Parkinson's and Movement Disorders
Parkinson’s disease (PD) is a progressive brain and spinal cord disorder that occurs when the brain’s nerve cells don't create enough dopamine. The specific cause is still unknown, although genetic and environmental factors may contribute.
Symptoms of Parkinson's Disease
Parkinson’s disease tends to occur in older adults and is somewhat more common in men. Symptoms tend to appear around age 60, although a small percentage of cases (five to 10 percent) are diagnosed in people younger than age 50.
Early symptoms tend to begin gradually and on one side of the body and typically get worse over time. Other symptoms include:
- Difficulty balancing;
- Muscle stiffness;
- Slow movement, known as bradykinesia;
- Small, cramped handwriting;
- Speech changes, such as slurring or speaking in a monotone;
- Stooped posture;
- Tremors in the fingers, hand, arm, jaw or face.
As Parkinson’s disease progresses, you may have difficulty talking, walking, sleeping, swallowing, speaking and performing simple tasks. You may also experience mental and behavioral changes, such as depression, fatigue and problems with memory.
Tremor is a symptom of both Parkinson’s disease and essential tremor, a movement disorder that often causes hand tremors. Essential tremor is about eight times more common than Parkinson’s disease.
While they may appear similar, essential tremor and Parkinson’s differ in several important ways:
- Parkinson’s tremors generally start around age 60 and initially affect one side of the body. Essential tremor often appears in adolescence or middle age (between ages 40 to 50) and tends to initially affect both sides of the body.
- Parkinson’s disease tremor usually occurs at rest. Essential tremor typically occurs during movement.
- Essential tremor appears to be more closely related to genetic causes than Parkinson’s disease.
- Over time, Parkinson’s disease affects the legs, jaw and other body parts, causing stiff muscles, slow movement, trouble balancing and stooped posture. Essential tremor typically involves the upper half of the body only; the hands, head and voice.
- Parkinson's tremor is often characterized by a “pill-rolling” — a circular movement of the tips of the index finger and thumb.
Although there is no specific test to diagnose Parkinson’s disease, our New Jersey-based Parkinson’s specialists will review your symptoms and medical history, perform a physical exam, and may conduct additional tests, such as:
- Blood or urine samples: Checks for markers of neurological disorders.
- Dopamine transport uptake assessment (DaT): A Parkinson’s neurologist measures the level of dopamine in a specific part of the brain using state-of-the-art imaging.
- Electromyography (EMG): Measures the electrical impulses of your muscles and nerves and how they work together.
- Imaging tests: A Parkinson’s disease specialist uses computed tomography (CT) and magnetic resonance imaging (MRI) to look for neurological abnormalities.
- Neurophysiological exam: A Parkinson’s doctor uses visual, electrical and other types of stimulation to detect neurological abnormalities.
- Neuropsychological exam: Assesses your memory, attention, language and other cognitive skills.
Treatments for Parkinson’s Disease in New Jersey
While there is currently no cure for Parkinson’s disease, our New Jersey-based neurological specialists and neurosurgeons continue to pioneer new advances to provide you with access to the latest surgical and nonsurgical treatments and therapies for Parkinson’s disease, dystonia, essential tremors and other movement disorders.
Non-Surgical Treatment for Parkinson’s Disease in New Jersey
- Chemodenervation uses Botox injections to block nerve signals to your muscles, reducing the degree of abnormal movement.
- Dietary therapy. Our neurological specialists collaborate with registered dietitians to design a dietary plan to provide optimal nutrition while maximizing the effectiveness of your medications and managing other symptoms, such as difficulty swallowing.
- Medication, such as dopamine substitutes, anti-seizure, and blood pressure medications can also relieve symptoms of movement disorders.
Surgical Treatment for Parkinson’s Disease in New Jersey
- Deep brain stimulation (DBS) may be recommended for patients with symptoms that are not well controlled by medication. It works by implanting a small device in your brain that uses electrical stimulation to prevent nerve signals from causing abnormal movement.
- Focused Ultrasound (FUS), a minimally invasive alternative to deep-brain stimulation for patients with essential tremor and Parkinson’s disease tremor that has not responded to medications.Hackensack University Medical Center is the only medical center in New Jersey, and one of just a few in the nation, to use this technique, also known as high-intensity focused ultrasound (HIFU), to treat brain tissue that is the source of the tremor. For more information or to schedule an appointment, call 551-996-5588 or email FUS@hmhn.org.
- Stereotactic pallidotomy may be an option for patients who can’t undergo deep-brain stimulation for Parkinson’s or other movement disorders. It uses radiofrequency ablation to create a small lesion in the part of the brain responsible for movement control.
