Parkinson's Disease

Last Updated: March 2, 2023

Parkinson’s disease is a neurodegenerative disease caused by progressive loss of dopamine-producing neurons in the brain. Symptoms are mild at first, but progress over time, leading to impaired movement as well as other neurocognitive and psychiatric symptoms like depression, dementia, bowel and bladder problems, and difficulty sleeping.

Parkinson's Disease falls under theBrain Healthcategory.

What is Parkinson’s disease?

Parkinson’s disease is a brain disorder caused by the death of dopamine-generating neurons in particular regions of the brain, affecting multiple body functions. Symptoms are initially mild but worsen over time and include a progressive loss of motor control, causing tremors, impaired balance, and bradykinesia (slowness of movement). Parkinson’s also affects non-motor functions of the brain, which can affect mood, behavior, and cognition. The onset of disease symptoms occurs after age 60 in most people, but 5-10% of people with Parkinson’s may start to experience symptoms before age 50.[1] Although men are around 1.5 times more likely to develop Parkinson’s, women tend to have a faster disease progression and higher mortality rates.[2][3][4]

What are the main signs and symptoms of Parkinson’s disease?

The effects of Parkinson’s disease on the brain cause both motor (i.e., movement-associated) and non-motor symptoms. The symptoms are subtle at first, but progressively worsen over time.[1]

Common motor symptoms of Parkinson’s disease include the following:

  • Tremors, which can occur in different parts of the body including the head, arms, legs, and jaw
  • Bradykinesia (slowness of movement)
  • Changes in gait
  • Impaired balance and coordination
  • Muscle stiffness

(These motor symptoms make patients prone to serious falls and injuries.)

People with Parkinson’s disease may experience any of the following non-motor symptoms:

  • Depression
  • Fatigue and excessive daytime sleepiness
  • Anxiety
  • Cognitive decline[5] / Dementia
  • Constipation or urinary problems
  • Skin problems[6]
How is Parkinson’s disease diagnosed?

Parkinson’s disease is diagnosed primarily by symptoms, medical history, and a physical exam.[4] Family medical history will also be reviewed, since a first-degree relative with Parkinson's disease increases the chance of diagnosis.[7] There are currently no available tests for Parkinson’s disease. However, biomarkers that may be able to diagnose the disease before symptoms appear could be on the horizon.[8] To be diagnosed with Parkinson’s disease, an individual needs to have parkinsonism, which is defined as bradykinesia (slowness of movement) along with muscle rigidity, tremors at rest, or both.[9] In cases where diagnosis of Parkinson’s isn’t conclusive based on a physical exam, an imaging technique may be used to identify neuronal changes in the brain that are specific for Parkinson’s disease.[10]

What are some of the main medical treatments for Parkinson’s disease?

Because Parkinson’s reduces dopamine levels in the brain through the death of dopamine-generating neurons, the main medical treatment strategies are centered on dopamine.[1] A few of the most common dopamine-based treatments are levodopa, which nerve cells use as a precursor to make dopamine; monoamine oxidase-B (MAO-B) inhibitors, which increase dopamine levels by reducing its breakdown; and dopamine agonists, which mimic the effects of dopamine.[11] Anticholinergic drugs are also used to help reduce tremors and muscle stiffness, and amantadine may be prescribed to suppress involuntary movements.[11]

Have any supplements been studied for Parkinson’s disease?

The mechanisms driving the loss of dopamine neurons in the brain of people with Parkinson’s disease are not well-understood. However, excess generation of reactive oxygen species (ROS),[12][13] inflammation, and mitochondrial dysfunction are common themes in the pathology.[14] Many of the supplements researched for their possible therapeutic effects in experimental models and in clinical trials affect one or more of these pathological mechanisms.[15][16]

The following supplements have been studied in people with Parkinson’s disease:

How could diet affect Parkinson’s disease?

The role of diet in Parkinson's disease has been studied extensively, with particular foods being associated with either increased or decreased risk. For example, dairy products have been associated with increased Parkinson's disease risk,[27] while coffee or tea consumption have been associated with decreased risk.[28][29] Another observational study suggested that increased intake of foods such as fresh fruits and vegetables, olive oil, wine, coconut oil, and non-fried fish were associated with reduced risk, while consuming foods such as beef, fried foods, soda, and dairy products were associated with increased risk.[30]

Although the above research suggests that an overall healthier diet pattern may help to decrease Parkinson's disease risk, cohort studies examining the associations between healthy diet patterns and Parkinson's disease have been inconclusive.[31] However, multiple studies have noted associations between reduced Parkinson's disease risk and adherence to a Mediterranean diet.[32][31]

Are there any other treatments for Parkinson’s disease?

For people who fail to respond to conventional therapies, deep brain stimulation may be used, wherein electrodes are implanted in the brain and attached to a small battery in the chest. The electrical impulses delivered to the brain help to relieve many of the motor symptoms of Parkinson's disease, such as tremor, rigidity, and bradykinesia.[11]

Since tremors are associated with dysfunctional neuron signaling in the thalamus region of the brain, treatments that target the thalamus are often used for people who have tremor-predominant Parkinson’s disease, a subtype associated with tremors but a lack of muscle rigidity or bradykinesia. MRI-guided focused ultrasound may be used to burn tissue in or around the thalamus, or less commonly, thalamotomy, which involves the surgical severing of nerve fibers in the thalamus.

Occupational therapy may also be prescribed as a treatment to promote improved quality of life and recover or maintain function for daily living or work.[33]

What causes Parkinson’s disease?

