Neurology

Parkinson's disease: slowing progression

Tremors, slowness, stiffness: the Parkinsonian triad

Dr. Antoine Mercier

Neurologist

8 min read
Parkinson's disease: slowing progression

A neurodegenerative disease

Parkinson's disease results from the degeneration of dopaminergic neurons in the substantia nigra. The 2nd most common neurodegenerative disease after Alzheimer's, it affects 1% of people over 60.

Motor symptoms

Asymmetrical resting tremor, akinesia (slowness), hypertonia (cogwheel rigidity), balance disorders. Non-motor symptoms often early: anosmia, REM sleep behavior disorder, constipation, depression.

Medication treatments

Levodopa (combined with carbidopa/benserazide): benchmark, especially after 70 years. Dopamine agonists (pramipexole, ropinirole): younger subjects. MAO-B inhibitors (rasagiline, selegiline) and COMT inhibitors (entacapone): adjuncts.

Advanced treatments

Pumps (apomorphine, intestinal levodopa), deep brain stimulation of the subthalamic nucleus for debilitating motor fluctuations.

Global approach

Active physiotherapy, speech therapy, physical activity (boxing, tango, Nordic walking: evidence of efficacy), psychological support.

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