Parkinson's disease (PD; paralysis agitans) is a neurodegenerative disease of the substantia nigra (an area in the basal ganglia of the brain). The disease was first discovered and its symptoms documented in 1817 (Essay on the Shaking Palsy) by the British physician Dr. James Parkinson; the associated biochemical changes in the brain of patients were identified in the 1960s. Some genes were identified only recently; others remain unknown. Neurodegenerative disease is a condition which affects the brain function. ... The substantia nigra (Latin for black substance) is a portion of the midbrain thought to be involved in certain aspects of movement and attention. ... The basal ganglia are a group of nuclei in the brain associated with motor and learning functions. ... In the anatomy of animals, the brain, or encephalon, is the supervisory center of the nervous system. ... 1817 was a common year starting on Wednesday (see link for calendar). ... James Parkinson (April 11, 1755 to December 21, 1824) was an English physician, geologist, paleontologist, and political activist. ... Biochemistry is the chemistry of life. ... In the anatomy of animals, the brain, or encephalon, is the supervisory center of the nervous system. ... In semantics, the patient is the passive part of a process. ... Events and trends The 1960s was a turbulent decade of change around the world. ... This stylistic schematic diagram shows a gene in relation to the double helix structure of DNA and to a chromosome (right). ...

The disease involves a progressive movement disorder of the extrapyramidal system, which controls and adjusts communication between neurons in the brain and muscles in the human body. It also commonly involves depression and disturbances of sensory systems. In human anatomy, the extrapyramidal system is a neural network located in the brain that is part of the motor system involved in the coordination of movement. ... Neurons (also spelled neurones or called nerve cells) are the primary cells of the nervous system. ... A top-down view of skeletal muscle Muscle is a contractile form of tissue. ... Human anatomy or anthropotomy is a special field within anatomy. ... The word depression can mean: A decrease of functional activity in behavior patterns. ...

In the United States, the prevalence of Parkinson's disease is 1 per 625 people, though this increases with age, as indicated by the mean onset of 55 years of age. Symptoms usually begin in the upper extremity, and are usually unilateral (one-sided) or asymmetrical at onset. The prevalence of a disease in a statistical population is defined as follows: Prevalence is useful because it is a measure of the commonality of disease. ...

Causes

The cause of Parkinson's disease is not known. Geneticists have since 1997 found nine different specific genetic defects, each of which causes the disease in one or a few families with extraordinarily high incidences of the disease, but such families are rare. While a strong inheritance pattern occurs in only a very small percentage of cases, an affected individual is three to four times more likely than an unaffected individual to have a close relative with Parkinson's. Having a parent with Parkinson's raises one's lifetime risk of developing the disorder threefold, from the general population's figure of 2% to about 6%. Genes that have been identified include SNCA (protein alpha-synuclein), UCHL1 (protein ubiquitin carboxy-terminal hydrolase L1), PARK2 (protein parkin), and PARK7 (protein DJ-1). Indeed, recent linkage studies excluded most of the above gene defects from consideration in the causation of sporadic (i.e. non-familial) Parkinson's disease, which constitutes more than 95% of cases. Most recently, a new gene was identified, ND5, mutation in which is thought to account for a vast majority of sporadic PD cases (see below). Genetics (from the Greek genno γεννώ= give birth) is the science of genes, heredity, and the variation of organisms. ... 1997 is a common year starting on Wednesday of the Gregorian calendar. ... In optics one considers angles of incidence. ... A representation of the 3D structure of myoglobin, showing coloured alpha helices. ... Alpha-synuclein is a normal protein found in the brain. ... Ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) (EC 3. ... Parkin is an E3 ligase in the ubiquitin-proteasome system. ...

A popular theory holds that the disease might result in most cases from the combination of a subtle genetically determined vulnerability to environmental toxins along with mild exposure to those toxins. The toxins most strongly suspected at present are certain pesticides and industrial metals. MPTP is used as a model for Parkinson's as it can rapidly induce parkinsonian symptoms in patients/animals of any age. Other toxin-based models employ paraquat (an herbicide) or rotenone (an insecticide). Studies have found a mild increase in PD in persons chronically exposed to these agricultural chemicals. A toxin, in a scientific context, is a biologically produced substance that causes injury to the health of a living thing on contact or absorption, typically by interacting with biological macromolecules such as enzymes and receptors. ... An airplane spreading pesticide. ... MPTP (1-methyl 4-phenyl 1,2,3,6-tetrahydropyridine) is a chemical that is related to the opioid analgesic drugs. ... Paraquat is a toxic chemical that is widely used as an herbicide (plant killer), primarily for weed and grass control. ... Rotenone (CAS number 83-79-4) is a colorless-to-red, odorless solid. ...

