Hello and welcome to the Zero to Finals podcast. My name is Tom and in this episode I'm going to be talking to you about Parkinson's disease.

And if you want to follow along with written notes on this topic, as always, you can follow along at zero to finals.com slash Parkinson's or in the neurology section of the Zero to Finals Medicine book.

So let's get straight into it.

Parkinson's disease is a condition where there's a progressive reduction of dopamine

in the basal ganglia of the brain.

And this leads to disorders of movement.

The symptoms are characteristically asymmetrical, so one side of the

body is affected more than the other, and there's a classic triad of features in Parkinson's disease,

and it's worth remembering these three key features, and they are resting tremor, rigidity,

and bradykinesia, and we'll talk about these in more detail.

So first let's talk about the path of physiology. The basal ganglia are a group of structures

that are situated in the middle of the brain. And they're responsible for coordinating habitual

movements like walking or looking around,

controlling voluntary movements, and also learning specific movement patterns.

Part of the basal ganglia, called the substantia nigra, produces a neurotransmitter called dopamine.

And dopamine is essential for the correct functioning of the basal ganglia.

And in Parkinson's disease, there's a gradual reduction and a progressive fall in the production of

dopamine, which means that the basal ganglia don't function as well as they were. So how does it

present? Well, the typical patient is an older aged man

around the age of 70, but it can affect both sexes and younger patients as well. Firstly, a unilateral

tremor is a key feature and the tremor in Parkinson's disease has a frequency of four to six

hertz, meaning that it occurs four to six times in a second. This is described as a pill rolling

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