Learn about PD - All Articles

What is Parkinson's?

M. J. Fox  Parkinson's 101

https://www.michaeljfox.org/parkinsons-101

APDA - Parkinson's disease (PD) is a neurodegenerative disorder that affects predominately dopamine-producing (“dopaminergic”) neurons in a specific area of the brain called substantia nigra.

Symptoms generally develop slowly over years. The progression of symptoms is often a bit different from one person to another due to the diversity of the disease.

https://www.parkinson.org/understanding-parkinsons/what-is-parkinsons

Research head

Parkinson's disease (PD) research aims to understand the causes, mechanisms, and potential treatments for this neurodegenerative disorder.

Areas of Research:

• Genetics: Identifying genetic mutations that increase the risk of PD.

• Neurobiology: Studying the changes in brain cells and pathways that occur in PD.

• Cell Death: Investigating why dopamine-producing neurons die in PD.

• Oxidative Stress: Examining the role of oxidative damage in the disease process.

• Mitochondrial Dysfunction: Exploring how impaired mitochondrial function contributes to PD.

• Stem Cell Therapy: Using stem cells to replace damaged neurons or to protect existing ones.

• Gene Therapy: Developing genetic interventions to stop or slow the progression of PD.

• Drug Discovery: Identifying and testing new medications to improve symptoms and potentially halt disease progression.

Leading Research Institutions: National Institute of Neurological Disorders and Stroke (NINDS), Parkinson's Foundation, Michael J. Fox Foundation for Parkinson's Research, Harvard Stem Cell Institute, and University of Miami Miller School of Medicine.

Trial Finders

Fox Trial Finder: Find Parkinson's Clinical Trials

https://www.michaeljfox.org/trial-finder

Search to find studies based on your location and health history. No login is required. Want to be notified when new studies match your profile? Sign up today.

Read an overview on Fox Trial Finder and its new features. If you have questions or if you'd like help, please email support@foxtrialfinder.org.

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ClinicalTrials.gov:

• A comprehensive, public registry of federally and privately supported clinical trials.

• Enables searches using keywords, locations, and specific disease, such as "Parkinson's disease".

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• Parkinson's Foundation Clinical Trials Page:

  • .Provides resources and links to studies, including genetic-specific trials like thePD GENEration study

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Common Symptoms of Parkinson’s Disease

The most common Parkinson’s disease symptoms. Remember that although these are the typical symptoms, they can vary greatly from individual to individual—both in terms of their intensity and how they progress. Motor symptoms generally involve movement, while non-motor symptoms do not.

Read about them [HERE]

Dystonia (abnormality of muscle tone) v. dyskinesia (abnormality of movement)

A Parkinson's Foundation video of dystonia (abnormality of muscle tone) v. dyskinesia (abnormality of movement) is here. 

Key differences between dyskinesia and dystonia are also explained in this HealthCentral story. 

Mental health symptoms in parkinson’s: common but treatable

https://youtu.be/dzfQi5sfrjU?si=0apNiSAijkq3ndHF

Speaker Bio:   Greg Pontone, MD, MHS is Division Chief and Professor Of Aging, Behavioral, and Cognitive Neurology at the University of Florida and Co-Director of Neuropsychiatry Program at The Norman Fixel institute for Neurological Diseases. Dr. Pontone earned his medical degree from the University of South Florida in Tampa. After medical school he completed a medical internship at Johns Hopkins Bayview followed by a residency in psychiatry and a fellowship in geriatric psychiatry and movement disorders research at The Johns Hopkins Hospital in Baltimore, Maryland.  Time Stamps: 

3:54 – Mental wellness challenges in Parkinson’s: anxiety, depression, apathy, and anger defined and discussed. 

4:42 – Breakdown of anxiety symptoms—how it feels mentally and physically, and how it relates to medication cycles.

7:27 – What depression looks like in Parkinson’s and why it’s the single most impactful non-motor symptom. 

9:36 – Apathy vs. depression: key differences and why apathy often goes unnoticed or unreported. 

11:18 – Why these symptoms happen: neurochemical changes and how Parkinson’s affects mood regulation. 

