agree 100% it is a complex mess, and that is even if we are just talking about the neurological part of it - i know very little about the other areas you mention. nonetheless, the current diagnostic criteria are such that every person diagnosed w/PD experiences 2 out of 3 of the cardinal symptoms. now. one could argue that the cardinal symptoms are inadequate or inaccurate or whatever, but the fact of the matter is that in spite of that complexity, i share at least one major motor symptom with every other person diagnosed w/PD.

agree also that search for cause is important, as is search for disease modifying therapy, however, given that:

• average age of diagnosis is 60 (roughly), and
• average life expectancy is 79,

something on the order of half of the people diagnosed w/PD are going to have to manage its symptoms for a minimum of 19 years, and given that:

• levodopa's useful life lasts on average 5 years (a number that decreases in tandem with age of onset, which, for me, was 32), and
• the only option after levodopa becomes completely unbearable is brain surgery, the long term efficacy of which in unknown,

and given that time horizon to a neuroprotective therapy is virtually guaranteed to be much longer than that to a better symptomatic therapy (consider the fact that, unlike symptomatic benefit, we are currently unable to determine whether or not neuroprotection has occured), personally, i see a clear need for a better symptomatic therapy to hold us over until the other two goals are accomplished.

agree 1000% and am looking forward to reading and talking more about this in the private forum.

thanks,
b