Parkinson’s disease (PD) is characterized as a progressive neurodegenerative disorder associated with the loss of dopamine-producing neurons in the substantia nigra region of the midbrain. Classically its presentation includes a triad of motor manifestations: bradykinesia, resting tremor, and muscle rigidity. Among non-motor manifestations are autonomic dysfunction, mood disorders, and cognitive impairment.
The prevalence of PD has doubled in the past 25 years. Worldwide, over 8.5 million people are estimated to have PD. In the United States the number of people diagnosed each year is approaching 90,000. The incidence of PD is increasing faster than any other neurological disorder. Its prevalence as a degenerative brain disease is only second to that of Alzheimer’s.
However, Parkinson’s disease is much more complex and heterogeneous than this classic presentation suggests. Recent research has shed light on the multifaceted nature of PD, revealing a wide range of symptoms and subtypes that extend far beyond the traditional motor manifestations. One of the most significant findings is the recognition of non-motor symptoms as an integral part of the disease process. Cognitive impairment, for instance, can precede the motor symptoms by several years, and in some cases, may even be the initial presenting feature.
Mood disorders, such as depression and anxiety, are also highly prevalent and can significantly impact the quality of life of patients with PD. Furthermore, the progression and severity of symptoms can vary greatly among individuals, leading to the identification of different subtypes of PD. Some patients may experience a predominance of tremor, while others may be more affected by gait disturbances or postural instability. This heterogeneity highlights the need for personalized treatment approaches tailored to each patient’s unique symptom profile and disease course.
Importantly, advances in neuroimaging techniques and biomarker research have provided valuable insights into the underlying pathophysiology of PD. These developments have not only improved our understanding of the disease mechanisms but also hold promise for earlier and more accurate diagnosis, as well as the development of targeted therapies. In light of these findings, it is clear that Parkinson’s disease is a complex and multifaceted disorder that extends beyond the classic motor symptoms. A comprehensive understanding of its diverse manifestations and subtypes is crucial for improving patient care, developing effective treatments, and ultimately, finding a cure for this debilitating condition.
Diagnosis is clinical presentation, with imaging and laboratory tests, such as DAT scanning and skin biopsy for alpha-synuclein respectively, to support the assessment. Conventional management is multidisciplinary, including supportive treatment through pharmacotherapy and non-pharmacological interventions like physical therapy. Deep brain stimulation offers an option for advanced cases. In addition to conventional care, complementary, alternative, and regenerative management continues to evolve.