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  • 1. Parkinson's Disease What is Parkinson's Disease? Parkinson's disease (PD) belongs to a group of conditions called motor system disorders, which are the result of the loss of dopamine-producing brain cells. The four primary symptoms of PD are tremor, or trembling in hands, arms, legs, jaw, and face; rigidity, or stiffness of the limbs and trunk; bradykinesia, or slowness of movement; and postural instability, or impaired balance and coordination. As these symptoms become more pronounced, patients may have difficulty walking, talking, or completing other simple tasks. PD usually affects people over the age of 50. Early symptoms of PD are subtle and occur gradually. In some people the disease progresses more quickly than in others. As the disease progresses, the shaking, or tremor, which affects the majority of PD patients may begin to interfere with daily activities. Other symptoms may include depression and other emotional changes; difficulty in swallowing, chewing, and speaking; urinary problems or constipation; skin problems; and sleep disruptions. There are currently no blood or laboratory tests that have been proven to help in diagnosing sporadic PD. Therefore the diagnosis is based on medical history and a neurological examination. The disease can be difficult to diagnose accurately. Doctors may sometimes request brain scans or laboratory tests in order to rule out other diseases. Is there any treatment? At present, there is no cure for PD, but a variety of medications provide dramatic relief from the symptoms. Usually, patients are given levodopa combined with carbidopa. Carbidopa delays the conversion of levodopa into dopamine until it reaches the brain. Nerve cells can use levodopa to make dopamine and replenish the brain's dwindling supply. Although levodopa helps at least three-quarters of parkinsonian cases, not all symptoms respond equally to the drug. Bradykinesia and rigidity respond best, while tremor may be only marginally reduced. Problems with balance and other symptoms may not be alleviated at all. Anticholinergics may help control tremor and rigidity. Other drugs, such as bromocriptine, pramipexole, and ropinirole, mimic the role of dopamine in the brain, causing the neurons to react as they would to dopamine. An antiviral drug, amantadine, also appears to reduce symptoms. In May 2006, the FDA approved rasagiline to be used along with levodopa for patients with advanced PD or as a single-drug treatment for early PD. In some cases, surgery may be appropriate if the disease doesn't respond to drugs. A therapy called deep brain stimulation (DBS) has now been approved by the U.S. Food and Drug Administration. In DBS, electrodes are implanted into the brain and connected to a small electrical device called a pulse generator that can be externally programmed. DBS can reduce the need for levodopa and related drugs, which in turn decreases the involuntary movements called dyskinesias that are a common side effect of levodopa. It also helps to alleviate fluctuations of symptoms and to reduce tremors, slowness of movements, and gait problems. DBS requires careful programming of the stimulator device in order to work correctly. What is the prognosis? PD is both chronic, meaning it persists over a long period of time, and progressive, meaning its symptoms grow worse over time. Although some people become severely disabled, others experience only minor motor disruptions. Tremor is the major symptom for some patients,
  • 2. while for others tremor is only a minor complaint and other symptoms are more troublesome. No one can predict which symptoms will affect an individual patient, and the intensity of the symptoms also varies from person to person. What research is being done? The National Institute of Neurological Disorders and Stroke (NINDS) conducts PD research in laboratories at the National Institutes of Health (NIH) and also supports additional research through grants to major medical institutions across the country. Current research programs funded by the NINDS are using animal models to study how the disease progresses and to develop new drug therapies. Scientists looking for the cause of PD continue to search for possible environmental factors, such as toxins, that may trigger the disorder, and study genetic factors to determine how defective genes play a role. Other scientists are working to develop new protective drugs that can delay, prevent, or reverse the disease. More information about Parkinson's Disease research is available at Select this link to view a list of studies currently seeking patients. Organizations American Parkinson Disease Association National Parkinson Foundation 135 Parkinson Avenue 1501 N.W. 9th Avenue Staten Island, NY 10305-1425 Bob Hope Road Miami, FL 33136-1494 Tel: 718-981-8001 800-223-2732 Calif: 800-908-2732 Tel: 305-243-6666 800-327-4545 Fax: 718-981-4399 Fax: 305-243-5595 Parkinson Alliance Michael J. Fox Foundation for P.O. Box 308 Parkinson's Research Kingston, NJ 08528-0308 Grand Central Station P.O. Box 4777 New York, NY 10163 Tel: 609-688-0870 800-579-8440 Fax: 609-688-0875 Tel: 212-509-0995 Parkinson's Action Network (PAN) Parkinson's Disease Foundation (PDF) 1025 Vermont Ave., NW 1359 Broadway Suite 1120 Suite 1509 Washington, DC 20005 New York, NY 10018 Tel: 800-850-4726 202-638-4101 Tel: 212-923-4700 800-457-6676 Fax: 202-638-7257 Fax: 212-923-4778 Parkinson's Institute Parkinson's Resource Organization
