Talk:Parkinson's disease

Trichloroethylene

Any strong evidence for trichloroethylene causing Parkinson's? The current research seems very coincidental because of the small number of cases. 176.55.164.53 (talk) 07:35, 19 January 2025 (UTC)

the existing research is based on a very limited number of cases. unclear as trichloroethylene is a very widely used chemical... 88.234.208.1 (talk) 19:02, 2 April 2025 (UTC)

Scope

Moved: was at Talk:WikiProject Medicine#Pubmed query: Parkinson's
SandyGeorgia recommended using this article to define the scope of our current article, which I think is a great idea. To help with this, I'm going to give a brief overview of the articles content:

Epidemiology- 2:1 male:female ratio, increases with age, incidence rates 47-77 cases per 100,000 persons 45+ and from 108-212 cases per 100,000 persons 65+, higher rates among white people than Asian or black people, prevalence of the disorder is about 572 cases per 100,000 persons 45+, mortality around 60%,

Definition: Uses the International Parkinson and Movement Disorder Society diagostic criteria. Talks about importance of MRI to detect brain changes and Lewy pathologies and loss of pigmented neurons on autopsy.

Causes- Multifactoral causes, genetic changes in 20% of people, talks about specefic genetic disorders causing parkisons. Talks about genetic risk loci with smaller effects that have been identified. Talks about how research here has been mostly focused on white people. Without genetic factors heritability is estimated to be 20 to 30%. Studies for non genetic factors are limited. Combination of factors more so than one single factor. pesticides and solvents increases risk by 40%, shown in lab studies to induce symptoms. some studies show head injury as a risk, less consistently, exposure to metals, type 2 diabetes, certain inflammatory disorders, and infections have increased risk. decreased risk with smoking, caffine, and physical activity.

Symptoms- motor symptoms, Nonmotor symptoms come before cognitive and motor, autonomic abnormalities, cognitive changes.

Treatment- Lifestyle changes (sleep, diet, excersize) No med slows the development, symptoms managment tailorized with mutiple specialists. For motor symptoms, levodopa, dopamine agonists, amantadine and istradefylline, Anti-cholinergic drugs, and O-methyltransferase (COMT) inhibitors, or MAO-B inhibitors to enhance levodopa. acetylcholinesterase inhibitors or memantine and rivastigmine for dementia. Selective serotonin-reuptake inhibitors, selective serotonin–norepinephrine reuptake inhibitors, or dopamine agonists for depression. Psychiatric symptoms treated using pimavanserin49 or atypical antipsychotics, avoid dopamine D2 receptor–blocking antipsychotic agents. Autonomic symptoms managed with increased fluids, additional dietary salt, compression stockings, and medications to increase blood pressure. research on pain treatment lacking. Drooling managed with sublingual atropine drops or salivary-gland botulinum toxin injections. Constipation managed with dietary fiber, stool softeners, or laxatives. Disrupted sleep treated with cognitive behavioral therapy, melatonin, or low-dose clonazepam. deep brain stimulation mentioned. unilateral thalamotomy or pallidotomy used rarely. Mentions gene therapies.

Future- Prevention, desparities across minorities/marginalized groups, and biomarkers.

I tried to reword things to avoid copyright issues. If you want the original article please email me asking for it and I will send it via email (or google the name of the study and the authors). As always use your best judgement for weight but I think this is a good start. Sorry for all the typos IntentionallyDense ^(Contribs) 03:45, 21 March 2025 (UTC)

Cleaning up sourcing and citation problems

Further information at Talk:Parkinson's disease/GA3 and Articles in Category:Harv and Sfn no-target errors

See also the scripts: User:Trappist the monk/HarvErrors.js for identifying HarvRef errors and User:Headbomb/unreliable for reliability of sources

As of this March 19 version, I had cleaned out all the HarvRef errors (identified by the Trappist the monk script) mentioned in the above-linked GA review. There remained numerous dubious sources, identified by the Headbomb script.

HAL333, as of this March 21 version, you have reintroduced several of the same issues I had already corrected:

1. In the Citations section, you have used Lozano, Tam and Lozano 2018 as a citation, but it is not listed in the sources, so a) is an unidentified source that is b) kicking off a Harv Ref error. Presumably you are referring to PMID 29194808; if so, please add that in alphabetical order to the list of journal sources, which will remove the HarvRef error.
2. In the Works cited section, you have added two sources: Binde CD, Tvete IF, Gåsemyr J, Natvig B, Klemp M (September 2018), as well as Tan Y, Jenner P, Chen S (2022), which are not used anywhere in the article as citations, so are also kicking off HarvRef errors.
3. You removed the maintenance tag for the second time, without correcting the issues (and while re-introducing new ones).

Thank you for the considerable work you have done on this article. Real life issues prevent me from doing more to help. Could you please correct these issues and avoid introducing them again? Best regards, SandyGeorgia (Talk) 17:42, 21 March 2025 (UTC)

SandyGeorgia I aim to correct all of these issues within the next week. Thanks, and stay well. ~ HAL333 15:43, 22 March 2025 (UTC)

Hypotheses

Still thinking about whether those hypotheses you incorporated under causes might fit better in the "clinical research" section. Sure, they're hypothesized as causes, but they still require much more research. Since you're the top editor, what do you think, @HAL333?

