Parkinson’s disease is caused by impaired dopamine production, resulting in uncontrolled movements and muscle stiffness. The disease is characterized by the presence of abnormal protein structures called Lewy bodies, which contribute to cell death and dysfunction. The pathophysiology is predominantly the same across all types of Parkinson’s, but the influencing factors may differ.
Pathophysiology refers to changes in the body’s normal biochemical, mechanical, and physical processes. The pathophysiology of Parkinson’s disease refers to physical and biochemical changes in the brain, which in turn produce abnormal mechanical and physical functioning seen throughout the rest of the body. The characteristic tremors associated with Parkinson’s disease are one example. Although the influencing and contributing factors may differ between early-onset, juvenile, and standard Parkinson’s disease, the pathophysiology of Parkinson’s is predominantly the same.
Deep inside the brain is a group of structures known as the basal ganglia, which translates as “basement structures,” and includes the globus pallidum internus, putamen, and caudate nucleus. These structures are partly responsible for controlling voluntary movement. Next to the basal ganglia is the substantia nigra, an area of the brain containing nerve cells that produce the chemical dopamine. Dopamine is a neurotransmitter that transmits messages or signals between nerve cells.
The corpus striatum are gray and white bands of tissue found within the caudate nucleus and putamen and are connected to the substantia nigra. Dopamine produced in the substantia nigra is transmitted along the connective tissue and released in the striatum. This process is essential for smooth, controlled, coordinated and voluntary muscle movement.
Parkinson’s disease is an impairment of dopamine production, which results in impaired and ineffective neurotransmission, or message transmission, between brain cells. It causes nerve cells to fire erratically and inappropriately, resulting in uncontrolled and involuntary movements and muscle stiffness. The pathophysiology of Parkinson’s begins with the death or impairment of dopamine-producing cells in the substantia nigra.
The pathophysiology of Parkinson’s is also characterized by the presence of Lewy bodies in the brain, particularly in the substantia nigra. Lewy bodies are abnormal protein structures found in the brain. They are a hallmark of Parkinson’s disease and contain the amino acid protein a-synuclein. In a normal state at normal levels, the function of this protein is to regulate the activity of dopamine transporters. At abnormal levels or in a mutated condition, such as in Lewy bodies, it will contribute to cell death and dysfunction.
Both Lewy bodies and α-synuclein are important in the pathophysiology of Parkinson’s when it occurs in persons younger than 40 years of age and in hereditary cases. Two mutations of α-synuclein have been identified in hereditary cases of early-onset Parkinson’s. In Parkinson’s cases with symptom onset after age 60, the pathophysiology includes related cell death. It is estimated that up to 13% of dopamine-producing neurons die for each decade of life. This means that more cases of age-related Parkinson’s will occur as people live longer because, by age 80, a person may have lost 80% to 90% of their dopamine-producing cells. Not everyone will lose that many cells or develop Parkinson’s.
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