A timeline for Parkinson's disease
Abstract
It is reasonably well established that prior to the motor phase of classical Parkinson's disease (PD) there is a prodromal period of several years duration. Once typical motor features appear, the disease continues up to 20 years depending on multiple variables. The clinical features of the prodromal and motor phases may be correlated with pathological changes in the central and autonomic nervous systems to allow a sequential plan of disease progression. We present a 'best guess' for a typical individual presenting with PD in their sixties and speculate that the disease will last approximately 40 years from the earliest non-motor features to death. Appreciation of this concept may allow better strategies for slowing or halting disease progression.
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Environmental factors such as microorganisms, including nasal/gut microbiota, and toxins like pesticides might start a pathological process at the olfactory bulbs and enteric nerve cell plexus, causing mucosal inflammation and oxidative stress and thereby initiating alpha-synuclein accumulation.
“Environmental factors such as microorganisms, including nasal/gut microbiota, and toxins like pesticides might start a pathological process at two sites, in the OB and within enteric nerve cell plexus (Hawkes et al., 2009b), causing mucosal inflammation and oxidative stress and thereby initiating alpha-synuclein accumulation (Hawkes et al., 2010).”
From The Gut-Brain Axis in Parkinson’s Disease: Possibilities for Food-Based Therapies (2017) · cites this paper as Hawkes et al., 2010
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- Authors
- Hawkes, C. H., Del Tredici, K., & Braak, H.
- Affiliations
- Queen Mary University of London (GB)
- Universität Ulm (DE)
- Corresponding author
- Hawkes, Christopher H.
- Venue
- Parkinsonism & Related Disorders
- Publisher
- Elsevier BV
- Published
- 2010-02
- Volume
- 16
- Issue
- 2
- Pages
- 79-84
- ISSN
- 1353-8020 (ISSN-L)
- OpenAlex
- W2046189898
- Cited by
- 594
- References
- 93
- Citations by year
- 2026: 8 · 2025: 28 · 2024: 51 · 2023: 34 · 2022: 50 · 2021: 47 · 2020: 49 · 2019: 55 · 2018: 37 · 2017: 33 · 2016: 36 · 2015: 33 · 2014: 35 · 2013: 33 · 2012: 29
- FWCI
- 2.40
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Parkinsonism & Related Disorders (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Neurology › Neurological disorders and treatments
- Keywords
- Parkinson's disease, disease progression
- MeSH terms
- Humans, Models, Biological, Parkinson Disease, Lewy Bodies, Disease Progression
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