14:57 – Introduction to the “wellness pyramid”: exercise, diet, sleep, and social connection as proactive tools. 

22:54 – Strategies for better sleep: sleep hygiene tips, melatonin, and setting a consistent “sleep opportunity.” 

25:50 – Socialization’s impact on brain health, mood, and longevity—why isolation is a major risk factor. 

33:46 – Medications for depression, anxiety, and apathy: what works, what doesn’t, and why patience is key. 

45:25 – How caregivers can help build structure and routine to reduce apathy and support long-term engagement. 

54:39 – Dr. Pontone shares what gives him hope: promising research on disease-modifying therapies for Parkinson’s.

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Anxiety in Parkinson’s Disease

• Anxiety affects about 40% of people with PD and can manifest as persistent worry, restlessness, panic attacks, physical symptoms (racing heartbeat, sweating, nausea), and avoidance of social situations due to fear or embarrassment.

• It can precede motor symptoms or develop during the disease course.

• Causes include dopamine loss and changes in other brain chemicals, “off” periods when medication effects wear off, sleep disturbances, social isolation, and uncertainty about the future [2], [4], [2].

Depression in Parkinson’s Disease

• Depression affects approximately 30-50% of people with PD.

• It is often a direct symptom of PD caused by neurochemical imbalances involving dopamine, serotonin, and norepinephrine, not just a psychological reaction.

• Symptoms include persistent sadness, loss of interest, fatigue, feelings of guilt or worthlessness, sleep disturbances, and in severe cases, thoughts of death or suicide.

• Depression can worsen motor symptoms and overall functioning but is treatable with medication, therapy, exercise, and social support [1], [3].

Anger and Irritability in Parkinson’s Disease

• Anger outbursts and increased irritability are common mood changes in PD, sometimes surprising to families due to personality shifts.

• Causes include emotional stress from coping with PD, direct brain changes, medication side effects, cognitive changes, or psychosis.

• These behavioral changes often coexist with depression, anxiety, or cognitive decline.

• Managing anger involves identifying triggers, medication review, counseling, stress reduction techniques, and caregiver support [5], [2].

Important Considerations

• Mental health symptoms may fluctuate with “on/off” medication periods.

• Sudden changes in mood or behavior require medical evaluation for infections, medication side effects, or other illnesses.

• Non-drug approaches should be tried first when possible.

• Safety is paramount if anger or psychosis leads to aggression.

• Collaboration among neurologists, psychiatrists, psychologists, and social workers is often needed [3], [2].

1. Depression and Mood - Parkinson’s Foundation

2. Anxiety and Depression in Parkinson’s - Parkinson’s UK Progress Summer

3. Treatment Approaches To Anxiety and Depression in Parkinson’s Disease

4. Managing Anxiety in Parkinson's - Parkinson’s Foundation

5. Mood and Cognition Webinar Notes - Stanford Parkinson’s Community

Motor-related symptoms

Motor symptoms — which means movement-related symptoms — of Parkinson’s disease include the following:

• Slowed movements (bradykinesia). 

• Tremor while muscles are at rest.

• Rigidity or stiffness.

• Unstable posture or walking gait.

Additional motor symptoms can include:

• Blinking less often than usual.

• Cramped or small handwriting. 

• Drooling.

• Mask-like facial expression

• Trouble swallowing (dysphagia). 

• Unusually soft speaking voice (hypophonia).

Sleep and PD

Sleep Disturbances in Parkinson’s Disease

People with Parkinson’s Disease frequently experience a range of sleep problems that differ from those typical in the general population. Common disturbances include:

• Insomnia: Difficulty falling asleep or staying asleep.

• REM Sleep Behavior Disorder (RBD): Acting out dreams during REM sleep due to loss of normal muscle paralysis, which can cause injury to self or bed partner.

• Restless Legs Syndrome (RLS): Urge to move legs often at night, which disturbs sleep.

• Excessive daytime sleepiness: Feeling very sleepy during the day, sometimes to the point of sudden sleep attacks.

• Sleep fragmentation: Frequent waking and disrupted sleep architecture.

