In 2019, the University of Colorado Movement Disorders Center was designated a Parkinson Disease Center of Excellence by the Parkinson’s Foundation. This designation was awarded in light of our commitment to the Parkinson’s community through clinical care, research, outreach, and education. Michelle Fullard, MD, MSCE serves as the director of the Parkinson’s Foundation Center of Excellence at the University of Colorado Movement Disorders Center.
To schedule an appointment at the Anschutz Medical Campus, please call 720-848-2080. To learn more about our Parkinson’s Disease Interdisciplinary Clinic, please click here. The Movement Disorders Center also offers educational visits for people newly diagnosed with Parkinson’s disease. Please click here for new information.
What is Parkinson’s disease?
Parkinson’s disease is a clinical syndrome characterized by bradykinesia (slowness of movements), tremor, rigidity, and postural instability (balance impairment that can result in falls). Additional symptoms that can be associated with parkinsonism include loss of sense of smell, decreased facial expression, depression and/or anxiety, speech changes (usually softening or mumbling), swallowing difficulty, constipation, handwriting changes (smaller, cramped writing), thinking difficulties, sleep disturbances, and bladder problems (difficulty urinating or holding your bladder). Few patients experience all of the above symptoms and there are additional symptoms that can be associated that are not mentioned above
What causes Parkinson’s disease?
Parkinson’s disease is a neurodegenerative disorder caused by loss of brain cells that produce dopamine, which is a chemical messenger in the brain. Most cases occur spontaneously, but there are some familial cases that are caused by genetic mutations. Many researchers think it’s caused by a combination of genetic predisposition and environmental risk factors, which we’re continuing to learn about.
How is Parkinson’s disease treated?
The current goal in treating Parkinson’s disease is to maximize a person’s quality of life. Treatments can improve symptoms, but they do not alter the underlying disease. One exception to this is exercise. Patients who incorporate regular exercise into their routines fare better in the long-term. Symptomatic treatments often include a combination of medications, rehabilitation therapy, and possibly surgery.
There are several medications used in Parkinson’s disease, but they are directed at supplying dopamine back to the brain or stabilizing dopamine within the brain. Many people end up on multiple types of medications because they affect dopamine in different ways.
Rehabilitation therapy often includes physical therapy, occupational therapy, and speech therapy. Physical therapy can help with developing an exercise plan, working on balance and walking ability, and maintaining flexibility and range of motion. Occupational therapy can assess for potential adaptive equipment to help maintain independence. Speech therapy helps with eating/drinking safely and speaking more effectively.
Some patients benefit from surgery to help manage their Parkinson’s disease. This is typically reserved for patients whose symptoms are not responding adequately to traditional treatments or they are having medication side effects that limit their effectiveness. Deep brain stimulation (DBS) involves the placement of wire electrodes deep in the brain to stimulate movement centers and improve mobility. Medication infusions are implanted medication devices that can deliver a consistent amount of medication throughout the day to improve symptom fluctuations.
What can I expect?
Parkinson’s disease is a progressive disorder that will gradually worsen over time. Everyone is different in what their symptoms are and the rate of progression, so it’s difficult to predict how fast people will progress and how they will respond to treatments. There is no known cure at this time, but treatments can allow many people to maintain a high level of function for several years.
Parkinson Disease Interdisciplinary Clinic
Each month our clinic offers the opportunity to meet with many different specialists in one visit. During these visits, patients will also have annual evaluations performed to assess balance, gait, grip strength, fine motor skills, swallow ability, and voice decibels. They also do an assessment using the Unified Parkinson’s Disease Rating Scale (UPDRS), perform a comprehensive mood screening and cognitive assessment, and do a medication review. Ideally, every Parkinson’s disease paient will go through these clinics once per year. An annual visit to the Parkinson’s Disease Interdisciplinary Clinic will help providers track the disease progress more accurately, collect data, and continue to provide comprehensive care.
These appointments usually last longer than a normal appointment since each patient will see multiple providers and are reserved for patients who are already established in the Movement Disorders Clinic.
To schedule an appointment, please call 720-848-2080.
Newly Diagnosed Parkinson Disease Education Visits
Getting your diagnosis is a big day. Often, other information is lost in the shock. The goal of these visits is to allow an opportunity for those newly diagnosed with Parkinson’s disease to come back to see a provider shortly after they are diagnosed. During this visit, newly diagnosed people with Parkinson’s disease will learn more about Parkinson’s disease and have any questions that they or their families have answered. Write down questions for the visit to make sure all questions are answered.