Talk:Parkinson's disease

PD without tremor

I have read that around 20-30% of people with PD don’t have tremor. Can we have that information in the article? --Dustfreeworld (talk) 08:29, 29 November 2023 (UTC)

@Dustfreeworld Definitely. I have no tremor. But we need a source of course. Doug Weller talk 11:40, 29 November 2023 (UTC)

In general, the article needs a rewrite and update, and that is best done by getting hold of the latest broadest and best secondary reviews and going top-to-bottom, rather than piecemeal. What are the recent secondary reviews that people are working from here ? I'm seeing a lot of emphasis on anecdote and images on the talk page and in the article, but the needed update should be based on first laying out what the best and newest sources are, and working from them. SandyGeorgia (Talk) 14:55, 29 November 2023 (UTC)

getting hold of the latest broadest and best secondary reviews

Totally agree. --Dustfreeworld (talk) 12:18, 2 December 2023 (UTC)

Citation style

This article had four different citation styles (I've corrected two of them), some harking to a time before the short footnote (sfn) template existed. Unless anyone objects, I will convert the book sources to sfns with page numbers. See Tourette syndrome and Dementia with Lewy bodies; TS has only books in short footnotes, while DLB uses sfns on all sources so that all page numbers or section headings are identified (the current standard for featured articles). SandyGeorgia (Talk) 11:15, 30 November 2023 (UTC)

Sounds good. ~ HAL333 18:39, 30 November 2023 (UTC)

SandyGeorgia, I think I'm going to use sfns w/ page numbers as I start rewriting sections. That means there will be a transitory period where some journal articles have sfns and others don't, if that's all right. ~ HAL333 02:08, 9 December 2023 (UTC)

Understood ... I think that's the way to go ... at Dementia with Lewy bodies#References, I found with some articles (depending on the pagination) it was much easier to use the loc= parameter to specify a section heading in some cases, rather than page nos. I intended to chip away at all the sfns on books, but I have had back-to-back tragedies IRL, so not keeping up ... will help as I am able on the converts, but no promises I can keep a close eye or help as much as I normally would. SandyGeorgia (Talk) 02:26, 9 December 2023 (UTC)

Another thing on the rewrite, HAL333 ... because there is SO much literature on PD, I think a strict summary style to sub-articles will be essential. We have to draw a line of how much detail can be included here, versus at parkinsonism, Signs and symptoms of Parkinson's disease, Causes of Parkinson's disease, Pathophysiology of Parkinson's disease, Management of Parkinson's disease and History of Parkinson's disease ... really need to be kept to a very broad overview level here. SandyGeorgia (Talk) 02:31, 9 December 2023 (UTC)

Will do. ~ HAL333 15:26, 9 December 2023 (UTC)

Recent reviews for rewrite

1. Bloem BR, Okun MS, Klein C (June 2021). "Parkinson's disease". Lancet. 397 (10291): 2284–2303. doi:10.1016/S0140-6736(21)00218-X. PMID 33848468.
2. Murakami H, Shiraishi T, Umehara T, Omoto S, Iguchi Y (January 2023). "Recent Advances in Drug Therapy for Parkinson's Disease". Intern Med. 62 (1): 33–42. doi:10.2169/internalmedicine.8940-21. PMC 9876715. PMID 35110492.
3. Omotosho AO, Tajudeen YA, Oladipo HJ, Yusuff SI, AbdulKadir M, Muili AO, et al. (August 2023). "Parkinson's disease: Are gut microbes involved?". Brain Behav. 13 (8): e3130. doi:10.1002/brb3.3130. PMC 10454343. PMID 37340511.
4. Pauwels EKJ, Boer GJ (2023). "Parkinson's Disease: A Tale of Many Players". Med Princ Pract. 32 (3): 155–165. doi:10.1159/000531422. PMC 10601631. PMID 37285828.
5. Tolosa E, Garrido A, Scholz SW, Poewe W (May 2021). "Challenges in the diagnosis of Parkinson's disease". Lancet Neurol. 20 (5): 385–397. doi:10.1016/S1474-4422(21)00030-2. PMC 8185633. PMID 33894193.
6. Wolff A, Schumacher NU, Pürner D, Machetanz G, Demleitner AF, Feneberg E, Hagemeier M, Lingor P (June 2023). "Parkinson's disease therapy: what lies ahead?". J Neural Transm (Vienna). 130 (6): 793–820. doi:10.1007/s00702-023-02641-6. PMC 10199869. PMID 37147404.