These disturbances reduce sleep quality, leading to fatigue and worsening other PD symptoms such as cognitive difficulties and mood changes.

Causes and Mechanisms

Sleep dysfunction arises from several PD-related factors:

• Neurodegeneration in brainstem and hypothalamic areas critical for sleep regulation.

• Effects of dopaminergic and other PD medications can disrupt sleep.

• Motor symptoms such as rigidity and tremor interfering with comfortable sleep.

• Psychiatric symptoms associated with PD like anxiety and depression exacerbate sleep problems.

Approaches to Improve Sleep in Parkinson’s

• Medication Review: Adjustments to PD and other medications can improve sleep quality.

• Behavioral Techniques: Sleep hygiene education, regular sleep schedules, reducing daytime naps.

• Treatment of Specific Disorders: For example, melatonin or clonazepam for REM sleep behavior disorder.

• Light therapy: Shown to improve circadian rhythms and sleep quality in PD.

• Exercise: Regular physical activity helps improve sleep and overall motor symptoms.

• Addressing co-morbidities: Treating sleep apnea, restless legs, or mood disorders.

Health Disclaimer

Sleep disturbances in people with Parkinson’s Disease are complex and individual. Please consult a neurologist or sleep specialist experienced in PD for diagnostic assessments and tailored treatment plans.

Sources

1. Parkinson's Disease: Sleep Disturbances and Fatigue | Sleep Foundation

2. Classification of sleep stages from EEG, EOG and EMG signals by SSNet (ArXiv)

3. End-to-End Automatic Sleep Stage Classification Using Spectral-Temporal Sleep Features (ArXiv)

Symptom management - podcast on Improving Quality of Life in Movement Disorders through Non-Motor System Management.

Symptom management  By Marco Meglio & Alexa Dessy, MD NeurologyLive.com August 8, 2025      Mind Moments is a podcast from NeurologyLive, and brings you an interview with Alexa Dessy, MD, on Improving Quality of Life in Movement Disorders through Non-Motor System Management.       The 17-minute podcast is here. 

PD and driving

Many individuals with Parkinson's disease (PD) can drive safely in the early stages, but symptoms like tremors, slowed reflexes, rigidity, and cognitive changes can eventually impair driving. To ensure safety, obtain a formal evaluation from your neurologist or a specialist and establish a proactive plan for transitioning away from driving.

Key Impacts on Driving

Parkinson's affects both motor and non-motor functions that are critical for operating a vehicle: 

• Physical: Bradykinesia (slowness of movement), involuntary tremors, rigidity, and limited neck rotation can make it difficult to brake, steer, or make safe lane changes. 

• Cognitive: Reduced multitasking ability, slower reaction times, and spatial awareness issues can cause confusion in heavy traffic or at intersections.

• Visual & Sleep: Impaired contrast sensitivity can make nighttime driving difficult, while daytime sleepiness and "off" periods (when medication wears off) significantly increase the risk of accidents.

Actionable Steps and Evaluations

Managing driving fitness requires careful assessment and monitoring as the disease progresses:

• Schedule a Driving Evaluation: Speak with your doctor about a clinical driving assessment. You can also find certified driver rehabilitation specialists through the Association for Driver Rehabilitation Specialists to evaluate your physical, visual, and cognitive readiness.

• Adjust Your Habits: If cleared to drive, stick to short, familiar routes, avoid nighttime and adverse weather conditions, and never drive when feeling drowsy or during the "off" periods of your medication cycle.

• Plan for "Driving Retirement": Because PD is progressive, ceasing to drive will eventually be necessary. Planning ahead and researching public transit, ride-sharing, and community transport services maintains independence without compromising safety. 

For comprehensive guidelines on managing your daily routines, consult the Parkinson's Foundation Activities of Daily Living page or review The Michael J. Fox Foundation Dexterity & Driving Overview to better gauge safety and passenger comfort

Driving when you have Parkinson's disease. Hand out

3 page PDF file

https://www.nhtsa.gov/sites/nhtsa.gov/files/10900f-drivewell-handout-parkinsons.pdf

Slides from meeting July 2026.

