Parkinson's disease: an animated, cited guide

This page needs JavaScript for its animations. The outline and key answers are below, and every claim in the full version carries a numbered citation.

Not medical advice. Parkinson's Companion is an educational synthesis of published literature. It does not replace a clinician.

What is in it

What Parkinson's is Parkinsonism versus Parkinson's disease, who it affects, the numbers.
The dopamine pathway Substantia nigra to striatum, the go and brake loops, and what losing dopamine does.
Alpha-synuclein and Lewy bodies From a small synaptic protein to a Lewy body, and how it may spread.
How it spreads: Braak stages Six stages from the brainstem to the cortex, and the body-first debate.
Genes and inheritance LRRK2, GBA1, SNCA and parkin, founder populations, and what a test means.
Before the tremor Dream enactment, smell, constipation and the prodromal criteria.
Stages and symptoms Hoehn and Yahr, motor and non-motor symptoms, and how fast it moves.
Diagnosis and the MDS criteria The clinical criteria as a calculator, DaT scans and synuclein tests.
The differential Essential tremor, drug-induced parkinsonism, MSA, PSP and Lewy body dementia.
Levodopa and carbidopa From the pill to the striatum, step by step.
Levodopa over time Wearing-off, dyskinesia, the narrowing window and what smooths it.
The other medicines Agonists, MAO-B and COMT inhibitors, amantadine and the order of use.
Deep-brain stimulation Targets, the stimulation field, the beta rhythm and what the trials found.
Beyond movement Mood, hallucinations, dementia, sleep and blood pressure.
Risk and protection Pesticides, solvents, head injury, smoking, coffee and exercise.
Living with Parkinson's Exercise, therapy, falls, speech, work, caregiving and the end of life.
Nursing care Medicines on time, drugs to avoid, swallowing, assessment, documentation.
Toward a cure Synuclein antibodies, GLP-1 drugs, LRRK2 and GBA1, cells and genes.
History and people From James Parkinson's 1817 essay to the synuclein test.
Flashcards and mnemonics Flip cards by topic.
Quiz Questions with explanations.
Glossary Every term, searchable.
Sources Every reference behind the guide.

Part 5 · Context & review

History and people

From a London surgeon's 1817 essay to a laboratory test that amplifies misfolded alpha-synuclein. Scrub the timeline or press play: each era is drawn as a scene, with the milestone and its source in the panel beside it.

1817 → 2023

Scenes are illustrations, not historical images, and quantities in them are schematic unless a number is printed. Eras are spaced evenly, not to scale in years. A "Check the date" label marks a date that sources give differently.

People

World Parkinson's Day and the red tulip

11 April

A birthday and a flower

World Parkinson's Day is held on 11 April, James Parkinson's birthday. The red and white "Dr James Parkinson" tulip was bred in 1980 by J.W.S. Van der Wereld, a Dutch horticulturist who had Parkinson's. The red tulip was adopted as the symbol of Parkinson's at the 9th World Parkinson's Disease Day Conference in Luxembourg on 11 April 2005. ²⁷⁷

Sources differ Some secondary pages give 1981 for the tulip. ²⁷⁷

What the history leaves open

Contradicted

"The senses and intellects being uninjured"

Parkinson's own definition said the intellect is spared. Long cohorts disagree: in the Sydney study, 83% of people alive 20 years after diagnosis had dementia. ^142,275 He also placed the cause in the upper cervical spinal cord, extending to the medulla. ^129,275

Sources disagree

1919 or 1921?

A centenary history dates Tretiakoff's Paris thesis on the substantia nigra to 1919; an earlier history review gives 1921. ^129,149

Hedged

An Israeli medicine

According to the Technion, professors Moussa Youdim and John Finberg developed rasagiline there in the 1970s, and Teva then developed it as Azilect. ³⁵¹ The FDA approved Azilect on 16 May 2006. ¹⁰⁰ A European approval in 2005 is reported only in secondary sources and could not be checked (unverified).

Not read

Cotzias's doses

The 1967 report that launched high-dose oral levodopa has no abstract, and its text could not be accessed, so the doses it used are not given here. ^69,129