Parkinson's Disease

Parkinson's disease (PD) is a long-term degenerative disorder of the nervous system that mainly affects the motor system. The symptoms generally come on slowly over time. Early in the disease, the most obvious symptoms are shaking, rigidity, slowness of movement, and difficulty with walking. Thinking and behavioral problems may also occur. Dementia becomes common in the advanced stages of the disease. Depression and anxiety are also common, occurring in more than a third of people with PD. Other symptoms include sensory, sleep, and emotional problems. The main motor symptoms are collectively called "parkinsonism", or a "parkinsonian syndrome".

Etiology

The cause of Parkinson's disease is generally unknown, but believed to involve both genetic and environmental factors. Those with a family member affected are more likely to get the disease themselves. There is also an increased risk in people exposed to certain pesticides and among those who have had prior head injuries. The motor symptoms of the disease result from the death of cells in the substantia nigra, a region of the midbrain, leading to a dopamine deficit.

Pathophysiology

The pathology of the disease is characterized by the accumulation of a protein called alpha-synuclein into inclusions called Lewy bodies in neurons, and from insufficient formation and activity of dopamine produced in certain neurons within parts of the midbrain. Lewy bodies are the pathological hallmark of the idiopathic disorder, and the distribution of the Lewy bodies throughout the Parkinsonian brain varies from one individual to another. The anatomical distribution usually corresponds to the expression and degree of the clinical symptoms of each individual.

Diagnosis

Parkinson's disease is typically diagnosed based on the presenting symptoms and signs, with support from medical imaging. The disease can be difficult to diagnose accurately. Early diagnosis and management are important for improving the quality of life of the person with the disease.

Management

There is no cure for Parkinson's disease, but medications, surgery, and multidisciplinary management can provide relief from the symptoms. The main families of drugs useful for treating motor symptoms are levodopa, dopamine agonists, and MAO-B inhibitors. The most commonly used treatment approach varies depending on the disease stage and the person's individual needs.

Prognosis

The progression of symptoms in Parkinson's disease is often a bit different from one person to another due to the diversity of the disease. People with Parkinson's disease can maintain high quality of life with appropriate treatment and support.

Epidemiology

Parkinson's disease affects more than 6 million people globally and is the second most common neurodegenerative disorder (after Alzheimer's disease). Most people with Parkinson's disease are aged 60 years or older, with the risk of the disease rising as people age.

History

Parkinson's disease was first formally described in 1817 by James Parkinson.

Society and culture

Many notable individuals have had Parkinson's disease. Public awareness campaigns include World Parkinson's Day (on the birthday of James Parkinson, 11 April) and regular Parkinson's disease walks.

Parkinson's Disease Resources
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