Parkinson’s
Disease
Sheila Mulhern
Parkinson’s Disease Stats (PDF)
 One
million Americans live with Parkinson's
disease, - more than the combined number
diagnosed with multiple sclerosis, muscular
dystrophy and Lou Gehrig's disease.
 Approximately 60,000 Americans are
diagnosed with PD each year,
 Worldwide: an estimated seven to 10 million
people are living with Parkinson's disease.
 Men are 1.5 times more likely to have
Parkinson's than women.
Healthcare Costs & PD
 The
combined direct and indirect cost of
Parkinson’s, including treatment, social
security payments and lost income from
inability to work, is estimated to be nearly
$25 billion per year in the United States
alone.
 Medication costs for an individual person
with PD average $2,500 a year, and
therapeutic surgery can cost up to
$100,000 per patient.
Parkinson’s Disease
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A degenerative disorder of the central nervous system
as a result from the death of dopamine-generating
cells in the substantia nigra, a region of the midbrain
Nerve cells can’t send signals properly causing loss of
muscle function
In response the adjacent thalamus and globus
pallidus interna become overactive resulting in a
tremor
Most often develops after age 50 and one of the most
common NS disorders of the elderly
Named after English doctor James Parkinson, who
published the first detailed description in An Essay on
the Shaking Palsy in 1817
Etiology of PD
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Cause not officially known but genetic and
environmental factors are linked
Genetic: modern research shows six genes have
been identified as causing familial PD
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alpha-synuclein, parkin, UCHL1, DJ1, PINK1, and
LRRK2
Environmental: not direct but demonstrated to have
the ability to cause nigrostriatal cell death appear to
interact by interfering with mitochondrial function,
inducing oxidative stress, and modifying proteasomal
function.
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DJ1 and PINK1 are mitochondrial proteins and
overexpression of alpha-synuclein and parkin induce
mitochondrial defects
Parkinson’s Disease
Characteristics
Tremor at rest
 Bradykinesia – slowness
of movement
 Rigidity and stiffness
 Increased resistance to
passive movement of
limbs or trunk
 Micrographia – small,
constricted handwriting
 Poor balance

 Diminished
 Dysphagia
arm swing
 Hypomimia
– lack of
facial expression “Parkinson mask”
 Dysarthria –
diminished voice
volume, stuttering
 Depression
 Dementia
PD & Nutritional Implications
Medical Interactions:
Levodopa
PD & MNT
 Focus
on drug-nutrient interactions
 Minimize dietary protein at
breakfast/lunch
 Recommend antioxidants and antiinflammatory diet
Study #1: The Mediterranean diet and
Parkinson's disease
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Official Journal of the Movement Disorder Society –
funding NIH & Parkinson's Disease Foundation (FEB 2012)
250 PD patients and 198 controls – diet questionnaire for
past year
Higher Mediterranean-type diet adherence was
associated with reduced odds for PD after adjustment.
Lower Mediterranean-type diet score was associated
with earlier PD age at onset.
PD patients adhere less than controls to a
Mediterranean-type diet. Dietary behavior may be
associated with age at onset.
2009 study on 1,410 French adults showed higher
adherence to Med-diet was associated with slower
MMSE cognitive decline (not other tests or assoc. with
dementia
Study #2
Study #3
Other study topics
 Caffeine
may improve motor PD
symptoms
 Flavonoids may aid PD risk
 Concussions as contributing factor to later
developing PD
Resources
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Case study: The association between Mediterranean diet
adherence and Parkinson's disease
http://onlinelibrary.wiley.com/doi/10.1002/mds.24918/abstract?syst
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Parkinson’s Disease Foundation
http://www.pdf.org/en/parkinson_statistics
Dopamine signaling in PD
http://www.cellsignal.com/reference/pathway/parkinsons_disease.
html
https://www.michaeljfox.org/
Etiology of PD http://www.ncbi.nlm.nih.gov/pubmed/16717248
http://www.pdf.org/en/science_news/release/pr_1330379372