central nervous system

The central nervous system (CNS) is a major part of the nervous system that includes the brain. It is responsible for coordinating all the body’s activities.

Cerebrovascular

Relating to the brain and the blood vessels which supply the brain.

Cervical dystonia

Cervical dystonia, also known as spasmodic torticollis, is dystonia affecting the neck muscles, which causes the head to twist to one side, forwards or, occasionally, backwards.

For more information, see: Dystonia

Chemotherapy

A treatment technique that uses chemical agents (medication) to treat disease or illness.

Commonly associated with cancer treatment to kill or stop cancer cells from growing or spreading and to shrink tumors prior to surgery.

Chemotherapy is administered orally or intravenously through a vein or muscle.

Chi

A term used in Chinese traditional medicine to refer to a vital life force present in all living things.

Practitioners believe that maintaining a good, free circulation of Chi and balancing its positive and negative aspects is necessary to ensure good health.

Chiropody

The care and treatment of the feet.

A chiropodist (also known as a podiatrist) deals with the assessment, diagnosis and treatment of the lower limb.

Also known as podiatry.

Chiropractic

The practice of manipulating the body joints, especially the spine, with the intention of affecting the nervous system and improving health. It is particularly used to treat pain such as backache and tension and postural problems.

Practiced by a chiropractor.

Cholinergic function

A function that uses the chemical acetylcholine as its neurotransmitter.

Chromosome

A threadlike strand of DNA in the cell nucleus that carries genes in a linear order.

Chronic

An illness of disease that is long-lasting or recurrent.

Clinical trial

A research study that tests the effectiveness and safety of medications in humans.

For more information see: Clinical trials

Coagulopathies

Disorders that cause blood clotting deficiencies, e.g. haemophilia.

Co-beneldopa

A levodopa/DDI preparation used to treat Parkinson's disease which is marketed as Madopar.

For more information, see: Types of medication

Co-careldopa

A levodopa/DDI preparation used to treat Parkinson's disease which is marketed as Sinemet.

For more information, see: Types of medication

Cognitive

Brain functions relating to thought processes such as thinking, reasoning and judgement, remembering, imagining, learning, intuition, sense and perception, and understanding.

Cognitive behavioural therapy

Cognitive behavioural therapy (CBT) is a form of counselling and psychological therapy with a focus on understanding how thoughts affect behaviour.

Combination therapy

When two or more medicines are used in combination to treat one illness.

Complementary therapies

Non-conventional health treatments, often based on ancient systems, which are used in addition to conventional or traditional medicine/techniques.

Examples include acupuncture, the Alexander technique, aromatherapy, ayurveda, creative therapies (involving art, music, dance or drama), chiropractic, herbal medicine, homeopathy, osteopathy, Pilates, reflexology, Tai Chi and yoga.

For more information, see: Complementary Therapies

Compliance

The act of following a medical regimen or schedule correctly and consistently, including taking medicines, following a diet and following medical advice.

Also known as adherenceconcordance, or capacitance

Computed tomography

Computed tomography or CT is a medical imaging technique that involves a type of X-ray.  A scanner rotates around the body to produce an image of the body or brain in cross-section.

COMT inhibitor

A class of medication used to prolong the duration of the effects of levodopa by blocking an enzyme called catechol-O-methyl transferase (COMT).  This enzyme breaks down levodopa so blocking it slows the destruction of levodopa in the body.

For more information, see: Classes of medication

Concentration

The term used to describe the relative amount of a substance mixed with another substance.  Often used to describe the strength of a solution, where a substance has been dissolved in a given volume of liquid or solvent.

Constipation

A condition where it becomes difficult to empty faeces from the bowel or where the stool is small, hard and difficult or painful to pass.

For more information, see: Bowel problems

Consul

An official appointed by the government of one state and residing in the territory of another. His or her role is to assist and protect the citizens of the consul's own country, and to facilitate trade and relations in a foreign city.

Continence

The ability to control the timing and process of urination and defecation (bowel movements).

Continence advisor

A specialist nurse who advises on continence problems to help with controlling the bowel, bladder movements and timing.

Contracture

The stiffening of a joint to the extent that it cannot be moved through its normal range of movement.

Contraindications

Any symptom or situation such as substance abuse, emotional health issues, or other health conditions, that might put you at increased risk for an otherwise recommended treatment and is therefore not advised.

Control group

A group of people who receive a placebo instead of the experimental treatment in a clinical trial.  This group is used as the standard by which to evaluate findings.

Controlled-release preparations

A form of levodopa that releases the medication more slowly, thereby making its effects last longer.  Slowing down levodopa's absorption in the gastrointestinal tract reduces fluctuations in the levodopa levels in the blood and results in smoother symptom control.

Corpus Striatum

A part of the brain, located in front of the thalamus, that helps regulate motor activities.

Corticobasal degeneration

Corticobasal degeneration (CD) is a rare type of Parkinsonism that can affect mental processes, personality and behaviour, as well as causing Parkinsonism symptoms.

It tends to be asymmetrical and causes an ‘alien limb’ phenomenon, where the person’s arms or legs seem to move without control, as if with a mind of their own. CD has some similarities with Progressive Supranuclear Palsy (PSP).

More information and support is available from the Pick’s Disease Support Group – www.pdsg.org.uk or the Progressive Supranuclear Palsy (PSP-Europe) Association – www.poseur.org

See also: Types of Parkinson's and Progressive Supranuclear Palsy

Craniosacral therapy

Craniosacral therapy (CST) is an holistic therapy involving gentle manipulation of the bones of the skull, the underlying meningeal membranes, and the nerve endings in the scalp.  The aim is to restore rhythmic flow to the craniosacral system in the body, which includes the brain, spinal cord, cerebrospinal fluid and surrounding membranes, and release restrictions of nerve passages.

'Craniosacral' refers to the movement of the cerebrospinal fluid that flows up and down the spinal cord from the cranium (head) to the sacrum (tailbone).

See also: Craniosacral therapy

Cueing

The process of providing cues, prompts, hints and other meaningful information, direction or instruction to aid a person who is experiencing difficulties.

For more information see: Coping Strategies

Cystitis

Inflammation of the bladder or urinary tract, usually caused by a bacterial infection. The condition is marked by abdominal pain as well as frequent, painful urination and fever.  It can also lead to the presence of blood in the urine.

D

Decarboxylase

An enzyme in the blood and brain that catalyses the decarboxylation of amino acids, beta-keto acids and alpha-keto acids.

This chemical reaction removes a molecule of carbon dioxide from carboxylic acid and creates, for example, an amine from an alpha-amino acid, and dopamine from levodopa.

Decarboxylase inhibitor

Decarboxylase inhibitor (DCI) is an enzyme that inhibits the conversion of levodopa (dopa) to dopamine by preventing a decarboxylase chemical reaction from taking place.

By preventing levodopa from breaking down outside the brain, each dose of levodopa is more effective and much lower amounts of can be given, avoiding many side effects.

Deep brain stimulation

Deep brain stimulation or DBS uses one or two surgically implanted medical devices called neurostimulators, similar to cardiac pacemakers, to deliver electrical stimulation to precisely targeted areas on each side of the brain.

Stimulation of these areas appears to block the signals that cause Parkinson's motor symptoms. As a result, many patients achieve greater control over their body's movements.

Deep brain stimulation is also known as:

  • SCP - Stimulation Cérébrale Profonde (French)
  • THS - Tiefen Hirnstimulation (German)
  • SCP - Stimolazione Cerebrale Profonda (Italian)
  • ECP - Estimulación Cerebral Profunda (Spanish)
  • DH - djup hjärnstimulering (Swedish)
  • DBS - Mély agyi stimuláció (Hungarian)
  • DBS - Globoka možganska stimulacija (Slovenia)
  • SCP - Stimulare Cerebrala Profunda (Romanian)

For more information see: Deep brain stimulation

Delirium

A state of excitement and mental confusion. It is usually brief and often accompanied by hallucinations.

