Among the many non-motor symptoms of Parkinson’s disease (PD) are blood pressure changes. One manifestation is neurogenic orthostatic hypotension, a condition in which blood pressure drops sharply when one moves from a reclining to a more upright position, such as standing up when getting out of bed or rising from a chair. The person may feel lightheaded, dizzy, lose balance, or, rarely, even lose consciousness. Besides being uncomfortable, the condition can be dangerous if it leads to a fall and subsequent injury. Orthostatic hypotension is common in mid- and late-stage PD, but it may also be an early sign of the disease.
Fortunately, there are strategies and other measures people can do for themselves to lessen the problem, and a variety of medications may help. Other conditions and medications can also lead to the condition, and they should be investigated in addition to a connection with PD. In this podcast, neurologist Dr. Katie Longardner of the University of California San Diego discusses the problem, how it is diagnosed, what people can do to alleviate it, and some of the research she and others are conducting.
Katherine ("Katie") Longardner, MD, earned her medical degree at Florida State University College of Medicine. She completed her internship, neurology residency, and two-year movement disorder fellowship at University of California San Diego (UCSD) Health. Dr. Longardner is a board-certified neurologist and movement disorder specialist who diagnoses and treats a variety of adult movement disorders, including Parkinson's disease, atypical parkinsonism, as well as tremor, myoclonus, dystonia, tics, and other hyperkinetic movement disorders. Her research focuses on parkinsonian non-motor symptoms, especially the relationship between orthostatic hypotension and cognition Parkinson's disease and related disorders. She developed an interest in orthostatic hypotension when she realized that this is an under-recognized yet treatable non-motor symptom that can be debilitating. She is currently collaborating with Dr. Sheng Xu's research team from the UCSD Dept. of Bioengineering to validate a non-invasive ultrasonic blood pressure monitor for continuous monitoring in orthostatic hypotension. Another research interest is utilizing non-invasive electrophysiological techniques to study movement disorders such as tremor.
Cuando uno piensa en la enfermedad de Parkinson (EP), es fácil asociarla más con los síntomas motores, como la rigidez o el temblor; pero también existen síntomas no motores, como los cambios de estado de ánimo, la ansiedad o la depresión.
En este episodio, hablamos con la doctora Elsa Baena, neuropsicóloga clínica en el Barrow Neurological Institute, Centro de Excelencia de la Parkinson’s Foundation, acerca de estos cambios cognitivos asociados con el Parkinson.
La doctora Baena explica la conexión entre el Parkinson y la cognición y cómo pueden prepararse las personas con Parkinson para estos cambios (no sólo las maneras farmacológicas, sino también las terapéuticas).
Asimismo aprenderemos acerca de los miembros del equipo de atención médica que pueden apoyar a una persona con Parkinson y a sus familiares con estos cambios cognitivos.
Lanzado: 18 de octubre de 2022
Elsa Baena, PhD, es neuropsicóloga en el departamento de neuropsicología clínica y en la unidad de neurorrehabilitación intrahospitalaria del Barrow Neurological Institute.
La experiencia de la Dra. Baena incluye la evaluación neuropsicológica y rehabilitación de individuos con una variedad de diagnósticos neurológicos, incluyendo condiciones neurodegenerativas, lesiones cerebrales adquiridas, enfermedades cardiovasculares y tumores cerebrales. También realiza evaluaciones pre y postquirúrgicas para la estimulación cerebral profunda (ECP o DBS, por sus siglas en inglés) y la cirugía de epilepsia. Domina el inglés y el español y es miembro de la Hispanic Neuropsychological Society, la National Latinx Psychological Association, la American Academy of Clinical Neuropsychology, la International Neuropsychological Society y la National Academy of Neuropsychology.
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Investigating How Neurons Rebalance Their Roles in Early Parkinson’s
In Parkinson’s disease (PD), cognitive symptoms often appear years before movement symptoms begin. However, these cognitive symptoms — difficulties performing tasks involving decision-making and learning — are linked to many different diseases and therefore difficult to use as an indicator for PD without additional clinical evidence.
