Parkinson's Disease
Parkinson's disease is the second most common neurodegenerative disease after Alzheimer's, affecting around 1 in 500 people. It results from the progressive loss of dopamine-producing neurons in a region of the brain called the substantia nigra. Dopamine is a neurotransmitter essential for coordinating smooth, controlled movement, and its depletion gives rise to the characteristic motor features of the disease.
Causes
In the majority of cases, the cause is idiopathic — meaning no single identifiable cause has been found. The disease likely results from a combination of ageing, genetic susceptibility, and environmental factors. Around 10–15% of cases have a clear genetic basis, with mutations in genes such as LRRK2, PINK1, and PRKN identified. Advancing age is the most significant risk factor; Parkinson's predominantly affects people over 60, though early-onset cases (before 50) do occur and tend to have a stronger genetic component.
Symptoms
The four cardinal motor features are tremor at rest (a "pill-rolling" tremor of the hand that is typically present at rest and diminishes with movement), rigidity (stiffness of the limbs and trunk), bradykinesia (slowness of movement and reduced amplitude of voluntary movements), and postural instability (impaired balance and righting reflexes). Other motor features include a shuffling gait, reduced arm swing, micrographia (small handwriting), hypophonia (quiet voice), and a masked facial expression. Importantly, Parkinson's is not purely a motor disease — non-motor symptoms are equally significant and include depression and anxiety, cognitive impairment (ranging from mild to dementia), sleep disturbances (particularly REM sleep behaviour disorder), autonomic dysfunction (constipation, orthostatic hypotension, urinary problems), hyposmia (reduced sense of smell), and chronic pain.
Diagnosis
Parkinson's disease is diagnosed clinically — through careful neurological examination — by a specialist with expertise in movement disorders. There is no definitive diagnostic blood test or scan, though dopamine transporter (DaT) scanning can support the diagnosis in uncertain cases.
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