A Review of Parkinson’s Disease: From Epidemiology to Treatment
Keywords:
Parkinson’s disease, neurodegeneration, genetic factors, treatment, epidemiologyAbstract
Parkinson’s disease (PD) is a fast-growing neurodegenerative disorder. It affects people at the ages of 55 to 65 years. PD causes substantial disability and so the patients would have a poor quality of life. There are many factors that could induce this disease such as genetic, environmental and lifestyle factors. While this disease is incurable, many scientific researchers are trying to find a cure in addition to managing the motor and non-motor symptoms. Levodopa is the key treatment for PD; though, its motor complications and induction of dyskinesia limited its long-term use. In patients with advanced stage PD, it is favorable to initiate combination therapy with dopamine agonists, catechol O methyltransferase inhibitors (COMT), or monoamine oxidase-B inhibitors (MAOs). Surgical procedures are the last option to treat patients with a late stage of the disease. In addition, managing a healthy lifestyle, balanced food and physical excesses are very crucial to improve patients’ life. This review discusses epidemiology of PD, risk factors, diagnosis and treatment that can deliver ideas about patient-specific care, so diminish drugs side effects and open new paths to develop updated strategies to control the progress of this disease
References
AHN, S., CHEN, Y., BREDOW, T., CHEUNG, C. & YU, F. 2017. Effects of non-pharmacological treatments
on quality of life in Parkinson's Disease: a review. Journal of Parkinson's disease and Alzheimer's disease, 4.
DOI: 10.58675/2682-339X.2366.
AL AGHORY, I. M., IBRAHIM, A. R. & ZAKI, A. A. 2024. Different Targets in Ablative Surgery in
Management of Parkinsonian Disease. Al-Azhar International Medical Journal, 5, 22. DOI:
21608/aimj.2024.123456.
BLAUWENDRAAT, C., NALLS, M. A. & SINGLETON, A. B. 2020. The genetic architecture of Parkinson's
disease. The Lancet Neurology, 19, 170-178. DOI: 10.1016/S1474-4422(19)30287-X
BRECKENRIDGE, C. B., BERRY, C., CHANG, E. T., SIELKEN JR, R. L. & MANDEL, J. S. 2016.
Association between Parkinson’s disease and cigarette smoking, rural living, well-water consumption, farming
and pesticide use: systematic review and meta-analysis. PloS one, 11, e0151841. DOI:
1371/journal.pone.0151841
BU, J., LIU, J., LIU, K. & WANG, Z. 2019. Diagnostic utility of gut α-synuclein in Parkinson’s disease: a
systematic review and meta-analysis. Behavioural Brain Research, 364, 340-347. DOI:
1016/j.bbr.2019.02.035.
BUNEEVA, O., FEDCHENKO, V., KOPYLOV, A. & MEDVEDEV, A. 2020. Mitochondrial dysfunction in
Parkinson’s disease: focus on mitochondrial DNA. Biomedicines, 8, 591. DOI: 10.3390/biomedicines8120591
CONG, S., XIANG, C., ZHANG, S., ZHANG, T., WANG, H. & CONG, S. 2022. Prevalence and clinical
aspects of depression in Parkinson’s disease: a systematic review and meta‑analysis of 129 studies.
Neuroscience & Biobehavioral Reviews, 141, 104749. DOI: 10.1016/j.neubiorev.2022.104749
COOK, L., SCHULZE, J., NAITO, A. & ALCALAY, R. N. 2021. The role of genetic testing for Parkinson’s
disease. Current Neurology and Neuroscience Reports, 21, 1-11. DOI: 10.1007/s11910-021-01112-0.
DE PABLO-FERNÁNDEZ, E., LEES, A. J., HOLTON, J. L. & WARNER, T. T. 2019. Prognosis and
neuropathologic correlation of clinical subtypes of Parkinson disease. JAMA neurology, 76, 470-479. DOI:
1001/jamaneurol.2018.4377.
