Parkinson's Syndrome vs. Parkinson's Disease : Identifying The Differences

Parkinson’s syndrome, also known as Parkinsonism syndrome and atypical Parkinsonism syndrome, refers to any condition that involves the types of movement problems observed in Parkinson’s disease. This includes movement problems such as bradykinesia (slowed movement), tremors, and stiffness of the limbs.

In this article, we will provide insight on Parkinson’s syndrome vs. Parkinson’s disease, diagnosis and treatment, and future methods for early, accurate Parkinson’s disease diagnosis.

Parkinson’s Syndrome vs. Parkinson’s Disease

In a recent poll of individuals with Parkinson’s disease, more than one in four (26%) participants reported having been misdiagnosed. Obtaining an accurate diagnosis is fundamental to receiving appropriate and effective treatment; however, many conditions can mimic Parkinson’s disease.

Here is a quick breakdown of Parkinson’s syndrome vs. Parkinson’s disease.

What Is Parkinson’s Disease?

Parkinson’s disease is a progressive neurodegenerative disease that is most commonly known for affecting function and movement, though it also affects cognition, particularly as the disease progresses. Parkinson’s disease primarily impacts dopaminergic, or dopamine-producing, neurons in a specific area of the brain known as the substantia nigra. Dopamine is a key neurotransmitter that transmits signals between neurons and plays a crucial role in movement and motor control.

The lack of dopamine makes it challenging for the brain to coordinate muscle movements and can also contribute to mood and cognitive issues later in the disease course. Patients with Parkinson’s disease also lose nerve endings that produce norepinephrine, a chemical messenger of the sympathetic nervous system responsible for controlling a wide range of functions in the body, such as blood pressure and heart rate.

What Is Parkinson’s Syndrome?

As mentioned above, Parkinson’s syndrome is a general term that refers to any condition that causes the types of movement problems observed in Parkinson’s disease. In other words, while Parkinson’s disease is the most common cause of Parkinson’s syndrome, many other conditions can cause Parkinson’s syndrome. These include:

• Drug-Induced Parkinsonism (DIP): Parkinson’s disease symptoms can be caused by medications. DIP is caused by side effects of certain medications, particularly those that affect dopamine levels, such as antipsychotics and antiemetic drugs.
• Progressive Supranuclear Palsy (PSP): PSP is a rare progressive neurological condition that causes problems with balance and coordination, eye movement, walking, and eventually swallowing. Other symptoms include sleep disturbances, depression and anxiety, stiffness, changes in speech, and falls.
• Multiple System Atrophy (MSA): MSA, previously called Shy-Drager syndrome, is a general term for a group of disorders in which one or more systems in the body stop functioning. Symptoms include muscle stiffness, bradykinesia, tremors, difficulty bending arms and legs, soft voice, and issues with posture and balance.
• Vascular Parkinsonism: Vascular parkinsonism—typically caused by clotting in the brain from one or more small strokes—can cause Parkinson’s-like symptoms. Vascular parkinsonism often affects the legs more than the arms, causing significant issues with walking and balancing. Because strokes occur suddenly, the onset of symptoms is often abrupt.
• Lewy Body Dementia (LBD): LBD is a neurological disorder that causes progressive dementia. It is clinically characterized by a decline in thinking, reasoning, and independent function. Individuals with LBD may also experience visual hallucinations and changes in attention and alertness. Many individuals with LBD experience functional impairments, such as rigid muscles, hunched posture, tremors, and difficulty walking. 

Other causes include:

• Corticobasal Degeneration (CBD)
• Brain Injury 
• Encephalitis 
• HIV/AIDS
• Meningitis
• Stroke
• Wilson’s disease
• Brain damage caused by anesthesia drugs
• Certain medications used to treat mental disorders or nausea (e.g. metoclopramide and prochlorperazine)
• Overdoses of narcotics 

Parkinson’s Syndrome vs. Parkinson’s Disease: Diagnosis and Treatment

Currently, there is no single test for Parkinson’s disease or Parkinson’s syndrome—no brain scan or lab test (e.g. blood, cerebrospinal fluid, and urine) can provide a definitive diagnosis. Instead, doctors diagnose Parkinson’s disease and Parkinson’s syndrome “clinically,” meaning a diagnosis is dependent on medical history, answers to certain questions, a physical examination, and the presence of specific physical symptoms.

Typically, the process for obtaining a diagnosis follows these general steps:

1. A physical examination and review of medical history
2. A review of current and past medications
3. A neurological examination (e.g. assessment of gait, balance, agility, and muscle tone)

There is no cure for Parkinson’s disease. Treatments for Parkinson’s disease and Parkinson’s syndrome are currently very symptom-oriented. Doctors typically prescribe a combination of multiple effective medications in accordance with symptoms present in a given patient. Medications prescribed to treat Parkinson’s disease symptoms include:

• Carbidopa-levodopa
• Inhaled carbidopa-levodopa
• Carbidopa-levodopa infusion
• Dopamine agonists
• MAO B inhibitors
• Catechol O-methyltransferase (COMT) inhibitors
• Anticholinergics 
• Amantadine

There is a bit of overlap in treatment for Parkinson’s disease and Parkinson’s syndrome. Dopaminergic therapy, the most common treatment used for Parkinson’s disease, can be effective in treating some causes of Parkinson’s syndrome, but not all. For example, while individuals with PSP may benefit from dopaminergic treatment (often in a higher dose than patients with Parkinson’s disease), individuals with MSA often do not benefit from this treatment approach.

Other common treatments for both Parkinson’s disease and Parkinson’s syndrome include lifestyle interventions (e.g. diet and exercise plans), physiotherapy, occupational therapy, and speech and language therapy. Some patients with Parkinson’s disease may benefit from a neurosurgical technique called deep brain stimulation (DBS).