Parkinson's disease--medical education and psychosocial aspects

This article describes the attempt to develop educational material for patients suffering from Parkinson's disease (PD) and for their partners. The material relates to the neuropathology of PD. The extent of the degeneration of dopaminergic neurons in the substantia nigra, present at the outbreak of the disease, is illustrated to the patient. The substantia nigra is explained as a TV-broadcasting system, the nerve fibers to the so-called striatum as cables and the striatum itself is explained as a TV-set with 2 channels (called dopamine D 1-receptor and dopamine D 2-receptor). The action of anti-Parkinsonian agents is exemplified with the substance L-DOPA, a precursor of the transmitter dopamine. The patient and his partner are introduced to the time-course of the L-DOPA concentration in blood after oral intake of the substance (the pharmacokinetics of L-DOPA). The pharmacokinetics can explain the clinical improvement and the long-term effects of L-DOPA therapy. The second part reports on psychosocial problems that Parkinsonian patients and their spouses encounter and how psychological interventions may help to solve some of these psychosocial problems.