Dementia

The progressive deterioration in intellectual and cognitive abilities including impairment of memory and the inability to pay attention, learn, make decisions and solve problems.

This typically has an adverse effect on emotions and may also affect language, personality, abstract reasoning and judgement.

Dementia is not a disease in itself, but a generic term given to a group of symptoms that characterise other diseases and conditions.

For more information, see: Dementia

Dementia with Lewy bodies

Dementia with Lewy bodies (DLB) is a neurodegenerative disorder associated with abnormal structures (Lewy bodies) found in certain areas of the brain.

DLB is often confused Alzheimer's as they both share symptom similarities, such as memory loss and variations in alertness and attention.

Around 75% of people with the disorder also develop Parkinsonism symptoms, in particular being susceptible to falls.

Further information and support is available from the Alzheimer’s Society – www.alzheimers.org.uk, the Pick’s Disease Support Group – www.pdsg.org.uk, and Alzheimer Europe - www.alzheimer-europe.org

For more information, see: Dementia with Lewy Bodies

Denture

A complete or partial set of artificial teeth that is set into piece of hard plastic or metal framework. Dentures can be removable or fixed in the mouth.

Depression

A mental state of melancholia, unhappiness or sadness characterised by decreased energy, reduced interest in sex, suppressed appetite, too much sleep or sleep disturbance, a pessimistic sense of inadequacy, a despondent lack of activity, despair, and discouragement.

For more information, see: Depression

Detrusor

The muscle in the wall of the bladder that contracts the bladder and expels the urine. As such, the bladder is also referred to as the detrusor muscle.

Diaphoretic

A medication or agent that induces sweating.

Diarrhoea

A condition in which there is an increase in frequency, liquidity and weight of stools, associated with urgency.

Severe or prolonged diarrhoea may lead to excess loss of fluid, salts and nutrients in the faeces.

Diastolic

The pressure exerted when the heart is at rest.

Diathermy

A physical therapy using high-frequency electric current, ultrasound or microwaves to deliver heat to muscles and ligaments.  This increases blood flow, relieves pain and destroys diseased tissue and abnormal cells.

The term literally means "electrically induced heat".

Also called cauterisation or electrodiathermy.

Dietetics

The study of diet and nutrition.

Dietician

A healthcare professional who advises on diet and specific dietary needs. 

Dieticians can offer advice on how diet can ease some symptoms, such as constipation. They may also liaise with a speech and language therapist regarding swallowing and eating difficulties.

See also: Eating well

Differentiation

The process through which unspecialised stem cells develop, or mature, into specific types of cells such as dopamine-producing neurons.

Disequilibrium

Dizziness or light-headedness.

Distend

To extend, expand or swell as if by an internal pressure.

Diuretic

A substance that increases the amount of urine passed.

Domperidone

An antidopaminergic medication that is used to treat nausea, vomiting and gastroparesis.

Dopa-decarboxylase inhibitor

Dopa-decarboxylase inhibitor (DDI) is a medication that is given with levodopa (often in the same tablet) to improve its action by blocking the conversion of levodopa to dopamine.  This allows more levodopa to reach the brain and, as a result, smaller doses are needed and side effects limited. 

The DDI used in co-careldopa (Sinemet) is carbidopa; in co-beneldopa (Madopar) it is benserazide.

See also: Types of medication

Dopamine

A neurotransmitter, or chemical messenger, produced in the substantia nigra, which is part of the basal ganglia in the brain. 

Dopamine sends messages from the brain to other parts of the body and has a major role in the control of movement.

There is a shortage of dopamine in the brains of people with Parkinson's disease.

Dopamine agonist

Medication that stimulates the dopamine receptors in the brain.

Unlike levodopa, dopamine agonists do not need to be converted into dopamine by the brain cells first. They may be given as a first treatment to delay the need for levodopa or used in combination with levodopa to treat the side effects caused by long term treatment.

See also: Classes of medication 

Dopamine receptor

The area of a nerve cell that is stimulated by dopamine or a dopamine agonist.

Dopaminergic

Means related to dopamine or to dopamine-producing cells.

Dopaminergic drugs

A general name given to medications that increase the level and promote the action of the neurotransmitterdopamine.

See also: Types of medication

Double-blind study

A clinical trial in which neither the participants nor the researchers know who is receiving the active treatment and who is receiving placebo.  This is in contrast to a single-blind trial where the researchers know, but not the participants, who is in which group, or an open-label trial in which both participants and researchers know who is receiving the active treatment or placebo.

See also: Clinical trials

Drug-Induced Parkinsonism

A term used to describe when Parkinsonism develops or Parkinson's symptoms worsen after taking certain medications. 

The medications involved are generally those that block the action of dopamine, the neurotransmitter that is depleted in the brains of people with Parkinson's. 

These include antipsychotic/neuroleptic medication used to treat schizophrenia and other psychiatric problems, prochlorperazine (Stemetil) used to treat dizziness and nausea, and Metoclopromide (Maxolon) used to treat nausea and indigestion.

See also Types of Parkinson's and Parkinsonism

Dysarthria

Difficulties in pronouncing words.

Dysexecutive syndrome

A disorder of the frontal lobe section of the brain resulting in difficulty with higher mental functions such as motivation, planning, problem solving, social behaviour,and speech.

Dyskinesia

Abnormal, involuntary movements usually seen in the limbs, trunk and head.

It tends to occur in people who have had Parkinson's disease for some years, as a side effect of long term use of Parkinson's medication.

For more information, see: Dyskinesia

Dysphagia

A medical term that refers to any kind of difficulty, discomfort or pain when swallowing.

The word dysphagia is derived from the Greek 'dys' (with difficulty) and 'phagia' (to eat).

For more information, see: Eating, swallowing and saliva control

Dysphasia

Difficulties in understanding language or being able to express oneself, often because of brain damage.

Dystonia

Involuntary, sustained muscle contractions causing abnormal movements and postures.

For more information, see: Dystonia

Dysuria

Painful or difficult urination.

 

E-F

E

Early wearing off

When the effects of the drug do not last until the next dose is due.

See also Wearing off

Efficacy

The effectiveness or ability of a treatment to produce the desired results, measured under laboratory conditions or in clinical trials.

Ekbom syndrome

A condition which causes an involuntary and irresistible urge to move the legs.

Also known as restless legs or RLS.

For more information, see: Restless Legs Syndrome

Electrocardiogram

The reading given by a machine used to show electrical activity of the heart.  Also known as an ECG.

Electroconvulsive treatment

A treatment for depression in which an electric current is passed through the patient’s brain when they are unconscious.

Electronic Medicines Compendium

The electronic Medicines Compendium (eMC) contains up-to-date, easily accessible information about medicines licensed for use in the UK. The eMC has more than 10,600 documents, all of which have been checked and approved by either the UK or European government agencies that license medicines. These agencies are the UK Medicines and Healthcare Products Regulatory Agency (MHRA) and the European Medicines Agency (EMA).

Eligibility criteria

Guidelines for an individual study to determine who is suitable and able to participate.  A study will require that participants share certain criteria, for example gender, age, medical history, to ensure that trial results are due to the treatment under investigation and are not influenced by other factors.  This allows for more accurate and meaningful results.

See also Clinical trials

Embryo

Early stage in the development of a human from after implantation until around eight weeks gestation.

Endorphins

Natural hormone-like substances produced by the body that function as painkillers.

The name endorphin, is derived from 'endogenous morphine', which literally means morphine produced naturally in the body. 

Entacapone

A COMT inhibitor used to treat Parkinson's disease.

For more information, see: Types of medication

Enteral

A method of delivering fluid, food or medication directly into the gastro-intestinal tract or into the rectum to be absorbed by the lower digestive tract (small intestine).  For example, a suppository. 

Enzyme

A type of protein made by the body that speeds up biological processes.  

It can also regulate or cause chemical changes in other substances, altering them from one form to another.

Ergot

A fungus (from the Claviceps Purpurea genus) that the first dopamine agonist medications were derived from.

