Diagnosis Of Idiopathic Parkinson's Disease Research Articles

Impact of Current Antipsychotic Medications on Comparative Mortality and Adverse Events in People With Parkinson Disease Psychosis

ObjectivesTo establish the mortality risk and adverse events associated with the use of atypical antipsychotic medications in people with Parkinson disease psychosis (PDP) in a clinically defined trial cohort. DesignPost hoc analysis of data from a multicenter, open-label extension study of pimavanserin comparing people taking and not taking current antipsychotics. SettingPrimary and secondary care medical centers in the United States, Canada, Europe, and India. ParticipantsA total of 459 people with PDP enrolled in the extension study. Participants were between ages 30 and 80 years, and had an established diagnosis of idiopathic Parkinson disease and moderate to severe psychosis. InterventionsParticipants were categorized into 2 groups: those receiving concomitant antipsychotic medications (“concurrent APD”) and those who did not take antipsychotic medications at any time during the study (“no APD”). Participants were receiving 40 mg pimavanserin daily in addition to concurrent antipsychotics and Parkinson disease medications. Main Outcome MeasuresSafety assessments at 2 weeks; 1, 3, 6, 9, and 12 months; and every 6 months thereafter, including evaluation of adverse events (AEs), vital signs, weight, physical examinations, 12-lead electrocardiograms, clinical laboratory tests (serum chemistry, hematology, and urinalysis), and the Unified Parkinson's Disease Rating Scale Parts II and III (UPDRS-II+III, activities of daily living and motor impairment, respectively). Differences between participants taking and not taking current antipsychotics were evaluated using incidence rate ratios (IRRs) with 95% confidence intervals (CIs). ResultsThere was significant increase in the mortality rate for participants taking concurrent antipsychotics compared with the group not taking antipsychotic medications (IRR 4.20, 95% CI 2.13–7.96). Participants who received a concurrent antipsychotic were also significantly more likely to experience overall a serious AE (IRR 2.95, 95% CI 2.02–4.24), any antipsychotic-related event (IRR 1.66, 95% CI 1.18–2.29), cognition-related events (IRR 2.70, 95% CI 1.19–5.58), infections (IRR 1.97, 95% CI 1.17–3.16), and edema (IRR 2.61, 95% CI 1.09–5.59). The risk of falls, stroke, sedation, orthostatic hypotension, and thromboembolic events was also increased in these individuals but this was not significant. ConclusionsThis study highlights a significant risk of mortality, and severe AEs in patients with Parkinson disease receiving atypical antipsychotics. This is similar to or greater than the risks seen in people with Alzheimer disease, although with a less clear-cut risk of stroke and a longer delay to increased mortality.

The Effect of Nocturnal Blood Pressure Changes on the Cognitive State of Patients With Parkinson’s Disease

This article has been retracted by the authors. Background: Recent data have revealed that cognitive involvement occurs, more or less, in every stage of idiopathic Parkinson’s disease (IPD), which is definitely going to cause radical changes in this traditional understanding. The effects of blood pressure changes during the night on the cognitive states of patients with IPD are not known for sure. The purpose of this study was to research the effects of blood pressure changes during the night on cognitive state of patients with IPD. Methods: A total of 30 patients, 14 females and 16 males, were followed with a diagnosis of IPD. Cognitive functions were assessed with an extensive neuropsychological test battery. Results: The fifth stage of Stroop test, test of line direction, test of face recognition and Hooper test were significantly different in dipper group when compared with the non-dipper group. Conclusion: Not having nocturnal blood pressure decrease in IPD can be accepted as a risk factor in terms of cognitive function disorders. J Neurol Res. 2015;5(3):207-212 doi: http://dx.doi.org/10.14740/jnr324w

The Effect of Nocturnal Blood Pressure Changes on the Cognitive State of Patients With Parkinson’s Disease

This article has been retracted by the authors. Background: Recent data have revealed that cognitive involvement occurs, more or less, in every stage of idiopathic Parkinson’s disease (IPD), which is definitely going to cause radical changes in this traditional understanding. The effects of blood pressure changes during the night on the cognitive states of patients with IPD are not known for sure. The purpose of this study was to research the effects of blood pressure changes during the night on cognitive state of patients with IPD. Methods: A total of 30 patients, 14 females and 16 males, were followed with a diagnosis of IPD. Cognitive functions were assessed with an extensive neuropsychological test battery. Results: The fifth stage of Stroop test, test of line direction, test of face recognition and Hooper test were significantly different in dipper group when compared with the non-dipper group. Conclusion: Not having nocturnal blood pressure decrease in IPD can be accepted as a risk factor in terms of cognitive function disorders. J Neurol Res. 2015;5(3):207-212 doi: http://dx.doi.org/10.14740/jnr324w