DEUSCHL, G., BEGHI, E., FAZEKAS, F., VARGA, T., CHRISTOFORIDI, K. A., SIPIDO, E., BASSETTI,
C. L., VOS, T. & FEIGIN, V. L. 2020. The burden of neurological diseases in Europe: an analysis for the Global
Burden of Disease Study 2017. The Lancet Public Health, 5, e551-e567. DOI: 10.1016/S2468-2667(20)30190-
DONZUSO, G., CICERO, C. E., VINCIGUERRA, E., SERGI, R., LUCA, A., MOSTILE, G.,
TERRAVECCHIA, C., ZAPPIA, M. & NICOLETTI, A. 2023. Gender differences in non-motor fluctuations
in Parkinson’s disease. Journal of Neural Transmission, 130, 1249-1257. DOI: 10.1007/s00702-023-02612-3.
DORSEY, E., SHERER, T., OKUN, M. S. & BLOEM, B. R. 2018. The emerging evidence of the Parkinson
pandemic. Journal of Parkinson's disease, 8, S3-S8. DOI: 10.3233/JPD-181474.
ESPAY, A. J., MORGANTE, F., MEROLA, A., FASANO, A., MARSILI, L., FOX, S. H., BEZARD, E.,
PICCONI, B., CALABRESI, P. & LANG, A. E. 2018. Levodopa‐induced dyskinesia in Parkinson disease:
current and evolving concepts. Annals of Neurology, 84, 797-811. DOI: 10.1002/ana.25364.
FEIGIN, V. L., NICHOLS, E., ALAM, T., BANNICK, M. S., BEGHI, E., BLAKE, N., CULPEPPER, W. J.,
DORSEY, E. R., ELBAZ, A. & ELLENBOGEN, R. G. 2019. Global, regional, and national burden of
neurological disorders, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The
Lancet Neurology, 18, 459-480. DOI: 10.1016/S1474-4422(18)30499-X.
FITZGERALD, E., MURPHY, S. & MARTINSON, H. A. 2019. Alpha-synuclein pathology and the role of the
microbiota in Parkinson’s disease. Frontiers in neuroscience, 13, 369. DOI: 10.3389/fnins.2019.00369.
FOLTYNIE, T., BRUNO, V., FOX, S., KÜHN, A. A., LINDOP, F. & LEES, A. J. 2024. Medical, surgical, and
physical treatments for Parkinson's disease. The Lancet, 403, 305-324. DOI: 10.1016/S0140-6736(23)01429-0.
GONZALES, M. M., GARBARINO, V. R., POLLET, E., PALAVICINI, J. P., KELLOGG, D. L., KRAIG, E.
& ORR, M. E. 2022. Biological aging processes underlying cognitive decline and neurodegenerative disease.
The Journal of clinical investigation, 132. DOI: 10.1172/JCI158453.
GONZALEZ-LATAPI, P., BAYRAM, E., LITVAN, I. & MARRAS, C. 2021. Cognitive impairment in
Parkinson’s disease: epidemiology, clinical profile, protective and risk factors. Behavioral Sciences, 11, 74.
DOI: 10.3390/bs11050074.
GORELL, J. M. & RYBICKI, B. A. 2003. Environmental risk factors for Parkinson’s disease. Handbook of
Parkinson's disease. CRC Press. DOI: 10.1201/9780203912473.ch5.
HÄHNEL, T., RASCHKA, T., SAPIENZA, S., KLUCKEN, J., GLAAB, E., CORVOL, J.-C.,
FALKENBURGER, B. H. & FRÖHLICH, H. 2024. Progression subtypes in Parkinson’s disease identified by
a data-driven multi cohort analysis. npj Parkinson's Disease, 10, 95. DOI: 10.1038/s41531-024-00495-0.
