Parkinson's Disease is a chronic, degenerative neurological disorder that affects one in 100 people over age 60. While the average age at onset is 60, people have been diagnosed as young as 18. There is no objective test, or biomarker, for Parkinson's Disease, so the rate of misdiagnosis can be relatively high.

Parkinson's Disease was first characterized by an English doctor, James Parkinson, in 1817. According to the National Institute of Health, Parkinson's Disease is a disorder of the central nervous system that results from the loss of cells in various parts of the brain, including a region called the substantia nigra. The substantia nigra cells produce dopamine, a chemical messenger responsible for transmitting signals within the brain that allow for coordination of movement. Loss of dopamine causes neurons to fire without normal control, leaving patients less able to direct or control their movement. Parkinson's Disease is one of several diseases categorized by clinicians as movement disorders.

Symptoms include tremor, rigidity, extreme slowness of movement, and impaired balance. Swallowing and speaking difficulties are also common, as are several non-motor symptoms that seriously affect quality of life. Parkinson's Disease belongs to a group of conditions called movement disorders. The four main symptoms are tremor, or trembling in hands, arms, legs, jaw, or head; rigidity, or stiffness of the limbs and trunk; bradykinesia, or slowness of movement; and postural instability, or impaired balance. These symptoms usually begin gradually and worsen with time. As they become more pronounced, patients may have difficulty walking, talking, or completing other simple tasks. Not everyone with one or more of these symptoms has Parkinson's Disease, as the symptoms sometimes appear in other diseases as well, which is why it's important to consult your doctor.

Parkinson's is both chronic, meaning it persists over a long period of time, and progressive, meaning its symptoms grow worse over time. It is not contagious. Although some Parkinson's Disease cases appear to be hereditary, and a few can be traced to specific genetic mutations, most cases are sporadic — that is, the disease does not seem to run in families. Many researchers now believe that Parkinson's Disease results from a combination of genetics and exposure to one or more environmental factors that trigger the disease.

The National Institute for Health recently announced that a new initiative, aimed at accelerating the search for biomarkers is underway. Biomarkers are changes in the body that can be used to predict, diagnose or monitor a disease. Improved collaboration among doctors, researchers and patients who get involved in clinical studies will help scientists develop the biomarker sooner so that better treatments can be created. A lack of biomarkers for Parkinson’s has been a major challenge for developing better treatments.

Actor Michael J. Fox was diagnosed in 1991 but announced in 1998 that he had young-onset Parkinson's Disease. Since then, he has started a foundation at his Web site. Here people can sign up to be a part of clinical trials and learn about the disease. Those interested in participating in trials can also sign up at the National Institute of Health website at the Parkinson’s Disease Biomarkers Program. The program is being launched by the National Institute of Neurological Disorders and Stroke at http://www.ninds.nih.gov.

There are also a number of resources and options people can access through these sites. Many explain in detail about symptoms and treatment options such as what drugs may be helpful to reduce symptoms and a description of "deep brain stimulation," an optional surgery which helps monitor circuits that are not functioning properly. Through the National Institute of Health website, there are also links to specific foundations that focus on Parkinson's Disease, such as the Michael J. Fox Foundation and the American Parkinson's Disease Association, which helped provide information for this column. You may also contact the Patient Recruitment and Public Liaison Office, Clinical Center at 800-411-1222 or www.cc.nih.gov/ccc/prpl to sign up for a trial. Many trials also need participants who do not have the disease to compare data.

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