Almost all of the PD-causing toxins act on the mitochondrial complex I of the electron transfer chain, and sporadic PD cases have been found to have a partial loss of activity of this enzyme complex. Studies in cybrids found that mitochondrial DNA, rather than the nuclear DNA is responsible for the dysfunction. Most recently, microheteroplasmic mutations in one of the mitochondrial complex I genes, ND5, were found to be sufficient to diagnose sporadic PD correctly in 27 out of 28 cases. While additional studies are needed, mitochondrial microheteroplasmic mutations may represent the true cause of the vast majority of PD cases. ... Categories: Biochemistry stubs | Cellular respiration | EC 1. ... The electron transfer chain (also called the electron transport chain, or simply electron transport), is a series of protein complexers and lipid messengers spanning the inner mitochondrial membrane that accepts electrons from electron donors such as NADH or succinate, shuttles these electrons from within the mitochondrial matrix across the inner... Cybrids, or CYtoplasmic hyBRIDs, are eukaryotic cell lines produced by the fusion of rho-zero cells and mitochondria from another donor. ... Mitochondrial DNA (mtDNA) is DNA which is not located in the nucleus of the cell but in the mitochondria. ... Microheteroplasmy is a form of heteroplasmy, a type of mutational damage to mitochondrial DNA. While heteroplasmy in general includes mutations present in any fraction of mtDNA (from fractions of a percent to almost a hundred percent), microheteroplasmy is the presence of mutations levels of up to about 2 - 5 %. This...

Minor past episodes of head trauma are also more commonly reported by sufferers than by others in the population. While emotional or a psychological trauma can precipitate the initial symptoms or aggravate existing symptoms, this is not the actual cause of the disorder. Psychological trauma may accompany physical trauma, or exist independently. ...

The symptoms of Parkinson's disease result from the loss of dopamine-secreting (dopaminergic) cells and subsequent loss of melanin, secreted by the same cells, in the pars compacta region of the substantia nigra (literally "black substance"). These neurons project to the striatum and their loss leads to inhibition of the direct pathway of movement and activation of the indirect pathway of movement. Since the direct pathway facilitates movement and the indirect pathway inhibits movement, the loss of these cells leads to a hypokinetic movement disorder. The lack of dopamine results in an excessive inhibition of the thalamus, leading to hypokinesia. Dopamine is a chemical naturally produced in the body. ... Melanin is a pigment ranging from brown to black in hue found in animals and plants. ... The substantia nigra (Latin for black substance) is a portion of the midbrain thought to be involved in certain aspects of movement and attention. ... The substantia nigra (Latin for black substance) is a portion of the midbrain thought to be involved in certain aspects of movement and attention. ... The striatum is a subcortical part of the brain consisting of the caudate nucleus and the putamen. ... The striatum modulates movement by two pathways: a direct pathway and an indirect pathway. ... The striatum modulates movement by two pathways: a direct pathway and an indirect pathway. ... Dopamine is a chemical naturally produced in the body. ...

Brain cells producing other brain chemicals such as GABA, norepinephrine, serotonin and acetylcholine exhibit minor damage in Parkinson's disease, accounting for some of the wide array of symptoms. Chemical structure of GABA Gamma-aminobutyric acid (GABA) is a neurotransmitter in widely divergent species. ... Norepinephrine, known as noradrenaline outside the USA, is a catecholamine and a phenethylamine with chemical formula C8H11NO3. ... Serotonin (5-hydroxytryptamine, or 5-HT) is a monoamine neurotransmitter synthesised in serotonergic neurons in the central nervous system and enterochromaffin cells in the gastrointestinal tract. ... The chemical compound acetylcholine, often abbreviated as ACh, was the first neurotransmitter to be identified. ...