HASNA, V. L., KASASIAH, A., MANALU, R. T. & MALAU, J. 2024. The Relationship Between COMT and
MAO-B Gene Polymorphisms with Levodopa in Parkinson’s Disease Patients; A Review. JURNAL
PEMBELAJARAN DAN BIOLOGI NUKLEUS (JPBN), 10, 1-10. DOI: 10.36987/jpbn.v10i1.3456.
HUANG, C.-H., LIN, C.-W., LEE, Y.-C., HUANG, C.-Y., HUANG, R.-Y., TAI, Y.-C., WANG, K.-W.,
YANG, S.-N., SUN, Y.-T. & WANG, H.-K. 2018. Is traumatic brain injury a risk factor for neurodegeneration?
A meta-analysis of population-based studies. BMC neurology, 18, 1-8. DOI: 10.1186/s12883-018-1197-4.
ISAACSON, S. H., HAUSER, R. A., PAHWA, R., GRAY, D. & DUVVURI, S. 2023. Dopamine agonists in
Parkinson’s disease: Impact of D1-like or D2-like dopamine receptor subtype selectivity and avenues for future
treatment. Clinical parkinsonism & related disorders, 100212. DOI: 10.1016/j.prdoa.2023.100212.
JANKOVIC, J. 2008. Parkinson’s disease: clinical features and diagnosis. Journal of neurology, neurosurgery
& psychiatry, 79, 368-376. DOI: 10.1136/jnnp.2007.131045.
JANKOVIC, J. & TAN, E. K. 2020. Parkinson’s disease: etiopathogenesis and treatment. Journal of Neurology,
Neurosurgery & Psychiatry, 91, 795-808. DOI: 10.1136/jnnp-2019-322338.
KIM, H. J., MASON, S., FOLTYNIE, T., WINDER‐RHODES, S., BARKER, R. A. & WILLIAMS‐GRAY,
C. H. 2020. Motor complications in Parkinson's disease: 13‐year follow‐up of the CamPaIGN cohort. Movement
Disorders, 35, 185-190. DOI: 10.1002/mds.27868.
KIM, S., CHEN, J., CHENG, T., GINDULYTE, A., HE, J., HE, S., LI, Q., SHOEMAKER, B. A., THIESSEN,
P. A. & YU, B. 2023. PubChem 2023 update. Nucleic acids research, 51, D1373-D1380. DOI:
1093/nar/gkac956.
KLEIN, C. & WESTENBERGER, A. 2012. Genetics of Parkinson’s disease. Cold Spring Harbor perspectives
in medicine, 2, a008888. DOI: 10.1101/cshperspect.a008888.
KOBYLECKI, C. J., NORDESTGAARD, B. G. & AFZAL, S. 2018. Plasma urate and risk of Parkinson's
disease: a Mendelian randomization study. Annals of Neurology, 84, 178-190. DOI: 10.1002/ana.25277.
KOULI, A., TORSNEY, K. M. & KUAN, W.-L. 2018. Parkinson’s disease: etiology, neuropathology, and
pathogenesis. Exon Publications, 3-26. DOI: 10.15586/codonpublications.parkinsonsdisease.2018.ch1.
LATIF, S., JAHANGEER, M., RAZIA, D. M., ASHIQ, M., GHAFFAR, A., AKRAM, M., EL ALLAM, A.,
BOUYAHYA, A., GARIPOVA, L. & SHARIATI, M. A. 2021. Dopamine in Parkinson's disease. Clinica
chimica acta, 522, 114-126. doi.org/10.1016/j.cca.2021.08.009.
LEE, T. K. & YANKEE, E. L. 2021. A review on Parkinson’s disease treatment. Neuroimmunol.
Neuroinflamm, 8, 222-244. DOI: 10.20517/2347-8659.2020.58.
LIVINGSTON, C. & MONROE-DUPREY, L. 2024. A review of levodopa formulations for the treatment of
Parkinson’s disease available in the United States. Journal of Pharmacy Practice, 37, 485-494. DOI:
1177/08971900221151194.
