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Parkinson's disease (also known as Parkinson disease or PD) is a degenerative disorder of the central nervous system that often impairs the sufferer's motor skills and speech. The disease can be difficult to diagnose accurately. Indeed, 75% of clinical diagnoses of PD are confirmed only at autopsy.
2. Parkinson disease affects movement (motor symptoms), and may include disorders of mood, behavior, thinking, and sensation (non-motor symptoms). Individual patients' symptoms may be quite dissimilar and progression of the disease is also distinctly individual.
3. There are currently no blood or laboratory tests that have been proven to help in diagnosing PD. As such, the diagnosis is based on medical history and a neurological examination. The Unified Parkinson's Disease Rating Scale is the primary clinical tool used to assist in diagnosis and determine severity of PD. Early signs and symptoms of PD may sometimes be dismissed as the effects of normal aging. The physician may need to observe the person for some time until it is apparent that the symptoms are consistently present. Doctors usually look for shuffling of feet and lack of swing in the arms.
 Dopaminergic pathways of the human brain in normal condition (left) and Parkinson's disease (right). Red Arrows indicate suppression of the target, blue arrows indicate stimulation of target structure. |
4. The symptoms of Parkinson's disease result from the loss of pigmented dopamine-secreting (dopaminergic) neurons in the pars compacta region of the substantia nigra (literally "black substance"), a heterogeneous portion of the midbrain. These neurons project to the striatum and their loss leads to alterations in the activity of the neural circuits within the basal ganglia that regulate movement, in essence an inhibition of the direct pathway and excitation of the indirect pathway. The direct pathway facilitates movement and the indirect pathway inhibits movement and thus, the loss of these cells leads to a hypokinetic movement disorder.
5. Most people with Parkinson's disease are described as having idiopathic Parkinson's disease (having no specific cause). There are far less common causes of Parkinson's disease including genetic, toxins, head trauma, cerebral anoxia, and drug-induced Parkinson's disease.
6. Parkinson's disease is a chronic disorder that requires broad-based management including patient and family education, support group services, general wellness maintenance, physiotherapy, exercise, and nutrition. At present, there is no cure for PD, but medications or surgery can provide relief from the symptoms. The most widely used form of treatment is L-DOPA in various forms. L-DOPA is transformed into dopamine in the dopaminergic neurons by L-aromatic amino acid decarboxylase (often known by its former name dopa-decarboxylase). However, only 1-5% of L-DOPA enters the dopaminergic neurons. The remaining L-DOPA is often metabolised elsewhere, causing a wide variety of side effects. Due to feedback inhibition, L-DOPA results in a reduction in the endogenous formation of L-DOPA, and so eventually becomes counterproductive.
7. Treating Parkinson's disease with surgery was once a common practice, but after the discovery of levodopa, surgery was restricted to only a few cases. Studies in the past few decades have led to great improvements in surgical techniques, and surgery is again being used in people with advanced PD for whom drug therapy is no longer sufficient. more... at Wikipedia