The mechanism by which the brain cells in Parkinson's are lost appears to center on an abnormal accumulation of the protein alpha-synuclein in the damaged cells. This protein forms proteinaceous cytoplasmic inclusions called Lewy bodies. The precise mechanism whereby aggregates of alpha-synuclein damage the cells is not known. The aggregates may be merely a normal reaction by the cells as part of their effort to correct a different, as-yet unknown, insult. It does appear that alpha-synuclein aggregation is enhanced by the presence of dopamine and the byproducts of dopamine production. Alpha-synuclein is a normal protein found in the brain. ... Lewy bodies are abnormal aggregates of protein that develop inside nerve cells. ...

Symptoms

Symptoms may vary among patients, and additionally may vary greatly over time in a single patient. However, the cardinal symptoms are: A cardinal symptom is the primary or major symptom by which a diagnosis is made. ...

• tremor (while this is the best known symptom, it is not displayed by an estimated 30% of patients),
• rigidity (increased tone or stiffness in the muscles),
• bradykinesia (slowness of movement) and akinesia (lack of spontaneous movement),
• failing balance,
• walking problems.

(The mnemonic TRAP (Tremor; Rigidity; Akinesia/bradykinesia; Postural instability) can be used to remember these symptoms.) In medicine (neurology), bradykinesia denotes slow movement (etymology: brady = slow, kinesia = movement). ... Akinesia is the inability to initiate movement, due to problems with selecting and activating motor programs in the brain. ... A mnemonic (Pronounced in American English, in British English) is a memory aid. ...

Additionally, the following signs and symptoms are commonly associated with Parkinson's Disease:

• Psychological
  • depression (occurs in 50% of cases)
  • anxiety or panic attacks
  • dementia, in approximately 20% of all patients, typically starting with slowing of thought and progressing to difficulty organizing thoughts
  • memory loss
  • altered sexual function
  • sleep disturbances

• Sensory
  • impaired visual contrast sensitivity, colour discrimination, and oculomotor control
  • dizziness
  • loss of sense of smell (anosmia),
  • pain

• Physical
  • speech problems (hypophonia; vocal cords can also be affected, causing monotonous, soft speech qualities),
  • stooped or flexed posture,
  • constipation,
  • fatigue (up to 50% of cases),
  • oily skin,
  • difficulty in swallowing,
  • masked facies (a mask-like face, with infrequent blinking),
  • drooling,
  • micrographia (small handwriting)
  • decreased arm swing
  • difficulty rolling in bed
  • slowness of gait

Symptoms usually only begin to appear after about 80% of the dopamine in the brain has been lost. More recent data based on PET scans suggests that symptoms may occur when 50-60% of dopaminergic neurons are lost. The level of dopamine will continue to fall slowly over time, with an attendant worsening of symptoms. Clinical Depression is a health condition of depression with mental and physical components reaching criteria generally accepted by clinicians. ... Dementia (from Latin demens) is progressive decline in cognitive function due to damage or disease in the brain beyond what might be expected from normal aging. ... Color is an important part of the visual arts. ... The term smell may refer to one of the following articles: Olfaction - The sense of smell, that is, the ability to perceive odors Odor - the object being perceived by the sense of olfaction See also Wiktionary:Smell This is a disambiguation page — a navigational aid which lists other pages that... Anosmia is the lack of olfaction, or a loss of the sense of smell. ... According to the International Society for the Study of Pain, there are two different terms: pain and nociception. ... Constipation is a condition of the digestive system where a person (or other animal) experiences difficulty in eliminating feces. ... This article refers to the sight organ. ... Drooling is caused by saliva flowing outside the mouth. ... Hookes drawing of a flea Published September, 1664, Micrographia was an immediate best-seller. ... Dopamine is a chemical naturally produced in the body. ... Positron emission tomography (PET) is a nuclear medicine medical imaging technique which produces a three dimensional image or map of functional processes in the body. ... Dopamine is a chemical naturally produced in the body. ...

It is an incapacitating disease, disturbing some important human functions and in some cases resulting in a substantial reduction in quality of life. As in many neurologic diseases, psychological complications are often extremely serious and require the patient's family members and relatives to pay keen attention to the emotional fragility that usually follows the emergence of the disease; indeed, the depression which often results is seen by many as one of the worst aspects of the disease. In some cases drugs are employed, especially in the fight against depression (given that Parkinson's-related depression is mainly induced by a complex of chemical-physical factors). Also, some common side effects of therapy can put the patient in a condition of humble self-consideration. External help is required to control the administration of the prescribed therapy: since patients are often confused or depressed, there is a risk of their improperly implementing the therapeutic regimen if left to their own devices, leading to symptoms not being adequately controlled. Neurology is a branch of medicine dealing with disorders of the central and peripheral nervous systems. ... Psychology (ancient Greek: psyche = soul and logos = word) is the study of behaviour, mind and thought. ... The word depression can mean: A decrease of functional activity in behavior patterns. ...

