In essence, I did the best I could with what I was provided.
Parkinson's disease (PD), first described by James Parkinson in 1817 (Figure 1), is one of the most prevalent disabling illnesses that can occur later in 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.
Patients with PD who experience such central fatigue have pathology causing reductions in dopamine and serotonin turnover within the basal ganglia and limbic circuits. These are the structures, which facilitate the link between emotion/motivation (limbic system) and motor response.
Estimates of the annual incidence of Parkinson's disease are in the range of 4-20 per 100,000 individuals. ...
Demonstrating an association between fatigue and limbic dysfunction in PD will help rationalise treatment approaches for this disabling illness and its symptoms.
Incidence and Prevalence
Estimates of the annual incidence of Parkinson's disease are in the range of 4-20 per 100,000 individuals. A widely accepted figure for the prevalence of Parkinson's disease is approximately 200 per 100,000 populations. In the Unite States, it is estimated that between 750,000 and 1.5 million people have the disease. In the United Kingdom, there are approximately 120,000-130,000 diagnosed cases, but there may be many more that remain undiagnosed.
Age, Sex, and Ethnicity
Both the incidence and prevalence of Parkinson's disease increase with age, and the prevalence may be as high as 1 in 50 for patients over the age of 80 years. Men are 1.5 times more likely than women to develop the condition are. Hospital-based studies have suggested that Parkinson's disease is less common in the Black population, than in other groups.
The main pathological feature of Parkinson's disease is the degeneration of neuromelanin-containing neurons in the pars compacta of the substantia nigra (Figure 1.1). Examination with the naked eye reveals pallor of this area, which is confirmed microscopically by a marked decrease in the number of neuromelanin-containing cells and the presence of Lewy bodies in the remaining nigral neurons. Degeneration of pigmented neurons in the brainstem is not limited to the nigra but extends to the locus ceruleus and the dorsal motor nucleus of the vagus. Lewy bodies are intracytoplasmic eosinophilic inclusions, which are typically found in the neurons of the substantia nigra (Figure 1.2). They are a pathological hallmark of