Abstract
Parkinson disease, named after James Parkinson who first described the disorder in 1817, is a chronic, progressive neurologic disorder clinically characterized by a combination of tremor, rigidity, and bradykinesia [1, 2]. Estimates of the incidence of Parkinson disease range from 5 to 20 new cases per 100,000 individuals per year, occurring with a slightly greater frequency in middle-aged and elderly men of European and North American descent [1, 3]. The cause of Parkinson disease is unknown, but it has been observed in humans and induced in primates by exposure to 1-methyl-4-phenylpyridine (MPP+), a metabolite of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), which poisons complex I of the mitochondrial electron transport chain (Fig. 1) [4]. Other risk factors associated with the development of Parkinson disease include oxidant stress, reduced glutathione stores, tobacco smoking (linked inversely to the development of Parkinson disease), and caffeine consumption (correlated with reduced risk) [3, 4]. Current scientific evidence suggests that Parkinson disease does not have a substantial genetic component [3].
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Grading System for Levels of Evidence Supporting Recommendations in Critical Care Toxicology, 2nd Edition
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I
Evidence obtained from at least one properly randomized controlled trial.
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II-1
Evidence obtained from well-designed controlled trials without randomization.
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II-2
Evidence obtained from well-designed cohort or case–control analytic studies, preferably from more than one center or research group.
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II-3
Evidence obtained from multiple time series with or without the intervention. Dramatic results in uncontrolled experiments (such as the results of the introduction of penicillin treatment in the 1940s) could also be regarded as this type of evidence.
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III
Opinions of respected authorities, based on clinical experience, descriptive studies and case reports, or reports of expert committees.
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Walsh, S.J., Katz, K.D. (2017). Antiparkinsonian Agents. In: Brent, J., et al. Critical Care Toxicology. Springer, Cham. https://doi.org/10.1007/978-3-319-17900-1_12
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DOI: https://doi.org/10.1007/978-3-319-17900-1_12
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