{"id":1329,"date":"2019-09-06T15:29:47","date_gmt":"2019-09-06T15:29:47","guid":{"rendered":"https:\/\/blogs.bmj.com\/jmg\/?p=1329"},"modified":"2026-02-24T00:30:07","modified_gmt":"2026-02-24T00:30:07","slug":"open-questions-on-the-nature-of-parkinsons-disease-from-triggers-to-spreading-pathology","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/jmg\/2019\/09\/06\/open-questions-on-the-nature-of-parkinsons-disease-from-triggers-to-spreading-pathology\/","title":{"rendered":"Open questions on the nature of Parkinson\u2019s disease: from triggers to spreading pathology (Contributed by Dr. Pedro Fernandez-Funez)"},"content":{"rendered":"<p>Parkinson\u2019s disease (PD) is a late onset neurological condition characterized by impaired movements: tremors, rigidity, slow movements, and abnormal posture. In recent years, numerous non-motor symptoms, including psychiatric, sleep, smell, and digestive alterations, have been identified as integral components of the disease. Loss of smell and constipation can appear a decade before the full motor symptoms, inviting arguments about the nature and origin of PD. Some argue that PD is caused by toxins that start the disease in exposed tissues (gut and olfactory epithelium) followed by spread to the brain areas that control movement. Alternative explanations include the sporadic development of toxic protein aggregates in multiple vulnerable neurons (multifocal). These aggregates can spread by neuronal networks to cause motor symptoms and multiple late complications. This paper discusses the merits of each hypothesis, which are a critical tool to better understand PD and, eventually, develop disease-modifying therapies. (<a href=\"https:\/\/jmg.bmj.com\/content\/early\/2019\/09\/03\/jmedgenet-2019-106210\">https:\/\/jmg.bmj.com\/content\/early\/2019\/09\/03\/jmedgenet-2019-106210<\/a> )<!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Parkinson\u2019s disease (PD) is a late onset neurological condition characterized by impaired movements: tremors, rigidity, slow movements, and abnormal posture. In recent years, numerous non-motor symptoms, including psychiatric, sleep, smell, and digestive alterations, have been identified as integral components of the disease. Loss of smell and constipation can appear a decade before the full motor [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/jmg\/2019\/09\/06\/open-questions-on-the-nature-of-parkinsons-disease-from-triggers-to-spreading-pathology\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":123,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-1329","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Open questions on the nature of Parkinson\u2019s disease: from triggers to spreading pathology (Contributed by Dr. Pedro Fernandez-Funez) - JMG Contact blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/jmg\/2019\/09\/06\/open-questions-on-the-nature-of-parkinsons-disease-from-triggers-to-spreading-pathology\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Open questions on the nature of Parkinson\u2019s disease: from triggers to spreading pathology (Contributed by Dr. Pedro Fernandez-Funez) - JMG Contact blog\" \/>\n<meta property=\"og:description\" content=\"Parkinson\u2019s disease (PD) is a late onset neurological condition characterized by impaired movements: tremors, rigidity, slow movements, and abnormal posture. In recent years, numerous non-motor symptoms, including psychiatric, sleep, smell, and digestive alterations, have been identified as integral components of the disease. Loss of smell and constipation can appear a decade before the full motor [...]Read More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/jmg\/2019\/09\/06\/open-questions-on-the-nature-of-parkinsons-disease-from-triggers-to-spreading-pathology\/\" \/>\n<meta property=\"og:site_name\" content=\"JMG Contact blog\" \/>\n<meta property=\"article:published_time\" content=\"2019-09-06T15:29:47+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2026-02-24T00:30:07+00:00\" \/>\n<meta name=\"author\" content=\"hqqu\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@HuiQiQu\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"hqqu\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/jmg\\\/2019\\\/09\\\/06\\\/open-questions-on-the-nature-of-parkinsons-disease-from-triggers-to-spreading-pathology\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/jmg\\\/2019\\\/09\\\/06\\\/open-questions-on-the-nature-of-parkinsons-disease-from-triggers-to-spreading-pathology\\\/\"},\"author\":{\"name\":\"hqqu\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/jmg\\\/#\\\/schema\\\/person\\\/be0250f8d5b52412c3e7c222dabd591b\"},\"headline\":\"Open questions on the nature of Parkinson\u2019s disease: from triggers to spreading pathology (Contributed by Dr. Pedro Fernandez-Funez)\",\"datePublished\":\"2019-09-06T15:29:47+00:00\",\"dateModified\":\"2026-02-24T00:30:07+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/jmg\\\/2019\\\/09\\\/06\\\/open-questions-on-the-nature-of-parkinsons-disease-from-triggers-to-spreading-pathology\\\/\"},\"wordCount\":174,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/jmg\\\/#organization\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/jmg\\\/2019\\\/09\\\/06\\\/open-questions-on-the-nature-of-parkinsons-disease-from-triggers-to-spreading-pathology\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/jmg\\\/2019\\\/09\\\/06\\\/open-questions-on-the-nature-of-parkinsons-disease-from-triggers-to-spreading-pathology\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/jmg\\\/2019\\\/09\\\/06\\\/open-questions-on-the-nature-of-parkinsons-disease-from-triggers-to-spreading-pathology\\\/\",\"name\":\"Open questions on the nature of Parkinson\u2019s disease: from triggers to spreading pathology (Contributed by Dr. Pedro Fernandez-Funez) - 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