Parkinson Disease

Roger L. Albin, M.D. is a graduate of Oberlin College and the University of Pittsburgh School of Medicine. He received clinical and post-doctoral training at the University of Michigan, where his mentors were Anne Young and the late Jack Penney. His primary research interest is the pathophysiology of basal ganglia disorders, including Parkinson disease, Tourette syndrome, and Huntington disease. He is presently Co-Director of the Parkinson Disease & Movement Disorders Division and Director of the Udall Center at the University of Michigan, and Associate Director for Research at the VAAAHS GRECC.

• Chapter 1: Definition, History, Nosology, and ClassificationIntroduction and Definition Brief History of PDNosology and Classification Scheme Classification Level 1Classification Level 2Ambiguities and Future DirectionsConclusion Chapter 2: EpidemiologyIntroductionPrevalenceIncidenceMortalityRisk FactorsImplications for Understanding Etiopathogenesis and the Future Burden of PD Chapter 3: PathologyIntroductionThe Aging BrainGross Pathology, Lewy Pathology, and a-Synucleinopathy Substantia Nigra Pars Compacta PathologyIdiopathic Lewy Body Disease (iLBD) The Braak et al. Staging SystemSynucleinopathy Outside the BrainNon-Synuclein Pathologies Chapter 4: Pathophysiology I - Basal Ganglia Architecture and the Standard ModelIntroductionBasic Basal Ganglia ArchitectureThe "Standard" Model of Basal Ganglia Pathophysiology Complexities of Basal Ganglia ArchitectureConclusion Chapter 5: Pathophysiology II - Neurotransmitter System DysfunctionsIntroductionNigrostriatal Dopamine Signaling Functions Habit Formation and ChunkingCholinergic Projection System Dysfunctions Serotoninergic System Dysfunctions Conclusions and Future Challenges Chapter 6: Genetics of Parkinson DiseaseIntroductionDominant Forms of PD Recessive Forms of PDGBAPD Genetic Risk Factors Implications of PD Genetic Research Chapter 7: PathogenesisNeuronal VulnerabilityAlpha-SynucleinThe Prion-Like HypothesisMitochondrial DysfunctionOxidative StressEndolysosomal Dysfunction NeuroinflammationNeuroprotection TrialsConclusions Chapter 8: Prodromal Parkinson DiseaseIntroductionREM Sleep Behavior Disorder Observational StudiesREM Sleep Behavior Disorder Cohort Studies Genetic Cohort StudiesAutonomic FailureFuture Directions Chapter 9: Clinical Features I - Initial EvaluationPresentation FeaturesNature of Diagnosis and Diagnostic Criteria History and Examination Differential DiagnosisTreatment Responsiveness Diagnostic Accuracy Chapter 10: Clinical Features II - Non-Motor FeaturesIntroductionCognitive ImpairmentsNeuropsychiatric Disorders Sleep DisordersPainFatigueAutonomic Disorders Visual DisordersOral HealthConclusion Chapter 11: Clinical Features III - Natural History IntroductionAssessing PD ProgressionPD Progression - Clinically Salient FeaturesSubgroupsNatural History Summary Continuing CareEnd of Life Care Chapter 12: Pharmacology I - L-Dopa Pharmacokinetics and PharmacodynamicsIntroductionDopaminergic Neurotransmission L-Dopa PharmacokineticsL-Dopa PharmacodynamicsPeak Dose DyskinesiasInteractions of L-Dopa Pharmacokinetics, Pharmacodynamics, and Disease Progression Summary and Future Directions Chapter 13: Pharmacology II - Treating Parkinson DiseaseIntroductionUsing L-DopaWhen the Honeymoon Is OverL-Dopa AdjunctsDopamine Agonists Cholinergic AgentsOther Symptomatic TherapiesFuture Directions Chapter 14: SurgeryIntroductionDeep Brain Stimulation: Rationale and Possible Mechanisms Deep Brain Stimulation: ProceduresDeep Brain Stimulation: STN DBS BenefitsDeep Brain Stimulation: GPi DBS Benefits and STN vs GPi DBSDeep Brain Stimulation: Adverse EventsLesional ProceduresCell-Based and Gene TherapiesFuture Directions Coda: Looking Ahead