Parkinson’s disease is caused by death of dopamine-producing neurons in the substantia nigra pars compacta (SNPC) region of the brain, an important control center for motor function.[34] The neurons in the SNPC communicate with other regions of the brain to control movement by releasing the neurotransmitter dopamine. When dopamine levels are reduced, the biochemical imbalance creates the characteristic PD motor symptoms such as tremors, bradykinesia, and impaired balance and coordination.[35]

Although neuronal death in the SNPC is responsible for the characteristic symptoms associated with motor function in PD, other areas of the brain are also affected[36] that may contribute to non-motor symptoms.[37]

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References
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Examine Database References
  1. Subjective Well-Being - Bender A, Koch W, Elstner M, Schombacher Y, Bender J, Moeschl M, Gekeler F, Müller-Myhsok B, Gasser T, Tatsch K, Klopstock TCreatine supplementation in Parkinson disease: a placebo-controlled randomized pilot trialNeurology.(2006 Oct 10)
  2. Parkinson's Disease Symptoms - Writing Group for the NINDS Exploratory Trials in Parkinson Disease (NET-PD) Investigators, Kieburtz K, Tilley BC, Elm JJ, Babcock D, Hauser R, Ross GW, Augustine AH, Augustine EU, Aminoff MJ, Bodis-Wollner IG, Boyd J, Cambi F, Chou K, Christine CW, Cines M, Dahodwala N, Derwent L, Dewey RB Jr, Hawthorne K, Houghton DJ, Kamp C, Leehey M, Lew MF, Liang GS, Luo ST, Mari Z, Morgan JC, Parashos S, Pérez A, Petrovitch H, Rajan S, Reichwein S, Roth JT, Schneider JS, Shannon KM, Simon DK, Simuni T, Singer C, Sudarsky L, Tanner CM, Umeh CC, Williams K, Wills AMEffect of creatine monohydrate on clinical progression in patients with Parkinson disease: a randomized clinical trialJAMA.(2015 Feb 10)
  3. Parkinson's Disease Symptoms - Mo JJ, Liu LY, Peng WB, Rao J, Liu Z, Cui LLThe effectiveness of creatine treatment for Parkinson's disease: an updated meta-analysis of randomized controlled trials.BMC Neurol.(2017-Jun-02)
  4. Parkinson's Disease Symptoms - Xiao Y, Luo M, Luo H, Wang JCreatine for Parkinson's disease.Cochrane Database Syst Rev.(2014-Jun-17)
  5. Power Output - Hass CJ, Collins MA, Juncos JLResistance training with creatine monohydrate improves upper-body strength in patients with Parkinson disease: a randomized trialNeurorehabil Neural Repair.(2007 Mar-Apr)
  6. Parkinson's Disease Symptoms - Phillips MCL, Murtagh DKJ, Gilbertson LJ, Asztely FJS, Lynch CDPLow-fat versus ketogenic diet in Parkinson's disease: A pilot randomized controlled trialMov Disord.(2018 Aug)
  7. Parkinson's Disease Symptoms - C B Carroll, P G Bain, L Teare, X Liu, C Joint, C Wroath, S G Parkin, P Fox, D Wright, J Hobart, J P ZajicekCannabis for dyskinesia in Parkinson disease: a randomized double-blind crossover studyNeurology.(2004 Oct 12)
  8. Parkinson's Disease Symptoms - Katzenschlager R, Evans A, Manson A, Patsalos PN, Ratnaraj N, Watt H, Timmermann L, Van der Giessen R, Lees AJMucuna pruriens in Parkinson's disease: a double blind clinical and pharmacological studyJ Neurol Neurosurg Psychiatry.(2004 Dec)
  9. Parkinson's Disease Symptoms - Roberto Cilia, Janeth Laguna, Erica Cassani, Emanuele Cereda, Nicolò G Pozzi, Ioannis U Isaias, Manuela Contin, Michela Barichella, Gianni PezzoliMucuna pruriens in Parkinson disease: A double-blind, randomized, controlled, crossover studyNeurology.(2017 Aug 1)
  10. Parkinson's Disease Symptoms - Roberto Cilia, Janeth Laguna, Erica Cassani, Emanuele Cereda, Benedetta Raspini, Michela Barichella, Gianni PezzoliDaily intake of Mucuna pruriens in advanced Parkinson's disease: A 16-week, noninferiority, randomized, crossover, pilot studyParkinsonism Relat Disord.(2018 Apr)
  11. Parkinson's Disease Symptoms - Müller T, Büttner T, Gholipour AF, Kuhn WCoenzyme Q10 supplementation provides mild symptomatic benefit in patients with Parkinson's diseaseNeurosci Lett.(2003 May 8)
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  13. Heart Rate - Joanne DiFrancisco-Donoghue, Ely Rabin, Eric M Lamberg, William G WernerEffects of Tyrosine on Parkinson's Disease: A Randomized, Double-Blind, Placebo-Controlled TrialMov Disord Clin Pract.(2014 Oct 23)
  14. Orthostatic Hypotension Symptoms - Shibao C, Okamoto LE, Gamboa A, Yu C, Diedrich A, Raj SR, Robertson D, Biaggioni IComparative efficacy of yohimbine against pyridostigmine for the treatment of orthostatic hypotension in autonomic failureHypertension.(2010 Nov)
  15. Depression Symptoms - A Di Rocco, J D Rogers, R Brown, P Werner, T BottiglieriS-Adenosyl-Methionine improves depression in patients with Parkinson's disease in an open-label clinical trialMov Disord.(2000 Nov)