Prevalence and Predisposing Factors of Parkinson Disease: A Community-Based Study In Barangay Mangilag Sur, Candelaria, Quezon: A Research Protocol


Parkinson Disease is a neurodegenerative disorder affecting the central nervous system caused by the death of dopaminergic cells in the ventral region of the pars compacta of the substancia nigra. The subsequent lack of dopamine causes movement-related disorders including tremors, rigidity, hypokinesia, and postural instability. The clinical diagnosis of PD is hinged on the triad of asymmetric bradykinesia, rest tremors and rigidity, with an expert (usually a Neurologist) eliminating those cases having mimics of the symptomatology. Development of the disease is through certain environmental, hereditary, and genetic factors. In the Philippines, PD is a rarely seen disorder and establishing of a prevalence study has been difficult for neurologists. Prevalence of the disease in the country has been estimated to be less than 1% based on a 2007 study conducted by the Philippine Neurologic Association but without ascertainment of cases. The researchers aim to determine the disease’s prevalence in a locale and explore on the possible predisposing factors on the development of the disease.

The research will be conducted through a two-phase descriptive design. Screening of the target population using a questionnaire will constitute the first phase, and the second phase will be through case ascertainment of positively screened participants by a neurologist. Point prevalence rate will be used for statistical treatment. The research protocol was approved by the UST Faculty of Medicine and Surgery – Department of Clinical Epidemiology, as it adheres to the Declaration of Helsinki in clinical studies or surveys.


1. Samii A., Nutt JG. and Ransom B.R. (2004) Parkinson disease. Lancet. 363(9423):1783-93

2. Davie, C.A. (2008). A review of Parkinson disease. Br. Med. Bull. 86 (1): 109–27. doi:10.1093/bmb/ldn013

3. Obeso, J.A., Rodríguez-Oroz, M.C., Benitez-Temino, B. et al. (2008). Functional organization of the basal ganglia: therapeutic implications for Parkinson disease. Mov. Disord. 23 (Suppl 3): S548–59. doi:10.1002/mds.22062

4. Gelb, D.J., Oliver, E., & Gilman S. (1999).Diagnostic criteria for Parkinson disease. Arch Neurol. 56(1):33-39. doi:10.1001/archneur.56.1.33

5. Jankovic, J. (2008). Parkinson disease: clinical features and diagnosis. J. Neurol. Neurosurg. Psychiatr. 79(4): 368–76.doi:10.1136/jnnp.2007.131045

6. Rabo, C., Rosales, R.L. (2009). The occurrence of fatigue in independent and clinically stable Filipino patients with idiopathic Parkinson Disease, Journal of Movement Disorders 2:18-21; KOREA

7. Go, C.L., Rosales, R.L., Tanglao, M.J., & Fernandez, H.H. (2011). Depressive symptoms among cognitively-intact, community-dwelling Filipino patients with Parkinson disease. International Journal of Neuroscience; 121(3):137-4. USA

8. de Lau L.M., Breteler M.M. and Breteler (June 2006). Epidemiology of Parkinson disease. Lancet Neurol. 5(6): 525–35.doi:10.1016/S1474-4422(06)70471-9

9. Sheperjans, F., Aho, V., Pereira, P.A.B., Koskinen, K., Paulin, L., Pekkonen, E., Haapaniemi, E., Kaakkola, S., Eerola-Rautio, J., Pohja, M., Kinnunen, E., Murros, K., Auvinen, P. (2014); Gut microbiota are associated with Parkinson disease and clinical phenotype – A case-control study, Movement Disorders; 29 Suppl 1:1548

10. Vizcarra, J.A., Wilson-Perez, H.E., Espay, A.J. (2014); The power in numbers: Gut microbiota in Parkinson disease (pages 296–298), Movement Disorders; 30 (3): 296-298

11. Braak, H., & Del Tredici K. (2008). Invited article: nervous system pathology in sporadic Parkinson disease. Neurology. 70: 1916–1925

12. Lesage, S., Brice, A., & Brice (2009).Parkinson disease: from monogenic forms to genetic susceptibility factors. Hum. Mol. Genet. 18(R1): R48–59. doi:10.1093/hmg/ddp012

13. Hatano Y, Li Y, Sato K, Asakawa S, Yamamura Y, Tomiyama H, Yoshino H, Asahina M, Kobayashi S, Hassin-Baer S, Lu C, Ng A, Rosales RL, Shimizu N, Toda T, Mizuno Y, Hattori N.; Novel PINK1 Mutations in Early-onset Parkinsonism. Annals of Neurology, 56:424-427, 2004, USA

14. Tan, L.C.S., Venketasubramanian, N., Hung, C.Y., et al. (2004) Prevalence of Parkinson disease in Singapore: Chinese vs Malays vs Indians. Neurology. 62: 1999-2004.