LOTANKAR, S., PRABHAVALKAR, K. S. & BHATT, L. K. 2017. Biomarkers for Parkinson’s disease:
recent advancement. Neuroscience bulletin, 33, 585-597. DOI: 10.1007/s12264-017-0183-5.
LUO, D., REITH, M. & DUTTA, A. K. 2020. Dopamine agonists in treatment of Parkinson's disease: an
overview. Diagnosis and Management in Parkinson's Disease, 445-460. DOI: 10.1007/978-3-030-43396-2_20.
MAAS, B. R., GÖTTGENS, I., TIJSSE KLASEN, H. P., KAPELLE, W. M., RADDER, D. L., BLOEM, B. R.,
POST, B., DE VRIES, N. M. & DARWEESH, S. K. 2024. Age and gender differences in non-motor symptoms
in people with Parkinson’s disease. Frontiers in Neurology, 15, 1339716. DOI: 10.3389/fneur.2024.1339716.
MACCHI, Z. A., KOLJACK, C. E., MIYASAKI, J. M., KATZ, M., GALIFIANAKIS, N., PRIZER, L. P.,
SILLAU, S. H. & KLUGER, B. M. 2020. Patient and caregiver characteristics associated with caregiver burden
in Parkinson’s disease: a palliative care approach. Annals of palliative medicine, 9, S24-S33-S2S33. DOI:
21037/apm.2020.03.34.
MAHATO, A. K. & SAARMA, M. 2024. Neurotrophic factors in Parkinson’s disease: clinical trials.
Regenerative Medicine and Brain Repair, 109-137. DOI: 10.1007/978-3-030-89711-5_6.
MESTRE, T. A., EBERLY, S., TANNER, C., GRIMES, D., LANG, A. E., OAKES, D. & MARRAS, C. 2018.
Reproducibility of data-driven Parkinson's disease subtypes for clinical research. Parkinsonism & related
disorders, 56, 102-106. DOI: 10.1016/j.parkreldis.2018.06.027.
MILLER, D. B. & O’CALLAGHAN, J. P. 2015. Biomarkers of Parkinson’s disease: present and future.
Metabolism, 64, S40-S46. DOI: 10.1007/s40265-014-0339-0.
MOHAMMAD, M. E., VIZCARRA, J. A., GARCIA, X., PATEL, S., MARGOLIUS, A., YU, X. X. &
FERNANDEZ, H. H. 2021. Impact of behavioral side effects on the management of Parkinson patients treated
with dopamine agonists. Clinical Parkinsonism & Related Disorders, 4, 100091. DOI:
1016/j.prdoa.2021.100091
MORTEZAZADEH, T., SEYEDARABI, H., MAHMOUDIAN, B. & ISLAMIAN, J. P. 2021. Imaging
modalities in differential diagnosis of Parkinson’s disease: opportunities and challenges. Egyptian journal of
radiology and nuclear medicine, 52, 1-12. DOI: 10.1186/s43055-021-00454-9
MÜLLER, T. 2015. Catechol-O-methyltransferase inhibitors in Parkinson’s disease. Drugs, 75, 157-174. DOI:
1007/s40265-014-0343-0.
MÜLLER, T. 2020. Pharmacokinetics and pharmacodynamics of levodopa/carbidopa cotherapies for
Parkinson’s disease. Expert opinion on drug metabolism & toxicology, 16, 403-414. DOI:
1080/17425255.2020.1750596.
MUNHOZ, R. P., TUMAS, V., PEDROSO, J. L. & SILVEIRA-MORIYAMA, L. 2024. The clinical diagnosis
of Parkinson's disease. Arquivos de Neuro-psiquiatria, 82, s00431777775.
NG, A. S. & TAN, E. K. 2017. Linking statins and lipids in Parkinson's disease. Movement disorders: official
journal of the Movement Disorder Society, 32, 807-809. DOI: 10.1002/mds.27001.
