CONy 2024 | Parkinson’s beyond dopamine: the role of acetylcholine, noradrenaline, and serotonin

The role of dopamine in the pathophysiology of Parkinson’s disease (PD) is widely understood. However, this is not the case for many other neurotransmitter systems. K Ray Chaudhuri, MD, DSc, FRCP, FEAN, King’s College London, London, UK, discusses the contribution of other neurotransmitters (acetylcholine, noradrenaline, and serotonin) to the symptoms seen in patients with PD. Through pathology studies, it has been identified that, in the advanced stages of PD, neuronal cells other than dopaminergic cells may preferentially die, causing atypical presentations of the syndrome. For example, if the serotoninergic system is affected, patients may experience sleep attacks, and dysfunction of the noradrenergic system is closely linked to pain. Therefore, these different neurotransmitter deficits lead to a range of non-motor subtypes being observed in PD patients in the clinic. Prof. Chaudhuri highlights that the widespread use of novel sophisticated imaging is needed to successfully identify these deficits and allow for the appropriate treatment and management of patients. This interview took place at the 18th Annual Congress on Controversies in Neurology (CONy 2024) in London, UK.

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