Essential oils

An aromatic liquid that has been extracted from a single botanical source by distillation or expression (squeezing).

There are over 400 essential oils extracted from plants all over the world; some of the most popular include chamomile, lavender, rosemary and tea tree.

Essential oils can be applied in a variety of ways:

  • massage (most common method)
  • creams and lotions (rubbed directly onto the skin)
  • baths (add a few drops to warm water)
  • inhalations (not for asthmatics).

Essential tremor

Essential tremor (ET) is a common neurological condition, often misdiagnosed as Parkinson’s, with fast, rhythmic trembling in the hands, head, legs, trunk or voice.  The tremor is more pronounced when the affected part of the body is being used, for example in the hands when writing.  In Parkinson's, the tremor is apparent during rest periods.

The cause of ET is unknown, but can run in families.

More information and support is available from the National Tremor Foundation – www.tremor.org.uk

See also: Essential tremor

European Medicines Agency (EMA)

The European Medicines Agency (EMA) is a decentralised agency of the European Union, located in London. The Agency is responsible for the scientific evaluation of medicines developed by pharmaceutical companies for use in the European Union.

The EMA publishes an EPAR for every medicine granted a central marketing authorisation by the European Commission following an assessment by the EMA's Committee for Medicinal Products for Human Use (CHMP). EPARs are full scientific assessment reports of medicines authorised at a European Union level. 

Exclusion criteria

Guidelines for an individual study to determine who is suitable and able to participate.  A study will require that participants share certain criteria, for example gender, age, medical history, to ensure that trial results are due to the treatment under investigation and are not influenced by other factors.  This allows for more accurate and meaningful results.

Expatriate

A person living or working outside of the country for which they hold a passport.

Extension

An insulated wire used in deep brain stimulation.

The wire is placed under the scalp and runs behind the ear, down the neck and into the chest below the collar-bone or the abdominal area where it connects to a neurostimulator.

Extrapyramidal system

Part of the nervous system that extends from the cortex to the medulla areas in the brain and is involved in the coordination of voluntary motor activity throughout the body.

 F

Fatigue

A condition marked by extreme tiredness, inability to function due lack of energy and a general state of lethargy, usually accompanied by a feeling of weariness, sleepiness, or irritability. Fatigue may be acute or chronic and be both physical and mental.

For more information, see: Fatigue

Festination

From the latin ‘festino’, meaning to hasten, festination is an involuntary shortening of stride and quickening of steps as if hurrying forward to keep balance. This appears as shuffling and hesitant steps when walking.

Fiberoptic Endoscopic Evaluation of Swallowing

Fiberoptic Endoscopic Evaluation of Swallowing (FEES) assesses swallowing function in the pharynx (the part of the throat that lies between the mouth and the larynx or voice box). A fiberoptic laryngoscope is passed through the nose to view the larynx and surrounding structures when food and liquid are swallowed. The FEES provides information regarding the safety of the swallow and oral feeding as well as enabling assessment of an individual’s response to strategies to improve swallow.

Fibrosis

The formation of fibrous, scar-like tissue due to infection, inflammation, injury or healing.

Focal Dystonia

Dystonia affecting only one part of the body.

For more information, see: Dystonia

Foetus

Stage in the development of a human being from approximately eight to twelve weeks after conception.

Free-radical

A molecule with at least one unpaired electron, and therefore unstable and highly reactive.

Freezing

A symptom of advanced Parkinson's where the person becomes ‘glued’ to the spot for a few seconds or even minutes before being able to continue walking.

For more information, see: Freezing

Functional stereotactic neurosurgeon

A surgeon who specialises in treating disorders of the central nervous system function using stereotactic techniques, for example in Deep brain stimulation.

G-H

G

Gait

The posture or positioning of the body during walking.

See also: Gait

Gastric

Relating to the stomach.

Gastroparesis

Delayed stomach emptying.

Gastrostomy

Use of a tube inserted through the nose and into the stomach allowing liquidised foods or medication to be passed through.

Gene therapy

A new approach to treating medical conditions, still undergoing research, that involves using genes as medication.

See also: Gene therapy

General Practitioner

A medical doctor who is trained to provide primary health care within a community.

Also known as a GP, family doctor or Primary care physician.

Generic name of medication

Medication name not protected by a trademark. 

Usually describes the chemical structure or active ingredient of the medication or class of medication. For example, levodopa.

See also: Types of medication

Glaucoma

An eye disease marked by increased pressure within the eyeball that may result in damage to the optic disk and subsequent gradual loss of vision.

Glial-derived neurotrophic factor

Glial-derived neurotrophic factor (GDNF) is a nerve growth factor that helps develop and control several types of nerve cells, including those that produce dopamine. 

Used in gene therapy and brain infusion surgery to treat Parkinson’s disease.

Globus Pallidus

The Globus Pallidus (GPi) is a part of the brain that is one of the target sites for deep brain stimulation and lesioning.

Gynaecologist

A medical doctor who specialises in the diseases and hygiene of females, especially of the reproductive organs and functions.

Most gynaecologists are also obstetricians.

H

Half life

The time taken by certain materials to lose half their strength or fall to half their initial value. 

In the case of medication, this is the time required for one half of the original dose of a medication to leave the body or for the level in the blood to decrease by half after the medication is stopped.

Hallucinations

A perception in the absence of a stimulus; people believe they are seeing, hearing or feeling things that are not really there.

It is symptom that can be produced by Parkinson's disease itself or by the medications used to treat it. 

See also: Hallucinations

Hamilton depression rating score

A questionnaire used by doctors to rate the severity of depression.

Heartburn

A form of indigestion usually felt as a pain behind the breastbone (in the front of the chest, over the heart).

Heartburn has, in fact, nothing to do with the heart.

Heartburn occurs when the acid contents of the stomach pass backwards up into the food pipe (the gullet or oesophagus). The pain of this can rise in the chest and may radiate to the neck, throat or angle of the jaw.  The pain can be so severe and, due to the painful area, people have been known to think they are experiencing a heart attack.

Most people have stomach acid reflux at some point in their lives, either as heartburn or acid regurgitation.

Also called pyrosis or stomach acid reflux.

Herbal medicine

A complementary therapy that uses plants or plant extracts to treat illness.

See also: Herbal medicine

High blood pressure

High blood pressure or hypertension, is a medical condition in which the blood is pumped through the arteries by the heart with too much force.  The pressure of which can damage the inside walls of blood vessels. This most commonly happens when the blood vessels and arteries become too narrow forcing the heart to pump harder to move blood through the body.

Blood pressure rises and falls throughout the day. However, if the pressure remains constant and greater than or equal to 140 over 90 mmHg (a systolic pressure above 140 with a diastolic pressure above 90), it is considered to be high blood pressure.

Systolic is the pressure when the heart beats (squeezes blood into the body). Diastolic is the pressure between heart beats.

In a normal adult, a blood pressure close to 120 over 80 mmHg is considered to be normal.

Hoehn & Yahr

The Hoehn and Yahr scale is a commonly used system for describing the severity of the symptoms of Parkinson's disease stages. 

  • Stage 0: No signs of disease.
  • Stage 1: Symptoms on one side of the body only (unilateral).
  • Stage 1.5: Unilateral and axial involvement.
  • Stage 2: Symptoms on both sides of the body.  No impairment of balance.
  • Stage 2.5: Mild bilateral disease with recovery on pull test.
  • Stage 3: Balance impairment. Mild to moderate disease. Physically independent.
  • Stage 4: Severe disability, but still able to walk or stand unassisted.
  • Stage 5: Needing a wheelchair or bedridden unless assisted.

See also Rating scales

Holistic

The treating of the whole person, taking into account mental, social and environmental factors, rather than addressing just the symptoms of a disease.

Homeopathy

A gentle, holistic therapy that works by using natural substances to stimulate the body’s own healing power to clear itself of any imbalance, treating the whole person not just the illness.

