Understanding Parkinson's Disease: It's More Than a Dopamine Problem
When most people think of Parkinson's disease, they picture a hand tremor.
While tremor can be one of the most recognisable symptoms, it tells only part of the story. Parkinson's is a complex neurological condition that affects movement, mood, sleep, digestion, thinking and energy. In many cases, these changes begin years before a diagnosis is made. As our understanding of Parkinson's continues to evolve, so too does the way we think about supporting people living with the condition. Rather than viewing it as simply a disorder of dopamine, researchers now recognise that Parkinson's involves multiple systems throughout the body.
What is Parkinson's disease?
Parkinson's disease is a progressive neurodegenerative condition that primarily affects the brain's ability to control movement. Deep within the brain is a region called the substantia nigra, home to specialised nerve cells that produce dopamine. Dopamine acts as a chemical messenger, helping coordinate smooth, controlled movement while also playing important roles in motivation, mood and learning. Over time, these dopamine-producing neurons become damaged or are lost. As dopamine levels decline, communication between different parts of the brain becomes less efficient, making movement slower, stiffer and more difficult to control. However, Parkinson's is about far more than dopamine alone. Other brain chemicals, including serotonin, noradrenaline and acetylcholine, can also be affected, helping explain why many people experience symptoms that extend well beyond movement.
More than movement
Although Parkinson's is often described as a movement disorder, many of its earliest symptoms have nothing to do with movement.
Motor symptoms may include:
Tremor, muscle stiffness or rigidity,
Slowness of movement (bradykinesia),
Changes in walking and balance
Reduced facial expression
Softer speech
Smaller handwriting
Non-motor symptoms can include:
Reduced sense of smell
Constipation
Fatigue
Disturbed sleep or vivid dreams
Anxiety or depression
Brain fog and slowed thinking
Bladder changes
For many people, these non-motor symptoms can have just as much impact on quality of life as movement changes.
Parkinson's often begins years before diagnosis
Parkinson's develops gradually. Research suggests changes within the nervous system may begin many years before the first tremor or movement difficulties appear. During this time, the brain is often able to compensate for the gradual loss of dopamine-producing neurons, meaning symptoms may not become obvious until a significant number of these cells have already been affected. This growing understanding has highlighted the importance of recognising symptoms early and taking a proactive approach to supporting long-term brain health.
A Whole-Body Condition
Parkinson's was once thought to affect only a small area of the brain. Today, researchers recognise it as a condition involving many interconnected systems throughout the body. Changes in the gut microbiome, chronic inflammation and reduced cellular resilience are all areas of active research. Another important focus is the role of mitochondria, the tiny structures inside our cells that do far more than produce energy. Mitochondria help cells respond to stress, regulate inflammation and support repair. Researchers have consistently found mitochondrial dysfunction in the dopamine-producing neurons affected by Parkinson's, making healthy mitochondrial function an important area of ongoing research.
Looking Ahead
Although there is currently no cure for Parkinson's disease, our understanding of the condition is advancing rapidly. By combining conventional medical care with strategies that support overall brain health, including movement, nutrition, sleep, and therapies that promote healthy cellular function, many people are taking a more comprehensive approach to living well with Parkinson's. In our next article, we'll explore why Parkinson's develops, the factors researchers believe may contribute to its progression, and why looking beyond the diagnosis may help guide a more personalised approach to care.
About the Author
Jennifer Harrington is a naturopath with over 20 years of clinical experience and a special interest in neurodegenerative conditions. She consults at MitoCore on Mondays and Fridays, providing evidence-informed, whole-person care to patients.