Insights into the mechanism of neuro-osseus overlap in Parkinson’s disease

Parkinson’s disease (PD) is a motor dysfunction disorder in which many patients also report of non-motor manifestations such as osteoporosis. Disease cure is challenging due to unavailability of prescribed treatment formats. Discovery of pathways of central modulation of bone mass and the stimulation of brain functions hints towards a loop with which the brain and bone interact. The current review critically analyses the basic and clinical literature pertaining to PD induced osteoporosis and reexamines the functional loop of bone in regard to maintaining metabolic dyshomeostasis in neurodegenerative conditions. It also explores newer overlaps for brain and bone axis in regards to finding common denominations and common mechanisms contributing to the pathogenesis of the two and questions whether early markers of autonomic nervous system (ANS) dysfunctions, could be recognized as important cues for late onset osteoporosis in PD. The contribution of DA in cases of parkinsonism is already established. PD induced bone loss is also reported. However there remains a conundrum for the participation of centrally regulated DA stimulating PD induced bone loss which needs further investigation.