Kauê M. Costa, PhD, recipient of a Parkinson’s Foundation Impact Award, is diving into the complex neuroscience of PD to better understand what causes cognitive PD symptoms to occur before movement symptoms. This research could help lead to improved treatments for PD cognitive symptoms and support earlier PD diagnoses.
“This research has the potential to shed light on intrinsic mechanisms of adaptation to cell loss that could be leveraged for developing new treatments for the disease, and to identify early biomarkers of Parkinsonian degeneration, which could be used for early diagnosis and intervention.” – Dr. Costa
As PD progresses, dopamine-producing neurons in the substantia nigra region of the brain lose function and break down. The most fragile of these neurons, and usually the first ones to degenerate, are located in the lateral substantia nigra (lSN) and are important for sending movement signals to another brain region called the dorsolateral striatum (DSL).
Dr. Costa hypothesizes that as these lSN neurons break down in early PD, the neighboring neurons in the medial substantia nigra (mSN) attempt to “pick up the slack”, taking over the lost movement signaling responsibilities. However, doing so means sacrificing efficiency in their other role, which involves cognitive signaling. This could explain why cognitive symptoms appear first, as the brain reorganizes neurons to preserve movement signaling at the expense of cognitive signaling.
From his lab at the University of Alabama at Birmingham, Dr. Costa will test his hypothesis by measuring the abilities of rats to perform learning-based and movement tasks before and after they are induced with simulated PD. Using state-of-the-art brain monitoring technology, Dr. Costa will also record dopamine released by both lSN and mSN neurons over time, observing how they change and adapt as the simulated disease progresses and if they follow his prediction of reorganized signaling roles.
By understanding what is happening in the brain in early PD to cause cognitive symptoms before movement ones, doctors could improve the ability to diagnose the disease earlier, treat cognitive symptoms more efficiently, and potentially delay additional symptoms.
“This Impact Award will allow me to apply my expertise to solving an important question in Parkinson's disease pathology, which I have been thinking about since I was a graduate student,” said Dr. Costa. “I am grateful to the Parkinson's Foundation for the opportunity to pursue my interests in the intersection of basic and translational neuroscience.”
Episode 184: Finding Relief: Bladder Issues in Parkinson’s
Many people with Parkinson’s disease experience urinary or bladder issues at some point in their journey. These symptoms can take different forms and may affect people differently based on gender. Recognizing the signs is the first step toward understanding how to manage them and when to seek care.
In this episode, Dr. Ankita Gupta, MD, MPH, FACOG, a urogynecologist at University of Louisville Hospital, talks about common bladder issues in Parkinson’s, such as urinary frequency, urgency, and nocturia. She explains how these symptoms can affect quality of life and even contribute to social isolation, and she highlights treatment options that can help manage them.
Released: October 14, 2025
Ankita Gupta, MD, MPH, FACOG is a Urogynecologist and the associate fellowship director for the Urogynecology & Reconstructive Surgery fellowship at University of Louisville Hospital in Louisville, Kentucky. Dr. Gupta has served on the editorial board of AUGS e-learning, was a member of the social media and DEI committees and was a part of the pelvic floor consortium working group on urinary incontinence. She was also a member of the Fellows, Trainees and Early Career Professionals Committee as well as the IUGA Education Committee. She currently chairs the Systematic Review Group arm of the Society of Gynecologic Surgeons, which aims to evaluate existing data and propose new guidelines to improve evidence-based patient care.
Medication plays a key role in managing Parkinson’s disease (PD), but it’s only one part of a broader care plan.
The following article is based on a Parkinson’s Foundation Expert Briefing exploring how medications fit into integrated, holistic Parkinson’s care, hosted by Danny Bega, MD, MSCI, associate professor of neurology, medical director and director of the Parkinson's Disease & Movement Disorders Center neurology residency program at Northwestern University Feinberg School of Medicine, a Parkinson's Foundation Center of Excellence. Dr. Bega is also the director of the Huntington's and Wilson’s diseases programs at Northwestern.
