Update on Parkinson disease

Ann Intern Med. 2003 Apr 15;138(8):651-8. doi: 10.7326/0003-4819-138-8-200304150-00013.


This Update reviews developments in the pathophysiology and treatment of Parkinson disease during the past several years. In the area of pathophysiology, studies have addressed the contribution of environmental factors such as caffeine and pesticides. Large-scale epidemiologic studies have also expanded the role genetic factors are thought to play. Detailed studies of kindreds with familial Parkinson disease due to alpha-synuclein and parkin have catalyzed basic science investigations into the pathologic mechanisms of the disease. These studies have led to the development of a pathophysiologic model of Parkinson disease that emphasizes abnormal protein aggregation. Studies of treatment have clarified the relative roles of l-dopa and dopamine agonists in early Parkinson disease and shown the potential for surgical interventions, particularly deep-brain stimulation, to relieve the symptoms of advanced, medically refractory disease.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Antiparkinson Agents / therapeutic use
  • Cell Transplantation
  • Dopamine Agonists / therapeutic use
  • Environment
  • Fetal Tissue Transplantation
  • Humans
  • Levodopa / therapeutic use
  • Parkinson Disease* / drug therapy
  • Parkinson Disease* / etiology
  • Parkinson Disease* / genetics
  • Parkinson Disease* / surgery


  • Antiparkinson Agents
  • Dopamine Agonists
  • Levodopa