Parkinson’s disease (PD) is a chronic and progressive movement disorder that affects dopamine-producing cells in the brain.

Quick Facts

• About 70% of people with PD experience tremor.

• PD symptoms often vary throughout the day, worsening with anxiety, fatigue or as medication wears off in between doses.

• Regular exercise can help manage PD symptoms and improve quality of life.
• Carbidopa/levodopa (brand name Sinemet) is still the “gold standard” in PD medications.
• It is common for people with PD to need adjustments to treatment as symptoms progress.

Parkinson’s disease is a progressive neurodegenerative disorder that causes a gradual loss of brain cells that produce dopamine, a chemical necessary for movement. As dopamine decreases over time, movement becomes more difficult for people with PD. Dopamine also affects mood and motivation. In addition to dopamine, Parkinson’s changes several other brain chemicals.

How common is Parkinson’s?

Nearly one million people in the U.S. and 10 million people worldwide are living with PD. About 90,000 Americans are diagnosed with Parkinson’s each year. It is the second most common neurodegenerative condition after Alzheimer’s. The number of people with PD will increase substantially in the next 20 years due to our aging population.

What are the symptoms of Parkinson’s?

The most visible and well-known signs of PD are movement (or motor) symptoms such as tremor, slow movement, stiffness and balance issues. However, most people also develop non-movement (or non-motor) symptoms that impact mood and quality of life. These can include anxiety, sleep issues and thinking changes.

Initial symptoms can be mild and sometimes mistaken for signs of aging. To learn about early signs of Parkinson’s, visit Parkinson.org/EarlySigns.

How does Parkinson’s progress?

Parkinson’s is a complex disease that affects everyone differently. For most people with PD, symptoms develop gradually over many years and worsen over time.

Who does Parkinson’s affect?

Parkinson’s is typically diagnosed after 60, but people under 50 can also have PD. This is known as young-onset Parkinson’s disease (YOPD). About 4% of people with Parkinson’s have YOPD. Men are 1.5 times more likely to have Parkinson’s than women, and certain geographic areas and ethnic groups experience higher rates of PD.

What causes Parkinson’s?

Researchers believe that Parkinson’s is caused by a combination of genetic, environmental and other factors. About 10 to 15% of people with PD have a genetic link.

How is Parkinson’s diagnosed?

There is no single test for Parkinson’s. A doctor makes a diagnosis based on a person’s symptoms, medical history and a physical examination. Sometimes conditions that look like PD can be ruled out by additional lab tests and imaging. To consider a diagnosis of Parkinson’s disease, a person must have bradykinesia (slow movement) in addition to one or more of the following:

• Shaking or tremor in a limb that occurs while it is at rest
• Stiffness or rigidity of the arms, legs, or trunk
• Trouble with balance and falls

A PD diagnosis can take time. When symptoms first appear, many people choose to speak to their family doctor, who may provide a referral to a neurologist if Parkinson’s is suspected. Some neurologists, called movement disorder specialists, have additional training in diagnosing and treating PD and other movement disorders.

How is Parkinson’s treated?

Though Parkinson’s varies from person to person, most people with PD need to take medications that boost, mimic or replace dopamine to manage their symptoms. Studies show that regular exercise also can benefit movement and non-movement symptoms and can improve overall quality of life. For some people, surgical intervention may be an option.

People with PD can experience a wide range of complex symptoms, so building a team of healthcare professionals is key. This team may include physical, occupational and speech therapists as well as other specialists, including mental health professionals, a urologist or gastrointestinal doctor. To learn more about medications and other treatments for Parkinson’s, visit Parkinson.org/Treatment.

In this podcast episode, we ‘Meet the Researcher’, featuring a prominent investigator who has received support from the Parkinson's Foundation. We illustrate how a research career develops, what motivates people to study what they do, and to give some insight into what support from the Parkinson’s Foundation can accomplish in understanding the disease better and finding solutions.

In this episode, Dr. William Dauer, Director of the Brain Institute at the University of Texas Southwestern Medical Center in Dallas, describes his career path and how he came to be interested in movement disorders and in dystonia in particular, a condition in which muscles contract involuntarily, causing repetitive or twisting movements. He has long been involved in basic science research as well as in clinical practice, and what he has found in each area he has been able to apply to the other.

Released: December 28, 2021

Unfortunately, many communities do not have access to the most up-to-date information and high-quality resources on Parkinson’s disease, even in the biggest cities. Every community has its own culture and flavor, and community outreach programs must recognize these differences to be successful. To design appropriate programs, it is also crucial to have a trusted contact and champion within the community. Aaron Daley of the University of California, San Francisco, describes his center’s outreach efforts and what is needed to bring Parkinson’s resources to underserved and underrepresented communities.

More and more people are exploring medical marijuana, also called cannabis, as a treatment option for various chronic health conditions, including Parkinson’s disease. Several states have legalized medical cannabis, but because federal drug laws have prevented scientific investigations on cannabis and its components for many years, much is still unknown about its use for medical purposes. Patients have questions about it, and physicians are still feeling their way through the landscape of medicinal cannabis use. Dr. Danny Bega of Northwestern University’s Parkinson’s Disease and Movement Disorders Center in Chicago, a Parkinson’s Foundation Center of Excellence, sheds light on some of the issues and concerns surrounding the use of medicinal cannabis.

Released: April 10, 2018

Until the ultimate goal of finding a cure for Parkinson’s disease (PD) is achieved, researchers are taking various approaches to developing a treatment that significantly slows its progression. Here, clinical science and basic science come together to understand the underlying biological mechanisms of PD and then using that knowledge to test medications that target those mechanisms. Having discovered such molecular and cellular malfunctions, scientists may tailor the development of medications to target the underlying causes of the disease.

