From the Guidelines
Parkinson's disease is a chronic, progressive neurodegenerative disorder resulting from dopamine depletion in the brain, characterized by symptoms such as tremor, muscular rigidity, bradykinesia, and postural instability. According to the espen guideline clinical nutrition in neurology 1, the main symptoms of Parkinson's disease include tremor, muscular rigidity, bradykinesia, and postural instability, and as the disease progresses, other symptoms emerge, such as dysphagia, dysarthria, impaired gastrointestinal motility, and gastroparesis, fatigue, depression, and cognitive impairment.
Key Characteristics of Parkinson's Disease
- Chronic and progressive neurodegenerative disorder
- Results from dopamine depletion in the brain
- Main symptoms: tremor, muscular rigidity, bradykinesia, and postural instability
- Other symptoms that may emerge as the disease progresses: dysphagia, dysarthria, impaired gastrointestinal motility, and gastroparesis, fatigue, depression, and cognitive impairment
Management and Treatment
Drug therapy is essential to control symptoms and maintain mobility in Parkinson's disease, and it acts by replacing or mimicking dopamine in the brain 1. Patients with Parkinson's disease are at increased risk of malnutrition and weight loss, and nutritional status should be monitored routinely throughout the natural history of the disease 1.
Nutritional Considerations
- Patients with Parkinson's disease are at increased risk of malnutrition and weight loss
- Nutritional status should be monitored routinely throughout the natural history of the disease
- Predictors of malnutrition include older age at diagnosis, higher levodopa equivalent daily dose/body weight, anxiety, and depression, and living alone 1
From the Research
Definition of Parkinson's Disease
- Parkinson's disease (PD) is a disorder characterized pathologically by progressive neurodegeneration of the dopaminergic cells of the nigrostriatal pathway 2
- It is a dopamine deficiency disorder, with the main therapeutic strategies relying on dopamine precursors, inhibition of dopamine metabolism, and dopamine receptor agonists 3
- PD is the second most common neurodegenerative disorder, with its global incidence on the rise 4
Characteristics of Parkinson's Disease
- The resulting dopamine deficiency is the cause of the typical motor features of Parkinson's disease, including bradykinesia, rigidity, and tremor 2
- Additional non-motor symptoms appear at various timepoints and are the result of non-dopamine nerve degeneration 2
- Patients with PD usually experience motor complications, mainly the wearing-off phenomenon and dyskinesias, resulting in disabled activities of daily life 4
Treatment of Parkinson's Disease
- Current dopaminergic pharmacotherapy for PD consists of levodopa and other dopaminergic drugs, such as dopamine agonists and monoamine oxidase B inhibitors 4
- Pramipexole, a non-ergolinic dopamine agonist, is well established as a treatment option for motor symptoms at all stages of PD 5
- Rasagiline, a novel selective and irreversible MAO B propargylamine inhibitor, is approved for PD therapy and provides an additional tool for PD treatment 3