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Parkinson's Disease: Overview

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Neurodegenerative disorders are progressive diseases that cause irreversible damage and loss to neurons in specific brain areas. Examples of these disorders include Parkinson's disease, Alzheimer's disease, Multiple Sclerosis (MS), and Amyotrophic Lateral Sclerosis (ALS). These disorders share characteristics such as proteinopathies, selective neuronal vulnerability, and a complex interplay between genetic and environmental factors. The primary therapeutic goal for these conditions is to...

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Parkinson disease (PD) is a progressive neurodegenerative disorder primarily affecting movement, with additional non-motor features. Its pathophysiology involves complex interactions among genetic susceptibility, environmental exposures, and cellular dysfunction, including dopaminergic neuron loss, protein aggregation, and mitochondrial impairment.Selective NeurodegenerationA key feature is the degeneration of dopaminergic neurons in the substantia nigra pars compacta, leading to reduced...

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Updated: Jun 27, 2026

Controlling Parkinson's Disease With Adaptive Deep Brain Stimulation

Controlling Parkinson's Disease With Adaptive Deep Brain Stimulation

Published on: July 16, 2014

"Brain-First" vs. "Body-First" PD: Definitions and Implications in Everyday Clinical Practice: A Systematic Review.

Ioannis Pilateris^1,2, Sevasti Bostanjopoulou³

¹Department of Neurology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.

Medicina (Kaunas, Lithuania)

|June 26, 2026

Summary

Parkinson's disease may have two distinct pathways: Body-first PD and Brain-first PD. Body-first PD shows faster progression and more non-motor symptoms, suggesting different disease trajectories.

Keywords:

Parkinson’s disease biomarkers body-first PD brain-first PD disease progression microbiome pathophysiology prognosis

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Dynamic Digital Biomarkers of Motor and Cognitive Function in Parkinson's Disease

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Published on: July 24, 2019

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Last Updated: Jun 27, 2026

Controlling Parkinson's Disease With Adaptive Deep Brain Stimulation

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Published on: July 16, 2014

Dynamic Digital Biomarkers of Motor and Cognitive Function in Parkinson's Disease

Dynamic Digital Biomarkers of Motor and Cognitive Function in Parkinson's Disease

Published on: July 24, 2019

Area of Science:

Neuroscience
Neurology
Pathophysiology

Background:

Parkinson's disease (PD) pathophysiology is not fully understood.
Braak's hypothesis suggests alpha-synuclein (ASyn) pathology propagation.
A novel model proposes two distinct ASyn pathways: Body-first PD and Brain-first PD.

Purpose of the Study:

To systematically review and synthesize literature comparing Body-first and Brain-first PD.
To focus on clinical characteristics, disease progression, diagnostic biomarkers, and management.

Main Methods:

Systematic literature search (March 2025) in PubMed, Cochrane Library, DOAJ, Google Scholar.
Included human observational, diagnostic, and interventional studies (2019-March 2025) of de novo or early PD.
Used pre-motor REM sleep behavioral disorder (RBD) as a key differentiator; risk of bias assessed using JBI checklists.

Main Results:

Sixteen studies (2107 patients) were included.
Body-first PD linked to higher non-motor symptom burden, faster progression, and cognitive impairment.
Differences observed in neurodegeneration patterns, electrophysiology, metabolism, biomarkers, and microbiome profiles.

Conclusions:

Brain-first and Body-first PD may represent distinct pathophysiological entities.
This classification has significant implications for PD diagnosis, prognosis, and management.
Current literature is mostly cross-sectional, limiting causal inference; longitudinal studies are needed.