Another approach has also relied on knowing the mechanisms of the disease but then searching through the vast array of current drugs to treat all sorts of conditions and rationally choosing ones that may work to slow progression of PD – so-called drug repurposing. Dr. Patrik Brundin, Director of the Parkinson’s Disease Center at Van Andel Institute in Grand Rapids, Michigan, explains that this is the approach that the International Linked Clinical Trials (iLCT) program for Parkinson’s has taken. Since its inception in 2010, the iLCT has become one of the most comprehensive drug repurposing programs focused on a single disease. Under this program, seven clinical trials have been completed, and 15 are ongoing, testing 16 potential candidate drugs to slow the progression of PD. The advantage is that the drugs under consideration have already been tested for safety and how they act in the body, speeding up the process of applying them to Parkinson’s.

Released: October 19, 2021

Gene-based therapies for Parkinson’s disease, while still in the developmental stage, are under active investigation. For this potential therapy, genes are engineered in a laboratory and then injected into specific parts of the brain. The genes may function either to induce cells in the brain to produce dopamine, or to code for the production of enzymes that then lead to the production of dopamine.

This episode is the second part of our conversation with Dr. Roger Barker, Professor of Clinical Neuroscience at the University of Cambridge in the United Kingdom. In our previous podcast with him, he discussed cell therapy for Parkinson’s. Here, he explains what gene-based therapy is, plans for the execution of the treatments, what symptoms they are aimed at, where the field currently stands, and how it compares to developments in cell-based therapies. As the field is still in the experimental stages, he again offers advice to people with Parkinson’s who are considering entering a clinical trial of gene-based or cell-based therapy and what they may expect in terms of symptom management and disease progression.

Released: October 5, 2021

Movement issues are central to Parkinson’s disease (PD), even in the early stages before complications may become obvious. From the time of diagnosis and throughout the course of the disease, movement and staying physically active are essential. Both regular exercise and physical therapy can help people with PD keep moving well and for as long as possible. The Parkinson’s Outcomes Project, the largest clinical study of PD, conducted across the Parkinson’s Foundation’s Centers of Excellence network, showed that physical activity of at least 2.5 hours a week can slow decline in quality of life. Plus, some studies suggest that physical therapy, including gait, balance, resistance training, and regular exercise of sufficient duration may slow the progression of the disease.

Physical therapists with a neurological specialization are an important part of the PD health care team and should be consulted early, both for an initial evaluation as well as to address any movement problems and encourage exercise as a part of treatment to minimize problems later. Heather Cianci is Outpatient Neurological Team leader at the Dan Aaron Parkinson’s Rehabilitation Center, part of the University of Pennsylvania Health System in Philadelphia, a Parkinson’s Foundation Center of Excellence. She says an early consultation can take advantage of a particularly valuable window of opportunity to address movement issues, and improving movement and physical impairments can improve one’s mental state as well.

Released: September 22, 2020

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Clinical studies, studies that involve people, first use healthy people to test a drug’s safety and then use people with a disease or condition to prove that the drug works as intended. They are essential for bringing any new therapy to the public. Getting U.S. Food and Drug Administration approval for devices require rigorous studies, as well. Recruiting enough people to participate is often a long process, and for trials that may go on for a year or more, retaining people in the studies is often a challenge. People may get bored, find multiple study visits burdensome, have an adverse reaction to a drug being tested, move away, or drop out for a multitude of other reasons. If too many people discontinue the study, it will not have enough statistical ”power” to give a meaningful answer when the data are analyzed.

Christine Hunter, BSN, RN, Research Director of the Parkinson’s Disease Center and Movement Disorders Clinic at Baylor College of Medicine in Houston, a Parkinson’s Foundation Center of Excellence, describes how her center finds people with Parkinson’s disease who may want to participate in trials, what factors drive retention in trials, and ways to facilitate retention.

Released: September 8, 2020

When people take a prescribed drug, they rarely if ever consider how it came to be. They assume it is the right drug and will work safely as it is supposed to. But leading up to that drug being available is a long process of discovery or invention of the molecule based on knowledge of the biology it is supposed to affect, then testing in the laboratory and in animals, and several phases of testing in people to make sure that it is safe and effective. Each of these steps takes time and lots of financial investment. Even after a drug is approved by the U.S. Food and Drug Administration for sale and then put on the market, further study of the drug in a larger population than in the testing phases may be carried out. In this episode, Dr. Hubert Fernandez, Director of the Center for Neurological Restoration at the Cleveland Clinic in Ohio, a Parkinson’s Foundation Center of Excellence, describes the process of bringing a drug to market, including how many of them never make it. And he explains why people need to participate in the clinical trials and what they can expect when they do.

Released: August 25, 2020

Personalized medicine has garnered a lot of attention over the past decade. Usually it means determining the factors for each person that affect their health, their diseases, and potentially their treatments. Some examples are biomarkers that are found in their blood, their genetic make-up, diet and nutrition, behaviors, and environment. One example is the Parkinson’s Foundation’s PD GENEration initiative that offers free genetic testing and counseling for people with Parkinson’s disease (PD) to determine what genes and gene variants affect the course of their disease and response to treatments.

But despite all the scientific advances that allow these forms of personalized medicine, one crucial aspect of personalized medicine is the voice of the patient, both in each person’s encounters with the medical system and treatment team, as well as to inform the kinds of research that should be done and how to design and perform them. Dr. Bas Bloem, a professor of movement disorder neurology at Radboud University Medical Center in Nijmegen, the Netherlands, a Parkinson’s Foundation Center of Excellence, discusses how people with PD want to be heard and how a new definition of health may best put people’s disease into the overall context of their lives.

Released: July 28, 2020