Update on Parkinson Disease

Update on Parkinson Disease

Andrew Siderowf, MD; and
Matthew Stern, MD

From University of Pennsylvania, Philadelphia, Pennsylvania.

Abstract

This Update reviews developments in the pathophysiology and treatment of Parkinson disease during the past several years. In the area of pathophysiology, studies have addressed the contribution of environmental factors such as caffeine and pesticides. Large-scale epidemiologic studies have also expanded the role genetic factors are thought to play. Detailed studies of kindreds with familial Parkinson disease due to α-synuclein and parkin have catalyzed basic science investigations into the pathologic mechanisms of the disease. These studies have led to the development of a pathophysiologic model of Parkinson disease that emphasizes abnormal protein aggregation. Studies of treatment have clarified the relative roles of l-dopa and dopamine agonists in early Parkinson disease and shown the potential for surgical interventions, particularly deep-brain stimulation, to relieve the symptoms of advanced, medically refractory disease.

Article and Author Information

Grant Support: Dr. Siderowf is supported by a career development award from the Agency for Healthcare Research and Quality (AHRQ K-08 HS00004).
Potential Financial Conflicts of Interest: Consultancies: M. Stern (Pharmacia Corp., GlaxoSmithKline); Honoraria: A. Siderowf (Pharmacia Corp.); Grant support: A. Siderowf (Medtronics, Inc., Pharmacia Corp.).
Requests for Single Reprints: Andrew Siderowf, MD, Parkinson's Disease and Movement Disorders Center, University of Pennsylvania, 330 South 9th Street, Philadelphia, PA 19107; e-mail, adsiderowf{at}pahosp.com.
Current Author Addresses: Drs. Siderowf and Stern: Parkinson's Disease and Movement Disorders Center, University of Pennsylvania, 330 South 9th Street, Philadelphia, PA 19107.