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 https://doi.org/10.47488/dhrp.v2iS2.72 

 

 

 
DHR Proceedings ǀ http://dhrproceedings.org 116 2022, Vol. 2 No. S2 116-121 

 

COMMENTARY 

Parkinson’s Disease 
 

Rodrigo Garcia1,2, Sulibella Alcantara1,2, Amanda Tinoco1,2, Sheryl Thomas1,2, Brayan Moreno1,3, 

Omar Resendez1,3, Omar Barrera1,3, Arely Villanueva, Oliver Solorzano1,2 

 
 

12nd Annual Junior Clinical Research Internship, South Texas Academy for Education & Training in Research, DHR Health 

Institute for Research & Development 
2Vela High School, Edinburg, TX 
3Zapata High School, Zapata, TX 

 

All correspondence should be addressed to Program Director, 2nd Annual Junior Clinical Research Internship Program, DHR 

Health Institute for Research & Development, 5323 S McColl Road, Edinburg Texas, 78539 

 

Received 08/04/2022 

Accepted for publication 08/15/2022 

Published 08/15/2022 

 
 

Introduction 
 

Parkinson's disease (PD) is a brain disorder 

that causes unintended or uncontrollable movements, 

such as shaking, stiffness, and difficulty with balance 

and coordination (1). Symptoms usually begin 

gradually and worsen over time. As the disease 

progresses, people may have difficulty walking and 

talking. 

 

Parkinson's disease affects 1-2 per 1000 of 

the population at any time. PD prevalence is increasing 

with age and PD affects 1% of the population above 

60 years (2). 

 

The risk of developing PD is twice as high in 

men than women, but women have a higher mortality 

rate and faster progression of the disease (3).  

 A race that is most affected is the Caucasian 

population.  

 

The prevalence rate of Parkinson’s disease 

has grown more than 50% in the span of five years. 

Sex is an important fact in PD, as a matter of fact it is 

more common in men than woman by a 2:1 ratio (4). 

One clear risk is age, Parkinson’s develops after 60 

and there is a 1% chance of getting Parkinson’s 

disease, but at 80 the chances increase by 5%. The 

largest study of Parkinson’s disease shows Hispanics 

(16%), followed by non-Hispanic whites (13.6%), 

which are the biggest ethnicities that are affected by 

Parkinson’s disease, and the least likely to get 

Parkinson’s disease are African Americans (5). 

Parkinson's disease keeps growing, and at the rate that 

it’s going it is soon to become the worst brain disease. 

 

Prevalence 
 

Parkinson’s disease (PD) is the second most 

common, age-related neurodegenerative disorder, 

affecting about 3% of the population by the age of 65 

and up to 5% of the people over 85 years (6). 

Parkinson's disease is most common in the Midwest 

and the Northeast and is twice as likely to affect 

whites. Studies have shown the prevalence in the white 

population compared to blacks and Asians (6). 

 

Pathophysiology 

 
The study of pathophysiology defines 

Parkinson’s Disease as the loss of dopaminergic 

neurons which are the main source of dopamine, a type 

of neurotransmitter and hormone located in the 

mammalian central nervous system in the substantia 

nigra which helps the brain move the body (7). In other 

words, it tells the brain to create movement of the 



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body. The loss of dopaminergic neurons creates a lewy 

body which is an abnormal clumping of alpha 

synuclein, a protein, which when found, indicates the 

onset of PD (8).  

 

Clinical Presentation 

 

Motor Symptoms  
 

According to The Clinical Symptoms of 

Parkinson’s disease, up to 80% dopaminergic cells in 

the nigro-striatal system are lost before the symptoms 

of Parkinson’s disease start to appear (9).  When fewer 

dopaminergic neurons in the striatum, it causes 

impairment of motor control in people with PD (10). 

Initial symptoms of this disease include muscular 

rigidity (muscle stiffness), resting tremor or loss of 

balance (11). Symptoms of disease progression 

include sharp muscle pain, loss of mobility, and loss 

of normal daily activities such as simply being able to 

walk (12). 

 

Sex-related differences in motor symptom 

pattern also play a big role in diagnosis. Symptoms in 

females develop longer after diagnosis than in males 

(13).In males, usually the first symptoms that show up 

are signs of freezing gait. Freezing gait is one of the 

most weakening motor symptoms in a patient with 

Parkinson’s disease. It is characterized by a patient's 

experience of short and temporary episodes of an 

inability to move their feet forward despite the 

intentions to walk (14). This leads to frequent falls and 

loss of independence. Although there are differences 

in the appearance of symptoms, ultimately, PD can be 

debilitating for both men and women.  