Understanding the Dopamine-Parkinson’s Connection
Parkinson’s is a progressive disorder linked to declining levels of dopamine, a brain chemical that influences movement, memory and many other vital body processes. Other brain chemicals, including norepinephrine and serotonin, can also be impacted in Parkinson's disease and influence symptoms.
As Parkinson’s advances, the number of brain cells making dopamine continues to decrease, and remaining cells struggle to store and release it. This leads to slowness of movement, tremor, rigidity and other motor symptoms. It can also cause various non-motor symptoms, such as constipation, loss of smell and thinking changes.
Managing Parkinson’s
Parkinson’s is a complex disease. There is no standard treatment. However, medications — along with exercise, comprehensive care, a nutritious diet and mindfulness practices — can manage Parkinson’s symptoms and help you live well.
Establishing a regular exercise routine soon after diagnosis may help slow disease progression and can improve movement, strength, balance and mood. It can also help you sleep better. Staying social and engaged can reduce feelings of loneliness.
Your care team is equally important. Look for healthcare professionals with expertise in Parkinson’s, including a neurologist, speech-language pathologist, physical and occupational therapist, social worker and other healthcare professionals, to help manage your PD symptoms. Be sure to attend regular checkups.
The Role of Medication
Most Parkinson’s medications work to improve symptoms by either increasing dopamine in the brain or acting like dopamine. Levodopa is the most effective drug for managing Parkinson’s symptoms. During the course of Parkinson’s, most people will take levodopa at some point.
Anxiety and depression can also be common in Parkinson’s and can impact well-being even more than motor symptoms. Treating these symptoms using a combination of medication, such as an SSRI, SNRI or mirtazapine — a tricyclic antidepressant drug — along with therapy, stress management and staying active, can significantly decrease disability.
People newly diagnosed with Parkinson’s often wonder when to begin prescription medication. Studies show there is no benefit in holding off. Most doctors agree you should start medication when symptoms begin to bother you.
Because no two people experience PD in exactly the same way, treatments vary from person to person, as does the rate of progression. However, knowing the typical stages of Parkinson’s can help you anticipate changes:
In the first five years following diagnosis, you may find symptoms don’t significantly impact your daily life. Your doctor might recommend a clinical trial. Participation in Parkinson’s research can potentially give you early access to new treatments, improve care and lay the foundation for a cure.
Within one to 10 years, as symptoms begin to interfere with activities, most people with Parkinson’s can expect a long-lasting, steady response to medication.
Between five and 20 years after diagnosis, it becomes increasingly harder for the brain to store dopamine. Your body’s response to levodopa can become shorter and less efficient. This can lead to motor fluctuations — "on" periods, when medication works well, and "off" periods, when medication wears off and symptoms return. It is important to work closely with your doctor to adjust your treatment and find what works best for you.
After 10 or more years of living with Parkinson’s, a person can experience more significant issues. Some people can develop significant memory and thinking problems. Trouble with balance, falls and freezing, a temporary inability to move, can also become an issue. Your doctor can discuss medication adjustments or drug therapies or provide a referral to the right healthcare professional for your needs, which might include a neuropsychologist, psychiatrist, or a speech or occupational therapist.
Types of Medications Used in Parkinson’s
It can be common for people with Parkinson’s to take a variety of medications, at different doses and different times of day, to manage symptoms. This can include:
Dopamine agonists: Early on, drugs that stimulate dopamine in the brain, such as pramipexole, ropinirole and rotigotine, can usually treat Parkinson’s movement symptoms. Dopamine agonists pose less risk for dyskinesia — involuntary erratic movements that usually begin after a few years of levodopa treatment.
Side effects can include nausea, dizziness, sleepiness, confusion and impulse control disorders, such as uncontrolled shopping, gambling, eating and sexual urges. Studies show 28% of people with Parkinson’s stop taking dopamine agonists due to side effects, while 40% need to add another medication within two years.
Levodopa: Levodopa, the most effective drug for Parkinson’s movement symptoms, replaces dopamine in the brain. It is usually given in combination with the drug carbidopa to reduce nausea, a common side effect. Taking levodopa with meals can also reduce nausea, but protein may interfere with the drug’s effectiveness. About 2% of people taking levodopa stop due to side effects, while 15% need to add another medication within two years.
