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Parkinson

According to the World Health Organization:

“Parkinson’s Disease (PD) is a chronic progressive neurodegenerative disorder of insidious onset, characterized by the presence of predominantly motor symptomatology (bradykinesia, rest tremor, rigidity, and postural disturbances).”

It is also associated to some non-motor symptoms such as hyposmia, rapid eye movements, sleep behaviour disorder, personality changes, pain, paresthesias and depression.1,2

The motor symptoms result from the denervation process that takes place after the progressive loss of dopamine-containing neuros of the pars compacta of the substantia nigra, a region of the midbrain.3 There are some genetic predisposing factors which in combination with environmental factors, such as age, sex, dietary habits, infections, environmental toxins and trauma, are thought to be responsible for the cellular degeneration, but the main cause is still unknown.4

REFERENCES

1 Nutt, J. G., & Wooten, G. F. (2005). Clinical practice. Diagnosis and initial management of Parkinson’s disease. The New England Journal of Medicine, 353(10), 1021–1027.

2 Chaudhuri, K. R., Yates, L., & Martinez-Martin, P. (2005). The non-motor symptom complex of Parkinson’s disease: a comprehensive assessment is essential. Current Neurology and Neuroscience Reports, 5(4), 275–283.

3Albin, R. L., Young, A. B., & Penney, J. B. (1995). The functional anatomy of disorders of the basal ganglia. Trends in Neurosciences, 18(2), 63–64.

4 Kalia, L. V., & Lang, A. E. (2015). Parkinson’s disease. Lancet, 386(9996), 896–912.

Liu, G., Peng, J., Liao, Z., Locascio, J. J., Corvol, J.-C., Zhu, F., … Scherzer, C. R. (2021). Genome-wide survival study identifies a novel synaptic locus and polygenic score for cognitive progression in Parkinson’s disease. Nature Genetics, 53(6), 787–793.

Wood, H. (2021). Could perampanel treat Parkinson disease? Nature Reviews. Neurology, 17(5), 262.

Boutet, A., Madhavan, R., Elias, G. J. B., Joel, S. E., Gramer, R., Ranjan, M., … Lozano, A. M. (2021). Predicting optimal deep brain stimulation parameters for Parkinson’s disease using functional MRI and machine learning. Nature Communications, 12(1), 3043.

Tanudjojo, B., Shaikh, S. S., Fenyi, A., Bousset, L., Agarwal, D., Marsh, J., … Tofaris, G. K. (2021). Phenotypic manifestation of α-synuclein strains derived from Parkinson’s disease and multiple system atrophy in human dopaminergic neurons. Nature Communications, 12(1).

Wood, H. (2019). Naturally occurring antibodies target Parkinson disease pathology. Nature Reviews. Neurology, 15(4), 186–187.

 Chen, Y., Cen, Z., Zheng, X., Pan, Q., Chen, X., Zhu, L., … Luo, W. (2019). LRP10 in autosomal‐dominant Parkinson’s disease. Movement Disorders: Official Journal of the Movement Disorder Society, 34(6), 912–916.

Dakin, S. G. (2019). Resolvin-g Parkinson’s disease. Science Translational Medicine, 11(512), eaaz3713.

Obeso, J. A., Stamelou, M., Goetz, C. G., Poewe, W., Lang, A. E., Weintraub, D., … Stoessl, A. J. (2017). Past, present, and future of Parkinson’s disease: A special essay on the 200th Anniversary of the Shaking Palsy: The Shaking Palsy: Past, Present and Future. Movement Disorders: Official Journal of the Movement Disorder Society, 32(9), 1264–1310.

Postuma, R. B., Berg, D., Stern, M., Poewe, W., Olanow, C. W., Oertel, W., … Deuschl, G. (2015). MDS clinical diagnostic criteria for Parkinson’s disease: MDS-PD Clinical Diagnostic Criteria. Movement Disorders: Official Journal of the Movement Disorder Society, 30(12), 1591–1601.

Voight, B. F. (2013). Ironing out Parkinson’s disease. Science Translational Medicine, 5(196), 196ec127-196ec127.

