Parkinson's disease (PD) belongs to a group of conditions called motor system disorders, which are the result of the loss of dopamine-producing brain cells. The four primary symptoms of PD are tremor, or trembling in hands, arms, legs, jaw, and face; rigidity, or stiffness of the limbs and trunk; bradykinesia, or slowness of movement; and postural instability, or impaired balance and coordination. As these symptoms become more pronounced, patients may have difficulty walking, talking, or completing other simple tasks. PD usually affects people over the age of 50.  Early symptoms of PD are subtle and occur gradually.  In some people the disease progresses more quickly than in others.  As the disease progresses, the shaking, or tremor, which affects the majority of PD patients may begin to interfere with daily activities.  Other symptoms may include depression and other emotional changes; difficulty in swallowing, chewing, and speaking; urinary problems or constipation; skin problems; and sleep disruptions.  There are currently no blood or laboratory tests that have been proven to help in diagnosing sporadic PD.  Therefore the diagnosis is based on medical history and a neurological examination.  The disease can be difficult to diagnose accurately.   Doctors may sometimes request brain scans or laboratory tests in order to rule out other diseases. At present, there is no cure for PD, but a variety of medications provide dramatic relief from the symptoms.  Usually, patients are given levodopa combined with carbidopa.  Carbidopa delays the conversion of levodopa into dopamine until it reaches the brain.  Nerve cells can use levodopa to make dopamine and replenish the brain's dwindling supply.  Although levodopa helps at least three-quarters of parkinsonian cases, not all symptoms respond equally to the drug. Bradykinesia and rigidity respond best, while tremor may be only marginally reduced. Problems with balance and other symptoms may not be alleviated at all.  Anticholinergics may help control tremor and rigidity.  Other drugs, such as bromocriptine, pramipexole, and ropinirole, mimic the role of dopamine in the brain, causing the neurons to react as they would to dopamine.  An antiviral drug, amantadine, also appears to reduce symptoms.  In May 2006, the FDA approved rasagiline to be used along with levodopa for patients with advanced PD or as a single-drug treatment for early PD. In some cases, surgery may be appropriate if the disease doesn't respond to drugs. A therapy called deep brain stimulation (DBS) has now been approved by the U.S. Food and Drug Administration. In DBS, electrodes are implanted into the brain and connected to a small electrical device called a pulse generator that can be externally programmed. DBS can reduce the need for levodopa and related drugs, which in turn decreases the involuntary movements called dyskinesias that are a common side effect of levodopa. It also helps to alleviate fluctuations of symptoms and to reduce tremors, slowness of movements, and gait problems. DBS requires careful programming of the stimulator device in order to work correctly. PD is both chronic, meaning it persists over a long period of time, and progressive, meaning its symptoms grow worse over time.  Although some people become severely disabled, others experience only minor motor disruptions. Tremor is the major symptom for some patients, while for others tremor is only a minor complaint and other symptoms are more troublesome.  No one can predict which symptoms will affect an individual patient, and the intensity of the symptoms also varies from person to person. The National Institute of Neurological Disorders and Stroke (NINDS) conducts PD research in laboratories at the National Institutes of Health (NIH) and also supports additional research through grants to major medical institutions across the country.  Current research programs funded by the NINDS are using animal models to study how the disease progresses and to develop new drug therapies. Scientists looking for the cause of PD continue to search for possible environmental factors, such as toxins, that may trigger the disorder, and study genetic factors to determine how defective genes play a role.  Other scientists are working to develop new protective drugs that can delay, prevent, or reverse the disease.More information about Parkinson's Disease research is available at http://www.ninds.nih.gov/research/parkinsonsweb/index.htm http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&term=parkinson+disease[majr]+AND+human[mh]+AND+english[la]+AND+(review[ptyp]+OR+review+literature[mh]+OR+practice+guidelines[mh]+OR+guideline[ptyp]+OR+clinical+trials[mh]+OR+clinical+trial[ptyp]+OR+consumerj[sb])&db=PubMed&orig_db=PubMed&filters=on&pmfilter_EDatLimit=1+Years http://www.nlm.nih.gov/medlineplus/parkinsonsdisease.html 1 http://clinicaltrials.gov/ct2/results?term= /disorders/parkinsons_disease/pubs_parkinsons_disease.htm /disorders/parkinsons_disease/xml_parkinsons_disease.xml xml_parkinsons_disease.xml V186 American Parkinson Disease Association