Btw., I moved the rest of the former hypotheses to "pathophysiology", as they target the mechanism and are somewhat better-established. I hope you understand the reasoning or we can aim for another solution. –Tobias (talk) 13:43, 26 March 2025 (UTC)

I'm going to but in here as someone who has done some research here. I think we would be better off finding an up to date source on the current mechanisms behind Parkinsons and going from there to judge what is due and undue weight here. I'll try to find some pubs on this topic. I do think we should move the hypothesis to the mechanisms section and leave the causes as just environmental, genetic, and risk/protective factors.IntentionallyDense ^(Contribs) 16:22, 26 March 2025 (UTC)

I was able to find these three articles:

• Zaman, Vandana; Shields, Donald C.; Shams, Ramsha; Drasites, Kelsey P.; Matzelle, Denise; Haque, Azizul; Banik, Narendra L. (2021). "Cellular and molecular pathophysiology in the progression of Parkinson's disease". Metabolic Brain Disease. 36 (5): 815–827. doi:10.1007/s11011-021-00689-5. ISSN 0885-7490. PMC 8170715. PMID 33599945. Retrieved 2025-03-26.
• Vázquez-Vélez, Gabriel E.; Zoghbi, Huda Y. (2021-07-08). "Parkinson's Disease Genetics and Pathophysiology". Annual Review of Neuroscience. 44 (1): 87–108. doi:10.1146/annurev-neuro-100720-034518. ISSN 0147-006X. Retrieved 2025-03-26.
• Simon, David K.; Tanner, Caroline M.; Brundin, Patrik (2020). "Parkinson Disease Epidemiology, Pathology, Genetics, and Pathophysiology" (PDF). Clinics in Geriatric Medicine. 36 (1): 1–12. doi:10.1016/j.cger.2019.08.002. PMC 6905381. PMID 31733690. Retrieved 2025-03-26.

I do think you could find some more in some textbooks though. IntentionallyDense ^(Contribs) 16:28, 26 March 2025 (UTC)

Images

@SandyGeorgia, you recently reinstated some deleted images. Personally, I don’t think they help in understanding Parkinson’s disease—one shows the X-ray whiteout of pneumonia, another a Lewy body micrograph already incorporated in the pathophysiology section, and another the structural formula of urate, which isn’t even directly related to PD itself. I’m curious to hear your thoughts on why you find them necessary. –Tobias (talk) 08:07, 31 March 2025 (UTC)

Your edit summary upon image removal said "reduced image count for readability" which made little sense to me ... one image per section is not impeding readability. I did not realize one of those images was a duplicate, so if you have good reasons for removing images, please feel free to revert me, but helpful edit summaries are a good thing :). Best regards, SandyGeorgia (Talk) 14:25, 31 March 2025 (UTC)

I've gone through now and addressed considerable MOS:SANDWICHing and removed the duplicates ... all yours now! SandyGeorgia (Talk) 15:27, 31 March 2025 (UTC)

By "for readability", I was referring to the left-aligned image of pneumonia, which interferes with the subsection header of "Other" below. Moreover, I don't see the encyclopedic added value of it. At no point were there too many images in general to clutter the article, I agree with that. –Tobias (talk) 16:01, 31 March 2025 (UTC)

I don't see any problem or interference from that image (ala what MOS cares about), but wouldn't care if it was moved to the right, or removed. As you wish, best regards, SandyGeorgia (Talk) 16:23, 31 March 2025 (UTC)

HAL333, this addition is causing text to be MOS:SANDWICHed between images. I had removed it once for that reason; the image is adding little to understanding of the article, but if you believe it does, then it needs to be somehow combined into a {{multiple image with the others. SandyGeorgia (Talk) 14:02, 1 April 2025 (UTC)

PS, when evaluating text SANDWICHing, please be sure you are viewing the article on a regular computer but also on an iPad or other mobile device, as those are now what most readers use. SandyGeorgia (Talk) 14:11, 1 April 2025 (UTC)

I don't personally find a drawing of an ancient Chinese emperor to be adding anything to the article, as the image conveys nothing about Parkinson's. SandyGeorgia (Talk) 17:19, 1 April 2025 (UTC)

I see no evidence of sandwiching, even with the smallest text size on a large desktop monitor. Further, essentially any page will have sandwiching when using desktop on a phone, so that is an unrealistic standard. That is the purpose, after all, of the mobile version. Further, if an image of Jean-Martin Charcot is due, it feels Eurocentric to not represent other cultural traditions and accounts. ~ HAL333 17:28, 2 April 2025 (UTC)

There is MOS:SANDWICHing. And MOS compliance will be a factor if/when approaching FAC. I have tried multiple ideas to address it, and none of them are optimal-- there are simply too many images in the section. Considering that History of Parkinson's disease exists, one of those images (at least) could be deleted to solve the image crowding problem -- this history (and images) is (or should be) covered in detail in the sub-article. SandyGeorgia (Talk) 00:00, 3 April 2025 (UTC)

By the way, History of Parkinson's disease has cited text that is not aligned with the text here in terms of Charcot's naming of the disease. SandyGeorgia (Talk) 00:04, 3 April 2025 (UTC)

I agree, I don't think either the illustration of Pierre D. or the image of the Yellow Emperor is necessary in this article, but they are suitable for the history of PD. –Tobias (talk) 11:22, 3 April 2025 (UTC)