Skip to main content

Parkinson’s Disease

  • Chapter
  • First Online:
Neurodegenerative Disorders

Abstract

Parkinson’s Disease (PD) is the second most common neurodegenerative disorder after Alzheimer’s disease. The majority of cases are sporadic, commonly referred to as idiopathic Parkinson’s disease (IPD). The cardinal clinical features are bradykinesia, rigidity, rest tremor, and postural instability. A flexed posture and the freezing phenomenon are also commonly seen.

Initial descriptions of Parkinson’s disease (PD) and its management following the introduction of levodopa concentrated on the cardinal motor features. Long-term studies and clinicopathological correlation make it clear, however, that this is a disease with diverse effects, also affecting cognition, mood, autonomic function, and the sleep cycle. Patient care has accordingly become increasingly complex. With the exception of deep brain stimulation, diagnostic and therapeutic options have changed little in the past 20 years. Validated biomarkers and disease-modifying therapies are still required. This chapter aims to practically address common clinical issues and update the practitioner on advances in the field.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Further Reading

Pathology, Clinical Features and Natural History of IPD

  • Braak H, Bohl JR, Muller CM, Rub U, de Vos RA, Del Tredici K. Stanley Fahn Lecture 2005: the staging procedure for the inclusion body pathology associated with sporadic Parkinson’s disease reconsidered. Mov Disord 2006;21:2042–2051.

    Article  PubMed  Google Scholar 

  • Chaudhuri KR, Schapira AH. Non-motor symptoms of Parkinson’s disease: dopaminergic pathophysiology and treatment. Lancet Neurol. 2009 May;8(5):464–74.

    Article  PubMed  CAS  Google Scholar 

  • de Lau LM, Schipper CM, Hofman A, Koudstaal PJ, Breteler MM. Prognosis of Parkinson disease: risk of dementia and mortality: the Rotterdam Study. Arch Neurol 2005;62(1265–1269)

    Article  PubMed  Google Scholar 

  • Fahn S. The freezing phenomenon in parkinsonism. Adv Neurol 1995;67:53–63.

    PubMed  CAS  Google Scholar 

  • Hely MA, Reid WGJ, Adena MA, Halliday GM, Morris JGL. The Sydney multicentre study of Parkinson’s disease: The inevitability of dementia at 20 years. Mov Disord 2008;23(6):837–844.

    Article  PubMed  Google Scholar 

  • Lippa CF, Duda JE, Grossman M, Hurtig HI, Aarsland D, Boeve BF, Brooks DJ, Dickson DW, Dubois B, Emre M, Fahn S, Farmer JM, Galasko D, Galvin JE, Goetz CG, Growdon JH, Gwinn-Hardy KA, Hardy J, Heutink P, Iwatsubo T, Kosaka K, Lee VM, Leverenz JB, Masliah E, McKeith IG, Nussbaum RL, Olanow CW, Ravina BM, Singleton AB, Tnner CM, Trojanowski JQ, Wszolek ZK; DLB/PDD Working group. DLB and PDD boundary issues: diagnosis, treatment, molecular pathology, and biomarkers. Neurology 2007;68(11):812–819.

    Article  PubMed  CAS  Google Scholar 

Therapeutics in IPD

  • Clarke CE, Worth P, Grosset D, Stewart D. Systematic review of apomorphine infusion, levodopa infusion and deep brain stimulation in advanced Parkinson’s disease. Parkinsonism Relat Disord 2009;15(10):728–741.

    Article  PubMed  Google Scholar 

  • Deuschl G, Schade-Brittinger C, Krack P, Volkmann J, Schäfer H, Bötzel K, Daniels C, Deutschländer A, Dillmann U, Eisner W, Gruber D, Hamel W, Herzog J, Hilker R, Klebe S, Kloss M, Koy J, Krause M, Kupsch A, Lorenz D, Lorenzi S, Mehdorn HM, Moringlane JR, Oertel W, Pinsker MO, Reichmann H, Reuss A, Schneider GH, Schnitzler A, Steude U, Sturm V, Timmermann L, Tronnier V, Trottenberg T, Wojtecki L, Wolf E, Poewe W, Voges J; German Parkinson Study Group, Neurostimulation Section. A randomised Trial of deep-brain stimulation for Parkinson’s disease. N Engl J Med 2006;355(9):896–908

    Article  PubMed  CAS  Google Scholar 

  • Fahn S, Oakes D, Shoulson I, Kieburtz K, Rudolph A, Lang A, Olanow CW, Tanner C, Marek K; Parkinson Study Group. Levodopa and the progression of Parkinson’s disease. N Engl J Med 2004;351(24):2498–2508

    Article  CAS  Google Scholar 

  • Fahn S. Parkinson’s Disease: 10 Years of Progress, 1997–2007. Mov Disord 2010; 25, (Suppl. 1):S2–S14

    Article  PubMed  Google Scholar 

  • Hauser RA, Rascol O, Korczyn AD, Jon Stoessl A, Watts RL, Poewe W, De Deyn PP, Lang AE. Ten-year follow-up of Parkinson’s disease patients randomized to initial therapy with ropinerole or levodopa. Mov Disord 2007;22(16):2409–2417.