Parkinson's disease is very widespread, with about 150-200 cases per 100,000 population at any given time. About 2% of the population develops the disease some time during life. Cases are reported at all ages, though it is quite rare in people younger than 30 and the average age at which symptoms begin is 58-60; the risk of developing it substantially increases with age. It occurs in all parts of the world, but appears to be more common in people of European ancestry than in those of African ancestry. Those of East Asian ancestry have an intermediate risk. It is more common in rural than urban areas and men are affected slightly more often than women.

Diagnosis

Differential diagnosis

The differential diagnosis for a patient presenting with Parkinsonian symptoms is: Differential diagnosis is the process by which a physician utiltizes the scientific method and the skills acquired in medical school, internship, and residency to take a history, examine the patient, and do the appropriate testing to determine the nature and extent of a disease process in a patient. ...

• Idiopathic Parkinson's disease
• Essential tremor
• Parkinson plus syndromes (see below)
• Secondary parkinsonism due to drugs, toxins, stroke, head trauma, or hydrocephalus

Parkinson's tremors differ from essential tremors in that the latter are posture or action tremors, have bilateral tremors involving the hands, head and voice, and are alcohol responsive. In contrast, Parkinson's tremors are rest tremors, and usually start unilaterally. Idiopathic is a medical adjective that indicates that a recognized cause has not yet been established. ... Essential tremor is a neurological disorder characterized by shaking of hands (and sometimes other parts of the body including the head), evoked by intentional movements. ... Many drugs are provided in tablet form. ... A toxin, in a scientific context, is a biologically produced substance that causes injury to the health of a living thing on contact or absorption, typically by interacting with biological macromolecules such as enzymes and receptors. ... A stroke or cerebrovascular accident (CVA) occurs when the blood supply to a part of the brain is suddenly interrupted by occlusion (an ischemic stroke- approximately 90%of strokes) or by hemorrhage (a hemorrhagic stroke - approximately 10% of strokes). ... Head trauma is injury to the head from any cause. ...

Imaging

SPECT with iodine-123 labeled 2-β-carboxymethoxy-3-β-(4-iodophenyl)tropane ([123I]β-CIT) or IBZM and PET with ¹⁸F-fluorodopa are imaging modalities used to assess the dopamine transporter density and nigrostriatal pathway integrity in the central nervous system. Neither have any place yet in the routine diagnostic workup of PD, although they are used in research setting. SPECT (Single Photon Emission Computed Tomography) is a nuclear medicine tomographic imaging technique using gamma rays. ... IBZM is a chemical substance. ... Positron emission tomography (PET) is a nuclear medicine medical imaging technique which produces a three dimensional image or map of functional processes in the body. ... Medical imaging is the process by which physicians evaluate an area of the subjects body that is not normally visible. ...

Treatment

The treatment of Parkinson's disease mainly relies on replacing dopamine with levodopa (L-DOPA) or mimicking its action with dopamine agonists such as pramipexole, ropinirole, pergolide or bromocriptine. Discovered as a Parkinson's treatment by Arvid Carlsson, levodopa is a dopamine precursor that is transfomed into dopamine by the brain. Levodopa is almost always supplemented with carbidopa, a drug which prevents levodopa from being metabolized in the gut, liver and other tissues, thus allowing more levodopa to reach the brain and allowing for a reduced dosage, thus reducing some of the side effects. The most frequent side effects of these dopaminergic drugs are nausea, sleepiness, dizziness, involuntary writhing movements and visual hallucinations. Often times, the treatment of the Parkinson's patient with these two drugs can result in them very much "coming back to life" in the eyes of their family and doctors, to the point of them appearing to not have any disease at all. However, the drugs are not effective forever. Sometimes a point is reached where the drugs only work for a few hours, or become completely ineffective ("off periods"). Dopamine is a chemical naturally produced in the body. ... L-DOPA (levodopa, 3,4-dihydroxy-L-phenylalanine). ... Chemical structure of ergoline Ergoline is a chemical compound whose structure serves as the skeleton for a diverse range of alkaloids and synthetic drugs. ... Bromocriptine is an ergoline derivitave dopamine agonist that is used in the treatment of amenorrhea, female Parkinsons disease, and acromegaly. ... Arvid Carlsson (b. ... In the anatomy of animals, the brain, or encephalon, is the supervisory center of the nervous system. ... The subject of this article might not be notable enough for inclusion in Wikipedia. ... For the Physics term GUT, please refer to Grand unification theory The gastrointestinal or digestive tract, also referred to as the GI tract or the alimentary canal or the gut, is the system of organs within multicellular animals which takes in food, digests it to extract energy and nutrients, and... The liver is an organ in vertebrates including humans. ...

