Parkinson's Disease: A Multisystem Disorder

 Helena Nunes Costa1,2 · Ana Raquel Esteves1,2 · Nuno Empadinhas1,2 · Sandra Morais Cardoso1,3
1 CNC–Center for Neuroscience and Cell Biology and CIBB– Center for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal 
2 IIIUC–Institute for Interdisciplinary Research, University of Coimbra, 3004-504 Coimbra, Portugal 
3 Faculty of Medicine, University of Coimbra, 3004-504 Coimbra, Portugal


Abstract
The way sporadic Parkinson's disease (PD) is perceived has undergone drastic changes in recent decades. For a long time, PD was considered a brain disease characterized by motor disturbances; however, the identification of several risk factors and the hypothesis that PD has a gastrointestinal onset have shed additional light. Today, after recognition of prodromal non-motor symptoms and the pathological processes driving their evolution, there is a greater understanding of the involvement of other organ systems. For this reason, PD is increasingly seen as a multiorgan and multisystemic pathology that arises from the interaction of susceptible genetic factors with a challenging environment during aging-related decline.

Keywords
Parkinson's disease; Gut microbiome; Intestinal barrier; α-Synuclein; Blood-brain barrier