Parkinson’s disease, first described by James Parkinson in 1817 in An Essay on the Shaking Palsy, is one of the most important disabling illnesses particularly prevalent in later life. It is estimated to affect 1% of 70-year-olds, but is also seen in younger people, with 10% of cases occurring before the age of 50.
The disease has become the pathfinder for other neurodegenerative disorders, since discovery of dopamine deficiency within the basal ganglia led to the development of the first effective treatment for a progressive neurodegenerative condition. Dopamine-replacement therapy substantially reduces the symptoms of Parkinson’s disease in most patients, improving their quality of life and initially appearing to decrease mortality.
However, recent advances suggest that many other neuropeptides such as acetylcholine, noradrenaline, serotonin for instance are involved right at the onset of the illness leading to a range of non motor symptoms. Some non motor symptoms such as hyposmia or sleep dysfunction ( rapid eye movement behaviour disorder) may occur up to 10 years before the onset of motor disease.
Studies led from Kings have also confirmed the overwhelming importance of non motor symptoms in addressing treatment and quality of life of people with Parkinson’s.