Update on Transcranial Sonography Applications in Movement Disorders

Over the past 20 years transcranial B-mode sonography (TCS) of brain parenchyma is being increasingly used as a diagnostic tool in movement disorders. The most widely recognised finding for movement disorders has been an increase in echogenicity of the substantia nigra, an area of the midbrain that is affected in idiopathic Parkinson’s disease (IPD). This finding has enabled a reliable diagnosis of IPD with high predictive values. Other sonographic features - such as hypoechogenicity of the brainstem raphe and hyperechogenicity of the lentiform nucleus - might help to increase the differential diagnosis of IPD and other movement disorders. In comparison with other neuroimaging modalities such as magnetic resonance imaging (MRI) and computed tomography (CT), TCS can currently be performed with portable machines and has the advantages of non-invasiveness with high resistance to movement artifacts. In distinct brain disorders TCS detects abnormalities that cannot be visualized - or can only be visualized with significant effort - with other imaging methods. This present update summarizes the current methodological standards and defines the assessment of diagnostically relevant deep brain structures such as substantia nigra, brainstem raphe, basal ganglia and ventricles

Authors' reply to Wang et al. comment on "Parkinson's disease associated with myasthenia gravis and rheumatoid arthritis".

We would like to thank Wang et al. [1] for their comments on our case report [2]. They highlight the fact that patients presenting with parkinsonism may fell into either idiopathic Parkinson’s disease (PD) or syndromes of secondary parkinsonism such as drug-induced parkinsonism, vascular parkinsonism, parkinsonism concomitant with autoimmune diseases, etc. [1]. In their comment, Wang et al. [1] dispute the diagnosis of idiopathic PD in our patient, since we haven’t provided some clinical, imaging, and laboratory data. Therefore, we would like to clarify that the diagnosis of idiopathic PD in our case was made 5 years prior to diagnosis of myasthenia gravis and rheumatoid arthritis. Apart from the initial clinical presentation of unilateral tremor, rigidity, and slowness of movement, the patient had had a brain MRI that was normal, and a DAT scan which was abnormal. Moreover, the patient’s symptoms had a very good response on levodopa. Five years after the diagnosis of PD, the patient was admitted because of progressive weakness in the flexion of his neck. During his admission, which lead to the diagnosis of myasthenia gravis and rheumatoid arthritis and details of which have been published in our case report [2], he had been screened for autoimmune disorders. The following antibodies were all negative; anti-nuclear antibodies (ANA), anti-doublestranded DNA (anti-dsDNA), perinuclear anti-neutrophil cytoplasmic antibodies (P-ANCA), cytoplasmic anti-neutrophil cytoplasmic antibodies (C-ANCA), anti-cardiolipin (ACLG and ACLM), anti-thyroid peroxidase (anti-TPO), anti-thyroglobulin (anti-TG). Moreover, his thyroid hormones titers (T3, T4, and TSH) were within normal limits. Finally, we must mention that the following paraneoplastic antibodies were also negative; Hu (ANNA-1), Ri (ANNA2), Yo (PCA-1), PNMA2 (Ma2/Ta), CV2 (CRMP-5), amphiphysin, recoverin, SOX1 (AGNA), zic4, and Tr (DNER). In conclusion, we agree with Wang et al. that it is always important to be careful before diagnosing idiopathic PD, especially when causes of secondary parkinsonism have not been excluded. As mentioned above, with this letter, we would like to clarify that our patient had a diagnosis of idiopathic PD, which was diagnosed 5 years before the diagnosis of rheumatoid arthritis and myasthenia gravis.

Gene expression profiling analysis of locus coeruleus in idiopathic Parkinson's disease by bioinformatics.