135 Parkinson Avenue

Staten Island NY 10305-1425 apda@apdaparkinson.org http://www.apdaparkinson.org 718-981-8001 800-223-2732 Young Onset Center: 877-223-3801 718-981-4399 Seeks to “Ease the Burden – Find the Cure” through funding scientific research. Provides comprehensive patient/caregiver support and education. V188 National Parkinson Foundation

1501 N.W. 9th Avenue

Bob Hope Road Miami FL 33136-1494 contact@parkinson.org http://www.parkinson.org 305-243-6666 800-327-4545 305-243-5595 Provides research, patient services, clinical studies, public and professional education, and physician referrals at over 60 locations and through a nationwide network of chapters and support groups. V611 Parkinson Alliance

P.O. Box 308

Kingston NJ 08528-0308 http://www.parkinsonalliance.org 609-688-0870 800-579-8440 609-688-0875 Raises and distributes money for the most promising research leading to a cure for Parkinson's disease. Partners with the Tuchman Foundation to ensure that every dollar donated by individuals and all net proceeds of events go directly to research. The Alliance is also devoted to improving quality of life within the DBS-STN community through an affiliated resource, www.DBS-STN.org. V606 Michael J. Fox Foundation for Parkinson's Research

Grand Central Station

P.O. Box 4777 New York NY 10163 http://www.michaeljfox.org 212-509-0995 Dedicated to advancing a cure for Parkinson’s disease by identifying promising research and raising funds for research support. V189 Parkinson's Action Network (PAN)

1025 Vermont Ave., NW

Suite 1120 Washington DC 20005 info@parkinsonsaction.org http://www.parkinsonsaction.org 800-850-4726 202-638-4101 202-638-7257 Non-profit education and advocacy organization that serves as a voice for the Parkinson's community by fighting for promising research that will produce effective treatments and a cure. V190 Parkinson's Disease Foundation (PDF)

1359 Broadway

Suite 1509 New York NY 10018 info@pdf.org http://www.pdf.org 212-923-4700 800-457-6676 212-923-4778 National nonprofit organization that supports Parkinson's disease research, education, and public advocacy programs. V617 The Parkinson's Institute and Clinical Center

675 Almanor Avenue

Sunnyvale CA 94085 info@thepi.org http://www.thepi.org 408-734-2800 800-655-2273 408-734-8522 Non-profit organization conducting patient care and research activities in the neurological specialty area of movement disorders. V589 Parkinson's Resource Organization

74-478 Highway 111

No 102 Palm Desert CA 92260 info@parkinsonsresource.org http://www.parkinsonsresource.org 760-773-5628 877-775-4111 877-775-4111 760-773-9803 Helps families affected by Parkinson’s by offering emotional and educational support programs, publishing a monthly newsletter about quality of life and family issues, providing information and referral services, promoting advocacy and public awareness, and providing respite for family caregivers. V85 WE MOVE (Worldwide Education & Awareness for Movement Disorders)

5731 Mosholu Avenue

Bronx NY 10024 wemove@wemove.org http://www.wemove.org 347-843-6132 718-601-5112 WE MOVE provides movement disorder information and educational materials to physicians, patients, the media, and the public. V812 Bachmann-Strauss Dystonia & Parkinson Foundation

Fred French Building 551 Fifth Avenue, at 45th Street

Suite 520 New York NY 10176 info@bsdpf.org http://www.dystonia-parkinsons.org 212-682-9900 212-987-0662 Non-profit foundation that supports patients, family members, researchers, clinicians, and volunteers working in partnership to find better medical treatments and a cure for dystonia and Parkinson's disease. V938 Davis Phinney Foundation

4676 Broadway

Boulder CO 80304 info@davisphinneyfoundation.org http://www.davisphinneyfoundation.org 866-358-0285 303-733-3340 303-733-3350 Dedicated to helping people with Parkinson’s disease to live well today. Provides information, inspiration, tools, resources, and opportunities to people living with PD and care partners to better manage their disease and promote increased engagement in health.