Pezzoli, G., & Cereda, E. (2013). Exposure to pesticides or solvents and risk of Parkinson disease. Neurology, 80(22), 2035–2041.

Sherer, T. B. (2011). Biomarkers for Parkinson’s disease. Science Translational Medicine, 3(79), 79ps14-79ps14.

Valente, A., Sousa, J., Outeiro, T., & Ferreira, L. (2010). A stem-cell ageing hypothesis on the origin of Parkinson’s disease. Nature Precedings.

World Health Organization. (2006). Neurological disorders: Public health challenges. Ginebra, Suiza: World Health Organization.

Jankovic, J., & Tolosa, E. (Eds.). (2006). Parkinson’s disease and movement disorders: Laboratory management and clinical correlations (5a ed.). Filadelfia, PA, Estados Unidos de América: Lippincott Williams and Wilkins.

  • American Parkinson Disease Association
  • Bachman-Strauss Dystonia & Parkinson Foundation
  • David Phinney Foundation
  • Michael J. Fox Foundation for Parkinson’s Research
  • Parkinson Alliance
  • Parkinson’s Foundation
  • Parkinson’s Resource Organizations
  • Columbia University Medical Center
  • Yale School of Medicine
  • University of Florida in collaboration with Emory University
  • University of Michigan in collaboration with the University of Texas Southwestern Medical Center
  • National Institute of Neurological Disorders and Stroke

According to the studies, Parkinson’s disease is more common in men than women, with a male-to-female ratio of 1.5.1 The explanation for this difference can include the neuroprotective effect of the oestrogen in women brains, the occupational exposures in men and X-linked genetic factors.2,3

On average, women develop the disease 2.1 years later than men, but the progression and duration of disease don’t change for any sex.4 The average life expectancy is the same for both sexes but, which is different than in the general population without PD, where women present a longer life expectancy than men.5

In the case of the symptons, there is not a tendency for every sex. They vary in presence and severity between patients, but in general, women experience tremor more often than men, 67% and 48% respectively.6

REFERENCES

Wooten, G. F., Currie, L. J., Bovbjerg, V. E., Lee, J. K., & Patrie, J. (2004). Are men at greater risk for Parkinson’s disease than women? Journal of Neurology, Neurosurgery, and Psychiatry, 75(4), 637–639.

Elbaz, A., Carcaillon, L., Kab, S., & Moisan, F. (2016). Epidemiology of Parkinson’s disease. Revue Neurologique, 172(1), 14–26.

Wirdefeldt, K., Adami, H.-O., Cole, P., Trichopoulos, D., & Mandel, J. (2011). Epidemiology and etiology of Parkinson’s disease: a review of the evidence. European Journal of Epidemiology, 26 Suppl 1(S1), S1-58.

Lyons, K. E., Hubble, J. P., Tröster, A. I., Pahwa, R., & Koller, W. C. (1998). Gender differences in Parkinson’s disease. Clinical Neuropharmacology, 21(2), 118–121.

Diamond, S. G., Markham, C. H., Hoehn, M. M., McDowell, F. H., & Muenter, M. D. (1990). An examination of male-female differences in progression and mortality of Parkinson’s disease. Neurology, 40(5), 763–766. Haaxma, C. A., Bloem, B. R., Borm, G. F., Oyen, W. J. G., Leenders, K. L., Eshuis, S., … Horstink, M. W. I. M. (2007). Gender differences in Parkinson’s disease. Journal of Neurology, Neurosurgery, and Psychiatry, 78(8), 819–824

  • Variations in prevalence of the disease had been shown at the international level attributed to ethnic differences across regions.
  • The higher rates can be found in Caucasians in Europe and North America, intermediate rates for Asians in China and Japan, and the lowest rates for Blacks in Africa.
  • Higher proportion of males are affected by this disorder.
  • It has a crude incidence rate of 4.5-19 per 100 000 population per year and recent evidence shows increased incidence with advancing age.
  • Some of the risk factors are:
    • Gender
    • Genetics
    • Enviromental causes
    • Age
    • Head injury
  • At present, the diagnosis is made through stringent clinical criteria as those developed by the Brain Bank of the Parkinson’s Disease Society in the United Kingdom.