- Stereotactic thalamotomy to treat essential tremor or tremor-dominant Parkinson’s disease. This procedure creates lesions that stop or reduce tremors using Gamma Knife stereotactic radiosurgery technology.
- MRI-guided Laser Interstitial Thermal Therapy (LITT) uses a minimally invasive robotically controlled laser thermal therapy to ablate unwanted tissue in the brain where a tremor originates, without harming surrounding healthy brain tissue.
Supportive Services for Parkinson’s and Movement Disorders in New Jersey
We offer a full range of supportive services, including:
- Cognitive remediation aimed at helping you manage challenges related to cognitive functions such as memory, planning and reasoning.
- Driving rehabilitation to help you maintain your driving independence.
- Inpatient and outpatient rehabilitation services designed to help you adjust to living with Parkinson’s disease.
- Neuropsychology and Psychological counseling to support your emotional challenges and help you cope with cognitive changes.
- Physical therapy and Parkinson’s group exercise classes that focus on improving your balance, strength and flexibility.
- Parkinson’s Wellness Program is a unique two-week inpatient rehabilitation program at JFK Johnson Rehabilitation Institute in Edison, New Jersey, that focuses on restoring and maintaining function.
- Speech therapy using the latest evidence-based treatment protocols to help preserve your voice.
- Support groups and services designed to help patients live well with Parkinson’s disease, including Ping Pong Parkinson's, Rock Steady Boxing, ParkinSINGS choir, SPEAK OUT speech therapy and voice training program and more.
Parkinson's Disease and Movement Disorders Treatment at Our Hospitals
360 Essex Street, Suite 303
Hackensack, NJ 07601
551-996-8100
Led by Rocco DiPaola, M.D., movement disorders neurologist, and Shabbar Danish, M.D., chair of Neurosurgery, our team is among the best in the nation.
Using innovative technology, non-invasive techniques and surgical solutions, our multidisciplinary team offers patients myriad options for treatment, care and support for movement disorders.
Dr. Robert H. Harris Neuroscience Treatment Center
Amdur Pavilion
1945 Route 33
Neptune, NJ 07753
732-897-3600
Neurosurgery
HOPE Tower
19 Davis Avenue, 4th Floor
Neptune, NJ 07753
732-974-0003
Led by Philip A. Hanna, M.D., director of the Parkinson’s Disease and Movement Disorders Center, and Stephen M. Bloomfield, M.D., director of Functional Neurosurgery, our team is uniquely equipped to deliver a comprehensive and individualized care plan that allows our patients to remain in control of their bodies and lives.
65 James Street
Edison NJ 08820
732-321-7010
Focused Ultrasound for Essential Tremor
Neurosurgeons at Hackensack Meridian Neuroscience Institute continue to pioneer new advances for treating Parkinson’s Disease and movement disorders. We are the only two locations in New Jersey using Focused Ultrasound (FUS), a minimally invasive alternative to deep brain stimulation, to treat patients with essential tremor and Parkinson’s disease tremor that has not responded to medications.
Focused ultrasound uses acoustic energy, or sound waves, to treat brain tissue that is the source of the tremor. The outpatient procedure, which typically takes two hours, doesn’t require surgical incisions or anesthesia and many patients experience immediate and significant reduction in hand tremors, which can make activities of daily living challenging. Patients can return home the same day.
Learn more about focused ultrasound and how to schedule an appointment.
How We Diagnose Parkinson’s Disease and Movement Disorders
To diagnose your condition, we will review your symptoms and health history, conduct a physical exam and may perform additional tests, including:- Blood or urine samples.Your health care provider may ask you to provide blood or urine samples to check for markers of neurological disorders and rule out other conditions.
- Electromyography (EMG). EMG measures the electrical impulses along your nerves and muscles to test how well your nerves and muscles work together.
- Imaging tests. Your health care provider may order imaging tests, such as magnetic resonance imaging (MRI) or computed tomography (CT), to help uncover neurological abnormalities and diagnose your movement disorder.
- Movement neurophysiological exam. We use a series of tests involving different types of stimulation — including visual, audible and electrical stimulation — to detect neurological abnormalities.
- Neuropsychological exam. This exam assesses cognitive skills, such as attention, executive functioning, memory, language and visuospatial processing.
Rehabilitation for Movement Disorders in New Jersey
Our specialists are leaders in movement disorder rehabilitation and follow the latest, evidence-based guidelines. Our movement disorder rehabilitation team includes:
- Board-certified physical medicine and rehabilitation physicians
- Movement disorder neurologists
- Certified rehabilitation registered nurses (CRRN)
- Movement disorder therapists
