Parkinson's Disease

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What is Parkinson's Disease?

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Parkinson's disease involves a depletion of dopamine-containing neurons in the substantia nigra of the basal ganglia in the brain. The classical features of Parkinson's disease include resting tremor, rigidity, bradykinesia (slowness) and postural instability. This cluster of symptoms is referred to as Parkinsonism syndrome, which can be caused by other neurodegenerative disorders, cerebrovascular disease and certain drugs.

Parkinson's disease is named after James Parkinson, an English physician who described the Shaking Palsy in 1817.

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Who gets Parkinson's Disease?

The incidence and prevalence of Parkinson's disease is uniform throughout the world. It generally commences in middle or late life, affecting 1-2 per 1,000 of the general population, and up to 2 per 100 people over 65 years. Parkinson's disease affects all ethnic groups. Males and females are equally affected. Approximately 78,000 Australians are affected by Parkinson's disease.

Predisposing Factors

The cause of Parkinson's disease is unknown. Many cases are described as idiopathic or sporadic Parkinson's disease (meaning they occur quite randomly in patients with no known predisposing factors). However, certain risk factors have been identified:

Non-smokers - Studies have shown Parkinson's disease to be less prevalent in tobacco smokers than in non-smokers.
Herbicides such as methylphenyltetrahydropyridine (MPTP) may be associated with Parkinson's disease.
Encephalitis lethargica - Survivors of this disease develop severe Parkinsonism.
Genetic factors - Some families will have multiple cases of early-onset Parkinson's, but the majority of cases are non-familial.

Parkinsonism (the syndrome of rigidity, slowness and tremor) can be induced by drugs (reserpine, phenothiazines), and is seen in neurodegeneration, arteriosclerosis, carbon dioxide poisoning, Wilson's disease, multi-system atrophy, communicating hydrocephalus and progressive supranuclear palsy (another illness causing rigidity and problems with eye movements and speech). Drinking moderate amounts of coffee, smoking, using non-steroidal anti-inflammatory drugs (NSAIDs) and oestrogen replacement in postmenopausal women (HRT) may actually reduce your incidence of Parkinson's disease.

Progression

Parkinson's disease does not affect everyone the same way. In some people the disease progresses quickly, in others it does not. Although some people become severely disabled, others experience only minor motor disruptions. Tremor is the major symptom for some patients, while for others tremor is only a minor complaint and different symptoms are more troublesome.

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