What is Parkinson’s Disease?

What is Parkinson’s Disease?

You may have noticed that your body doesn’t respond as quickly in the mornings, and simple tasks like buttoning a shirt require more patience. Your arms no longer swing naturally while walking, and your steps become shorter. People around you may ask why your mood seems low, even though you feel normal. These signs are not just natural aging—they may indicate that dopamine reserves in your brain have fallen below a critical level.

Parkinson’s disease is often thought of only as hand tremors, but it is actually a neurodegenerative disorder characterized by slowed movement, muscle stiffness, and disruption of the body’s automatic rhythms. Assoc. Prof. Dr. Mehmet Sorar approaches Parkinson’s not only as a motor disorder but as a complex process that threatens independence and social engagement. In this article, we explore the biological basis, motor and non-motor symptoms, and diagnostic process of Parkinson’s disease in detail.

What Happens in the Brain When Dopamine Decreases?

The basal ganglia, located deep in the brain, coordinate movements and ensure their fluidity. Dopamine is the key neurotransmitter in this system. When dopamine-producing cells in the substantia nigra die due to genetic factors, environmental toxins, or aging, communication within the system is disrupted.

When dopamine levels drop, the brain’s command to move muscles is delayed or diminished. As a result, movements become stiff and slow. Critically, by the time early symptoms appear, approximately 60–80% of dopamine-producing neurons may already be lost. Early recognition and consultation with a neurology or neurosurgery specialist are vital for disease progression.

Four Primary Motor Symptoms of Parkinson’s

Experts rely on four main findings to diagnose Parkinson’s. Not all symptoms appear at the same time or with equal severity.

1. Bradykinesia (Slowness of Movement)

This is the hallmark symptom of Parkinson’s. Movements are not only slow but also reduced in amplitude.

• Micrographia: Handwriting gradually shrinks and becomes cramped and difficult to read.
• Hypomimia: Facial muscles lose mobility, leading to a masked, expressionless appearance with reduced blinking and fixed gaze.
• Loss of Fine Motor Skills: Difficulty with precise tasks such as using cutlery, writing, or brushing teeth.

2. Rigidity (Muscle Stiffness)

During examination, doctors may feel strong resistance when moving a patient’s arm or leg, sometimes described as a “cogwheel” sensation. Stiffness causes persistent pain, tightness, and fatigue. Many patients first present to physical therapy for shoulder or back pain before Parkinson’s is diagnosed.

3. Resting Tremor

Typically begins in one hand with a rhythmic movement resembling counting coins or rolling a pill. It is most noticeable when the hand is at rest, such as watching TV or sitting in the lap. Tremor often stops or decreases during purposeful movement, distinguishing Parkinson’s tremor from other types.

4. Postural Instability

Seen more in advanced stages. Patients may lean slightly forward, and weakened reflexes increase the risk of imbalance and falls during turns or minor stumbles.

Hidden Non-Motor Symptoms

Parkinson’s affects more than movement. Dopamine deficiency can deeply impact the autonomic nervous system, mood, and sleep. Some non-motor symptoms appear years before motor signs:

• Loss of Smell: Inability to detect coffee, perfume, or food aromas.
• Constipation: Slowed bowel movements causing chronic constipation.
• Sleep Disorders: Especially REM sleep behavior disorder, characterized by acting out dreams, shouting, kicking, or falling out of bed.
• Mood Changes: Dopamine deficiency may cause depression, anxiety, and general lack of motivation.

How is Parkinson’s Diagnosed?

There is no blood test or imaging that directly measures dopamine levels for Parkinson’s diagnosis. Diagnosis relies on clinical evaluation and patient history. MRI is essential to rule out Parkinson’s mimics such as brain tumors, hydrocephalus, or vascular lesions. The Levodopa Test is also a key diagnostic tool: noticeable symptom improvement after dopamine-containing medication supports the diagnosis.

Frequently Asked Questions (FAQ)

Q: Can Parkinson’s occur at a young age?
A: Yes, cases under 40 are called Early-Onset Parkinson’s, often driven by genetic factors and progressing slower than in older patients.

Q: Is the disease fatal?
A: Parkinson’s itself is not fatal. However, advanced stages can lead to serious complications such as pneumonia from swallowing difficulties or falls causing fractures.

Q: Can Parkinson’s occur without tremor?
A: Yes, about 20% of patients never experience tremor. In these cases, slow movement and stiffness dominate. Lack of tremor does not rule out the disease.

Q: Is there a cure?
A: Current treatments do not eliminate Parkinson’s but manage symptoms, allowing patients to maintain normal life. Medication and surgery help preserve quality of life.

Diagnosis and Confidence with Assoc. Prof. Dr. Mehmet Sorar

Receiving a Parkinson’s diagnosis is challenging for patients and families. Worries about the future, loss of mobility, and negative thoughts are natural.

Assoc. Prof. Dr. Mehmet Sorar supports patients not only with expertise but also with compassionate guidance. In his Ankara clinic, he carefully evaluates even subtle neurological signs.

Each patient is unique, and treatment plans are personalized according to age, profession, lifestyle, and expectations. Knowing Parkinson’s is a long-term journey, Dr. Sorar ensures clear communication, realistic guidance, and transparent care—whether adjusting medications or planning surgical interventions.

With experienced hands, the diagnostic process transforms from uncertainty to informed decision-making, easing the journey for patients and their families.

Let’s simplify and support your Parkinson’s journey together.