Parkinson’s disease: The four major cardinal symptoms of the disease indicating risk

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Parkinson’s disease is a neurodegenerative disorder that affects predominantly dopamine-producing neurons in a specific area of the brain called substantia nigra. Dopamine plays a vital role in regulating the movement of the body. A reduction in dopamine is responsible for many of the symptoms of Parkinson’s disease. What are the four cardinal signs of Parkinson’s disease to spot?

In a study published in the National Library of Health, the description of all four cardinal signs of Parkinson’s disease was analysed.

“Although individual signs of Parkinson’s disease – most frequently tremor – have been described since ancient times, the first systematic description of the disease is attributed to James Parkinson in 1817,” noted the study.

It added: “We present evidence that not only individual signs, but the disease itself with all four cardinal signs were first described in 1690.”

The study found the four cardinal symptoms being major warnings for Parkinson’s disease include tremor, bradykinesia, rigor and postural instability.


Tremors have been characterised as a key sign of the disease.

Tremors involve a persistent twitching or shaking of the hands, legs or chin.

The tremors may start gradually, sometimes starting with a barely noticeable tremor that may be in just one hand.


Parkinson’s Victoriaa charity organisation said: “Everybody with Parkinson’s experiences a different range of symptoms and no two people will be affected in the same way or to the same extent.

“Slowness of movement known as bradykinesia and muscle stiffness known as rigidity are both typical motor symptoms of Parkinson’s.

“Bradykinesia or slowness of movement is one of the main symptoms of Parkinson’s.

“The general effect of bradykinesia is that it takes more time and effort to complete daily tasks, which can result in fatigue.”


Muscle rigidity, also known as muscle tension, rigor, or stiffness, is one of the most common causes of muscle pain.

It’s characterised by the inability of the muscles to relax normally.

The condition can affect any of the muscles in the body, causing sharp pain that makes it difficult to move.

Parkinson’s rigidity is often most noticeable when a person moves a joint through a circular movement with the movement feeling as if the joint is moving through a number of cogs, known as “cogwheel rigidity”.

Postural instability

This symptom usually occurs in the later stages of the disease and is a balancing issue.

A person may find it difficult to maintain an upright position and is unstable when standing.

This instability leads to a person with Parkinson’s to often fall over.
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