To dopamine and beyond, a review of the mechanisms of Parkinson's disease
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Parkinson’s Disease is a disorder of the midbrain dopaminergic system with characteristic neurodegenerative patterns, recognized for its motor symptoms. The neurodegeneration is most prevalent in the substantia nigra pars compacta, while dopaminergic neurons in neighboring structures are comparatively spared. There are many possible explanations for this disparity, including differences in tolerance to oxidative stress, and vulnerability to α-synuclein aggregates. The substantia nigra is part of the basal ganglia, a network of nuclei in the midbrain and base of the forebrain which are responsible for coordinating voluntary movement. Dopamine has an inhibitory effect in the basal ganglia. It dampens signals to remove noise, so the basal ganglia circuitry is not hyperactive. In the absence of dopamine, the flow of information through the basal ganglia is disrupted. This results in tremor, bradykinesia, and rigidity, known as the classic triad. No cure currently exists and therapies are unable to slow disease progression, so treatments are aimed at symptom management. Degenerative processes in Parkinson’s Disease occur rapidly, early in the disease progression, with about 60% neuronal death in the substantia nigra prior to diagnosis. There is a need for biomarkers or other signs which can be used to clinically to diagnose the disease at an earlier stage. In conclusion this paper provides suggestions for future lines of research.