As in many other diseases, the therapy requires a continuing regimen of medicines, the dosage of which has to be specifically calculated for each single case and might vary during the evolution of the disease. The treatment is complex and usually consists of a mixture of drugs (basically focused on levodopa), some of which compensate for the side effects of others. Amantadine hydrochloride, anticholinergics and COMT inhibitors tolcapone or entacapone are sometimes prescribed. Tolcapone should be used with extreme caution because of the possibility of liver failure. However entacapone has not been shown to cause significant alterations of liver function. Foods rich in proteins can reduce the uptake of levodopa, because the same uptake system is used both by certain amino acids and levodopa. However, this can usually be dealt with by redistributing meal times: in many cases it is advisable to move the consumption of proteins towards the evening, so to have symptoms appearing when the patient has less need of mobility. While these therapies are a good attempt at treating the symptoms, they are not a cure--they do not attack the underlying cause of the disease which is a loss of dopamine producing neurons. Therapy (in Greek: θεραπεία) or treatment is the attempted remediation of a health problem, usually following a diagnosis. ... An anticholinergic agent is a member of a class of pharmaceutical compounds which serve to reduce the effects mediated by acetylcholine in the central nervous system and peripheral nervous system. ... In chemistry, an amino acid is any molecule that contains both amino and carboxylic acid functional groups. ...

Regular physical exercise and/or therapy are beneficial to the patient and essential for maintaining and improving mobility, flexibility, balance and a range of motion, and for a better resistance against many of the secondary symptoms and side effects.

Surgical interventions are currently being researched, and deep brain stimulation is presently the most popular and effective such treatment. In the future, implantation of cells genetically engineered to produce dopamine or stem cells that transform into dopamine-producing cells may become available. Deep Brain Stimulation (DBS) is a surgical procedure used to treat severe essential tremor and tremor, rigidity and bradykinesia (slow movement) associated with Parkinsons disease. ...

Even these, however, will not constitute cures because they do not address the widespread loss of several different types of cells in the brain and even for the dopamine-producing cells, do not re-establish all of the original connections with neighboring brain cells. A true cure will have to detect the earliest signs of the disorder before they cause important symptoms and will intervene in the process that damages the brain cells in the first place.

In the early stages Parkinson's disease does not necessarily affect intellectual integrity, apart from the emotional effects of eventual psychological complications, and in those cases where the patient is still compos mentis (in control of the situation), their role in the treatment is fundamental. The patient's cooperation is required in order to provide the physicians with all the details that might help in the making a correct diagnosis and consequent determination the best appropriated therapy. Conversely, it is crucial for doctors to explain the precise extent of the disease's progress, and provide as much information as possible about the prescribed therapy, how the symptoms and side effects can be reduced. Working together in this manner, the patient and doctor can ensure the maximum quality of life for the sufferer.

Related diseases

Parkinson-Plus diseases

There are other disorders that are called Parkinson-Plus diseases. These include:

• Multiple System Atrophy (MSA)
  • Shy-Drager Syndrome (SDS)
  • Striatonigral degeneration (SND)
  • Olivopontocerebellar Atrophy (OPCA)
• Progressive Supranuclear Palsy (PSP)
• Corticobasal Degeneration (CBD)

Some people include Dementia with Lewy Bodies (DLB) as one of the 'Parkinson-Plus' syndromes. Multiple System Atrophy (MSA) is a rare and always terminal degenerative neurological disorder characterized by a combination of Parkinsonism, cerebellar or corticospinal signs, pyramidal signs, and autonomic dysfunction. ... Shy-Drager syndrome (named after Dr. Milton Shy and Dr. Glenn Drager, who identified this syndrome in 1960) is a rare, progressively degenerative disease of the autonomic nervous system. ...