These substances, when used in larger quantities, would cause symptoms that are similar to those of the illness or disease.  Hence, the word 'homeopathy' means ‘similar suffering’ in Greek.

See also: Homeopathy

HRQol

Health-related quality of life: a measure that assesses the effects of chronic illness. It is used to better understand how an illness interferes with a person’s day-to-day life.

Hydrotherapy

Use of water to treat illness and disability as well as promote physical and emotional wellbeing.

See also: Hydrotherapy

Hypersexuality

Increased sexual desire.

Hypertension

Hypertension or high blood pressure, is a medical condition in which the blood is pumped through the arteries by the heart with too much force.  The pressure of which can damage the inside walls of blood vessels. This most commonly happens when the blood vessels and arteries become too narrow forcing the heart to pump harder to move blood through the body.

Blood pressure rises and falls throughout the day. However, if the pressure remains constant and greater than or equal to 140 over 90 mmHg (a systolic pressure above 140 with a diastolic pressure above 90), it is considered to be high blood pressure.

Systolic is the pressure when the heart beats (squeezes blood into the body). Diastolic is the pressure between heart beats.

In a normal adult, a blood pressure close to 120 over 80 mmHg is considered to be normal. 

Hypoesthesia

Partial loss of feeling, reduced sensitivity to touch, or numbness.

Hypomania

A mood disorder characterised by persistent feelings of euphoria or irritability.

Hypomimia

Reduced facial expression.

Hyposmia

An impairment of the sense of smell resulting in a reduced ability to detect odours (also known as olfactory deficit).

See also Olfactory dysfunction (loss of sense of smell)

Hypotension

Low blood pressure.

I-J

I

Idiopathic Parkinson's disease

The most common form of Parkinsonism.

Parkinson's disease is also called idiopathic Parkinson's because the cause for the condition is unknown.

Also called PD.

Inclusion criteria

Guidelines for an individual study to determine who is suitable and able to participate.  A study will require that participants share certain criteria, for example gender, age, medical history, to ensure that trial results are due to the treatment under investigation and are not influenced by other factors.  This allows for more accurate and meaningful results.

See also: Clinical trials

Incontinence

The inability to control accidental or involuntary leaking of urine or stool.

See also: Bladder problems

Indigestion

A painful or burning feeling in the upper abdomen often accompanied by heartburn, bloating or nausea as a result of eating too quickly or improper digestion of food in the stomach.

Also known as dyspepsia.

Informed consent

A document that details a clinical study in very understandable terms.  This usually includes the purpose and duration of the study, the proposed treatment, its potential benefits and risks, details of any studies to date, agreed procedures and key contacts.  All participants must give their consent based on the information contained in this document. If unable to give consent then someone authorised to act on their behalf must do so.  Although this document must be signed, it does not constitute a contract and volunteers can withdraw from a study at any time.

See also: Clinical trials

Infusion

A process of putting fluids and/or medications into a vein slowly and over a period of time.

In-patient

A patient who is admitted to, and stays in, a hospital or clinic.

Insomnia

A sleep disorder causing the inability to fall asleep or to enjoy uninterrupted sleep.

Intermittent catheterisation

The insertion of hollow tubes into the urethra to drain urine away from the bladder, which can be inserted oneself (or by a carer).

Also known as self catheterisation.

Interpersonal therapy

Interpersonal therapy (IPT) is a form of psychotherapy that aims to help a person cope with immediate problems and difficult transitions (such as divorce), by focusing on a patient's relationships with peers and family members and the way they see themselves.

Intravenous

Within or by means of a vein.

Irritable bowel syndrome

Irritable bowel syndrome (IBS) is a common disorder of the gut in which the nerves that control the muscles in the gastrointestinal tract are too active causing over-sensitivity to food, stool, gas and stress. 

It is not known what causes IBS. Symptoms can be quite variable and include abdominal pain, bloating, mucus in stools, irregular bowel habits, diarrhoea and constipation.

Also called spastic colon or mucous colitis.

J

Jejunum

The middle section of the small intestine.

 

K-L

K

Kidneys

Two bean-shaped organs that maintain the body’s chemical balance by filtering impurities from the blood and excreting them in the urine. 

The kidneys are located in the abdomen, below the ribs, toward the middle of the back, on either side of the spinal cord.

Most people have two kidneys but people can live with one.

L

Laryngeal dystonia

Dystonia that affects the vocal chords or speech muscles causing strained and difficult speaking.

Also known as spasmodic dystonia.

See also: Dystonia

Laxative

Foods, compounds or medication taken to induce bowel movements.

Most often taken to treat constipation.

Lead

An insulated wire with four electrodes that connects the neurostimulator implanted in the chest in deep brain stimulation to the extension placed under the scalp.

Lentivirus

A group of slowly acting viruses, including the ‘wild’ lentivirus that leads to human immunodeficiency virus (HIV), which causes AIDS.

Lesioning

A surgical technique used to treat advanced Parkinson's disease. It involves making deliberate, selective damage (a lesion) within particular parts of the brain.

There are currently three target sites: the thalamus (thalamotomy), the globus pallidus (pallidotomy) and the subthalamic nucleus (subthalamotomy).

Levodopa

The main type of medication prescribed to treat Parkinson's disease and has been in use since the late 1960s.

The aim is to increase the levels of dopamine in the brain. Dopamine cannot be directly replaced because it cannot cross the blood-brain barrier that prevents potentially harmful substances in the blood from entering the brain. Levodopa is a chemical compound that can cross this barrier and is then converted into dopamine.

See also: Types of medication

Lewy bodies

Lewy bodies are abnormal deposits of microscopic protein that develop inside nerve cells in Parkinson's disease (PD) and some other disorders. They are identified under the microscope when histology is performed on the brain.  Lewy bodies contain high levels of the protein alpha-synuclein.

Libido

Term used by Freud* to refer to sexual energy: the human sexual urge, desire or drive.

* Sigmund Freud (6 May, 1856 – 23 September, 1939) was an Austrian neurologist who founded the psychoanalytic school of psychology.  Freud is well known for his many theories particularly on the unconscious mind, his redefinition of sexual desire as the primary motivational energy of human life, and the interpretation of dreams as sources of insight into unconscious desires. He was also an early neurological researcher into cerebral palsy.

Lisuride

A dopamine agonist used to treat Parkinson's disease.

See also: Types of medication

M-N

M

Magnetic resonance imaging (MRI)

Magnetic resonance imaging or MRI is a medical imaging technique involving a scan that uses radio waves to generate an image of body tissues. It is especially useful for examining the nervous system, muscles and bones.

MAO-B inhibitors

A class of medication that is used to treat the symptoms of early Parkinson's, as well as to treat levodopa-induced motor fluctuations in the more advanced stages of the disease.

MAO-B inhibitors work by blocking the enzyme monoamine oxidase B which breaks down dopamine in the brain and can be used to make the dose of co-beneldopa or co-careldopa last longer or to reduce the amounts of these drugs needed. They can also help reduce the motor fluctuations that can occur as a side effect of levodopa.

See also: Classes of medication

Meditation

A mental discipline of focusing and controlled breathing designed to bring about a heightened state of thought or awareness.

Menopause

It is the time when the ovaries stop producing the hormone estrogen and a woman stops having menstrual periods (menstruation). Menopause marks the end of a woman's childbearing years, usually between the ages of 40 and 55.

The word menopause is derived from the Greek 'meno-' (month) and 'pausis' (a pause, a cessation).

The World Health Organization defines this point as one year after the last period.

Menstruation

The regular or periodic discharge of blood and tissue from the uterus (womb) that comes at the beginning of each menstrual cycle. It lasts for an average of three to five days.

Until the menopause, menstruation occurs approximately every 28 days after a woman has reached sexual maturity and when a woman is not pregnant.

Also called periods.

Meta analysis

Analysis of data that combines statistically the results of several studies.

Metaphysical

Coined by Aristotle, this term describes theological philosophy but is now often used to refer to something spiritual, beyond the physical realm and to a reality beyond what is perceptible to the senses.

