Parkinson's disease: a review

Abstract

Parkinson's Disease is the second most common progressive neurodegenerative disorder affecting older American adults and is predicted to increase in prevalence as the United States population ages. Resulting from a pathophysiologic loss or degeneration of dopaminergic neurons in the substantia nigra of the midbrain and the development of neuronal Lewy Bodies, idiopathic Parkinson's Disease is associated with risk factors including aging, family history, pesticide exposure and environmental chemicals (e.g., synthetic heroin use). Its ultimate cause(s) is (are) unknown. Characterized by both motor and non-motor symptoms, PD patients classically display rest tremor, rigidity, bradykinesia, and stooping posture. PD can also be associated with neurobehavioral disorders (depression, anxiety), cognitive impairment (dementia), and autonomic dysfunction (e.g., orthostasis and hyperhidrosis). Recent decades have witnessed a proliferation of medical pharmacologic therapies and innovative surgical interventions like deep brain stimulation (DBS). However, definitive disease-modifying therapy is still lacking. Experimental therapies are being developed and tested with limited results. Knowledge of strategies to promote optimal quality of life for PD patients is of paramount importance for caregivers, health providers and patients themselves.