That's just a very small start. With over 500 reviews in the last year alone, there is no reason for this article to be mentioning anything that isn't covered in a secondary review in the last five years, because there is such an abundance to indicate due weight. Over the years, from what was once a fine and succint broad overview using summary style with a series of sub-articles, has been degraded by a lack of attention to WP:DUE, and chunking in of pet theories and bits of text without using secondary reviews. If something isn't covered in a recent broad overview, it might have a place in a sub-article, but with the amount of research available, it's hard to see a reason for WP:NOTNEWS-style additions of primary sources here. A rewrite with the most recent secondary reviews to hand is indicated-- updating the still valid to newer sources, and removing the dated and primary studies and UNDUE content, either entirely, or to sub-articles. SandyGeorgia (Talk) 17:21, 1 December 2023 (UTC)

More:

1) Verhoeff MC, Eikenboom D, Koutris M, de Vries R, Berendse HW, van Dijk KD, Lobbezoo F (July 2023). "Parkinson's disease and oral health: A systematic review". Arch Oral Biol. 151: 105712. doi:10.1016/j.archoralbio.2023.105712. PMID 37120970.

2a) Gunnarsson LG, Bodin L (January 2019). "Occupational Exposures and Neurodegenerative Diseases-A Systematic Literature Review and Meta-Analyses". Int J Environ Res Public Health. 16 (3). doi:10.3390/ijerph16030337. PMC 6388365. PMID 30691095.{{cite journal}}: CS1 maint: unflagged free DOI (link)

2b) Chambers-Richards T, Su Y, Chireh B, D'Arcy C (March 2023). "Exposure to toxic occupations and their association with Parkinson's disease: a systematic review with meta-analysis". Rev Environ Health. 38 (1): 65–83. doi:10.1515/reveh-2021-0111. PMID 34796708.

3a) Thiyagalingam S, Kulinski AE, Thorsteinsdottir B, Shindelar KL, Takahashi PY (2021). "Dysphagia in Older Adults". Mayo Clin Proc. 96 (2): 488–497. doi:10.1016/j.mayocp.2020.08.001. PMID 33549267.

3b) Akbar U, McQueen RB, Bemski J, Carter J, Goy ER, Kutner J, Johnson MJ, Miyasaki JM, Kluger B (March 2021). "Prognostic predictors relevant to end-of-life palliative care in Parkinson's disease and related disorders: a systematic review". J Neurol Neurosurg Psychiatry. 92 (6): 629–36. doi:10.1136/jnnp-2020-323939. PMC 8142437. PMID 33789923.

4a) Bougea A, Papagiannakis N, Simitsi AM, Panagiotounakou E, Chrysovitsanou C, Angelopoulou E, Koros C, Stefanis L (February 2023). "Ambiental Factors in Parkinson's Disease Progression: A Systematic Review". Medicina (Kaunas). 59 (2). doi:10.3390/medicina59020294. PMC 9962232. PMID 36837495.{{cite journal}}: CS1 maint: unflagged free DOI (link)

4b) Dhiman V, Trushna T, Raj D, Tiwari RR (August 2023). "Is ambient air pollution a risk factor for Parkinson's disease? A meta-analysis of epidemiological evidence". Int J Environ Health Res. 33 (8): 733–750. doi:10.1080/09603123.2022.2047903. PMID 35262433.

4c) Huang M, Bargues-Carot A, Riaz Z, Wickham H, Zenitsky G, Jin H, Anantharam V, Kanthasamy A, Kanthasamy AG (September 2022). "Impact of Environmental Risk Factors on Mitochondrial Dysfunction, Neuroinflammation, Protein Misfolding, and Oxidative Stress in the Etiopathogenesis of Parkinson's Disease". Int J Mol Sci. 23 (18). doi:10.3390/ijms231810808. PMC 9505762. PMID 36142718.{{cite journal}}: CS1 maint: unflagged free DOI (link)

5a) Solch RJ, Aigbogun JO, Voyiadjis AG, Talkington GM, Darensbourg RM, O'Connell S, Pickett KM, Perez SR, Maraganore DM (March 2022). "Mediterranean diet adherence, gut microbiota, and Alzheimer's or Parkinson's disease risk: A systematic review". J Neurol Sci. 434: 120166. doi:10.1016/j.jns.2022.120166. PMID 35144237.

5b) Bianchi VE, Rizzi L, Somaa F (July 2023). "The role of nutrition on Parkinson's disease: a systematic review". Nutr Neurosci. 26 (7): 605–628. doi:10.1080/1028415X.2022.2073107. PMID 35730414.

6) "Parkinson's Disease: Challenges, Progress, and Promise | National Institute of Neurological Disorders and Stroke".

