Parkinson’s Disease

Parkinson’s disease is a chronic neurological disease which usually begins in mid-life. It is estimated that over 1,000,000 people suffer from this condition in the United States. The cause of Parkinson’s disease is unknown.

Tremor at rest, slowness of movement (bradykinesia), rigidity, and postural instability are common symptoms. Decreased facial movement (hypomimia), small handwriting (micrographia), drooling, and gait difficulties are additional signs.

The pathology of the disease relates to the degeneration of cells in the substantia nigra which is located in the midbrain. The destruction of these cells results in a loss of dopamine. The symptoms result from decreased amounts of dopamine in the brain.

The disease is progressive and causes increasing disability. Drug treatment with anticholinergics such as trihexyphenidyl (Artane) and benztropine (Cogentin), levodopa/carbidopa (Sinemet, Sinemet CR, generics), dopamine agonists such as ropinirole (Requip), pramipexole (Mirapex), pergolide (Permax) and bromocriptine (Parlodel), COMT inhibitors such as entacapone (Comtan) and tolcapone (Tasmar) as well as the triple formulation of carbidopa/levodopa/entacapone known as Stalevo and MAO-B inhibitors such as selegiline (Eldepryl) and amantadine help alleviate symptoms, but often have long-term complications including motor fluctuations, dyskinesia and hallucinations. Surgical treatment (link to this surgery page) such as deep brain stimulation of the subthalamic nucleus or globus pallidus are treatment options when motor fluctuations and dyskinesia are no longer controlled by medication.

See related resources for more information about Parkinson’s disease.