This study aimed to explore the underlying molecular mechanisms of idiopathic Parkinson's disease (IPD) by bioinformatics analysis. Gene expression profile GSE34516 was downloaded from the Gene Expression Omnibus. Eight locus coeruleus post-mortem tissue samples derived from four IPD patients and four neurological healthy controls were used to identify the differentially expressed genes (DEGs) by paired t test. Based on the DEGs, principal components were analyzed. The Gene Ontology functional and Kyoto Encyclopedia of Genes and Genomes pathway analysis of the genome microarray data were then performed. Finally, protein-protein interaction (PPI) network of the DEGs was constructed. Total 261 DEGs including 195 up-regulated and 66 down-regulated DEGs were identified. Intracellular protein transport and RNA splicing via transesterification reactions were selected as the most two significantly enriched functions. Mismatch repair, N-glycan biosynthesis, spliceosome and nucleotide excision repair were the significantly enriched pathways. In the PPI network, CTSS, CD53, IGSF6, PTPRC and LAPTM5 were the hub nodes. Intracellular protein transport and RNA splicing via transesterification reactions were closely associated with IPD. The DEGs, such as CX3CR1, SLC5A7, CD53 and PTPRC may be the potential targets for IPD diagnosis and treatment.

Skin nerve α-synuclein deposits

To investigate (1) whether phosphorylated α-synuclein deposits in skin nerve fibers might represent a useful biomarker for idiopathic Parkinson disease (IPD), and (2) the underlying pathogenesis of peripheral neuropathy associated with IPD. Twenty-one well-characterized patients with IPD were studied together with 20 patients with parkinsonisms assumed not to have α-synuclein deposits (PAR; 10 patients fulfilling clinical criteria for vascular parkinsonism, 6 for tauopathies, and 4 with parkin mutations) and 30 controls. Subjects underwent nerve conduction velocities from the leg to evaluate large nerve fibers and skin biopsy from proximal (i.e., cervical) and distal (i.e., thigh and distal leg) sites to study small nerve fibers and deposits of phosphorylated α-synuclein considered the pathologic form of α-synuclein. Patients with IPD showed a small nerve fiber neuropathy prevalent in the leg with preserved large nerve fibers. PAR patients showed normal large and small nerve fibers. Phosphorylated α-synuclein was not found in any skin sample in PAR patients and controls, but it was found in all patients with IPD in the cervical skin site. Abnormal deposits were correlated with leg epidermal denervation. The search for phosphorylated α-synuclein in proximal peripheral nerves is a sensitive biomarker for IPD diagnosis, helping to differentiate IPD from other parkinsonisms. Neuritic inclusions of α-synuclein were correlated with a small-fiber neuropathy, suggesting their direct role in peripheral nerve fiber damage. This study provides Class III evidence that the presence of phosphorylated α-synuclein in skin nerve fibers on skin biopsy accurately distinguishes IPD from other forms of parkinsonism.

Teaching Video Neuro Images : Spasmodic dysphonia preceding idiopathic parkinsonism

An 83-year-old woman presented initially with a 20-year history of phonatory breaks (video e-1 on the Neurology ® Web site at [www.neurology.org][1]), exacerbated by stress, and then recently a left hand rest tremor. After the onset of rest tremor, DaTscan SPECT of the brain, obtained in the Parkinson's Progression Markers Initiative clinical research trial,1 revealed near symmetrical loss of dopaminergic terminals in the striata (figure), supporting a diagnosis of idiopathic Parkinson disease (PD). Most patients with PD will demonstrate vocal difficulties during their disease course,2 including some with spasmodic dysphonia (focal dystonia of the intrinsic laryngeal muscles arising from a dysfunction of the basal ganglia/extrapyramidal tract), which may precede PD by many years. [1]: http://www.neurology.org/

Predictors of quality of life in people with Parkinson’s disease: evidence for both domain specific and general relationships

Purpose: To assess the determinants of health-related quality of life (HrQoL) in people with Parkinson’s disease (PD). Method: Eighty-one people with a diagnosis of idiopathic PD took part in a cross-sectional questionnaire-based study. Measures were collected in a community setting and included established determinants of HrQoL (demographic, clinical and cognitive variables) but also included a wide range of mental health variables (depression, anxiety and stress) and, for the first time, positive psychological functioning (optimism and self-esteem). HrQoL was measured by the full version of the Parkinson’s Disease Questionnaire (PDQ-39) which includes eight domains of functioning. Results: Mental health measures (depression, anxiety and stress) were more influential than any other block of determinants and influenced a broader array of HrQoL domains including physical ones. There was some evidence of domain-specific relationships, e.g. between physical determinants and the more physically-oriented HrQoL domains, and between mental health determinants and emotional well-being. However, cognitive ability did not influence the HrQoL domain of cognitive impairment. Conclusions: The contribution of a multi-disciplinary approach is crucial given the many variables which affect HrQoL; in particular, significant overall improvements on HrQoL are unlikely if only physical rehabilitation is offered. Rehabilitation is likely to be beneficial in terms of HrQoL only if it is planned and delivered holistically.Implications for RehabilitationInterventions to improve physical function may have only limited impact on quality of life and might be limited to more physical HrQoL domains.Psychological interventions have the potential to improve quality of life over a wider range of both emotional and physical HrQoL domains.Clinician-measured level of functioning does not necessarily translate into patient-perceived levels of functional ability and relatively small objective decreases in ability can be appraised much more significantly disabling by people with PD.