Patients often begin with typical Parkinson's disease symptoms and these Parkinson-Plus diseases can only be diagnosed when other symptoms become apparent after some years. These Parkinson-Plus diseases usually progress more quickly than the typical main illness, and the usual anti-Parkinson's medications do not work as well at controlling symptoms.

Secondary parkinsonism

Secondary parkinsonism (or briefly parkinsonism) is a term used for a symptom constellation that is similar to that of Parkinson's disease but is caused by other disorders or medications. Major reasons for secondary parkinsonism are stroke, encephalitis, narcotics, toxins and carbon monoxide poisoning, and normal pressure hydrocephalus. A stroke or cerebrovascular accident (CVA) occurs when the blood supply to a part of the brain is suddenly interrupted by occlusion (an ischemic stroke- approximately 90%of strokes) or by hemorrhage (a hemorrhagic stroke - approximately 10% of strokes). ... Encephalitis is an acute inflammation of the brain, commonly caused by a viral infection. ... The term narcotic, derived from the Greek word for stupor, originally referred to a variety of substances that induced sleep (such state is narcosis). ... For a list of biologically injurious substances, including toxins and other materials, as well as their effects, see poison. ... Carbon monoxide, chemical formula CO, is a colourless, odourless, flammable and highly toxic gas. ... Normal pressure hydrocephalus (NPH) is a neurological disorder often misdiagnosed as Parkinsons disease, Alzheimers disease, and senility. ...

There are other idiopathic (of unknown cause) conditions as Parkinson's disease that may cause parkinsonism. In these conditions the problem is not the deficient production of dopamine but the inefficient binding of dopamine to its receptors located on globus pallidus. Idiopathic is a medical adjective that indicates that a recognized cause has not yet been established. ... The globus pallidus is one of the major nuclei of the basal ganglia. ...

Notable Parkinson's sufferers

One famous sufferer of young-onset Parkinson's is Michael J. Fox, who has written a book about his experience of the disease. The film Awakenings (starring Robin Williams and Robert de Niro and based on genuine cases reported by Oliver Sacks) deals sensitively and largely accurately with a similar disease, postencephalitic parkinsonism; the state of the art in treatment remains roughly the same as it was at the time of the events depicted, the 1960s, although patients with postencephalitic parkinsonism lose benefit from their medication far faster than do patients with Parkinson's disease. Michael J. Fox (born June 9, 1961) is a Canadian-born actor, made famous by his role in the Back to the Future trilogy. ... Awakenings is a 1990 fact-based film which tells the story of a doctor who in 1969 discovers beneficial effects of the then-new drug L_Dopa on patients who are comatose after surviving the 1917_1928 epidemic of encephalitis lethargica. ... Robin Williams performing in Iraq. ... Robert De Niro Robert De Niro, Jr. ... Oliver W. Sacks (born July 9, 1933, London) is a neurologist who has written popular books about his patients. ... This disease is believed to have been caused by a viral illness, stimulating degeneration of the nerve cells in the substantia nigra, leading to clinical parkinsonism. ... Events and trends The 1960s was a turbulent decade of change around the world. ...

Other famous people, past and present, with Parkinson's include:

• Brockman Adams
• Muhammad Ali (suffers from Pugilistic Parkinson's syndrome)
• Jim Backus, American actor (1913-1989)
• Margaret Bourke-White
• Jack Buck, sportscaster (1924-2002)
• Salvador Dalí
• US Representative Lane Evans (D - IL)
• Michael J. Fox (1961-)
• Francisco Franco Spanish dictator (1892-1975)
• Estelle Getty, actress (1923-)
• Katharine Hepburn, actress (1907-2003)
• Adolf Hitler (1889-1945)
• Pope John Paul II (1920-2005)
• Ray Kennedy
• Jimmy Knepper, jazz trombonist (1927-2003)*Hans Ras
• Alois Mock, former Austrian foreign minister
• Janet Reno
• Pierre Elliott Trudeau
• Farnsworth Wright
• Mao Zedong (1893-1976)