Micrographia

Very small handwriting or handwriting that decreases in size from normal to very small. This symptom is often seen in Parkinsonism.

Micturition

Urination, that is passing of urine.

Mitochondria

Structures in human cells that turn nutrients into energy.

Monoamine oxidase B inhibitor

Monoamine oxidase B (MAO-B) inhibitors are a class of medication that is used to treat the symptoms of early Parkinson's, as well as to treat levodopa-induced motor fluctuations in the more advanced stages of the disease.

MAO-B inhibitors work by blocking the enzyme monoamine oxidase B which breaks down dopamine in the brain and can be used to make the dose of co-beneldopa or co-careldopa last longer or to reduce the amounts of these drugs needed. They can also help reduce the motor fluctuations that can occur as a side effect of levodopa.

See also: Classes of medication

Monotherapy

Describes medication which is prescribed on its own rather than in combination with other preparations. Some Parkinson's drugs are used in this way, usually to treat the early stages of the condition.

Morphine

A highly potent analgesic medication. It is the principal active agent in opium and acts directly on the central nervous system to relieve pain.

Motor

Referring to motion or movement of a part of the body.

Motor fluctuations

The oscillations, or variations, in the control of motor symptoms associated with the long term use of levodopa.  These can include early wearing off,  ‘on off’ syndrome and dyskinesia.

See also: Wearing off and motor fluctuations

Motor symptoms

Those symptoms affecting movement.  For example, tremor, rigidity, bradykinesia and freezing.

See also: Symptoms

Movement disorders

The collective name for conditions that affect a person’s abilities to produce and control movement. They include Parkinson’s disease, restless leg syndrome and dystonia.

Mucuna

Mucuna pruriens, a tropical vine also known as velvet bean and cowitch

Multiple system atrophy

Multiple system atrophy (MSA) is a progressive neurological disorder that causes problems with movement, balance and the automatic functions of the body, such as bladder control, sweating and blood pressure.

More information and support is available from the Sarah Matheson Trust for Multiple System Atrophy – www.msatrust.org.uk

See also: Multiple System Atrophy

Muscle relaxants

Medications used to treat muscular tension and pain.

Muscular tension

Muscles being pulled or stretched causing stress and pain.

Musculoskeletal

Relating to or involving the muscles and the skeleton.

The musculoskeletal system is the system of muscles, tendons, ligaments, bones, joints and associated tissues that move the body and maintain its form.

 

N

Narcolepsy

A neurological condition characterised by a sudden, recurrent, uncontrollable compulsion to sleep and excessive daytime sleepiness.

Nasogastric feeding

Feeding through a tube leading through the nose and into the stomach.

Nasogastric tube

A tube leading through the nose and into the stomach.

Nausea

From the Greek Ναυτεία or "sea-sickness", it is the sensation of unease and discomfort in the stomach with an urge to vomit.

Nerve growth factors

Proteins secreted by the body that regulate nerve cell development, survival and repair.

Nervous system

A network of nerves in the body which communicate messages to the brain, such as cold, hot, pain etc.  

It is also responsible for the body’s contacts and responses to the external world.

Neuro fibrillary

An accumulation of paired filaments composed of abnormally formed tau protein. Found mainly in the cytoplasm of brain nerve cells, particularly the cerebral cortex and hippocampus, and typically found in Alzheimer's disease.

Neurodegenerative

The loss of structure, function or death of neurons.

Neuroimaging

Medical imaging techniques that enable doctors to study structures and functioning within the brain and nervous system.

Neuroleptic

A tranquilising or antipsychotic medication, used to treat psychotic behaviour.

Neurologist

A physician who specialises in the field of neurology, a branch of medicine dealing with disorders of the nervous system.  

Trained to diagnose, treat, and manage patients with neurological disorders. 

Paediatric neurologists, nearly always a sub-specialty of paediatrics, treat neurological disease in children.

Neurologists may also be involved in clinical research, clinical trials, as well as basic research and translational research.

Neurons

Neurons are the core components of the nervous system, which includes the brain, spinal cord, and peripheral ganglia. They conduct nerve impulses by electrical and chemical signaling.

Neurons connect to each other to form networks and transmit nerve signals via synapses, specialized connections with other cells.

Also known as neurone or nerve cell.

Neurophysiologist

A scientist who studies neurophysiology, the study of the brain processes and nervous system function.

Neuroprotection

The mechanisms and strategies used to protect nerve cells (neurons) from injury, degeneration or death in the central nervous system (CNS).

See also: Neuroprotection

Neuroprotective

Relating to the mechanisms and strategies used to protect nerve cells (neurons) from injury, degeneration or death in the central nervous system (CNS)

Neuropsychiatric

Concerning neurological and psychiatric disorders resulting from diseases of the nervous system.

Neuropsychologist

A psychologist with expertise in how behaviour and cognitive abilities are affected by brain structure and symptoms.

Neuroradiologist

A doctor trained in radiology and working within the neurological X-ray department.

Specialises in the diagnosis and treatment of diseases of the nervous system using clinical imaging techniques, including computerised tomography (CT) and magnetic resonance imaging (MRI).

Neurostimulator

A pacemaker-like device that is the power source for the deep brain stimulation system. 

It is implanted in the patient’s chest or abdominal area and contains a small battery and computer chip programmed to send electrical pulses to control Parkinson's symptoms.

See also: Deep brain stimulation

Neurosurgeon

A surgeon who specialises in treating diseases of the nervous system.

Neurotransmitter

Chemicals, such as dopamine and acetylcholine, which are made in the brain and send messages between different nerve cells.

Neurotrophic

Relating to a group of proteins that stimulate the growth of nerve cells.

Nigrostriatal

Used to describe the bundle of nerve fibres that connects the substantia nigra with the striatum areas in the brain.

Nocturia

Waking at night with the urge to urinate.

Non-motor symptoms

Symptoms other than those affecting movement. In Parkinson's disease they include depression, drooling, swallowing problems, fatigue, pain and sleep/night time problems.

See also: Symptoms

Noradrenaline

A chemical neurotransmitter that is produced in the brain.

Noradrenaline reuptake inhibitor

A class of medications often used as antidepressants. Also known as NRIs.

O-P

O

Obstetrician

A doctor who specialises in the care of pregnant women and the delivery of babies.

Obstipation

Severe constipation.

Occupational therapist

An occupational therapist (OT) is trained professional in the practice of occupational therapy.

See also: Occupational therapy

Occupational therapy

A health profession that helps people of all ages who are disabled, ill or aged to remain independent and lead fulfilling lives at home, in work and through leisure pursuits. The methods they use include specific activities and equipment.

For more information, see: Occupational therapy

On-off

Where symptoms reappear unexpectedly and quickly; which some people describe as being like a light turning on and off.

The ‘on’ period is when the medication is working and there is good symptom control.

The ‘off ’ period is when the medication is not working and the Parkinson's symptoms return. 

This appears to be caused by an interaction between Parkinson's disease itself and the drug treatment.

See also Wearing off and motor fluctuations

Opicapone

A medication that may be used for the treatment of motor symptoms in Parkinson's. 

See also: Types of medication.

Opiod

A chemical like substance used mainly for pain relief that has a morphine-like action in the body.

Oral

Relating to, affecting, or for use in the mouth.

Orally

Relating to, affecting, or for use in the mouth.

Oromandibular dystonia

Dystonia affecting the jaw area, tongue, mouth or one side of the face. The jaw may be pulled either open or shut, and speech and swallowing can be difficult.

For more information, see: Dystonia

Orphenadrine

An anticholinergic used to treat Parkinson's disease.

See also: Types of medication.

Orthodox medicine

Term used to refer to conventional medical approaches, approved of and widely practiced by ‘the medical establishment’, including treatments involving medication, surgery and radiation techniques.

Orthostatic

Relating to or caused by an upright posture.

Osteopathy

A type of alternative medicine that focuses on the manipulation of the musculoskeletal system while taking a holisticapproach to health. It is not to be confused with osteopathic medicine which also uses treatments such as medication and surgery.