Imaging of olfactory bulb and gray matter volumes in brain areas associated with olfactory function in patients with Parkinson's disease and multiple system atrophy

We explored if magnetic resonance imaging sequences might aid in the clinical differential diagnosis of idiopathic Parkinson's disease (IPD) and multiple system atrophy (MSA). We measured the volumes of the olfactory bulb, the olfactory tract, and olfaction-associated cortical gray matter in 20 IPD patients, 14 MSA patients, and 12 normal subjects, using high-resolution magnetic resonance imaging sequences in combination with voxel-based statistical analysis. We found that, compared to normal subjects and MSA patients, the volumes of the olfactory bulb and tract were significantly reduced in IPD patients. The gray matter volume of IPD patients decreased in the following order: the olfactory area to the right of the piriform cortex, the right amygdala, the left entorhinal cortex, and the left occipital lobe. Further, the total olfactory bulb volume of IPD patients was associated with the duration of disease. The entorhinal cortical gray matter volume was negatively associated with the UPDRS III score. ConclusionStructural volumes measured by high-resolution magnetic resonance imaging may potentially be used for differential diagnosis of IPD from MSA.

Standard strategies for diagnosis and treatment of patients with newly diagnosed Parkinson disease: UNITED STATES.

Special clues to diagnosis of idiopathic Parkinson disease (PD) are asymmetric onset, resting tremor, and an objective, robust response to treatment with l-dopa. Brain MRI is used to exclude rare structural causes of parkinsonism. Ceruloplasmin levels to exclude Wilson disease and thyroid function tests are appropriate in some patients. Dopamine uptake scans, or DaTscans, are now available in the US for diagnosis of PD. Currently DaTscan technology in the US is not able to estimate duration or severity of PD. These tests also do not differentiate idiopathic PD from atypical parkinsonism and are used mainly when there is uncertainty concerning diagnosis, for example, in patients in whom drug-induced or arteriosclerotic parkinsonism may simulate PD.

Palliative care in people with idiopathic Parkinson's disease who die in hospital

BackgroundThe UK National Institute for Health and Clinical Excellence guidelines state that palliative care options for people with Parkinson's disease (PD) should be discussed.AimsTo investigate whether palliative care guidelines are...

Spotlight on the October 8 Issue

Eighty-seven adults with a diagnosis of idiopathic Parkinson disease and on a stable medication regimen participated in either 20 hours of self-administered speed of processing training or a no-contact control condition. Speed of processing training improved Useful Field of View Test performance among persons in the mild to moderate stages of Parkinson disease. See p. 1284; Editorial, p. 1278 The authors examined the association between B vitamin supplementation and endpoint events using a fixed-effects model on 54,913 participants. B vitamin supplementation for homocysteine reduction reduced stroke events, especially in subjects with certain characteristics who received …

Randomized trial of cognitive speed of processing training in Parkinson disease

To examine the efficacy of cognitive speed of processing training (SOPT) among individuals with Parkinson disease (PD). Moderators of SOPT were also examined. Eighty-seven adults, 40 years of age or older, with a diagnosis of idiopathic PD in Hoehn & Yahr stages 1-3 and on a stable medication regimen were randomized to either 20 hours of self-administered SOPT (using InSight software) or a no-contact control condition. Participants were assessed at baseline and after 3 months of training (or an equivalent delay). The primary outcome measure was useful field of view test (UFOV) performance, and secondary outcomes included cognitive self-perceptions and depressive symptoms. Results indicated that participants randomized to SOPT experienced significantly greater improvements on UFOV performance relative to controls, Wilks λ = 0.938, F 1,72 = 4.79, p = 0.032, partial η(2) = 0.062. Findings indicated no significant effect of training on secondary outcomes, Wilks λ = 0.987, F2,70 < 1, p = 0.637, partial η(2) = 0.013. Patients with mild to moderate stage PD can self-administer SOPT and improve their cognitive speed of processing, as indexed by UFOV (a robust predictor of driving performance in aging and PD). Further research should establish if persons with PD experience longitudinal benefits of such training and if improvements translate to benefits in functional activities such as driving. This study provides Class III evidence that SOPT improves UFOV performance among persons in the mild to moderate stages of PD.