--Dustfreeworld (talk) 15:20, 11 January 2024 (UTC)

• 7) Simuni T, Chahine LM, Poston K, Brumm M, Buracchio T, Campbell M, Chowdhury S, Coffey C, Concha-Marambio L, Dam T, DiBiaso P, Foroud T, Frasier M, Gochanour C, Jennings D, Kieburtz K, Kopil CM, Merchant K, Mollenhauer B, Montine T, Nudelman K, Pagano G, Seibyl J, Sherer T, Singleton A, Stephenson D, Stern M, Soto C, Tanner CM, Tolosa E, Weintraub D, Xiao Y, Siderowf A, Dunn B, Marek K (February 2024). "A biological definition of neuronal α-synuclein disease: towards an integrated staging system for research". Lancet Neurol. 23 (2): 178–190. doi:10.1016/S1474-4422(23)00405-2. PMID 38267190.

@SandyGeorgia: Pinging ... Lancet seems to be doing some major updates. Hopefully more accurate diagnosis based on biomarkers (as well as new treatments and new definition of the disease) will be available in the near future. A few more papers (reviews) --Dustfreeworld (talk) 20:08, 27 January 2024 (UTC); 08:10, 28 January 2024 (UTC)

Lead image

Is there any chance we could find an alternative lead image? The text on it is barely legible without expanding it — I don't think readers should have to click on an image to see what it represents. ~ HAL333 23:44, 6 December 2023 (UTC)

Not thrilled with what is there. SandyGeorgia (Talk) 00:29, 7 December 2023 (UTC)

• 
  A
• 
  B
• 
  C
• 
  D
• 
  E
• 
  F

I think some kind of histological sample would be the best way to go. If you look at current featured articles on diseases (Dementia with Lewy bodies, Chagas disease, Coeliac disease, Hepatorenal syndrome etc.) that's what most go with. It's the status quo. If we do go down that route, I've attached some tentative images. F is my preference — I like the staining. B is nice as well. ~ HAL333 03:26, 7 December 2023 (UTC)

That’s not what most go with. It’s not the status quo. This is the status quo:

• 
• 

File:Blausen_0348_EndometrialCancer.png

File:LungCACXR.PNG

File:Van_Gogh_-_Trauernder_alter_Mann.jpeg

File:Meninges-en.svg

File:Head_of_femur_avascular_necrosis.jpg

File:File-Oxygen_toxicity_testing.jpeg

File:Diagram_showing_the_position_of_the_pancreas_CRUK_356.svg

File:Polio_lores134.jpg

File:RhabdoUrine.JPG

File:Cloth_embroidered_by_a_schizophrenia_sufferer.jpg

File:Illu08_thyroid.jpg

File:Tourette2.jpg; edited to make page loads faster 05:12, 12 January 2024 (UTC)

14 medical FAs out of the total 23.

BTW, the current lead image doesn’t mean much to me without reading the caption. And even after reading the caption, IMHO our global lay audience won’t know much about alpha-synuclein or Lewy bodies. Further, currently PD isn’t diagnosed by those (unlike other diseases such as Dementia with Lewy bodies), it’s diagnosed by symptoms. --Dustfreeworld (talk) 13:44, 12 December 2023 (UTC)

I’ve edited the page :) , added images created from an image uploaded by Msokun, who generously released it under the CC0 license. --Dustfreeworld (talk) 14:31, 12 December 2023 (UTC)

It's a bit too many images I think - bloats the infobox. ~ HAL333 21:24, 12 December 2023 (UTC)

I concur that the image is trying to do too much at once ... when it comes to infoboxes, less is more. It would make better since in prognosis or another section which discusses progression. SandyGeorgia (Talk) 22:22, 12 December 2023 (UTC)

I concur that the new four-way image is trying to do too much at once ... when it comes to infoboxes, less is more. It would make better sense in prognosis or signs/symptoms or another section which discusses progression. SandyGeorgia (Talk) 22:24, 12 December 2023 (UTC)

• https://en.wikipedia.org/w/index.php?title=Talk:Parkinson%27s_disease&diff=prev&oldid=1181239793
• https://en.wikipedia.org/w/index.php?title=Talk:Parkinson%27s_disease&diff=prev&oldid=1181240012

Good --Dustfreeworld (talk) 22:30, 12 December 2023 (UTC)

The new proposal is four images, where A is pretty much the same as D, and the images are captioned in a way that they are trying to convey the entire progression of PD in the infobox ... it's too much. SandyGeorgia (Talk) 22:36, 12 December 2023 (UTC)

GOOD. --Dustfreeworld (talk) 22:39, 12 December 2023 (UTC)

And it’s really good to know the BIG differences between 3 images and 4 images.