It is believed that manipulating the skeleton and muscles is useful in stimulating the body's ability to fight disease and in restoring health.

Osteoporosis

A condition in which the bones become progressively less dense and fragile.  Dry, brittle bones can easily crack or collapse.

Occurs most commonly in post-menopausal women and elderly men, and is the result of a number of different diseases and abnormalities.

Out-patient

A patient who attends a hospital or clinic for treatment, but does not stay overnight.

Ovulation

The release of an ovum (egg cell) from an ovary.

Ovulation begins during puberty and most commonly continues on a monthly basis into the menopausal years, usually occurring half way into a woman's menstrual cycle.

During pregnancy and after the menopause, ovulation stops.

 

P

Pallidotomy

A surgical procedure involving the placement of a tiny electrical probe in the globus pallidus internus (GPi) area of the basal ganglia in the brain - the part of the brain that controls movement.  

The intention is to use the probe to destroy surrounding brain cells, via the emission of radiowaves, in order to reduce brain activity in that specific area.  This may help relieve motor symptoms such as tremor and rigidity.

Before surgery, detailed brain scans using MRI are carried out to identify the precise location for treatment.

Until the late 1990s, pallidotomy was the most common type of Parkinson's disease surgery. However, doctors now rarely perform pallidotomy due to risks involved.  Instead, deep brain stimulation is preferred, a procedure that does not destroy brain tissue and has fewer risks than pallidotomy.

Palpitation

Irregular or forceful heartbeat.

Paralanguage

The non-verbal elements of communication, expressed consciously or unconsciously, and used to modify meaning and convey emotion. These includes the pitch, volume, and, in some cases, intonation of speech and changes how something is said rather than what is being said.

Some examples of paralanguage include laughing, crying, whispering, snoring, sucking, sneezing, sighing, hissing, shushing and whistling.

Parasomnias

Sleep-related disorders characterised by partial arousal during sleep or during transitions between wakefulness and sleep.  The person exhibits symptoms of being both asleep and awake at the same time, and undesirable physical or verbal behaviors or experiences, including:

  • sleep walking
  • sleep talking (somniloquy)
  • sleep eating
  • sleep sex
  • teeth grinding
  • night terrors
  • rhythmic movement disorder
  • REM behaviour disorder
  • restless legs syndrome
  • seizures (convulsions)
  • respiratory dyskinesia (difficulty in performing respiratory movements)
  • arrhythmias (abnormal heart rhythms)
  • gastroesophageal reflux (food or liquid regurgitating from the stomach into the foodpipe). 

See also Sleep 

Paresthesia

A tingling, pricking or numb sensation of the skin. Colloquially it is sometimes described as “pins and needles".

Parkinsonism

Parkinsonism is the generic name given to a group of conditions that feature the main characteristics of Parkinson’s disease: tremors, rigidity of muscles, mobility problems and bradykinesia (slowness of movement).

About 85% of people with Parkinsonism have the most common form, Parkinson’s disease (also known as PD or idiopathic Parkinson’s disease).  The other 15% have different, much rarer conditions.

See also: Types

Pars compacta

A layer of large pigmented nerve cells in the midbrain, part of the substantia nigra, that produce dopamine and whose destruction is associated with Parkinson's disease.

PDQ-39

A self-administered questionnaire comprising of 39 questions, relating to eight key areas of health and daily activities, including both Motor and Non-motor symptoms. 

PEG

Percutaneous Endoscopic Gastrostomy (PEG) tube ia a type of feeding tube that is inserted through the abdomen, directly into the stomach.

Pelvic floor muscles

The muscles located between the back, front and sides of the pelvic bones and create the 'pelvic floor’, stretching from the pubic bone at the front of the body to the tail bone in the back.

These muscles support the pelvic organs such as the bladder, bowel and uterus (in women). They are involved in the control of urination and bowel elimination, as well as the sexual response.

They can be weakened by many disorders, including Parkinson’s, and cause continence problems. Pelvic floor exercises can help overcome these difficulties.

Pergolide

A dopamine agonist used to treat Parkinson's disease.

See also: Types of medication.

Peripheral

On the outer edge or surface.

Peripheral nerves

Nerves that transmit messages from the spinal cord and the brain to all other parts of the body.

Peripheral nervous system

The section of the nervous system lying outside the brain and spinal cord that connects to the body’s blood vessels, organs, muscles and glands.

Peripheral vascular disorder

A disease of the arteries which supply blood to the arms and legs.

PET scan

An abbreviation of positron emission tomography, a PET scan can detect chemicals in the brain. It is sometimes used to produce pictures (scans) showing the arrangement of dopamine-producing nerve cells.

Pharmacist

A person qualified to prepare and dispense drugs, and give advice on prescribed medications.

Pharmacologic

Relating to the use, preparation, composition, properties and actions of drugs.

Pharmacology

The study of how medicines interact with living organisms to produce a change in function. If substances have medicinal properties, they are considered pharmaceuticals.

Physiotherapist

A professional trained in physiotherapy who treats and manages patient with musculoskeletal problems using exercises and other forms of physical therapy.

For more information, see: Physiotherapy

Physiotherapy

A health profession that treats people of all ages who have physical problems that occur as a result of injury, illness or ageing.  Methods used include exercise, heat treatments, manipulation and hydrotherapy.

For more information, see: Physiotherapy

Pilates

A complete exercise method dedicated to improving physical and mental health. It is a system of body control which, by realigning and correcting poor body posture, aims to teach people how to use their muscles more efficiently.

For more information, see: Pilates

Placebo

A medically inactive substance or dummy treatment administered to a control group to compare its effects with a real substance, medicine or treatment.

A placebo effect is a positive or therapeutic benefit resulting from the administration of a placebo to someone who believes the treatment will help and not due to any medical treatment or substance. Placebos have been shown to lessen symptoms in some people, most likely because of the individual's positive attitude about treatment.

Plaque

A build up of bacteria and minerals on the teeth that forms a hard coating and can lead to gum disease.

Podiatrist

An expert on feet, as well as the way we walk and how this can affect other joints, who provides specialised food care.

Podiatry

The care and treatment of the feet.

A podiatrist (also known as a chiropodist) deals with the assessment, diagnosis and treatment of the lower limb.

Also known as chiropody.

For more information, see: Foot care

Post-encephalitic Parkinsonism

The Parkinsonian syndrome that is believed to have been caused by a viral illness, stimulating degeneration of the nerve cells in the substantia nigra area of the brain and leading to clinical Parkinsonism.

Postural hypotension

Low blood pressure caused by a change in a person’s body position. For example, when a person moves from sitting to standing quickly.

Postural imbalance / instability

Difficulty with keeping balance steady when standing, sitting or walking.

Posture

The way a person stands or sits.

Postural problems, especially a tendency to stoop forwards, are a common feature of Parkinson’s.

Power of attorney

A legal appointment of someone to act on your behalf if you become unable to make decisions for yourself.

Pramipexole

A dopamine agonist used to treat Parkinson's disease.

See also: Types of medication.

Procyclidine

An anticholinergic used to treat Parkinson's disease.

See also: Types of medication.

Progesterone

A female hormone produced by the ovaries and placenta that helps to regulate a woman's reproductive cycle.

Prognostic

Indicating the future course of an illness.

Progressive disorder

A disease or health condition that gets worse over time, resulting in a general decline in health or function.

Progressive supranuclear palsy (PSP)

Progressive supranuclear palsy (PSP) is a progressive neurological disorder, predominantly affecting balance, but also impairs mobility, vision, speech and the ability to swallow.

A particular feature that many people with PSP experience is difficulty in moving the eyes when trying to look up or down.

More information and support is available from the Progressive Supranuclear Palsy (PSP-Europe) Association – www.pspeur.org

See also: Progressive Supranuclear Palsy

Proteins

Proteins (also known as polypeptides) are the basic building block of the body in animal and human tissue. They are complex organic compounds made of amino acids using information encoded in genes. 

