in this essay i present a new `` '' global approach hypothesis '' '' to explain the pathophysiology of parkinson 's disease : `` '' susceptibility to parkinsonism is genetically determined and is reflected in all cells . i propose that idiopathic parkinson 's disease is the combined result of a generalized cell aging process accelerated , in susceptible individuals , by a variety of often repetitive trigger factors . these factors have in common the fact that they cause a transient increase in turnover within catecholamine producing neurons , centrally as well as peripherally . this results in accumulation within these neurons of free radicals . when the level of the toxic substances , in quantity or in time of exposure , exceeds the scavenging capacity of the cell , damage to organelles and to membranes results , leading to the formation of lewy bodies through an autoimmune reaction to damaged filaments and to cell death , particularly in the pigmented neurons of the brainstem . the progressive cell depletion leads to a compensatory increase in catecholamine turnover in the remaining pigmented cells , and an ever-accelerating degenerative process . the resulting neurotransmitter imbalance in the basal ganglia explains the symptoms of parkinson 's disease '' '' .
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