C9ORF72 expansions, parkinsonism, and Parkinson disease

To determine the histopathologic bases for the observed incidence of parkinsonism in families with C9ORF72 expansions, which typically cause amyotrophic lateral sclerosis (ALS) and/or frontotemporal dementia. DNA was extracted from 377 brains with the histopathologic diagnosis of idiopathic Parkinson disease or related disorders and analyzed for C9ORF72 expansions. α-Synuclein and p62 immunohistochemistry of the substantia nigra (SN) was undertaken in brains of 17 ALS cases with (C9ORF72+) and 51 without (C9ORF72-) the C9ORF72 expansion. Only 1 of 338 cases with pathologically confirmed idiopathic Parkinson disease had a C9ORF72 expansion. Similarly, only 1 of 17 C9ORF72+ brains displayed features suggestive of α-synucleinopathy. In contrast, p62-positive, TDP-43-negative neuronal cytoplasmic inclusions within the SN were considerably more frequent in C9ORF72+ brain tissue than in the C9ORF72- brains (p = 0.005). Furthermore, there was a more marked loss of dopaminergic neurons in the SN of C9ORF72+ ALS brains than C9ORF72- ALS brains (p = 0.029). SN involvement is common in C9ORF72+ ALS but can be clearly distinguished from Parkinson disease-related mechanisms by the presence of p62-positive inclusions and the absence of α-synuclein-positive Lewy bodies or Lewy neurites.

Evaluation of transcranial sonographic findings and MIBG cardiac scintigraphy in the diagnosis of idiopathic Parkinson's disease

The diagnosis of idiopathic Parkinson's disease (IPD) is based on clinical criteria. In the last two decades several neuroimaging methods using transcranial sonography (TCS) or radiolabelled tracers such as the myocardial MIBG scintigraphy were applied to support diagnosis of IPD. They have been used independently of each other and their interrelation is not yet clear. In the present study we analyzed the relation between findings of TCS, MIBG scintigraphy, and clinical presentation in 42 patients with IPD who were clinically diagnosed and underwent clinical follow-up over ≥3 years in order to confirm IPD diagnosis throughout the clinical course. The extent of substantia nigra hyperechogenicity (SN+) contralateral to the clinically more affected body side (SNcontra) was compared to myocardial 123I-MIBG uptake. SNcontra did not correlate with the myocardial MIBG uptake (r = −0.10; p = 0.52). Both myocardial MIBG uptake and TCS did not correlate significantly with Hoehn and Yahr stage (r = −0.03; p = 0.87 and r = −0.10; p = 0.54, respectively). Sensitivity of TCS in the diagnosis of IPD was 79%, of MIBG scintigraphy 81%. The combination of both measurements reached a sensitivity of 95%. TCS and MIBG scintigraphy may disclose complementary aspects of IPD. The combined use of both neuroimaging methods might improve the diagnostic sensitivity regarding IPD.

Differential diagnosis of parkinsonian syndromes using F-18 fluorodeoxyglucose positron emission tomography

Positron emission tomography (PET) imaging with F-18 fluorodeoxyglucose (FDG) has been used to identify characteristic patterns of regional glucose metabolism in patients with idiopathic Parkinson's disease (IPD) and the atypical parkinsonian syndromes of progressive supranuclear palsy (PSP), multiple system atrophy (MSA), and corticobasal syndrome (CBS). We undertook this study to assess the utility of fluorodeoxyglucose-PET in the differential diagnosis of individual patients with clinical parkinsonism. "Visual" and "computer-supported" reading of the fluorodeoxyglucose-PET scans were used for image interpretation and compared with each other. One hundred thirty-six parkinsonian patients were referred from movement disorder clinics in specialty neurology centers for the fluorodeoxyglucose-PET study. Imaging-based diagnosis was obtained by visual assessment of individual scans by a PET physician blinded to the clinical diagnosis and also by computer-assisted interpretation using statistical parametric mapping (SPM) analysis. The results were compared with a 2-year follow-up clinical assessment made by a movement disorder specialist. Concordance of visual evaluation of fluorodeoxyglucose-PET with clinical diagnosis was achieved in 91.7% of patients scanned, 97.6% IPD, 80% MSA, 76.6% PSP, and 100% CBS. Blinded computer assessment using SPM was concordant with the clinical diagnosis in 91% of cases evaluated (90.4% IPD, 80% MSA, 93.3% PSP, and 100% CBS). Fluorodeoxyglucose-PET performed at the time of initial referral for parkinsonism is useful for the differential diagnosis of IPD, PSP, MSA, and CBS. Computer-assisted methods can be used for objective evaluation especially when expert readers are not available.

