Parkinson's Disease

Parkinson’s Disease is a degenerative disorder of the nervous system that results in difficulty in movement. It is the second most common neurodegenerative disorder after Alzheimer’s Disease.  The most obvious manifestations are tremor at rest, slouched posture, and slowed ambulation.  Other prominent features are constipation, drooling, loss of balance, decreased blink decreased sense of smell and cognitive impairment.  The Parkinson’s patient is two to six times more likely to suffer from dementia than the general population. Depression, apathy and anxiety are also more frequently seen in PD patients than in the general population.  

Parkinson’s disease is most common in people over the age of 50.  The motor symptoms are a result of a loss of dopamine-containing cells in part of the midbrain called the substantia nigra. While all brains begin to lose these cells gradually after the age of 20, the brains of patients afflicted with Parkinson’s disease have an accelerated loss of these cells.

The cause of Parkinson’s disease is unknown.  Studies have shown an increased risk of Parkinson’s Disease in patients exposed to certain pesticides and a reduced risk in smokers. Rarely, there is a genetic origin.

The hallmark of treatment has been in replacing the dopamine with levodopa and with dopamine agonists (substances similar to dopamine that act at different receptors). Other agents act to reduce the metabolic toxins that promote faster cell loss.
The difficulties in treatment lie in the fact that the medication regimine will need to be adjusted frequently to accommodate the progressive cell loss and the fact that exposure to levodopa, the medication that provides the best motor control, can result in dyskinesias (involuntary writhing movements).

In recent years surgery and deep brain stimulation have been used to address tremor and slowed movement .  This is usually reserved for last resort therapy.

Any successful treatment must address emotional problems and sleep difficulties as well as the impact on activities of daily living.

Parkinson’s Disease Diet

One of the biggest obstacles to good motor control is related to delayed stomach emptying, which is often associated with Parkinson’s Disease.  Allowing increased time, ideally 30 minutes,  between taking levodopa  (Sinemet) and eating meals may result in increased levodopa uptake.  Controlled release Sinemet may be taken with meals but may take longer to take effect. Small, frequent meals and healthy snacks may results in quicker stomach emptying and may prevent weight loss in PD patients with decreased appetites.  Protein intake may affect the effectiveness of levodopa.  A ratio of five parts carbohydrate to one part protein (5:1) or greater may help.  For those who are highly protein-sensitive, it may be best to avoid protein throughout the day and ingest protein mostly at the evening meal.

In spite of common belief, vitamins that have antioxidant activity, such as Vitamin C and D, have not been proven to reduce the risk of developing Parkinson’s disease. A possible protective role of estrogens and anti-inflammatory drugs has been suggested.


American Parkinson Disease Association
Davis Phinney Foundation
Michael J. Fox Foundation
National Parkinson Foundation
Parkinson’s Disease Foundation

Go to top