As Secretary of Transportation, Brock Adams supported increasing automobile fuel efficiency and mass transit. ... Other people with this name: Muhammad Ali of Egypt, Mehemet Ali (Turkey), Muhammad Ali Jinnah of Pakistan Muhammad Ali-Haj (born January 17, 1942 as Cassius Marcellus Clay Jr. ... Pugilistic Parkinsons syndrome is a disorder that occurs among professional boxers who receive multiple blows to the head. ... Jim Backus (February 25, 1913 - July 3, 1989) was a radio, television and movie actor, and voice actor. ... Margaret Bourke-White (June 14, 1906 - August 27, 1971) was an American photographer and photo journalist. ... John Francis Buck (August 21, 1924 - June 18, 2002), born in Holyoke, Massachusetts, was an American sportscaster, best known for his work announcing Major League Baseball games of the St. ... Salvador Dalí as photographed in 1934 by Carl Van Vechten Salvador Domenec Felip Jacint Dalí Domenech (May 11, 1904 – January 23, 1989) was an important Catalan-Spanish painter, best known for his surrealist works. ... Lane Allen Evans (born August 4, 1951), American politician, has been a Democratic member of the United States House of Representatives since 1983, representing the 17th District of Illinois. ... Michael J. Fox (born June 9, 1961) is a Canadian-born actor, made famous by his role in the Back to the Future trilogy. ... Francisco Franco Francisco Paulino Hermenegildo Teódulo Franco y Bahamonde Salgado Pardo de Andrade (December 4, 1892 - November 20, 1975), abbreviated Francisco Franco Bahamonde and sometimes known as Generalísimo Francisco Franco, was dictator of Spain from 1939 until his death in 1975. ... Getty as Sophia on The Golden Girls Estelle Getty (born Estelle Scher on July 25, 1923) is an American actress best known for her role as Sophia Petrillo on the popular 1980s sitcom, The Golden Girls. ... Katharine Hepburn Katharine Houghton Hepburn (May 12, 1907 – June 29, 2003) was an iconic star of American film, television and stage, widely recognized for her sharp wit, New England gentility and fierce independence. ... Adolf Hitler (April 20, 1889–April 30, 1945) was the Führer und Reichskanzler (Leader and Imperial chancellor) of Germany from 1933 to his death. ... His Holiness Pope John Paul II (Latin: ), born Karol Józef Wojtyła [1] (May 18, 1920 – April 2, 2005), reigned as Pope of the Roman Catholic Church and sovereign of Vatican City for almost 27 years, from 16 October 1978 until his death. ... Ray Kennedy (born Northumberland, England, 28 July 1951) was a top footballer of the 1970s who won every domestic honour in the game with Arsenal and Liverpool. ... James M. (Jimmy) Knepper (*November 22, 1927 in Los Angeles, † 2003) was an American jazz trombonist. ... Johannes Jacobus (Hans) Ras (1 April 1926 – 22 October 2003) was emeritus professor of Javanese language and literature at Leiden University, the Netherlands. ... Dr. Alois Mock (born June 10, 1934) is a politician and member of the Christian-conservative Austria (German: Vizekanzler) from 1991 to 1995. ... Janet Reno (born July 21, 1938) was the 78th Attorney General of the United States (1993–2001), and was the first woman to hold that post. ... Name Pierre Elliott Trudeau Number Fifteenth First term April 20, 1968–June 4,1979 Second term March 3, 1980–June 30, 1984 Predecessor Lester Bowles Pearson Successors Joe Clark John Napier Turner Date of birth October 18, 1919 Place of birth Montreal, Quebec Date of death September 28, 2000 Spouse... Farnsworth Wright was a British ] who published the book Britain in the Age of Economic Management. ... Mao Zedong (December 26, 1893 – September 9, 1976) was the chairman of the Politburo of the Communist Party of China from 1943 and the chairman of the Central Committee of the Communist Party of China from 1945 until his death. ...

External links

• Dr. Abe Lieberman's Ask the Doctor Parkinson Forum (http://www.liebermanparkinsonclinic.com/)
• The PD Webring (http://www.pdring.com/)
• Useful links (http://www.apdaparkinson.com/)
• Parkinson's Disease Foundation (http://www.pdf.org/)
• The PD Webring (http://www.pdring.com/)
• National Parkinson Foundation, Inc. (http://www.parkinson.org/)
• Parkinson's Resources on the WWWeb (http://www.geocities.com/murraycharters)
• Parkinson's Disease Society (UK) (http://www.parkinsons.org.uk/)
• Parkinson's NSW (In AUS) (http://www.parkinsonsnsw.org.au/)
• Michael J. Fox Foundation for Parkinson's Research (http://www.michaeljfox.org/)
• Parkinson's Disease Pictures (http://health.allrefer.com/health/parkinsons-disease-info.html)