Understanding Parkinson's Disease -- The Basics

What Is Parkinson's Disease?

Parkinson's disease mostly affects older people but can also occur in younger adults. The symptoms are the result of the gradual degeneration of nerve cells in the portion of the midbrain that controls body movements. The first signs are likely to be barely noticeable -- a feeling of weakness or stiffness in one limb, or a fine trembling of one hand when it is at rest. Eventually, the shaking (tremor) worsens and spreads, muscles become stiffer, movements slow down, and balance and coordination deteriorate. As the disease progresses, depression, cognitive issues, and other mental or emotional problems are common.

Parkinson's disease usually begins between the ages of 50 and 65, striking about 1% of the population in that age group; it is slightly more common in men than in women. Medication can treat its symptoms and decrease the disability.

What Causes Parkinson’s Disease?

Body movements are regulated by a portion of the brain called the basal ganglia, whose cells require a proper balance of two substances called dopamine and acetylcholine, both involved in the transmission of nerve impulses. In Parkinson's, cells that produce dopamine begin to degenerate, throwing off the balance of these two neurotransmitters. Researchers believe that genetics sometimes plays a role in this cellular breakdown. In rare instances, Parkinson's disease may be caused by a viral infection or by exposure to environmental toxins such as pesticides, carbon monoxide, or the metal manganese. But in the great majority of Parkinson's cases, the cause is unknown.

Parkinson's disease is a form of parkinsonism. This is a more general term used to refer to the set of symptoms that is commonly associated with Parkinson's disease but sometimes stems from other causes. The distinction is important because some of these other causes may be treatable, while others do not respond to treatment or medication. Other causes of parkinsonism include:

• An adverse reaction to prescription drugs
• Use of illegal drugs
• Exposure to environmental toxins
• Stroke
• Thyroid and parathyroid disorders
• Repeated head trauma (for example, the trauma associated with boxing and multiple concussions)
• Brain tumor
• An excess of fluid around the brain (called hydrocephalus)
• Brain inflammation (encephalitis) resulting from infection

Parkinsonism may also be present in persons with other neurological conditions, including Alzheimer's, Lewy body disease, Multiple System Atrophy (MSA), Progressive Supranuclear Palsy (PSP), and Corticobasal Syndrome (CBS).

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