  • 3. 1170 Morse Avenue 74-090 El Paseo Drive Sunnyvale, CA 94089-1605 Suite 102 Palm Desert, CA 92260-4135 Tel: 408-734-2800 800-786-2958 Fax: 408-734-8522 Tel: 760-773-5628 310-476-7030 877-775-4111 Fax: 760-773-9803 WE MOVE (Worldwide Education & Bachmann-Strauss Dystonia & Awareness for Movement Disorders) Parkinson Foundation 204 West 84th Street Mt. Sinai Medical Center One Gustave L. New York, NY 10024 Levy Place P.O. Box 1490 New York, NY 10029 Tel: 212-875-8312 Fax: 212-875-8389 Tel: 212-682-9900 Fax: 212-987-0662 Related NINDS Publications and Information • Parkinson's Disease: Hope Through Research Parkinson's disease patient information compiled by the National Institute of Neurological Disorders and Stroke (NINDS). • Parkinson's Disease: Challenges, Progress, and Promise Parkinson's disease (PD) research update published by the National Institute of Neurological Disorders and Stroke (NINDS), November 2004. • NINDS Deep Brain Stimulation for Parkinson's Disease Information Page Deep brain stimulation (DBS) information sheet compiled by the National Institute of Neurological Disorders and Stroke (NINDS). • NINDS Tremor Information Page Tremor information sheet compiled by the National Institute of Neurological Disorders and Stroke (NINDS). • Myoclonus Fact Sheet Myoclonus fact sheet compiled by the National Institute of Neurological Disorders and Stroke (NINDS). • Parkinson's Disease Research Agenda NINDS Parkinson's Disease Research Agenda, March 2000. • Parkinson's Disease Backgrounder A backgrounder on Parkinson's disease. • Gene for Rapid-Onset Dystonia Parkinsonism Found September 2004 news summary on identification of a gene for rapid-onset dystonia parkinsonism (RDP).
  • 4. • Vaccine Reduces Parkinson's Disease Neurodegeneration in Mice July 2004 news summary on a mouse study showing success with an experimental vaccine to halt Parkinson's disease neurodegeneration. • New Findings About Parkinson's Disease: Coffee and Hormones Don't Mix April 2003 news summary on a finding that caffeine consumption and hormone replacement therapy combined may increase the risk of Parkinson's disease. • Parkinsonian Symptoms Decrease in Rats Given Stem Cell Transplants January 2002 news summary on embryonic stem cells used in a mouse model for Parkinson's disease. • Researchers Find Genetic Links for Late-Onset Parkinson's Disease December 2001 news summary on recent findings in Parkinson's disease genetics. • Genetic Testing for Parkinson's Disease and Related Disorders Minutes Genetic Testing for Parkinson's Disease and Related Disorders Minutes • Summary - Diagnosis of Depression in Parkinson's Disease An NIH disease specific web site to facilitate research on Parkinson's Disease. NINDS, the National Institute of Neurological Disorders and Stroke, is the leading supporter of biomedical research on the brain and nervous system. • Imaging in Parkinson's Disease Parkinson's Disease Coordinating Committee Minutes • Summary - Deep Brain Stimulation Consortium Meeting Deep Brain Stimulation Consortium Meeting Summary • Parkinson's Disease Cell Biology Meeting Summary Parkinson's Disease Cell Biology Meeting Summary • Udall Centers Meeting—Expediting Parkinson’s Disease Research Opportunities Through Collaboration • Udall Centers Meeting-- Extensive Collaboration Speeds Parkinson's Research Udall Centers Meeting-- Extensive Collaboration Speeds Parkinson's Research • Parkinson's Disease Research Web: Udall Meeting Theme is Sharing Summary of Third Annual Udall Centers for Parkinson's Disease Research meeting. NINDS, the National Institute of Neurological Disorders and Stroke, is the leading supporter of biomedical research on the brain and nervous system. • 2002 Deep Brain Stimulation Consortium Meeting Consortium Meeting on Deep Brain Stimulation Held on June 3-4, 2002. • Parkinson's Disease Research Agenda Implementation Review Meeting Parkinson's Disease Research Agenda Implementation Review Meeting Cites Progress, Future Directions, and Common Themes • 2002 Parkinson's Disease Testimony NINDS opening statement to the Senate Committee on Appropriations, Subcommittee on Labor, Health and Human Services, Education, May 22, 2002. • September 1999 Parkinson's Disease Testimony NINDS Director's September 1999 Congressional testimony on NIH Parkinson's disease research.