 

Non-motor Symptoms  
 

Parkinson's disease is a progressive 

neurological disorder characterized by a large number 

of motor and non-motor features that can impact on 

function to a variable degree (15).  It is said that Non 

motor features play an excessively important and 

sometimes dominant role in the management and even 

the diagnosis of the disorder (16). Non-motor 

symptoms of PD include drooling, loss of smell, and 

disturbances in sleeping patterns with restless leg 

syndrome (16). Non motor symptoms occasionally 

appear years ahead of the motor symptoms (17). 

Alongside these symptoms, mental health is also 

disrupted with bouts of depression, increased risk of 

dementia, and occurrences of autonomic disturbance 

(18).  Patient reflection essays have reported “I feel 

trapped inside my body . . . as if I’m not in control . . . 

almost as if someone or something else is running my 

life.’’  PD makes patients feel they have lost their sense 

of control of their own mind which then leads to 

mental health problems (18). Although PD is known 

for its motor symptoms, the non-motor symptoms can 

be just as debilitating.  

 

Treatment/Diagnosis/Risk Factors 
 

According to the research of John Hopkins 

Medicine, it shows that Parkinson’s is not a curable 

disease. Treatment for Parkinson’s does help with the 

risk of progression of the disease, doctors typically 

prescribe medication, or supportive therapies such as 

occupational therapy, speech therapy, physiotherapy, 

and even surgery (19). The success rate for physical 

therapy is four weeks of gait training and eight weeks 

for balance training, which needs to be continued for 

the maximum positive results (20). Drug development 

since 1999 had a success rate of 14.9% with the overall 

357 trials. The drugs that are used for the patients are 

levodopa, safinamide, and droxidopa (21). For self-

care, usually patients that are affected with 

Parkinson’s take care of themselves by diet and 

exercise, like aerobic training, strength training 

workouts, and balance training workouts. In some 

cases, people resort to traditional Chinese medicine 

and acupuncture, which aids the patient by relieving 

symptoms of the disease (22, 23). Patients that are 

diagnosed by a neurologist (diagnosed by the given 

medical history and signs/symptoms) (24), are given 

medication, but the medications come with 

complications. Carbidopa- levodopa (Sinemet) can 

induce nausea, hallucinations, confusion, 

lightheadedness, and dyskinesia. On the other hand, 

dopamine agonists (pramipexole, ropinirole, 

rotigotine patch) can induce nausea, dizziness, leg 

swelling, sleepiness, sleep attacks, worsening 

cognition, hallucinations, and impulse control 

disorders (25). With the side effects and the rising cost, 

depending on whether the person's insurance may be 

covered or they might not have insurance in general, 

some patients would resort to not taking any 

treatments. If the patient does not take any form of 

treatment, PD will progress at a much faster rate, and 

more complications will occur throughout the patient's 

life such as apathy, depression, anxiety, psychosis, 

sleep disorders, and cognitive impairment (26).    

 

Therapies 
 

Medical therapies should address both motor 

and non-motor symptoms. There are several therapies 

that can help patients recuperate involving exercise 

that encourages maintaining muscle strength, 

increasing flexibility and motion, improving 

cardiovascular function, walking, jogging, running, 

https://www.ncbi.nlm.nih.gov/books/n/nicecg35/glossary/def-item/glossary.gl1-d65/


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DHR Proceedings ǀ http://dhrproceedings.org 118 2022, Vol. 2 No. S2 116-121 

swimming, cycling. While not curative, these 

exercises reduce the risk of progression of the disease. 

Other non-pharmacological therapies for Parkinson’s 

include education, support groups, speech therapy and 

nutrition therapy (27). There was a hypothesis about 

empirical evidence, turns out their hypothesis was 

indeed incorrect. Although there are some factors, 

there's no remedy that can help the disease from 

advancing from the host.   

 

In addition to non-medicinal therapies, drugs such as 

levodopa, can be very effective against the disease. If 

a patient consumes (Carbidopa/Levodopa) with 

10/100mg and is weight 2263. The Side effect will be 

low blood pressure, nausea, confusion, dynsekia. The 

drug's main focus is converting dopamine into the 

cerebrum (28).  

 

Although there are many therapies to combat or 

stabilize Parkinson's disease that are not possible to 

prevent, some habits can reduce it. 