Dyskinesia, also linked to levodopa, can often be managed by a dose adjustment or through direct treatment, using a medication called amantadine. It works by blocking NMDA, a chemical that causes extra movement. Immediate-release amantadine is also sometimes used alone for Parkinson’s movement symptoms. There is an increased risk of confusion and hallucinations with amantadine use in people over 75. It can also be associated with leg swelling, skin changes and other side effects.
Anticholinergics:The medications trihexyphenidyl and benztropine are sometimes used to improve tremor or dystonia — painful, sustained cramping . They work by blocking acetylcholine, a brain chemical tied to movement. However, their use should be avoided in people 70 and older due to the risk of confusion and hallucinations. Anticholinergics can also be associated with blurred vision, dry mouth, constipation and urinary retention.
Medications your doctor might consider to improve the effects of levodopa include:
MAO-B inhibitors: Monoamine oxidase-B inhibitors rasagiline, selegiline and safinamide make more dopamine available to the brain. These medications can be used alone or in combination with levodopa to extend effectiveness. MAO-B inhibitors are generally well tolerated, but 70% of people taking them alone for Parkinson’s will need to add another medication within twoyears.
COMT inhibitors: Medications such as entacapone and opicapone increase available levodopa in the brain by blocking the catechol-O-methyl transferase enzyme.
A2A receptor antagonist: Istradefylline, an adenosine A2A antagonist, blocks adenosine at A2A receptors in the brain to reduce levodopa “off “time.
Inhaled levodopais often used with levodopa, as needed, for sudden “off” time. Injectable apomorphine can also be used on demand, for “off” time relief. Both medications can increase the risk of dyskinesia.
It is important to work with your doctor to find the right balance for you. Your doctor might increase or decrease your levodopa based on your symptoms. For example, tremor, stiffness or mobility issues might benefit from an increase in levodopa. However, hallucinations, confusion and low blood pressure might improve with a decrease in levodopa.
There are also strategies and medications to manage drooling, runny nose, sleep issues, gut issues, thinking changes and other Parkinson’s challenges.
What if levodopa doesn’t seem to be working?
If you are taking levodopa but aren’t seeing benefits, talk to your doctor. Here are some questions to ask:
Is the symptom troubling you one that doesn’t respond well to levodopa? Could it be related to another health issue?
Could something be interfering with how your body is absorbing medication? Some people experience less benefit when taking levodopa with a high-protein meal.
It is also important to discuss whether your dose needs to be adjusted. For example, the effects of Sinemet, a form of levodopa, only last a short time — after 90 minutes half of it is gone. Your doctor might adjust the timing and dose of levodopa, use a longer-acting formulation or recommend taking your medications 30 minutes before or 60 minutes after eating a meal.
Advanced Therapies
If it becomes difficult to control motor fluctuations by adjusting oral medications, there are other options to improve medication absorption and reduce “off” time:
Duopa therapy delivers carbidopa-levodopa gel directly to your intestine through a surgically placed tube.
Foscarbidopa and foslevodopa (Vyalev) therapy uses a pump to steadily deliver a form of levodopa under the skin through a small tube called a cannula. A needle is used to place the cannula.
Continuous apomorphine therapy (Onapgo) uses a pump to deliver continuous apomorphine through a fine needle placed under the skin.
These medications require lifestyle adjustments, training to use and a commitment to good skin care to reduce the risk of irritation and infections.
Options Beyond Medication
More advanced Parkinson’s symptoms can sometimes benefit from other treatment strategies, such as deep brain stimulation (DBS) — which involves surgically implanting an electrical pulse generator connected to electrodes placed in the brain to address Parkindeep-brainson’s movement symptoms and some non-movement symptoms.
DBS might be considered for someone who:
lives with classic Parkinson’s disease
has symptoms that respond to levodopa
experiences frequent motor fluctuations and tremor, despite consistent medication dosing
has bothersome dyskinesia
Following DBS, many people can reduce their medications and still experience a reduction of their PD symptoms. The reduction in dose of medication can lead to decreased dyskinesia.