15. Roxas, A., Gose, M., Dominguez, J., Liban, S., Rosales, R.L. & Sosa, M. (2007). The prevalence of stroke, Parkinsonism, dementia, migraine and epilepsy in the Philippines, part I: the validation of the PNA questionnaire. Philippine Journal of Neurology (PhilJNeurol) 11(1): 1-4

16. Roxas, A., Gose, M., Dominguez, J., Liban, S., Rosales, R.L. & Sosa, M. (2007). The prevalence of stroke, Parkinsonism, dementia, migraine and epilepsy in the Philippines, part II: application of the PNA questionnaire in the 2003 National Nutrition Health Survey. Philippine Journal of Neurology (PhilJNeurol) 11(1): 5-11

17. Rosales, R.L. (2010). X-Linked Dystonia Parkinsonism: Clinical Phenotype, genetics and therapeutics. Journal of Movement Disorders 3:32-38 pISSN 2005-940X / eISSN 2093-4939, KOREA

18. Fernandez, H.H., & Rosales, R.L. (2011). Uncovering the Mystery From the Philippine Island of Panay. International Journal of Neuroscience, 121, 1–2, USA

19. Lee, L.V., Rivera, C., Teleg, R., Dantes, M,. Pasço, P.M., Jamora, R.D., Arancillo, J., et al. (2011). The Unique Phenomenology of Sex-Linked Dystonia Parkinsonism (XDP, DYT3, Lubag). International Journal of Neuroscience 121, 3–11, USA

20. Rosales, R.L. (2011). Global Clinical studies in Asia: Philippine side. Clinical Evaluation, 38(4): 676-89. ISSN 0300-305, JAPAN

21. Tanner C.M., &Goldman S.M. (1996) Epidemiology of Parkinson disease.Neurol. Clin. 14: 317–335

22. Alves, G., Forsaa, E.B., Pedersen, K.F., Gjerstad, M.D., & Larsen, J.P. (2008) Epidemiology of Parkinson disease. J Neurol. 2008; 255(Suppl 5): 18-32

23. Elbaz, A., &Tranchant, C. (2007) Epidemiologic studies of environmental exposures in Parkinson disease. J Neurol Sci. 262(1-2): 37-44

24. Wider C. and Wszolek Z. K. (2008) Etiology and pathophysiology of frontotemporal dementia, Parkinson disease and Alzheimer disease: lessons from genetic studies. Neurodegener. Dis. 5: 122–125

25. Fearnley J. M., & Lees A. J. (1991). Ageing and Parkinson disease: substantianigra regional selectivity. Brain. 114(Pt 5): 2283–2301

26. Baba, M., Nakajo, S., Tu, P.H., Tomita, T., Nakaya, K., Lee, V. M., Trojanowski, J. Q., &Iwatsubom T. (1998) Aggregation of alphasynuclein in Lewy bodies of sporadic Parkinson disease and dementia with Lewy bodies. Am. J. Pathol. 152, 879–884

27. Schulz-Schaeffer, W. J. (2010). The synaptic pathology of α-synuclein aggregation in dementia with Lewy bodies, Parkinson’s disease and Parkinson’s disease dementia. Acta Neuropathologica, 120(2), 131–143.

28. Olanow C. W. and McNaught K. S. P. (2006) Ubiquitin–proteasome system and Parkinson disease. Movement Disorders. 21(11): 1806-1823

29. Philippine Neurological Association. (2007). Diagnosis and initiation of treatment

of Parkinsondisease. PPD’s Compendium of Philippine Medicine (10th 2008 ed.). Retrieved from

30. Caballol, N., Martí, Maria, J., Tolosa, E. (2007). Cognitive dysfunction and dementia in Parkinson disease. Movement Disorders 22(Suppl 17): S358–S366. doi:10.1002/mds.21677

31. Dickson D.V. (2007). Neuropathology of movement disorders.In Tolosa E, Jankovic JJ. Parkinson disease and movement disorders. Hagerstown, MD: Lippincott Williams & Wilkins. pp. 271–83. ISBN 0-7817-7881-6.

