Parkinson's disease
Long-term degenerative neurological disorder / From Wikipedia, the free encyclopedia
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Parkinson's disease (PD), or simply Parkinson's, is a long-term neurodegenerative disease of the central nervous system that affects both the motor system and non-motor systems. The symptoms usually emerge slowly, and as the disease progresses, non-motor symptoms become more common. Usual symptoms are tremor, rigidity, slowness of movement, and difficulty with walking, collectively known as parkinsonism. Parkinson's disease dementia, falls and neuropsychiatric problems such as sleep abnormalities, psychosis, mood swings or behavioral changes may arise in advanced stages.
Parkinson's disease | |
---|---|
Other names | Parkinson disease, idiopathic or primary parkinsonism, hypokinetic rigid syndrome, paralysis agitans, shaking palsy |
Specialty | Neurology |
Symptoms | Rigidity, slowness of movement, tremor, difficulty walking[1] |
Complications | Dementia, depression, anxiety,[2] eating problems, and sleep problems |
Usual onset | Age over 60[1][3] |
Duration | Long-term |
Causes | Unknown[4] |
Risk factors | Pesticide exposure, head injuries[4] |
Diagnostic method | Based on symptoms[1] |
Differential diagnosis | Dementia with Lewy bodies, progressive supranuclear palsy, essential tremor, antipsychotic use,[5] fragile X-associated tremor/ataxia syndrome, Huntington's disease, dopamine-responsive dystonia, Wilson's disease[6] |
Treatment | Medications, surgery[1] |
Medication | L-DOPA, dopamine agonists[2] |
Frequency | 6.2 million (2015)[7] |
Deaths | 117,400 (2015)[8] |
Named after | James Parkinson |
Most of the cases of Parkinson's disease are idiopathic but a few contributing factos have been identified. Pathophysiology is characterized by nerve cell death in the locus coeruleus and substantia nigra, latter being a midbrain region that supplies dopamine to the basal ganglia which are involved in voluntary motor control. The cause of this cell death is poorly understood but includes the alpha-synuclein aggregation into Lewy bodies within the neurons. Other possible factors involve genetic and environmental mechanisms as well as medications, lifestyle or previous conditions.
Diagnosis is mainly based on signs and symptoms, usually motor-related, found via neurological examination, though medical imaging like neuromelanin MRI can support the diagnosis. Usual onset is in people over 60 years of age of whom about one percent are affected. In those younger than 50, it is termed early-onset PD. The life expectancy is reduced yet.
No cure is known, and treatment aims to mitigate symptoms. Initial treatment typically includes L-DOPA, MAO-B inhibitors, or dopamine agonists. As the disease progresses, these medications become less effective and produce a side effect marked by involuntary muscle movements. Diet and certain forms of rehabilitation have shown some effectiveness at improving symptoms. Surgery to place microelectrodes for deep brain stimulation has been used to reduce severe motor symptoms where drugs are ineffective. Evidence for treatments for the non-movement-related symptoms of PD, such as sleep disturbances and emotional problems, is less strong.
The disease is named after English doctor James Parkinson, who published the first detailed description in An Essay on the Shaking Palsy, in 1817. Public awareness campaigns include World Parkinson's Day and the use of a red tulip symbolizes Parkinson's awareness. People with PD who have increased the public's awareness of the condition include boxer Muhammad Ali and actor Michael J. Fox.