Focused ultrasound, a non-invasive therapy, does not require a surgical incision. During the procedure, high-frequency sound waves are aimed at a specific area of the brain connected to tremor to relieve Parkinson’s tremor. Unlike DBS therapy, which is adjustable and reversible, focused ultrasound changes are permanent.
If you have questions about PD treatment options, contact our Helpline at 1-800-4PD-INFO (473-4636) or Helpline@Parkinson.org.
Learn More
Explore our resources about medications to treat symptoms of Parkinson’s:
When I was diagnosed in early 2010, it was a long, long walk back to our car. My wife was with me. We had been told in a matter of a few minutes that based on initial indications, at age 45, "you no doubt have Parkinson's disease (PD)…"
Little did I realize my life had changed forever from that moment.
Now, at 61 years young, I recall stepping into that full range of emotions we people with PD all go through: shock, denial, confusion, fear, anger and sadness.
Looking back, what I really wanted was information that may quickly outline and answer the range of "what now" questions multiplying in my head. What I did not want to do was immediately search the internet and travel down those "rabbit holes" that so often end in false assumptions or conclusions. I found that much of what I came across online was largely irrelevant to my personal situation. Afterall, I was told very early on that my PD journey would be just that: mine.
To my surprise, I soon found THE one-stop-shop for everything PD — the Parkinson Foundation website!I quickly realized that THIS was the general guide for the early onset and recently diagnosed that could also lead me to detailed specifics.
As an added bonus, I found that the Foundation could be a reliable roadmap to forming a PD team of advisers and movement disorders specialists around me. I've nicknamed my group “The B Team."
I tell them they will become "The A Team" once they find the cure!
Seriously though, if I have any advice for people who are newly diagnosed, it would be to develop your own “B Team” ASAP. This can include:
Neurologist and/or Nurse Practitioner, with specialty in Movement Disorders with a focus on PD.
Neuro Psychiatrist, with experience in treating PD.
Physical Trainer. Exercise is THE #1 activity PD patients can do to help slow down the PD progression.
Family Practitioner (MD in my case that has experience with PD).
In 2012, I learned about Moving Day, A Walk for Parkinson’s in Columbus. For the last 14 years my family, known as TeamRamsey's Racers, has raised more than $117,000 and has placed first overall of Central Ohio team fundraising in the last several years.
My wife is my world, and both of my sons, Max and Tyler, are everything to me. I asked my boys if they would like to comment on the "Ramsey PD Story." They replied with this:
Even though this list may seem extensive, the one great point that dad repeats to us is he will never let these PD complications define him. Dad has always been a fighter. Dad recognizes that organizations like the Parkinson’s Foundation need money to help people with Parkinson’s. They are making life better for people with PD. Now, that’s what our local Moving Day family team is all about: fundraising for resources that can help slow the progression of this terrible disease.
Dad represents these ideals everyday."
Overall, I am doing well. I now struggle with speech and see a speech therapist after I found that with retirement also comes much less talking, so there are fewer daily benchmarks to test along the way.
While I don't see myself getting down, I do realize that there is no going back to life before PD. I have a neurodegenerative disease. However, don't mistake these physical indications as me crying in my beer.
I'm VERY lucky all-around and have MUCH to be thankful for.
Expert Briefing: Managing Nighttime Interruptions in Parkinson's Disease
May 14, 2025
Sleep disturbances are a common and often challenging symptom of Parkinson’s disease (PD). This program explores three prevalent nighttime interruptions—Restless Legs Syndrome (RLS), REM Sleep Behavior Disorder (RBD), and insomnia—that can affect individuals with PD and their care partners. This session will provide an in-depth look at the causes, symptoms, and practical management strategies for these sleep disorders.