32. Svensson, E., Beiske, A. G., Loge, J. H., Beiske, K. K., and Sivertsen, B. (2012). Sleep problems in Parkinson disease: a community-based study in Norway. BMC Neurology. 12:71. doi: 10.1186/1471-2377-12-71

33. Winder-Rhodes, S. E., Evans, J. R., Ban, M., Mason, S. L., Williams-Gray, C. H., Foltynie, T., Duran, R., Mencacci, N. E., Sawcer, S. J., and Barker, R. A. (2013). Glucocerebrosidase mutations influence the natural history of Parkinson disease in a community-based incident cohort. Brain. 136, 392-399.doi:

34. Caramelli, P. (2011). Dementia associated with Parkinson disease: usefulness of the Movement Disorder Sociaety diagnostic criteria in Brazil. Arq. Neuro-Psiquiatr., 69:5. doi:

35. Tandberg E., Larsen J.P., Karlsen K. (1998) A community-based study of sleep disorders in patients with Parkinson disease. MovDisord. 13(6): 895-9

36. Torpy, J.M. (2004) Dementia. The Journal of the American Medical Association. 292(12)

37. Aarsland, D., Andersen, K., Larsen, J.P., Lolk, A., Nielsen, H. and Kragh-Sørensen, P. (2001). Risk of dementia in Parkinson disease: a community-based prospective study. Neurology. 56(6): 730-6

38. Torpy, J.M. (2010) Depression. The Journal of the American Medical Association.303(19)

39. Tandberg E., Larsen J.P., Aarsland D., Cummings J.L. (1996) The occurrence of depression in Parkinson disease: a community-based study. Arch Neurol. 53(2): 175-9

40. Bharucha, N.E., Bharucha, E.P., Bharuch, A.E., et al. (1988). Prevalence of Parkinson disease in the Parsi community of Bombay, India. Arch Neurol. 45: 1321-1323

41. Li, S.C., Schoenberg, B.S., Wang, C.C., et al. (1985). A prevalence survey of Parkinson disease and other movement disorders in the People’s Republic of China. Arch Neurol. 42: 655-657

42. Wang, Y.S., Shi Y.M., Wu Z.Y., et al. (1991) Parkinson disease in China. Coordinational Group of Neuroepidemiology. PLA. Chin Med J. 104: 960-964

43. Wang, S.J., Fuh, J.L., Teng, E.L., et al. (1996) A door-to-door survey of Parkinson disease in a Chinese population in Kinmen. Arch Neurol, 53: 66-71

44. Chen, R.C., Chang, S.F., Su, C.L., et al. (2001). Prevalence, incidence and mortality of Parkinson disease: a door-to-door survey in Ilan county, Taiwan. Neurology. 57: 1679-1686.

45. Moriwaka, F., Tashiro, K., Itoh, K., et al. (1996).Prevalence of Parkinson disease in Hokkaido, the northernmost island of Japan. Internal Medicine. 53: 276-279

46. Lee L.V., Munoz E.L., Tan K.T. and Reyes M.T. (2001) Sex linked recessive dystonia parkinsonism of Panay, Philippines (XDP). MolPathol. 54(6): 362–368

47. Pasco P.M., Ison C.V., Magpusao N.S., Muňoz E.L., Reyes M.T. (2011) Understanding XDP through imaging, pathology, and genetics. Int J Neurosci. 121(Suppl 1): 12-7 doi: 10.3109/00207454.2010.526729

48. Evidente, V.G., Dickson, D., Singleton, A., Natividad F., Hardy J., Hernandez D. (2002). Novel neuropathological findings in lubag or x-linked dystonia-parkinsonism. MovDisord. 17( Suppl 1): 294

49. Goto S., Lee L.V., Munoz E.L., Tooyama I., Tamiya G., Makino S., et al. (2005) Functional anatomy of the basal ganglia in X-linked recessive dystonia-parkinsonism. Ann Neurol. 58: 7–17

50. Kaji R., Goto S., Tamiya G., Ando S., Makino S. and Lee L.V. (2005) Molecular dissection and anatomical basis of dystonia: X-linked recessive dystonia-parkinsonism (DYT3). J Med Invest. 52: 280-3

51. Chen, C., Chen, T., Hwang, Y., Wen, Y., Chiu, Y., Wu, C., et al. (2009). Different Prevalence Rates of Parkinson Disease in Urban and Rural Areas: A Population-Based Study in Taiwan. Neuroepidemiology, 350-357. Retrieved March 4, 2015, from


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