Parkinson’s Disease – Course, natural history, and prognosis

The clinical effects of Parkinson’s disease (PD) are often visually obvious, but the underlying pathology of PD is still not fully understood.^1,2 PD pathology is thought to spread from brain region to brain region over multiple long-distance relays during long periods of …

The progression of PD is generally slow, taking place over years (often many years).⁴ While diagnosis tends to occur with the onset of motor symptoms, this can be preceded by a long prodromal phase of 15 years or more.⁵ This prodromal phase is typically characterised by a…

Compared with people with sporadic Parkinson’s disease, people with LRRK2-associated Parkinson’s disease tend to experience few cognitive and psychiatric symptoms, with slower disease progression, whereas people with GBA-associated Parkinson’s disease tend to experience a…

During Stage 1 of PD, many individuals experience a loss of smell (hyposmia) and/or suffer from constipation.² In addition, sleep may become disordered or disturbed, accompanied by crying out, punching, or kicking during rapid eye movement (REM) sleep,^2,3 and people may e…

While there have been major advances in the management and reduction of PD-related symptoms, there is still no effective way of preventing or slowing the underlying neurodegeneration.^2,5 As the disease becomes more extensive during its advanced stages, the ability of drug…

Levodopa is the major symptomatic therapy for PD and is the most common first-line therapy because it provides benefit to virtually all patients.^1,3 In the short-term, the effects of levodopa tend to be long-lasting and side effects are tolerable.¹ In the longer-term, how…

The slide includes some basic definitions of terms used to describe the course of PD.

References used on slide:
1.Kalia LV, Lang AE. Parkinson’s disease. Lancet 2015; 386 (9996): 896–912.

2.Stacy M, Bowron A, Guttman M, et al. Identification of motor and nonmotor wearin…

Levodopa-induced dyskinesias cover a broad clinical spectrum of different types of involuntary movements, ranging from chorea affecting the limbs, trunk, and head, slow dystonic movements, fixed dystonic postures, or (more rarely) myoclonus or ballism.^1,2 Levodopa-induced…

As the extent of neurodegeneration in the substantia nigra becomes greater, its capacity to produce dopamine diminishes to the point where patients require larger doses of levodopa to maintain normal function.⁴ Motor complications, such dyskinesia and motor fluctuations, …