Roneil G. Malkani, MD
Associate Professor, Northwestern University Feinberg School of Medicine
Neurologist, Northwestern Memorial Hospital
Specializing in Sleep Medicine and Movement Disorders
My PD Story
Researchers
Xiaolin (Lindsay) Huang, PhD
2025 Postdoctoral Fellowship
Exploring the Neurochemistry Behind Parkinson’s-related Sleep Disruption
The primary impact of Parkinson’s disease (PD) is a progressive loss of neurons in the brain that produce dopamine. Dopamine is a small signaling molecule used by neurons to relay messages and commands important for many tasks, including coordinated movement. As dopamine levels decline over time, the ability to perform these tasks decreases and manifests as PD symptoms.
It was recently discovered that dopamine likely plays a critical role in regulating sleep. People with PD often experience disrupted sleep as an early symptom of the disease, which significantly impairs health even before movement symptoms begin. Xiaolin (Lindsay) Huang, PhD, a recipient of a Parkinson’s Foundation Postdoctoral Fellowship, is exploring the neurochemistry behind dopamine and sleep, generating new knowledge to guide future therapies that treat PD-associated sleep disruption.
Research suggests that dopamine is important for waking up and staying awake. However, diminishing dopamine in PD does not lead to chronic sleepiness like this finding would suggest. Dr. Huang, under the mentorship of Yang Dan, PhD, at the University of California, Berkeley, is solving this puzzle by investigating how dopamine signaling coordinates with the “sleep pressure” molecule called adenosine, as well as how dopamine deficits affect a sleep-regulating region of the brain called the medialsubstantia nigra pars reticulata (mSNr).
“By uncovering the neural mechanisms driving PD-associated sleep disturbances, the study will shed light on a critical and underexplored aspect of the disease.” - Dr. Huang
While dopamine promotes wakefulness, adenosine promotes sleepiness. Adenosine accumulates in the brain throughout the day and eventually overwhelms dopamine levels, leading to growing tiredness until it is time for bed. Using mice with and without simulated PD, Dr. Huang will utilize highly sensitive brain monitoring techniques to observe how PD affects the balance between dopamine and adenosine and how that disruption may impact sleep behaviors.
Additionally, previous research from Dr. Dan’s lab has revealed that the mSNr region of the brain is important for regulating sleep-wake behaviors. Using the same experimental PD mice, Dr. Huang will assess if and how dopamine loss impairs neuron activity in the mSNr region, further disrupting sleep patterns in those animals.
Altogether, these investigations into how PD-related sleep disruption are related to adenosine levels and mSNr changes can lead to future research and treatment development addressing this debilitating non-movement PD symptom. When asked what this award means for her work and career in PD research, Dr. Huang said “Receiving the Parkinson’s Foundation Postdoctoral Fellowship is both an honor and a pivotal step in my scientific journey. Ultimately, the findings may inform the development of new therapies to improve sleep and enhance quality of life for people living with PD.”
Reclaiming Restful Sleep by Unraveling How Parkinson’s Changes the Brain
Along with the typical movement-related symptoms, many people with Parkinson’s disease (PD) also experience other non-movement health issues. These non-movement symptoms can be quite debilitating and sometimes more difficult to notice by care partners.
One common non-movement PD symptom is difficulty sleeping, often in the form of waking up frequently throughout the night. Pamela Marcott, MD, PhD, a recipient of a Parkinson’s Foundation Postdoctoral Fellowship, is casting a spotlight on the sleep-associated circuits of the brain to understand how exactly PD impacts sleep patterns. By uncovering the mechanisms behind PD-related sleep problems, she hopes to help advance new therapies for such disturbances.
While much of the neuroscience of sleep is still a mystery, researchers do know that staying asleep through the night requires a highly calibrated balance of different signals in the brain. These sleep signals are relayed through brain cells called neurons and can vary in frequency and intensity, depending on their purpose. If these signals become altered and imbalanced, sleep fragmentation occurs with "frequent changes between different sleep and wake states, leading to less consolidated and restful sleep,” said Dr. Marcott.
Under the mentorship of Alexandra Nelson, MD, PhD, and Ying-Hui Fu, PhD, at the University of California, San Francisco, a Parkinson’s Foundation Center of Excellence, Dr. Marcott is investigating how PD changes the behavior of neurons in a specific sleep-regulating region of the brain called the pedunculopontine nucleus (PPN). PPN neurons act like telephone operators, relaying important signals across the brain. Using mice with and without PD-like symptoms, she will measure how the disease affects the ability of PPN neurons to transmit their important sleep signals.