 

Surgical Therapies 
 

There is only one approved surgical therapy 

of the different brain structures that has been studied 

and used for Parkinson's disease for several decades. 

People who are living with Parkinson's disease may be 

a candidate for deep brain stimulation (29). Deep brain 

stimulation has become an official therapeutic tool for 

treating patients with Parkinson's disease. It is an 

elective surgical procedure in which electrodes are 

implanted into certain areas of the brain. Although, 

one of the main dilemmas of deep brain stimulation 

are side effects such as tiredness, depression, and 

suicide (30). This treatment is clear for people who 

have had Parkinson's disease for at least four years. 

Some benefits of deep brain stimulation are to get up 

to five additional good movements without dyskinesia. 

It also benefits you to use less medication, and just 

improves a better quality of life. 

 

Experimental Therapies 

 
While traditional therapies may help some 

patients, there is no known cure for PD. Parkinson's 

disease is a progressive disorder that affects the 

nervous system and the parts of the body controlled by 

the nerves. Current treatment focuses on the symptoms 

of the disease and mainly involves replacement of 

dopamine deficiency. (31) Dopamine deficiency is 

having low levels of dopamine, a neurotransmitter and 

hormone that regulates blood pressure, motivation, 

helps with memory and learning, increasing attention 

and focus. (31). Patients with Parkinson's disease 

benefit from dopamine replacement therapy by seeing 

improved outcomes for conditions linked to 

interference and decreased results for disorders linked 

to facilitation. While treatment for Parkinson’s is very 

scarce one of the current experimental treatments is 

medical marijuana. Medical Marijuana is being used 

at the moment as an experimental therapy to relax the 

minds (32). Medical marijuana is currently being used 

by 44% of the population with PD (32). CBD 

(cannabidiol) and THC (tetrahydrocannabinol) are 

responsible for the medicinal effects of marijuana. 

Medical marijuana helps with regulating memory, 

pleasure, concentration, thinking, movement, 

concentration, sensory and time perception, pain, and 

much more. CBD (cannabidiol) inhibits the 

psychotropic effects of THC (tetrahydrocannabinol) 

and improves its tolerability and therapeutic window, 

without being intoxicated. (32) Medical marijuana 

helps both motor and non-motor symptoms including 

bradykinesia, rigidity, tremor, sleep, and pain. Medical 

marijuana has greatly improved PD patients.  

 

Conclusion 

 
Parkinson’s disease has reached many people 

throughout our society.  It has affected both men and 

women.  Parkinson’s disease is the second most 

neurodegenerative disease; it has affected more than 6 

million people in the world (33).  Knowledge of the 

disease manifestations, the treatments, and the 

progressive long-term course of the disease is 

necessary to maintain a normal life.  No cure has yet 

been found for such illness, however, clinical trials 

continue with research for a better quality of life.   

 

Clinical trials have advanced for Parkinson’s 

Disease to gain access for new research treatments to 

find cure for disease. Clinical trials are performed by 

nonprofit organizations, such as the Michael J. Fox 

Foundation (33). It focuses on studies that increase the 

chances of slowing the progression of PD.  Patients 

participating in clinical research are important in an 

effort to provide research and outcomes in which 

studies were expanded to include anti-inflammatory 

agents to reduce inflammatory processes in the brain 

(33).  There are ongoing studies in every clinical 

phase. Studies are focusing on targeting dopaminergic 

symptom relief, and evaluating supplements and other 

remedies such as cannabidiol, melatonin, and 

probiotics (33). The hope and goal of research is that 

some day in the near future a cure is found to treat PD 

to improve the quality of life of patients afflicted with 

PD.  In addition, a cure would make PD a disease of 

the past, so that patients with PD can enjoy a life of 

dignity/happiness with loved ones. 

 



Garcia, et al  Parkinson’s Disease 
https://doi.org/10.47488/dhrp.v2iS2.72 

 

 

 
DHR Proceedings ǀ http://dhrproceedings.org 119 2022, Vol. 2 No. S2 116-121 

Acknowledgments 

 

Dr. Monica Betancourt-Garcia, MD, Scientific 

Director; Melissa Eddie, MS, Program Manager; 

Xochitl Lopez, BS, Program Coordinator 

 

Funding 

Funded by DHR Health Institute for Research & 

Development; DHR Health; Region One ESC 

GEARUP College Ready, Career Set!; Region One 

ESC GEARUP College Now, Career Connected and 

Region One ESC PATHS 

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