The Role of Neuroimaging in the Diagnosis of Parkinson’s Disease

Parkinson's disease (PD), the second most common neurodegenerative disease, is characterized by the progressive loss of dopaminergic neurons in the substantia nigra pars compacta (SNpc) and the formation of intracytoplasmic Lewy inclusion bodies. To date, the diagnosis of idiopathic PD is mainly based on its cardinal clinical features: resting tremor, bradykinesia and rigidity. In recent years, advances in magnetic resonance imaging (MRI), transcranial sonography (TCS) and functional imaging - which includes positron emission tomography(PET)and single photon emission computed tomography (SPECT) - have provided new tools for the diagnosis of PD in its early stages and have discriminated it from other atypical Parkinsonian syndromes. This review focuses mainly on the current development of neuroimaging and its application in the diagnosis and differential diagnosis of PD.

Symptoms and Quality of Life in Late Stage Parkinson Syndromes: A Longitudinal Community Study of Predictive Factors

BackgroundPalliative care is increasingly offered earlier in the cancer trajectory but rarely in Idiopathic Parkinson's Disease(IPD), Progressive Supranuclear Palsy(PSP) or Multiple System Atrophy(MSA). There is little longitudinal data of people with late stage disease to understand levels of need. We aimed to determine how symptoms and quality of life of these patients change over time; and what demographic and clinical factors predicted changes.MethodsWe recruited 82 patients into a longitudinal study, consenting patients with a diagnosis of IPD, MSA or PSP, stages 3–5 Hoehn and Yahr(H&Y). At baseline and then on up to 3 occasions over one year, we collected self-reported demographic, clinical, symptom, palliative and quality of life data, using Parkinson's specific and generic validated scales, including the Palliative care Outcome Scale (POS). We tested for predictors using multivariable analysis, adjusting for confounders.FindingsOver two thirds of patients had severe disability, over one third being wheelchair-bound/bedridden. Symptoms were highly prevalent in all conditions - mean (SD) of 10.6(4.0) symptoms. More than 50% of the MSA and PSP patients died over the year. Over the year, half of the patients showed either an upward (worsening, 24/60) or fluctuant (8/60) trajectory for POS and symptoms. The strongest predictors of higher levels of symptoms at the end of follow-up were initial scores on POS (AOR 1.30; 95%CI:1.05–1.60) and being male (AOR 5.18; 95% CI 1.17 to 22.92), both were more predictive than initial H&Y scores.InterpretationThe findings point to profound and complex mix of non-motor and motor symptoms in patients with late stage IPD, MSA and PSP. Symptoms are not resolved and half of the patients deteriorate. Palliative problems are predictive of future symptoms, suggesting that an early palliative assessment might help screen for those in need of earlier intervention.

Serum Iron and Ferritin Level in Idiopathic Parkinson

Parkinson disease is a prevalent progressive neurodegenerative disorder, especially in western countries and among the elderly. This study aimed at evaluating serum iron and ferritin in patients with idiopathic Parkinson disease. In this case-control study, 50 patients with clinical diagnosis of idiopathic Parkinson disease (case group) were evaluated during a 12 month period. Fifty healthy persons (control group) recruited as well. Serum iron and ferritin levels were measured by biochemical and quantitative luminance methods, respectively in the case and control group. Fifty patients, 28 males and 22 females with the mean age of 64.53 +/- 10.18 (40-84) years and 50 controls were enrolled. Serum iron levels were 70.22 +/- 25.18 mg dL(-1) and 67.62 +/- 39.53 mg dL(-1) in case and control group, respectively. Serum ferritin levels were 129.79 +/- 137.67 ng dL(-1) and 109.87 +/- 154.71 ng dL(-1) in case and control group, respectively. There was no significant difference between different grades of Parkinson disease considering the serum level of iron or ferritin. The current study showed that generally there is no significant difference between the patients with the idiopathic Parkinson disease and healthy controls in terms of serum iron and ferritin levels. The same results were attributable to different grades of the disease.