OBESO, J., STAMELOU, M., GOETZ, C., POEWE, W., LANG, A., WEINTRAUB, D., BURN, D.,
HALLIDAY, G. M., BEZARD, E. & PRZEDBORSKI, S. 2017. Past, present, and future of Parkinson's disease:
A special essay on the 200th Anniversary of the Shaking Palsy. Movement disorders, 32, 1264-1310. DOI:
1002/mds.27115.
OLANOW, C. W., AGID, Y., MIZUNO, Y., ALBANESE, A., BONUCELLI, U., DAMIER, P., DE
YEBENES, J., GERSHANIK, O., GUTTMAN, M. & GRANDAS, F. 2004. Levodopa in the treatment of
Parkinson's disease: current controversies. Movement disorders, 19, 997-1005. DOI: 10.1002/mds.20238.
ÖZDEMIR, Z., ALAGÖZ, M. A., BAHÇECIOĞLU, Ö. F. & GÖK, S. 2021. Monoamine oxidase-B (MAO-B)
inhibitors in the treatment of Alzheimer’s and Parkinson’s disease. Current medicinal chemistry, 28, 6045-6065.
DOI: 10.2174/0929867328666210203204710.
POHL, C. & DIKIC, I. 2019. Cellular quality control by the ubiquitin-proteasome system and autophagy.
Science, 366, 818-822. DOI: 10.1126/science.aax3769.
POLITIS, M. 2014. Neuroimaging in Parkinson disease: from research setting to clinical practice. Nature
Reviews Neurology, 10, 708-722. DOI: 10.1038/nrneurol.2014.205.
REGENSBURGER, M., IP, C. W., KOHL, Z., SCHRADER, C., URBAN, P. P., KASSUBEK, J. & JOST, W.
H. 2023. Clinical benefit of MAO-B and COMT inhibition in Parkinson’s disease: practical considerations.
Journal of Neural Transmission, 130, 847-861. DOI: 10.1007/s00702-023-02620-1.
RITZ, B., LEE, P.-C., LASSEN, C. F. & ARAH, O. A. 2014. Parkinson disease and smoking revisited: ease of
quitting is an early sign of the disease. Neurology, 83, 1396-1402. DOI: 10.1212/WNL.0000000000000850.
RIZEK, P., KUMAR, N. & JOG, M. S. 2016. An update on the diagnosis and treatment of Parkinson disease.
Cmaj, 188, 1157-1165. DOI: 10.1503/cmaj.151179 .
ROTONDO, R., PROIETTI, S., PERLUIGI, M., PADUA, E., STOCCHI, F., FINI, M., STOCCHI, V., VOLPE,
D. & DE PANDIS, M. F. 2023. Physical activity and neurotrophic factors as potential drivers of neuroplasticity
in Parkinson’s Disease: A systematic review and meta-analysis. Ageing Research Reviews, 102089. DOI:
1016/j.arr.2023.102089.
RUAN, X., LIN, F., WU, D., CHEN, L., WENG, H., YU, J., WANG, Y., CHEN, Y., CHEN, X. & YE, Q. 2021.
Comparative efficacy and safety of dopamine agonists in advanced Parkinson's disease with motor fluctuations:
a systematic review and network meta-analysis of double-blind randomized controlled trials. Frontiers in
Neuroscience, 15, 728083. DOI: 10.3389/fnins.2021.728083.
RUSSILLO, M., ANDREOZZI, V., ERRO, R., PICILLO, M., AMBONI, M., CUOCO, S., BARONE, P. &
PELLECCHIA, M. 2022. Sex Differences in Parkinson’s Disease: From Bench to Bedside. Brain Sci. 2022, 12,
s Note: MDPI stays neutral with regard to jurisdictional claims in published. DOI:
3390/brainsci12070917.
