Parkinson's
What is Parkinson's Disease?
Parkinson’s Disease (PD) is a progressive neurological disorder that primarily affects movement, though it also impacts many other bodily functions. It occurs when nerve cells in a specific part of the brain—the substantia nigra—become impaired or die. These cells are responsible for producing dopamine, the chemical messenger that allows for smooth, coordinated muscle movement.
The diagnosis and management of Parkinson's Disease (PD) have evolved significantly in 2024 and 2025, moving toward a "biomarker-supported" clinical approach and more continuous drug delivery systems to reduce the "on-off" fluctuations of traditional therapy.
As of 2025, Parkinson's is the fastest-growing neurological condition in the world, with over 10 million people living with the disease globally.
Diagnosis
PD remains primarily a clinical diagnosis, meaning it is based on a doctor’s observation of symptoms rather than a single blood test. However, new tools are now used to confirm the diagnosis more accurately.
Clinical Criteria
To meet the threshold for a PD diagnosis, a patient must have Bradykinesia (slowness of movement and decreasing amplitude/speed) plus at least one of the following:
Resting Tremor: Often described as a "pill-rolling" motion in the hand.
Rigidity: Muscle stiffness (cogwheel or lead-pipe resistance)
Postural Instability: Balance issues (typically appears in later stages).
Emerging Diagnostic Tools (2024–2025)
Syn-One Test (Skin Biopsy): A recently popularized test that identifies abnormal alpha-synuclein (the protein hallmark of PD) in the small nerve fibers of the skin.
DaTscan (Dopamine Transporter Scan): A specialized SPECT imaging tool that visualizes the brain's dopamine system. It helps distinguish PD from "Essential Tremor."
Seed Amplification Assay (SAA): A breakthrough test using cerebrospinal fluid (CSF) to detect misfolded alpha-synuclein before motor symptoms even appear.
Non-Motor Symptoms
These often appear years before movement problems begin:
Loss of Smell (Anosmia): One of the earliest warning signs.
Sleep Issues: Acting out dreams (REM sleep behavior disorder) or chronic insomnia
Mood Changes: High rates of depression and anxiety.
Cognitive Changes: Trouble with multitasking or, in later stages, Parkinson’s dementia.
Digestive Issues: Particularly chronic constipation.
Causes and Risk Factors
The exact cause is unknown (referred to as "idiopathic"), but scientists believe it is a combination of several factors:
Age: The greatest risk factor. Most cases occur after age 60.
Genetics: While only about 10–15% of cases are purely hereditary, certain genes (like LRRK2 or GBA) increase susceptibility.
Environment: Recent 2025 research has highlighted strong links between pesticide exposure (specifically near golf courses or farms) and industrial solvents like trichloroethylene (TCE).
Head Trauma: History of concussions or repeated head injuries.
Stages:
Parkinson’s is unique to every individual but it generally follows these stages on the Hoehn and Yahr scale.
Current & Emerging Treatments
There is currently no cure, but treatments are highly effective at managing symptoms
Pharmacological Management
Treatment is individualized based on age, symptom severity, and how much the disease impacts daily life.
Surgical and Advanced Therapies
When oral medications no longer provide consistent relief, advanced options are considered:
Deep Brain Stimulation (DBS): Electrodes are implanted in the brain to regulate abnormal signals. New Adaptive DBS (aDBS) systems (2025) can now sense brain activity and adjust stimulation in real-time.
Focused Ultrasound (FUS): A non-invasive procedure using sound waves to create a small lesion in the brain to stop tremors. In 2025, bilateral (both sides) treatments became more widely available.
Non-Motor Symptom Management
Parkinson’s is more than a movement disorder. Management must also address:
Mood & Cognition: Depression, anxiety, and dementia are common. SSRIs and medications like Rivastigmine are often prescribed.
Autonomic Issues: Management of orthostatic hypotension (dizziness upon standing), constipation, and sleep disorders (REM Sleep Behavior Disorder).
Physical Therapy: Specialized programs like Rock Steady Boxing or LSVT BIG are critical for maintaining mobility and preventing falls.
Note on Protein: For patients on Levodopa, high-protein meals can sometimes interfere with drug absorption. It is often recommended to take medication 30–60 minutes before eating.
The Role of Exercise
In 2025, exercise is no longer seen as just "helpful" for Parkinson’s—it is considered a core part of the medical treatment. Research now confirms that intensive exercise can promote neuroplasticity, helping the brain bypass damaged areas and potentially increasing dopamine production.
Intense, consistent exercise is the only intervention currently shown to potentially slow the progression of the disease. High-intensity aerobic work, boxing (Rock Steady Boxing), and Tai Chi are frequently recommended by specialists.
The most effective routine typically involves 150 minutes per week of moderate-to-high intensity activity, broken down into these four key areas:
1. Aerobic & High-Intensity (The "Engine" Builders)
Stationary Cycling
HIIT (High-Intensity Interval Training)
Swimming
2. Skill & Coordination (Retraining the Brain)
Rock Steady Boxing
Dance (Tango & Ballroom)
LSVT BIG Therapy
3. Balance & Flexibility (The Fall-Preventers)
Tai Chi
Yoga
4. Strength Training
Resistance Bands/Weights
Expert Tip: Before starting, consult a Physical Therapist who is "LSVT BIG" certified or specializes in neurology. They can help you identify "Freezing of Gait" triggers and ensure your routine is safe for your specific stage of progression.