“Results of this study will improve our understanding of the circuit mechanisms that regulate sleep disturbances in PD, which will inform future therapeutic treatments.” - Dr. Marcott
After learning more about how PD changes the sleep-related neurons’ signaling ability, Dr. Marcott will then monitor the brains of the mice as they sleep. She will keep a close eye on how the PPN neurons activate during sleep phase transitions, as she believes PD causes these neurons to be overactive and lead to fragmented sleep. Observing in real time how PD alters sleep regulation in the brain will provide a strong foundation for understanding how to treat this symptom and give restful nights back to people with PD.
“As a physician scientist in this space I am committed to making meaningful discoveries in the laboratory that will benefit my patients, and I am excited to have the opportunity to start this phase of my career with the support of the Parkinson's Foundation,” said Dr. Marcott.
Meet a Researcher Exploring Parkinson’s-related Sleep Disruption
The primary impact of Parkinson’s disease (PD) is a progressive loss of neurons in the brain that produce dopamine. Dopamine is a small signaling molecule used by neurons to relay messages and commands important for many tasks, including coordinated movement. As dopamine levels decline over time, the ability to perform these tasks decreases and manifests as PD symptoms.
It was recently discovered that dopamine likely plays a critical role in regulating sleep. People with PD often experience disrupted sleep as an early symptom of the disease, which significantly impairs health even before movement symptoms begin. Xiaolin (Lindsay) Huang, PhD, a recipient of a Parkinson’s Foundation Postdoctoral Fellowship, is exploring the neurochemistry behind dopamine and sleep, generating new knowledge to guide future therapies that treat PD-associated sleep disruption.
“As a neuroscientist, my long-term goal is to understand why people with Parkinson’s disease (PD) often have trouble sleeping and to find ways to help,” said Dr. Huang. “This interest was shaped by my research experience during college, graduate school and early postdoctoral training. Now, I use state-of-the-art tools to study how brain circuits that control sleep are affected in PD.”
Research suggests that dopamine is important for waking up and staying awake. However, diminishing dopamine in PD does not lead to chronic sleepiness like this finding would suggest. Dr. Huang, under the mentorship of Yang Dan, PhD, at the University of California, Berkeley, is solving this puzzle by investigating how dopamine signaling coordinates with the “sleep pressure” molecule called adenosine, as well as how dopamine deficits affect a sleep-regulating region of the brain called the medialsubstantia nigra pars reticulata (mSNr).
“By uncovering the neural mechanisms driving PD-associated sleep disturbances, the study will shed light on a critical and underexplored aspect of the disease,” said Dr. Huang.
While dopamine promotes wakefulness, adenosine promotes sleepiness. Adenosine accumulates in the brain throughout the day and eventually overwhelms dopamine levels, leading to growing tiredness until it is time for bed. Using mice with and without simulated PD, Dr. Huang will utilize highly sensitive brain monitoring techniques to observe how PD affects the balance between dopamine and adenosine and how that disruption may impact sleep behaviors.
Additionally, previous research from Dr. Dan’s lab has revealed that the mSNr region of the brain is important for regulating sleep-wake behaviors. Using the same experimental PD mice, Dr. Huang will assess if and how dopamine loss impairs neuron activity in the mSNr region, further disrupting sleep patterns in those animals.
These investigations into how PD-related sleep disruption are related to adenosine levels and mSNr changes can lead to future research and treatment development addressing this debilitating non-movement symptom.
“Receiving this award is both an honor and a pivotal step in my scientific journey,” said Dr. Huang. “It provides essential support for me to pursue an exciting project aimed at uncovering novel mechanisms underlying sleep disturbances in Parkinson’s disease. With the Foundation’s backing, I will actively engage with the broader PD research community through symposia and seminars, fostering meaningful collaborations and broadening my perspective on the field. This fellowship marks a critical milestone toward my long-term goal of establishing an independent research lab focused on understanding and treating sleep deficits in PD at the circuit and systems level.”
