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neurodegenerative disorders
What system does Parkinson’s disease affect?

I know it affects the autonomic central nervous system. But more specifically, does it affect the sympathetic or parasympathetic system?

While Parkinson’s seems to begin as a disease of the central nervous system, it actually affects most of the systems in the body.

Because Parkinson’s is a chronic progressive neurodegenerative disease, it can eventually work its way through all systems: digestive (gastrointestinal), respiratory and circulatory systems, musculoskeletal. excretory and urinary systems, reproductive system, immune system, endocrine system.

The autonomic nervous system controls heart rate, digestion, respiration rate, salivation, perspiration, diameter of the pupils, the discharge of urine, and sexual arousal. Although most of its actions are involuntary, some ANS functions work together with the conscious mind, in breathing for example. Common symptoms of a problem are erectile dysfunction, dizziness, decrease in blood pressure and urinary incontinence; all of which are common to PD.

Since your question is also specific to the parasympathetic nervous system, read the abstract below (link also provided) and then you can find your own words. The important thing to know is that not all PD patients develop Lewy bodies. But the dementia caused by their presence is found in both Parkinson’s disease with dementia (PDD) and in Lewy Body Disorder (LBD) with parkinsonian symptoms. A third condition associated with lewy bodies is ANS.

“Lewy body formation has been considered to be a marker for neuronal degeneration, because postmortem studies of Parkinson’s disease (PD) patients have shown loss of neurons in the predilection sites for Lewy bodies. We systemically studied the autonomic nervous system in patients with PD. Lewy bodies were widely distributed in the hypothalamus, sympathetic system (intermediolateral nucleus of the thoracic cord and sympathetic ganglia) and parasympathetic system (dorsal vagal and sacral parasympathetic nuclei). The number of neurons in the intermediolateral nucleus was significantly reduced. Furthermore, Lewy bodies were also found in the enteric nervous system of the alimentary tract, cardiac plexus, pelvic plexus and adrenal medulla. These findings indicate that both central and peripheral autonomic nervous systems are involved in the disease process in PD.”

Another relation comes with orthostatic hypotension and the sudden drop in blood pressure upon standing. This can become common in PD because it is a side effect of aging and in one sense, PD is very accelerated aging of select neurons which result in the many symptoms of aging.

You can read about the imbalance between the autonomic and the parasympathetic nervous system
in ANS disorder: “Malfunction of the ANS is called autonomic failure. It results from an imbalance between the sympathetic and parasympathetic divisions. Aging is associated with several abnormalities in ANS function that can impair elderly people’s adaptation to stress.

The most common signs of ANS impairment are a drop in blood pressure when a person is standing or stands up suddenly (orthostatic hypotension) or a drop in blood pressure within one hour of eating a meal (postprandial hypotension).

The drop in blood pressure causes inadequate blood flow to the brain. That’s why it’s common for people with this problem to feel dizzy or lightheaded. These conditions occur more often in people with high blood pressure.

Several abnormalities make normal elderly people more likely to have low blood pressure. The onset of disease in old age, such as diabetes, stroke and Parkinson’s disease, as well as medications used to treat them, may have other adverse effects in the ANS that are obvious in the cardiovascular system.”

You might also be interested in reading about the clinical trial which is currently enrolling by invitation only in Finland.
Duodenal Levodopa Infusion, Quality of Life and Autonomic Nervous System in Parkinson’s Disease
“Parkinson’s disease (PD) is one of the most common neurodegenerative Disorders with increasing prevalence because of aging population. The main symptoms include rigidity, hypokinesia, tremor and impaired balance, but the disease also causes autonomic dysfunction. Motor fluctuations are common treatment related problems in PD, around 50-70% of patients treated with levodopa finally develop motor fluctuations. Continuous duodenal levodopa infusion has been effective in the treatment of motor dysfunction in advanced PD. However, little is known of its effects on autonomic nervous system”

This is another area in general research and there is not the body of information to help answer everything.

Parkinson’s disease – The Neurodegenerative Diseases Initiative (HD) | A film by the Wellcome Trust

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