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"Parkinson's" and "Parkinson's Disease" redirect here. For the medical journal, see Parkinson’s Disease (journal). For other uses, see other uses (disambiguation).


Parkinson's disease
Other namesParkinson disease, idiopathic or primary parkinsonism, hypokinetic rigid syndrome, paralysis agitans, shaking palsy
Two sketches (one from the front and one from the right side) of a man, with an expressionless face. He is stooped forward and is presumably having difficulty walking.
Illustration of Parkinson's disease by William Richard Gowers, first published in A Manual of Diseases of the Nervous System (1886)
Medical specialtyNeurology
SymptomsShaking, rigidity, slowness of movement, difficulty walking[1]
ComplicationsDementia, depression, anxiety[2]
Usual onsetAge over 60[1][3]
CausesUnknown[4]
Risk factorsPesticide exposure, head injuries[4]
Diagnostic methodBased on symptoms[1]
Differential diagnosisDementia with Lewy bodies, progressive supranuclear palsy, essential tremor, antipsychotic use[5]
TreatmentMedications, surgery[1]
MedicationL-DOPA, dopamine agonists[2]
PrognosisLife expectancy ~ 15 years[medical citation needed][6]
Frequency6.2 million (2015)[7]
Deaths117,400 (2015)[8]

Parkinson's disease (PD), or simply Parkinson's, is a long-term degenerative disorder of the central nervous system that mainly affects the motor system.[1] As the disease worsens, non-motor symptoms become more common.[1][4] The symptoms usually emerge slowly.[1] Early in the disease, the most obvious symptoms are shaking, rigidity, slowness of movement, and difficulty with walking.[1] Thinking and behavioral problems may also occur.[2] Dementia becomes common in the advanced stages of the disease.[2] Depression and anxiety are also common, occurring in more than a third of people with PD.[2] Other symptoms include sensory, sleep, and emotional problems.[1][2] The main motor symptoms are collectively called "parkinsonism", or a "parkinsonian syndrome".[4][9]

The cause of Parkinson's disease is unknown, but is believed to involve both genetic and environmental factors.[4] Those with a family member affected are more likely to get the disease themselves.[4] There is also an increased risk in people exposed to certain pesticides and among those who have had prior head injuries, while there is a reduced risk in tobacco smokers and those who drink coffee or tea.[4][10] The motor symptoms of the disease result from the death of cells in the substantia nigra, a region of the midbrain.[1] This results in not enough dopamine in this region of the brain.[1] The cause of this cell death is poorly understood, but it involves the build-up of proteins into Lewy bodies in the neurons.[4] Diagnosis of typical cases is mainly based on symptoms, with tests such as neuroimaging used to rule out other diseases.[1]

There is no cure for Parkinson's disease.[1] Treatment aims to improve the symptoms.[1] Initial treatment is typically with the antiparkinson medication levodopa (L-DOPA), followed by dopamine agonists when levodopa becomes less effective.[2] As the disease progresses and neurons continue to be lost, these medications become less effective, while at the same time producing a complication marked by involuntary writhing movements.[2] Diet and some forms of rehabilitation have shown some effectiveness at improving symptoms.[11][12] Surgery to place microelectrodes for deep brain stimulation has been used to reduce motor symptoms in severe cases where drugs are ineffective.[1] Evidence for treatments for the non-movement-related symptoms of PD, such as sleep disturbances and emotional problems, is less strong.[4]

In 2015, PD affected 6.2 million people and resulted in about 117,400 deaths globally.[7][8] Parkinson's disease typically occurs in people over the age of 60, of whom about one percent are affected.[1][3] Males are more often affected than females at a ratio of around 3:2.[4] When it is seen in people before the age of 50, it is called early-onset PD.[13] The average life expectancy following diagnosis is between 7 and 15 years.[2][6] The disease is named after the English doctor James Parkinson, who published the first detailed description in An Essay on the Shaking Palsy, in 1817.[14][15] Public awareness campaigns include World Parkinson's Day (on the birthday of James Parkinson, 11 April) and the use of a red tulip as the symbol of the disease.[16] People with Parkinson's who have increased the public's awareness of the condition includes boxing legend Muhammad Ali, actor Michael J. Fox, Olympic cyclist Davis Phinney, and actor Alan Alda.[17][18][19][20]

