Research Archives - Michigan Head & Spine Institute Blog



Dr. Fredrick Junn
Fredrick S. Junn, M.D.

While most people have heard of Parkinson’s disease, which affects nearly 1 million people in the United States, fewer of us are aware of its symptoms, risk factors and treatment.

Knowing about Parkinson’s Disease, including early signs to watch for, can help you and your loved ones catch the disease earlier, understand its signs, and learn how to manage it.

What Is Parkinson’s Disease?

Parkinson’s disease is a disorder of the central nervous system that affects movement, specifically how your brain communications with the rest of your body to create and execute movement.

With Parkinson’s disease, damage to nerve cells in the brain lead to reduced levels of dopamine, which plays a role in movement. When dopamine decreases, the brain and the body can’t communicate properly, leading to symptoms of Parkinson’s disease.

Parkinson’s disease is a progressive neurological condition, meaning it starts slowly and gets worse over time. It typically starts in one portion of the body, such as the arm or leg, and eventually crosses over to affect the other side of the body as well. Early- to mid-stage symptoms of Parkinson’s disease include:

  • Tremors/shaking in fingers, thumb, hand or chin
  • Stiffness
  • Constipation
  • Trouble sleeping
  • Smaller handwriting (micrographia)
  • Speaking in a lower or softer voice (hypophonia)
  • Dizziness
  • Slowed movement (bradykinesia)
  • Loss of smell
  • Stooped posture

Very recently, new research has identified two more early signs of Parkinson’s disease: hearing loss and epilepsy.

Since many of these symptoms could be caused by other health conditions, it’s important to talk with your healthcare provider to potentially rule out Parkinson’s disease if you’re experiencing them.

As Parkinson’s disease progresses, so do the symptoms. Some that may show up later in the course of the disease include:

  • Tremors and stiffness on both sides of the body
  • Walking problems
  • Loss of balance
  • Shuffling gait
  • Markedly stooped posture

Parkinson’s disease can also affect a person’s mental health, and is linked to conditions such as depression, anxiety and dementia.

Risk Factors for Parkinson’s Disease

Although scientists haven’t been able to pinpoint what causes Parkinson’s disease, they have identified some risk factors. These include:

  • Genetics
    When people develop Parkinson’s disease at a young age (in their 20s or 30s), the cause is often genetic.
  • Advanced age
    The average age of onset for Parkinson’s disease is around 60 years old.
  • Gender
    Parkinson’s disease is more common in men than women.
  • Environmental triggers
    Exposure to pesticides/herbicides, heavy metals and other toxic chemicals has been shown to increase the risk for developing Parkinson’s disease. A street drug called “synthetic heroin” is also associated with Parkinson’s disease.

Treatments and Management for Parkinson’s Disease

There is no cure for Parkinson’s disease, but it can be managed and even slowed, depending how early the disease is diagnosed. Treating Parkinson’s disease typically involves increasing the amount of dopamine in the brain. This can be done with medications, including some types of antidepressants; newer anti-Parkinsonian medications are designed to provide a steady level of dopamine so patients don’t experience the crash associated with earlier treatments.

In addition to medication, deep brain stimulation (DBS) can be helpful for managing Parkinson’s disease symptoms. DBS is a surgical procedure where electrodes are implanted that deliver tiny electrical impulses to the parts of the brain that control movement. A major advantage of DBS is that it levels off dopamine levels without the side effects associated with some Parkinson’s disease medications.

Keeping the body healthy and moving are also key to controlling Parkinson’s disease symptoms, and many people find physical therapy to be helpful for maintaining movement.

If you think you may be experiencing Parkinson’s disease symptoms, or if you have a family history of the disease, you may want to ask your healthcare provider for a neurological referral. A neurologist can provide a diagnosis and start you down the path of managing your Parkinson’s disease.


If you or a loved one is seeking treatment for a condition of the brain, or to schedule an appointment with Dr. Junn or any of our MHSI experts, visit or call 248-784-3667.


Over two-thirds of individuals experience chronic low back pain (LBP) in their lifetime, according to the New England Journal of Medicine. Some of the most common causes of low back pain include the biochemical degeneration of the intervertebral disc (IVD), spinal stenosis, and disc herniation. For these individuals, posterolateral and interbody fusion techniques are frequently considered for those with one- or two-level degenerative disc disease whose symptoms are unresponsive to conservative treatment. Nevertheless, pre-operative diagnostic techniques that may identify those patients with degenerative disc disease without significant neurological compression who may benefit from surgical intervention remain elusive.

Henry C. Tong, M.D. of MHSI and his colleague at Oakland University William Beaumont School of Medicine, Mengqiao Alan Xi, BSc, recently published their research that re-evaluated the effectiveness of lumbar discography with post-discography CT.

Their study results indicate that discography with post-discography CT can be an effective method to evaluate patients with discogenic back pain refractory to non-operative treatments. Those patients with one- or two-level high concordant pain scores with associated annular tears and negative control disc represent good surgical candidates for lumbar interbody spinal fusion.

To read the full study, click this link.


Jeffrey Jacob, M.D.
Jeffrey Jacob, M.D.

Jeffery Jacob, M.D., along with his former Mayo Clinic colleagues in the Department of Neurosurgery and Anesthesia.  The article was published in Neurology, Sept. 8, 2015, which presented findings from a study on obese patients undergoing elective spinal fusion.

The objective of the study was on the impact of obesity on resource utilization and early complications in patients undergoing surgery for degenerative spine disease.

The conclusions drawn from this single-institution retrospective analysis is that increased BMI is associated with longer operative times, increased complication rates and increased cost independent of co-morbidities. The results further indicated the need for preoperative weight loss.