Proteins are responsible for specific and unique biological functions, especially the growth, regeneration and repair of cells within the body. Examples of proteins include hormones, enzymes, and antibodies.

Protocol

A very detailed plan which forms the basis for the conduct of a scientific or medical experiment, treatment, or procedure.  A protocol is in place for all clinical trials both to protect the participants and to answer specific research questions.  Key points in a protocol include the nature of the participants, the schedule of any procedures or tests, the medications and dosages involved, and the time-span of the study. 

Psychiatric

Affecting mental or emotional processes.

Psychiatrist

A medical doctor (MD) who specialises in treating mental health issues and disorders, such as anxiety and depression.

A psychiatrist evaluates a person’s mental health along with his or her physical health and can prescribe medications to treat mental and emotional disturbances.

Psychologist

A trained specialist with whom to discuss emotional and personal matters, and who can help with overcoming emotional or psychological reactions to injury or disease.

Psychosis

Any form of severe mental disorder in which the individual’s contact with reality becomes highly distorted. 

People experiencing psychosis often exhibit personality changes, inappropriate behaviour and a deterioration in normal social functioning.

Psychotherapeutic

Relating to psychotherapy, the treatment of emotional or behavioural problems by a mental health professional (psychiatrist, psychologist, counsellor, psychotherapists) using psychological means, often in one-to-one interviews or small groups.

Psychotherapy

The treatment of emotional or behavioural problems by a mental health professional (psychiatrist, psychologist, counsellor, psychotherapists) using psychological means, often in one-to-one interviews or small groups.

In the treatment of depression, it is aimed at helping the patient develop new ways to cope with challenges in life and to identify and understand more about depression and how to avoid it in the future.

Also known as talk therapy or counselling.

Psychotropic

Affecting the mind or mood or other mental processes, such as behaviour and emotion.

Pulmonary

Relating to the lungs and respiratory system.

Pulsatile

Characterised by pulses (an alternate increase and decrease) as opposed to continuous.

Punding

A compulsive fascination with and performance of repetitive, mechanical tasks, such as assembling and disassembling, collecting or sorting household objects.

See also: Compulsive and impulsive behaviour

Q-R

Q

QT interval

Part of the electrical signal the heart produces, visible on an electrocardiogram.

Qualitative

Expressed in terms of quality.

Quantitative

Expressed in numerical values.

Quinine sulphate tablets

Medicine usually used to treat malaria that is also prescribed for night time leg cramps.

R

Radiocarbon dating

A technique used to determine the age of carbon-bearing minerals, including wood and plant remains, charcoal, bone, peat and calcium carbonate shell.  

Carbon dating measures the loss of radiocarbon (carbon-14 or C14). All living things contain radiocarbon: plants absorb it from the atmosphere as carbon dioxide, and animals/humans take in by eating plants or animals. 

When an organism dies, it stops absorbing radiocarbon and the amount already within it starts to decay and reduce. The rate at which this occurs is a known quantity: it takes 5,730 years for half of the radiocarbon available in the organism to decay. By comparing the amount left in a dead organism to the available radiocarbon levels in the atmosphere, it is possible to estimate when that organism died.

Also called carbon dating or carbon-14 dating.

Randomised study

A clinical trial in which participants are randomly assigned to receive a test medicine, or a placebo.

See also: Clinical trials

Rapid eye movement sleep behaviour disorder

A sleep disorder that involves abnormal behaviour during the REM phase of sleep that is characterised by the absence of normal muscle paralysis. It is associated with movement ranging from simple limb twitches to more complex and sometimes violent activity in which people appear to be unconsciously acting out their dreams and which can lead to falling out of bed, crying, shouting or even hurting their bed partner.

See also: Sleep

Rasagiline

A MAO-B inhibitor used to treat Parkinson’s disease.

See also: Types of medication.

Reflexology

A therapy based on the principle that the anatomy of the body is reflected by reflex zones on the feet and, to a lesser extent the hands.  By using specific techniques of holds and pressures on these zones, healing is initiated and accelerated in the corresponding areas of the body.

For more information, see: Reflexology

Reiki

A Japanese word meaning Universal Life Force, Reiki is an energy healing therapy.  The practitioner places his or her hands on the body to channel energy into the body, thereby reducing stress, increasing energy and creating feelings of peace and wellbeing.

For more information, see: Reiki 

REM sleep

Rapid eye movement (REM) sleep is a normal stage of sleep characterised by the rapid movement of the eyes. It is physiologically different from the other phases of sleep and is the phase when vividly-recalled dreams mostly occur.

See also: Sleep 

Respiratory

Relating to breathing (respiration) and the movement of air in and out of the lungs, and the use of oxygen to produce energy and carbon dioxide waste.

Response rate

The number of patients who respond to a treatment or medication.

Restless legs syndrome (RLS)

Restless Legs Syndrome (RLS) is a condition characterised by unusual, painful sensations in the calves and/or thighs (often described as ‘burning’ or pins and needles) which result in an involuntary urge to move the legs.

For more information, see: Restless Legs Syndrome

Retroperitoneal

The organs which lie behind (retro) or outside of the peritoneum (the lining of the abdominal cavity), including the stomach, liver, pancreas, kidneys, and parts of the large and small intestine.

Rigidity

Stiffness of the limbs or joints that makes movement and bending difficult.

See also: Rigidity.

Ropinirole

A dopamine agonist used to treat Parkinson's disease.

See also: Types of medication.

Rotigotine

A dopamine agonist used to treat Parkinson's disease that is administered via a transdermal (skin) patch.

See also: Types of medication.

S-T

S

Screening

The process for the selection of clinical trial participants based on agreed eligibility criteria.

Secondary dystonia

Dystonia that occurs as a symptom of other diseases or syndromes including Parkinson’s.

Also known as symptomatic dystonia.

Selective serotonin reuptake inhibitor

A class of antidepressant medications.  Also know as SSRIs.

Selegiline

A MAO-B inhibitor used to treat Parkinson’s disease.

For more information, see: Types of medication

Serotonin

A neurotransmitter that regulates functions including mood, appetite and sensory perception.

Sex therapy

The professional treatment of difficulties with sexual function and expression.

Treatment is provided for issues with sexual desire, arousal, orgasm, satisfaction, erectile dysfunction, premature or rapid ejaculation, delayed or inhibited ejaculation, painful sex, and the inability to perform sexually due to medical disabilities, mental problems, abuse or any obsessive behaviour.

Shiatsu massage

This relaxation and healing method uses the fingertips and thumbs in massage and manipulation to apply pressure to specific points of the body.  This causes the stimulation and release of the 'meridians' (paths of the body) through which energy flows.

Also called acupressure.

Sialorrhoea

Increased salivary flow.

See also: Eating, swallowing and saliva control

Small intestine

The section of the intestines between the stomach and the colon, and includes the duodenum (closest to the stomach), the jejunum, and the ileum (closest to the large intestine).

Most digestion occurs here as it is where food is broken down into nutrients that the body can absorb and use.

Social worker

A trained professional who assists with the social, emotional and financial needs of the person with Parkinson's, their carer and family.

In some countries, state-funded social workers may be provided to help in accessing available services and appropriate benefits.

Somnolence

Sleepiness.

Spasmodic Dystonia

Dystonia that affects the vocal chords or speech muscles causing strained and difficult speaking.

Also known as laryngea dystonia.

SPECT Scan

An abbreviation for Single Photon Emission Computed Tomography.

This scan produces images of the brain and can be used to detect dopamine-producing nerve cells.

Speech and language therapist

Speech and language therapists assess and treat speech, language and communication problems.

See also: Speech and language therapy.

Speech and language therapy

A health profession which helps people who have problems with communication, swallowing, drooling, eating and drinking.

See also: Speech and language therapy.

Sphincter

A circular band of muscle that tightens or closes a natural opening of the body.  For example, the external anal sphincter, which closes the anus, and the internal and external urinary sphincters, which close the urinary canal.