    Article  PubMed  Google Scholar 

  • Lang AE. When and how should treatment be started in Parkinson disease? Neurology 2009;72(Suppl 2):S39-S43.

    Article  PubMed  CAS  Google Scholar 

  • Lees AJ, Katzenschlager R, Head J, Ben-Shlomo Y. Ten-year follow-up of three different initial treatments in do-novo PD: a randomised trial. Neurology 2001;57:1687–1694.

    PubMed  CAS  Google Scholar 

  • Olanow CW, Goetz CG, Kordower JH, Stoessi AJ, Sossi V, Brin MF, Shannon KM, Nauert GM, Perl DP, Godbold J, Freeman TB. A double-blind controlled trial of bilateral fetal nigral transplantation in Parkinson’s disease. Ann Neurol 2003;54:403–414.

    Article  PubMed  Google Scholar 

  • Schapira AH, Obeso J. Timing of treatment initiation in Parkinson’s disease. A need for reappraisal? Ann Neurol 2006;59(559–562)

    Article  PubMed  Google Scholar 

Genetics of IPD

  • Healy DG, Falchi M, O’Sullivan SS, Bonifati V, Durr A, Bressman S, Brice A, Aasly J, Zabetian CP, Goldwurm S, Ferreira JJ, Tolosa E, Kay DM, Klein C, Williams DR, Marras C, Lang AE, Wszolek ZK, Berciano J, Schapira AH, Lynch T, Bhatia KP, Gasser T, Lees AJ, Wood NW; International LRRK2 Consortium. Phenotype, genotype, and worldwide genetic penetrance of LRRK2-associated Parkinson’s disease: a case-control study. Lancet Neurol 2008;7(7):583–590

    Article  PubMed  CAS  Google Scholar 

  • Lucking CB, Durr A, Bonifati V, Vaughan J, De Michele G, Gasser T, Harhangi BS, Meco G, Denèfle P, Wood NW, Agid Y, Brice A; French Parkinson’s Disease Genetics Study Group; European Consortium on Genetic Susceptibility in Parkinson’s Disease. Association between early-onset Parkinson’s disease and mutations in the parkin gene. N Engl J Med 2000;342:1560–1567

    Article  PubMed  CAS  Google Scholar 

  • Marder K, Tang MX, Mejia H, Alfaro B, Côté L, Louis E, Groves J, Mayeux R. Risk of Parkinson’s disease among first-degree relatives: A community based study. Neurology 1996;47(1):155–160.

    PubMed  CAS  Google Scholar 

  • Polymeropoulos MH, Lavedan C, Leroy E, Ide SE, Dehejia A, Dutra A, Pike B, Root H, Rubenstein J, Boyer R, Stenroos ES, Chandrasekharappa S, Athanassiadou A, Papapetropoulos T, Johnson WG, Lazzarini AM, Duvoisin RC, Di Iorio G, Golbe LI, Nussbaum RL. Mutation in the alpha-synuclein gene identified in families with Parkinson’s disease. Science 1997;276(5321):2045–2047.

    Article  PubMed  CAS  Google Scholar 

Neuroprotection

  • Olanow CW, Rascol O, Hauser R, Feigin PD, Jankovic J, Lang A, Langston W, Melamed E, Poewe W, Stocchi F, Tolosa E; ADAGIO Study Investigators. A double-blind, delayed-start trial of rasagaline in Parkinson’s disease. N Engl J Med 2009;361(13):1268–1278

    Article  PubMed  CAS  Google Scholar 

  • Schapira AH. Neuroprotection in Parkinson’s disease. Parkinsonism Relat Disord 2009;15(Suppl. 4):S41-S43.

    Article  PubMed  Google Scholar 

  • Shoulson I, Oakes D, Fahn S, Lang A, Langston JW, LeWitt P, Olanow CW, Penney JB, Tanner C, Kieburtz K, Rudolph A, Parkinson Study Group. Impact of sustained deprenyl (selegiline) in levodopa-treated Parkinson’s disease: a randomized placebo-controlled extension of the deprenyl and tocopherol antioxidative therapy of parkinsonism trial. Ann Neurol 2002;51(5):604–612

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Richard A. Walsh .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer-Verlag London Limited

About this chapter

Cite this chapter

Walsh, R.A., Lynch, T., Fahn, S. (2011). Parkinson’s Disease. In: Hardiman, O., Doherty, C. (eds) Neurodegenerative Disorders. Springer, London. https://doi.org/10.1007/978-1-84996-011-3_5

Download citation

  • DOI: https://doi.org/10.1007/978-1-84996-011-3_5

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84996-010-6

  • Online ISBN: 978-1-84996-011-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics