Parkinson’s Disease

Parkinson’s Disease
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Introduction to Parkinson’s Disease
Parkinson’s Disease (PD) affects more than six million people globally and around 930,000 are from the United States. There are 60,000 newly diagnosed cases annually (The Augusta Chronicle, 2020). James Parkinson, the first physician who noted the signs and symptoms of the disease, published “An Essay on the Shaking Palsy.” Decades after his discovery, other physicians noted the same symptoms and contributed to the diagnosis of the disease, including Jean Marie Charcot and William Growers. It was not until the 1960s when the drug Levodopa was discovered, which is the mainstay of treatment. Treatments before these, such as vibratory therapy, belladonna alkaloids, and bloodletting from the neck vessels, had minimal, if not ineffective, at all (Mandal, 2019).
PD affects the central nervous system, resulting in the midbrain's neurodegeneration, particularly the substantia nigra, resulting in movement problems, particularly its hallmarks, including postural instability, resting tremors, slowness of movement, and rigidity (Montgomery, 2020; The Augusta Chronicle, 2020). It also has non-motor symptoms, particularly neurogenic hypotension, which is often misdiagnosed due to the delays in the reports from the patients, who only opt for consultation once the condition is worst. The people who suffer from this range from 40% to 60% worldwide, and it is secondary to autonomic system dysfunction, resulting in a decrease in blood pressure with the abrupt change from a horizontal to a vertical position (The Augusta Chronicle, 2020). Other symptoms include emotional lability or mood changes, the most common of which is depression, delusions or hallucinations, insomnia, changes in the circadian rhythm, poor gastrointestinal motility, fatigue, and dementia (Han, 2021; McGregor & Nelson, 2019).
Related Anatomy and Physiology
The basal ganglia (BG) receive input from various brain parts, particularly the cerebral cortex. This is divided into several parts, including globus pallidus internus and externus (GPi and GPe, respectively), striatum, substantia nigra pars reticulata, and pars compacta (SNr and SNc, respectively), and subthalamic nucleus (STN). The striatum receives the input from the other parts of the CNS while the SNr and GPi send the output to the thalamus (Magrinelli et al., 2016).
The Classical Model of Basal Ganglia is frequently used to explain decreased dopamine in the midbrain. It di...