Statistical outlier

An observation that lies an abnormal distance from other values in a random sample of the population.

Statistical significance

A statistical interpretation of data that indicates that a result is unlikely to have occured by chance.

Stereotactic techniques

Surgical techniques that involve using a frame to keep the patient’s head still during surgery.

The neurosurgeon will then employ special medical imaging techniques such as magnetic resonance imaging (MRI) or computerised tomography (CT) to map the brain and locate the surgical site.

Stiffness

Rigidity of the limbs or joints that makes movement and bending difficult.

Stratified

A method which separates patients taking part in a study into groups based on different characteristics.

Striatum

Part of the basal ganglia in the brain controlling movement, balance and walking.  It connects to and receives impulses from the substantia nigra, the area of the brain that produces dopamine.

Stroke

An interruption of the blood supply to the brain. A stroke happens when blood flow to a part of the brain is interrupted because a blood vessel in the brain is blocked or bursts open.

Subcutaneous infusion

The administration of fluids (medication) directly into subcutaneous tissues (beneath the skin).

Substantia Nigra

The area of the brain within the basal ganglia where dopamine is produced.

Subthalamic nucleus

The Subthalamic nucleus (STN) is a part of the basal ganglia and one of the target sites for deep brain stimulation.

Subthalamotomy

A surgical procedure involving the placement of a tiny electrical probe in the subthalamic nucleus (STN) area of the basal ganglia in the brain - the part of the brain that controls movement.  

The intention is to use the probe to destroy surrounding brain cells, via the emission of radiowaves, in order to reduce brain activity in that specific area.  This may help relieve motor symptoms such as tremor and rigidity.

Before surgery, detailed brain scans using MRI are carried out to identify the precise location for treatment. 

Surgical Ablation

Removal of a tissue body part through surgery.

Symptomatic

To do with the symptoms or signs of a disease or illness.

Symptomatic Dystonia

Dystonia that occurs as a symptom of other diseases or syndromes including Parkinson’s.

Also known as secondary dystonia

Systolic

The pressure exerted when the heart contracts.

 

T

Tai Chi

A healing and fighting art which emphasises the mind/body connection, focusing on developing the ability to centre oneself and not be easily distracted. Practitioners believe the mind is the most important single factor in being able to achieve excellence in all areas of life, including health.

The physical side of Tai Chi is a series of coordinated, rhythmical and seemingly effortless moves that aim to increase the body's movement range, aids relaxation, reduces stress and assists with good balance and posture.

Also known as T'ai Chi or Tai Chi Chuan.

See also: Tai Ch.

Tartar

A hardened or calcified plaque that forms from mineral salts in the saliva and deposits on the teeth.  A cause of tooth decay and gum disease, it requires scaling by a dentist or dental hygienist to remove.

Also known as calculus.

Thalamotomy

A surgical operation in which a specific group of cells within the thalamus - the part of the brain that controls some involuntary movements - is surgically destroyed.

Before surgery, detailed brain scans using a CT scan or MRI scan are done to identify the precise location for treatment.

Although the positive effects on tremor are immediate, this procedure is often poorly tolerated because of increased complication and risk, including vision and speech problems. Other less destructive procedures are preferred, such as subthalamic deep brain stimulation (DBS), since this procedure can also improve tremor as well as other symptoms of Parkinson's disease.

For more information, see: Deep brain stimulation

Thalamus

The part of the brain that relays sensory information to the cortex.  It is one of the target sites for lesioning surgery used to treat Parkinson’s.

Tincture

A solution prepared by steeping or soaking medicinal substances (especially plant materials such as herbs) in alcohol, vinegar or glycerol. 

More commonly used in complementary therapy practices than conventional medicine.

Tolcapone

A COMT inhibitor used to treat Parkinson's disease.

See also: Types of medication

Toxins

Poisonous substances produced by living cells or organisms which are harmful to humans, animals or plants.

Trade name of medication

The name by which a medication is marketed. For example, 'Sinemet' (carbidopa-levodopa) or 'Madopar' (levodopa and benserazide).

Transdermal Patch

A medicated, adhesive patch which releases a dose of medication through the skin into the bloodstream.  

For example, Rotigotine, one of the dopamine agonists used to treat Parkinson's disease, is administered in this way.

Treatment discontinuation

Discontinuation or withdrawal from a treatment during a clinical study.

Tremor

Rhythmic shaking of a part of the body. It is one of the main symptoms of Parkinson's disease although it is not experienced by everyone.

See also: Tremor

U-V

U

Undifferentiated cells

Cells that have not yet expressed signs of their future.

UPDRS

The Unified Parkinson’s Disease Rating Scale (UPDRS) is a scale used to follow the progression of Parkinson’s disease. The recently updated version of the scale is in four sections:

Part I: Non-motor aspects of experiences of daily living 
Part II: Motor aspects of experiences of daily living 
Part III: Motor examination 
Part IV: Motor complications

See also: Rating Scales

Urethra

The tube that connects the bladder to the outside of the body.

Urinary infections

Infections involving any part of the urinary tract.

Urinary tract

The part of the body that makes and expels urine. It includes the kidneys, bladder, ureters and urethra.

V

Vascular Parkinsonism

A form of atypical Parkinsonism in which Parkinson-type symptoms, such as rigidity, slowness, shuffling steps and speech problems are experienced.  

It is caused by one or more small strokes in the corpus striatum (the part of the brain that receives information about position and movement), rather than by a gradual loss of nerve cells as happens in Parkinson's disease.

It can be difficult to distinguish from Parkinson’s. But the primary difference is that symptoms caused by stroke tend to appear suddenly and do not progress, whereas those of Parkinson’s are gradual in appearance and worsen over time.

Also known as arteriosclerotic Parkinsonism.

More information and support on stroke is available from the Stroke Association, or the Stroke Alliance for Europe

See also: Types of Parkinson's and Parkinsonism

Vasodilation

Widening of the blood vessels which causes the blood flow to increase.

Vector

A carrier molecule, often used to deliver a therapeutic gene to target cells.

Venules

The smallest divisions of the veins.

Videofluoroscopy

Videofluoroscopy is a radiographic procedure that provides objective information on the four stages of swallowing, on the time it takes food to pass and any difficulties in its movement. Food or liquid containing barium is given in different consistencies. The barium allows progress through the mouth, pharynx and oesophagus to be video recorded and observed. Therapy techniques and compensatory postures can also be tried out during the assessment and their effectiveness can be evaluated.

W-X

W

Wearing off

The gradual return of symptoms that occurs at the end of a dose of levodopa. This pattern appears when a person with Parkinson's disease has been using levodopa for many years.

See also: Wearing off and motor fluctuations.

X

Xadago

A medication that may be used for the treatment of motor symptoms in Parkinson's.  It is also under investigation for other symptoms of the condition.

See also: Types of medication

Xenograft

The transplant of cell tissue or organs from one species to another.

Y-Z

Y

Yoga

A system of personal development involving an integrated approach of mind and body control to promote health and inner peace.

It usually involves gentle activities designed to maintain fitness, suppleness and muscle tone as well as to strengthen the body’s own healing powers. Breathing is important and, together with meditation and visualisation exercises, is thought to help energise body and mind, reduce stress and improve concentration and clarity.

Young-onset Parkinson's

Medically, young-onset Parkinson’s disease describes someone who develops the symptoms of Parkinson's after the age of 21 years and before the age of 40. 

In other contexts, the term may be used to mean people of working age (usually under 65).  

Although there is no difference in the treatments available to younger and older people with Parkinson's, the management of the disease in younger people is different.  It has to take into account the fact that they will live with the disease for much longer than most older people, that their response to the medication can be much more sensitive and that they are at a different stage in their lives, for example needing to earn a salary and raise children.

Also called early-onset Parkinson’s disease.

Z

Zonisamide

A medication that may be used for the treatment of motor symptoms in Parkinson's.  It is also under investigation for other symptoms of the condition.

For more information, see Types of medication

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