SALAMON, A., ZÁDORI, D., SZPISJAK, L., KLIVÉNYI, P. & VÉCSEI, L. 2022. What is the impact of
catechol-O-methyltransferase (COMT) on Parkinson’s disease treatment? Expert Opinion on Pharmacotherapy,
, 1123-1128. DOI: 10.1080/14656566.2022.2071780.
SAVICA, R., TURCANO, P., BOWER, J. H., AHLSKOG, J. E. & MIELKE, M. M. Survival and progression
in synucleinopathy phenotypes with parkinsonism: a population-based study. Mayo Clinic Proceedings, 2019.
Elsevier, 1825-1831. DOI: 10.1016/j.mayocp.2019.05.034.
SONG, Z., ZHANG, J., XUE, T., YANG, Y., WU, D., CHEN, Z., YOU, W. & WANG, Z. 2021. Different
catechol-o-methyl transferase inhibitors in Parkinson's disease: a bayesian network meta-analysis. Frontiers in
Neurology, 12, 707723. DOI: 10.3389/fneur.2021.707723.
TALEBI, A. H., DARWEESH, S. K., BLOEM, B. R., BUCUR, I. G. & HESKES, T. 2024. Effect of Early
Levodopa Treatment on Mortality in People with Parkinson's Disease. Movement Disorders Clinical Practice.
DOI: 10.1002/mdc3.13580.
TAN, Y.-Y., JENNER, P. & CHEN, S.-D. 2022. Monoamine oxidase-B inhibitors for the treatment of
Parkinson’s disease: past, present, and future. Journal of Parkinson's Disease, 12, 477-493. DOI: 10.3233/JPD-
TIAN, Y.-Y., TANG, C.-J., WU, J. & ZHOU, J.-S. 2011. Parkinson’s disease in China. Neurological Sciences,
, 23-30. DOI: 10.1007/s10072-010-0379-4.
TITOVA, N. & CHAUDHURI, K. R. 2017. Personalized medicine in Parkinson's disease: time to be precise.
Movement Disorders, 32, 1147. DOI: 10.1002/mds.27027.
TUITE, P. 2017. Brain magnetic resonance imaging (MRI) as a potential biomarker for Parkinson’s disease
(PD). Brain sciences, 7, 68. DOI: 10.3390/brainsci7060068.
VAIDYA, B., DHAMIJA, K., GURU, P. & SHARMA, S. S. 2021. Parkinson's disease in women: mechanisms
underlying sex differences. European journal of pharmacology, 895, 173862. DOI:
1016/j.ejphar.2021.173862.
VÁZQUEZ-VÉLEZ, G. E. & ZOGHBI, H. Y. 2021. Parkinson's disease genetics and pathophysiology. Annual
review of neuroscience, 44, 87-108. DOI: 10.1016/j.ejphar.2021.173862.
WEN, M., ZHOU, B., CHEN, Y.-H., MA, Z.-L., GOU, Y., ZHANG, C.-L., YU, W.-F. & JIAO, L. 2017. Serum
uric acid levels in patients with Parkinson’s disease: A meta-analysis. PloS one, 12, e0173731. DOI:
1371/journal.pone.0173731.
YAN, D., ZHANG, Y., LIU, L., SHI, N. & YAN, H. 2018. Pesticide exposure and risk of Parkinson's disease:
dose-response meta-analysis of observational studies. Regulatory Toxicology and Pharmacology, 96, 57-63.
DOI: 10.1016/j.yrtph.2018.05.005.
YAO, N.-T., ZHENG, Q., XU, Z.-Q., YIN, J.-H., LU, L.-G., ZUO, Q., YANG, S., ZHANG, C.-L. & JIAO, L.
Positron emission computed tomography/single photon emission computed tomography in Parkinson
disease. Chinese Medical Journal, 133, 1448-1455. DOI: 10.1097/CM9.0000000000000836.
