Parkinson’s disease

Parkinson’s disease (PD) is a long-term degenerative disorder of the central nervous system that mainly affects the motor system. The symptoms usually emerge slowly, and as the disease worsens, non-motor symptoms become more common.

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 (on the birthday of James Parkinson, 11 April) and the use of a red tulip as the symbol of the disease.

The most obvious early symptoms are tremor, rigidity, slowness of movement, and difficulty with walking. Cognitive and behavioral problems may also occur with depression, anxiety, and apathy occurring in many people with PD.

Parkinson’s disease dementia becomes common in the advanced stages of the disease. Those with Parkinson’s can also have problems with their sleep and sensory systems. 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.

The cause of this cell death is poorly understood, but involves the build-up of misfolded proteins into Lewy bodies in the neurons. Collectively, the main motor symptoms are also known as parkinsonism or a parkinsonian syndrome.

The cause of PD is unknown, with both inherited and environmental factors being believed to play a role. Those with a family member affected by PD are at an increased risk of getting the disease, with certain genes known to be inheritable risk factors.

Other risk factors are those who have been exposed to certain pesticides and who have prior head injuries. Coffee drinkers, tea drinkers, and smokers are at a reduced risk.

Diagnosis of typical cases is mainly based on symptoms, with motor symptoms being the chief complaint.

Tests such as neuroimaging (magnetic resonance imaging or imaging to look at dopamine neuronal dysfunction) can be used to help rule out other diseases. Parkinson’s disease typically occurs in people over the age of 60, of whom about one percent are affected.

No cure for PD is known; treatment aims to reduce the effects of the symptoms.

Exercise in middle age may reduce the risk of PD later in life. Caffeine also appears protective with a greater decrease in risk occurring with a larger intake of caffeinated beverages such as coffee.

Antioxidants, such as vitamins C and E, have been proposed to protect against the disease, but results of studies have been contradictory and no positive effect has been proven.

The results regarding fat and fatty acids have been contradictory, with various studies reporting protective, risk-increasing, or no effects.

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