See Slides from Donna Stressel Tice OTR, CDI, CDRS • Sunnyview Rehabilitation Hospital

Transportation Directory for older adults in Albany and surrounding counties -.Albany Guardian Society

The Albany Guardian Society (AGS), in partnership with the Capital Region Transportation Council, publishes the definitive Transportation Directory for older adults in Albany and surrounding counties. The directory details senior transit vans, medical transport, volunteer programs, and technology-based solutions like GoGoGrandparent.

Treatment for Parkinson's Disease

Soon after diagnosis, you will begin exploring the wide range of treatments available to help manage symptoms of Parkinson’s. Since Parkinson’s looks different for everyone, no two treatment paths will be the same. Treatment typically includes some combination of medication, exercise and rehabilitation strategies like physical and speech therapy to manage symptoms and give you the best possible quality of life. Non-medical therapies are just as important as medication. These therapies can treat or prevent many symptoms affecting movement, speech and your ability to do daily life and work activities.

Parkinson's disease is a progressive neurological disorder that affects movement. There is no cure, but treatments can help manage symptoms and improve quality of life.

Medications:

• Levodopa: The primary medication for Parkinson's, it increases dopamine levels in the brain.

• Dopamine agonists: These medications mimic dopamine and can help reduce tremors and stiffness.

• MAO-B inhibitors: These drugs prevent the breakdown of dopamine in the brain.

• Anticholinergics: These medications help control tremors and drooling.

Other Therapies:

• Deep brain stimulation (DBS): A surgical procedure that implants electrodes in the brain to regulate abnormal electrical activity.

• Focused ultrasound surgery (FUS): A non-invasive procedure that uses ultrasound waves to target specific areas of the brain and improve symptoms.

• Physical therapy: Exercises to improve balance, coordination, and mobility.

• Occupational therapy: Activities to help patients with daily tasks, such as dressing and eating.

• Speech therapy: To address speech problems, such as tremors and slurred speech.

• Lifestyle changes: Exercise, a healthy diet, and stress management can help improve symptoms.

Emerging Treatments:

• Gene therapy: Research is ongoing to develop gene therapies that can stop or slow the progression of Parkinson's.

• Stem cell therapy: Stem cells may have the potential to replace damaged dopamine-producing cells in the brain.

• Pharmacological interventions: New medications are being developed to target different aspects of Parkinson's pathology.

Personalized Treatment:

The best treatment plan for Parkinson's disease is individualized based on the patient's symptoms, age, and overall health. It's important to work closely with a healthcare team to determine the most effective treatment options.

LSVT BIG is a specialized exercise-based therapy designed to improve movement and coordination in people with Parkinson's disease.

What does LSVT BIG do?

• Improves balance, gait, and overall mobility

• Enhances coordination and agility

• Reduces freezing of gait (sudden involuntary stops while walking)

• Increases the amplitude (size) of movements

How does LSVT BIG work?

LSVT BIG involves intensive, individualized sessions with a certified therapist. The therapist guides the patient through a series of exercises that progressively challenge their movements, forcing them to make bigger, more exaggerated motions. This helps the brain rewire itself and adapt to the new movement patterns.

Who is LSVT BIG for?

LSVT BIG is primarily intended for individuals with Parkinson's disease who are experiencing movement difficulties. It may also be beneficial for other conditions that affect motor control, such as multiple sclerosis or stroke.

Benefits of LSVT BIG

• Studies have shown that LSVT BIG can significantly improve movement and quality of life for people with Parkinson's disease.

• It is a safe and well-tolerated therapy.

• LSVT BIG can provide long-lasting benefits, even after the therapy sessions are completed.

Where to find LSVT BIG

LSVT BIG is typically offered by physical or occupational therapists who are certified in the program. To find a certified therapist, you can contact your healthcare provider or search online.

Additional Information

• LSVT BIG is also known as "Lee Silverman Voice Treatment for Parkinson's Disease Big".

• There is also an LSVT LOUD (Lee Silverman Voice Treatment Loud) program, which focuses on improving speech and communication in people with Parkinson's disease.

• For more information, visit the LSVT Global website: https://www.lsvtglobal.com/