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Commentary on “Parkinson Disease: Research Update and Clinical Management”

Paul R. Casner, MD, PhD
Volume: 105 Issue: 12 December, 2012

Abstract:

In 1817, James Parkinson published the essay “Shaking Palsy,” in which he described patients with “involuntary tremulous motion” and “a propensity to bend the trunk forward and to pass from a walking to a running pace.”1 The disorder was further characterized by Jean-Martin Charcot in 1872, who first referred to the disorder as Parkinson disease. Almost 100 years would pass before patients would be offered an effective treatment. The discovery in the late 1950s of dopamine as an important neurotransmitter in the brain was a landmark accomplishment in understanding Parkinson disease. Clinical trials of levodopa followed soon after in the 1960s. Levodopa was to become the most effective agent for the treatment of Parkinson disease. Despite these advances, the ultimate cause of Parkinson disease remains as unknown now as it was when first described by James Parkinson. As noted by Fritsch et al in this issue of theSouthern Medical Journal, theories regarding the pathogenesis of Parkinson disease include viral pathogens, environmental factors, and genetic susceptibility.2

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References:

1. Goetz CG. The history of Parkinson’s disease: early clinical descriptions and neurological therapies.h ttp://perspectivesinmedicine.org/content/1/1/a008862.full. Accessed June 25, 2012.
 
2. Fritsch T, Smyth KA, Wallendal MS, et al. Parkinson disease: research update and clinical management. South Med J 2012; 105: 650–656.
 
3. Yoshikawa TT. Future direction of geriatrics: “gerogeriatrics.” J Am Geriatr Soc 2012; 60: 632–634.
 
4. Institute of Medicine. Retooling for an aging America: building the health care workforce. http://www.iom.edu/Reports/2008/Retooling-for-an-Aging-America-Building-the-Health-Care-Workforce.aspx. Published April 11, 2008. Accessed July 2, 2012.
 
5. Swartztrauber K, Grafe E. Nonphysicians and physician’s knowledge and care preferences for Parkinson’s disease. Mov Disord 2007; 22: 704–707.
 
6. Patterns of medication use in the United States 2006. A report from the Slone Survey. http://www.bu.edu/slone/SloneSurvey/AnnualRpt/SloneSurveyWebReport2006.pdf. Published 2006. Accessed September 15, 2011.
 
7. American Geriatrics Society 2012 Beers Criteria Update Expert Panel. American Geriatrics Society updated Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc2012; 60: 616–631.

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