Pathophysiology and management of parkinson disease: a review

Abstract

Parkinson’s disease is a neurological disorder that is characterized by the typical motor symptoms of Parkinsonism associated with Lewy bodies and loss of dopaminergic neurons within the substantia nigra. It is associated with fluctuations of motor and non-motor symptoms, dyskinesia and psychosis. Parkinson’s disease affects almost 1% of individuals older than 60 years. The incidence is higher in Europe, North and South America compared to Africa. Male to female ratio is 3:2. The aim of this review is to describe the pathophysiology and management of Parkinson’s disease. Aetiological risk factors of Parkinson’s disease were theorised to be due to genetic and environmental factors. Some of the environmental risk factors include chronic pesticide exposure, prior head injury etc. while some of the genetic risk factors include beta-glucocerobrosidase gene (GBA), leucine- rich repeat kinase-2 (LRRK2) and synuclein alpha (SNCA) genes. Parkinson disease is mainly a disorder of the basal ganglia, a group of nuclei located at the base of the forebrain. There are two main neuropathological discoveries related to the disease: the damage of pigmented dopaminergic neurons in the substantia nigra pars compacta (SNpc), and the appearance of Lewy bodies that leads to the formation of Lewy neurites, which are typical pathologic outcomes in Parkinson disease. The management comprises of diagnosis and treatment. The diagnosis is mainly clinical while the treatment is essentially medical which include. Levodopa/carbidopa administration in combination for control of motor symptoms.

Keywords; Parkinson’s disease, Substantia nigra, Lewy bodies, levodopa, dopaminergic
neurons.