https://en.wikipedia.org/w/index.php?title=Talk:Parkinson%27s_disease&diff=prev&oldid=1181240012

Thanks for telling me that. --Dustfreeworld (talk) 22:45, 12 December 2023 (UTC)

I don't think we should determine "What image should lead this article?" based on whatever shit, frankly, editors managed to find that was free and stick on other articles, featured or otherwise. Wikipedia is extremely limited in its choice of pictures and most articles are badly illustrated. A better question would be "What images does media with an image budget choose to illustrate articles/books on PD?" And aim to get that if we can. -- Colin°^Talk 16:38, 12 December 2023 (UTC)

Agree (the only reason DLB is a stain TS is Georges is that there is nothing else available). We also need to stop indiscriminately changing images here, and start discussing before changing. The article text/content needs major work; the image issues have so far been a distraction. SandyGeorgia (Talk) 16:43, 12 December 2023 (UTC)

The textbook put out by Cold Spring has a graphic highlighting the substantia nigra. Since that's the brain region largely at play, it might be worth it to do the same or have some graphic regarding dopaminergic neurons.

• 
• 
• 

Here are some candidates. ~ HAL333 18:54, 13 December 2023 (UTC)

They can be added to the article, but not the lead. A quote from the first link you posted “this volume is a vital reference for neurobiologists, cell biologists, and pathologists pursuing the biological basis of Parkinson's disease, as well as scientists and clinicians”. I don’t think the images are intended for most of our readers. --Dustfreeworld (talk) 19:07, 13 December 2023 (UTC)

And I really don’t think we need a fancy animation in the lead. --Dustfreeworld (talk) 19:25, 13 December 2023 (UTC)

Different versions

I have been testing with different image combinations and have come up with 3 different versions of infobox, A, B, and C here (it’s the sandbox of another user, used in previous lead image discussion [1]). The total width was reduced. C is a variation of A, but the 1880s image doesn’t come first. B uses only 2 images (the photos that are now in the article). Long caption has been removed. But they can be added back or edited easily. The space between images can also be changed (by changing a parameter) if needed. --Dustfreeworld (talk) 08:11, 13 December 2023 (UTC)

I'm not opposed to two images (the donkey and fish sizing looks fine), but four is simply too many. I also really don't like the two images we currently have of the gait. They are pretty low resolution and something about it (maybe the low overall quality or pixelated faces) reminds me of a terrorist hostage video. I still think an image of an alpha-synuclein deposit would be the best way to go, but I'm open to alternatives. ~ HAL333 18:47, 13 December 2023 (UTC)

I think the image of alpha-synuclein deposit belongs to the body, but not the infobox. I still think WP:Technical applies:

This page in a nutshell: Strive to make each part of every article as understandable as possible to the widest audience of readers who are likely to be interested in that material.

I would like to know more on why you insist that we should have it in the lead though. The edit summary you left when adding the current image was simply “added meaningful image ...” --Dustfreeworld (talk) 21:41, 13 December 2023 (UTC)

I have updated the two images (gait). Hope that addresses your concern. --Dustfreeworld (talk) 08:34, 14 December 2023 (UTC)

I added 3 more versions, so there are A to F now.

• https://en.wikipedia.org/w/index.php?title=User:WhatamIdoing/Sandbox_3&oldid=1189771208

Actually any combination of the different images is possible. --Dustfreeworld (talk) 19:11, 13 December 2023 (UTC)

In this updated sandbox page the infobxes’ width were reduced to 300px, and an image of alpha-synuclein deposit was added below infobox for testing. --Dustfreeworld (talk) 08:39, 14 December 2023 (UTC)

This is the latest sandbox page, which contains 8 versions of infobox, with almost all the possibilities I can think of. While I don’t think the number of images in the box is a big problem, considering that we have 7 images and 4 maps in article like this, I’m open to an infobox with fewer images. Discussion welcomed in case anyone is still not happy with infobox A, which have been included in the article already. I’d be happy with any version (A-H) in the sandbox. --Dustfreeworld (talk) 19:41, 15 December 2023 (UTC)

As a side, there are two versions of Gowers’ sketch in the sandbox. Both are made from his original drawings. The difference between them is that one has better image quality, while the other has thicker lines and thus resembles the long-standing etching more. I made two because I’m not sure which one people would prefer. The later one is in the article now. --Dustfreeworld (talk) 20:41, 15 December 2023 (UTC)

I'm cool with what we have now. Nice work. ~ HAL333 00:43, 16 December 2023 (UTC)

Thanks, HAL333! --Dustfreeworld (talk) 04:10, 16 December 2023 (UTC)