Parkinson disease

Parkinson disease

PD treatments are in majority pharmaceutical. It aim to reduce the PD symptoms, notably by compensating the dopamine depletion. The Drugs vary according to their modality of action (levodopa, dopamine agonists, monoamide oxidase inhibitor). In some advanced PD forms, a surgical treatment can be proposed, consisting on an electro-stimulation of the brain sub-thalamic nucleus.

Physical activities are recommended early on and consist with speech training, on essential complementary therapies for the PD patient care.

PD causes

The causes of the Parkinson disease are still largely unknown. There are some rare hereditary forms but for most case, it is likely that PD is a multifactorial disease, combining genetic predisposition with environmental factors.

Research is currently investigating further to better understand the the different mechanisms involved in PD

Parkinson disease is characterized by progressive neuron destruction of the “locus niger”, a deeply embedded structure within the brain. Those neurons produce dopamine, a molecule involved notably in the movement control, the regulation of emotions and the motivation. Dopamine interacts with other principal system of neurotransmission within the brain and it scarcity can induce numerous dysfunctions.

Usual Parkinson disease symptoms are: slow motion, stiffness, and resting tremor. The diagnosis is made in presence of at least, two of the three major motor symptoms.

Parkinson disease starts around 58 years. In France, 200 000 patients are suffering from PD and 25 000 new patients are detected every year. PD is the second most common neurodegenerative disease (after Alzheimer disease).

The exact cause of the disease is yet to be understood. Some therapies can attenuate the symptoms and improve the patients’ quality of life, however PD still can’t be cured.

The Parkinson disease diagnosis is based on the observation of at least two on three main motor symptoms: akinesia or slow initiation of movement; muscle stiffness and the resting tremor. A postural instability in Parkinson disease patients is also often noticed

Usually, those symptoms start often on one side for the upper or the lower limbs then, spread to both sides even if an asymmetry is observed.

The motor disorders come always along with non-motor symptoms. It can be neurovegetative signs (Excessive drooling, arterial hypotension, urinary bladder disorders, constipation, swallowing disorder…), pain, extreme tiredness, sexual dysfunction, sleep disorders (insomnia, REM sleep behavior disorder, excessive daytime sleepiness…), cognitive disorders (attention and memory deficit disorders) or psycho-behavioral disorders (depression, anxiety, apathy, visual hallucination and impulse control disorder). Loss of smell and taste are also often observed

Patients and their relatives are usually not aware of such non-motor symptoms and do not relate it to PD. This induces a low PD detection rate and a major delay in the clinical care of patients inducing a lower quality of life and a major impact on the motor disorders of PD patients.

PD symptoms expression can vary significantly between patients and increase as the disease progress, giving rise to a very large panel of PD disease phenotypes which are still difficult to report. This large PD variability requires a personalized care for each patient by specialists able to detect the symptoms and adjust accordingly the treatments.


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