References

[change | change source]
  1. ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 1.15 "Parkinson's Disease Information Page". NINDS. 30 June 2016. Archived from the original on 4 January 2017. Retrieved 18 July 2016.
  2. ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 Sveinbjornsdottir S (October 2016). "The clinical symptoms of Parkinson's disease". Journal of Neurochemistry. 139 Suppl 1: 318–324. doi:10.1111/jnc.13691. PMID 27401947.
  3. ↑ 3.0 3.1 Carroll WM (2016). International Neurology. John Wiley & Sons. p. 188. ISBN 9781118777367. Archived from the original on 8 September 2017.
  4. ↑ 4.00 4.01 4.02 4.03 4.04 4.05 4.06 4.07 4.08 4.09 Kalia LV, Lang AE (August 2015). "Parkinson's disease". Lancet. 386 (9996): 896–912. doi:10.1016/s0140-6736(14)61393-3. PMID 25904081.
  5. ↑ Ferri FF (2010). Ferri's differential diagnosis : a practical guide to the differential diagnosis of symptoms, signs, and clinical disorders (2nd ed.). Philadelphia, PA: Elsevier/Mosby. p. Chapter P. ISBN 978-0323076999.
  6. ↑ 6.0 6.1 [medical citation needed]Golbe LI, Leyton CE (November 2018). "Life expectancy in Parkinson disease". Neurology (Editorial). 91 (22): 991–992. doi:10.1212/WNL.0000000000006560. PMID 30381371.
  7. ↑ 7.0 7.1 GBD 2015 Disease Injury Incidence Prevalence Collaborators (October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1545–1602. doi:10.1016/S0140-6736(16)31678-6. PMC 5055577. PMID 27733282. {{cite journal}}: |author1= has generic name (help)CS1 maint: numeric names: authors list (link)
  8. ↑ 8.0 8.1 GBD 2015 Mortality Causes of Death Collaborators (October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1459–1544. doi:10.1016/s0140-6736(16)31012-1. PMC 5388903. PMID 27733281. {{cite journal}}: |author1= has generic name (help)CS1 maint: numeric names: authors list (link)
  9. ↑ Jones, H. Royden (2013). The Netter collection of medical illustrations. a compilation of paintings (2nd ed.). Philadelphia, PA: Saunders Elsevier. p. 161. ISBN 9781455733873. Archived from the original on 8 September 2017.
  10. ↑ Barranco Quintana JL, Allam MF, Del Castillo AS, Navajas RF (February 2009). "Parkinson's disease and tea: a quantitative review". Journal of the American College of Nutrition. 28 (1): 1–6. doi:10.1080/07315724.2009.10719754. PMID 19571153.
  11. ↑ Barichella M, Cereda E, Pezzoli G (October 2009). "Major nutritional issues in the management of Parkinson's disease". Movement Disorders. 24 (13): 1881–92. doi:10.1002/mds.22705. hdl:2434/67795. PMID 19691125.
  12. ↑ Ahlskog JE (July 2011). "Does vigorous exercise have a neuroprotective effect in Parkinson disease?". Neurology. 77 (3): 288–94. doi:10.1212/wnl.0b013e318225ab66. PMC 3136051. PMID 21768599.
  13. ↑ Mosley, Anthony D. (2010). The encyclopedia of Parkinson's disease (2nd ed.). New York: Facts on File. p. 89. ISBN 9781438127491. Archived from the original on 8 September 2017.
  14. ↑ Parkinson, James (1817). An Essay on the Shaking Palsy. London: Whittingham and Roland for Sherwood, Neely, and Jones. Archived from the original on 24 September 2015.
  15. ↑ Shulman JM, De Jager PL, Feany MB (February 2011) [25 October 2010]. "Parkinson's disease: genetics and pathogenesis". Annual Review of Pathology. 6: 193–222. doi:10.1146/annurev-pathol-011110-130242. PMID 21034221. Archived from the original on 28 August 2021. Retrieved 2 August 2020.
  16. ↑ Lees AJ (September 2007). "Unresolved issues relating to the shaking palsy on the celebration of James Parkinson's 250th birthday". Movement Disorders. 22 Suppl 17 (Suppl 17): S327–34. doi:10.1002/mds.21684. PMID 18175393.
  17. ↑ Davis P (3 May 2007). "Michael J. Fox". The TIME 100. Time. Archived from the original on 25 April 2011. Retrieved 2 April 2011.
  18. ↑ Macur, Juliet (26 March 2008). "For the Phinney Family, a Dream and a Challenge". The New York Times. Archived from the original on 6 November 2014. Retrieved 25 May 2013. About 1.5 million Americans have received a diagnosis of Parkinson's disease, but only 5 to 10 percent learn of it before age 40, according to the National Parkinson Foundation. Davis Phinney was among the few.
  19. ↑ Brey RL (April 2006). "Muhammad Ali's Message: Keep Moving Forward". Neurology Now. 2 (2): 8. doi:10.1097/01222928-200602020-00003. Archived from the original on 27 September 2011. Retrieved 2 April 2011.
  20. ↑ Alltucker, Ken (31 July 2018). "Alan Alda has Parkinson's disease: Here are 5 things you should know". USA Today. Archived from the original on 6 May 2019. Retrieved 6 May 2019.
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