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What is Parkinson’s disease? Jeremy Paxman presents final University Challenge

Jeremy Paxman, 73, has said his Parkinson’s disease symptoms ‘are currently mild’ but has stepped down after hosting the BBC Two show since 1994 (BBC)
Jeremy Paxman, 73, has said his Parkinson’s disease symptoms ‘are currently mild’ but has stepped down after hosting the BBC Two show since 1994 (BBC)

Jeremy Paxman has presented his final episode of University Challenge after being diagnosed with Parkinson's disease in 2021.

Paxman, 73, has said his symptoms “are currently mild” but has stepped down as host of the BBC Two show after presenting it since 1994. He will be replaced by Amol Rajan.

Paxman said the disease, which affects 145,000 people in the UK, would have become more obvious to viewers if he had continued hosting University Challenge. He had previously stopped presenting Newsnight in 2014 and has left the BBC after 51 years.

So what is Parkinson’s disease, what are its symptoms and causes, and how it is treated?

What is Parkinson’s disease?

Parkinson’s disease is a neurodegenerative disorder that primarily affects the motor system.

It is characterised by the progressive loss of dopamine-producing cells in a region of the brain called the substantia nigra. Dopamine is a neurotransmitter that plays a crucial role in co-ordinating movement, so the depletion of dopamine leads to a variety of motor symptoms.

What are the symptoms of Parkinson’s disease?

The symptoms of Parkinson’s disease are usually gradual at first, with the three main symptoms affecting physical movement:

  • Tremors (involuntary shaking): This usually begins in the hand or arm, and is more pronounced when the limb is resting.

  • Slowness of movement (bradykinesia): Physical movements are much slower than normal, which can make everyday tasks difficult and result in a slow, shuffling walk and very small steps.

  • Muscle stiffness (rigidity): Stiffness and tension in the muscles can make it difficult to move around and make facial expressions.

These symptoms can be caused by other issues, and are referred to by doctors as Parkinsonism.

Parkinson’s disease may also cause non-motor symptoms, such as depression, anxiety, sleep disturbances, cognitive changes, and autonomic dysfunction (problems with blood pressure regulation, digestion, and sweating).

What causes Parkinson’s disease?

The exact causes of Parkinson’s disease are not fully understood, but research suggests a combination of genetic and environmental factors contribute to its development. Here are some factors that are associated with the condition:

  1. Genetic Factors: Certain genetic mutations and variations have been identified as risk factors for developing Parkinson’s disease. However, these are relatively rare and account for a small percentage of cases.

  2. Age: The risk of Parkinson’s disease increases with age, and the majority of cases occur in people over 60.

  3. Environmental Factors: Exposure to certain environmental factors may increase the risk of Parkinson’s disease. These factors include pesticides, herbicides, industrial chemicals, and certain toxins such as MPTP (a chemical compound).

  4. Oxidative Stress: This phenomenon, which occurs due to an imbalance between the production of harmful free radicals and the body’s ability to neutralise them, is believed to play a role in Parkinson’s disease. It can damage cells and contribute to the degeneration of dopamine-producing neurons.

  5. Alpha-synuclein accumulation: The accumulation of abnormal protein deposits called Lewy bodies, primarily consisting of a protein called alpha-synuclein, is a hallmark of Parkinson’s disease. It is not entirely clear why these deposits form or how they contribute to the disease process.

  6. Other factors: Some studies have suggested potential links between Parkinson’s disease and factors such as head injuries, certain viral infections, and gut microbiota imbalances. However, more research is needed to establish their precise roles, if any, in the development of the disease.

It’s important to note that while these factors are associated with Parkinson’s disease, having one or more of them does not guarantee that a person will develop the condition. Parkinson’s disease remains a complex and multifactorial disorder, and further research is needed to better understand its causes and risk factors.

How is Parkinson’s disease treated?

Parkinson’s disease is a chronic condition without a cure, but treatments aim to manage symptoms and improve quality of life. The following approaches are commonly used:

  1. Medications: Drugs such as levodopa, dopamine agonists, and others help manage motor symptoms by replenishing dopamine levels in the brain.

  2. Deep brain stimulation (DBS): Electrical impulses are delivered via implanted electrodes to targeted areas of the brain, helping to regulate abnormal brain activity and alleviate motor symptoms.

  3. Physical therapy: Exercise programmes and physical therapy improve mobility, balance, and muscle strength.

  4. Occupational therapy: This helps sufferers to maintain independence and adap to changes in motor skills for daily activities.

  5. Speech therapy: This addresses speech and swallowing difficulties through exercises and techniques.

  6. Supportive therapies: Music, art, and dance therapies can improve well-being, reduce stress, and enhance mood.

  7. Lifestyle nodifications: Regular exercise, a balanced diet, stress management, and sufficient sleep can have positive effects.

Collaboration with a healthcare team, including neurologists and specialists, is crucial to developing an individualised treatment plan. Regular adjustments and follow-ups are important to optimise management as symptoms change.