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Age is the single most consistent risk factor and it has been estimated that there is a cumulative lifetime risk of one in 40 for developing Parkinson’s disease.100 Loss of pigmented cells in the substantia nigra is the most consistent finding in Parkinson’s disease and normally the quantity of nigral cells diminishes from 425 000 to 200 000 at 80 yr.

In Parkinson’s disease, the substantia nigra shows marked depletion of cells (‐acetyltranferase 2, in the pathogenesis of Parkinson’s disease have been inconclusive.5107Parkinson’s disease was first described during the industrial revolution suggesting that environmental toxins may play a role in its pathogenesis.

In Parkinson’s disease, there is a 30–40% decrease in complex‐1 activity in the substantia nigra pars compacta which may contribute to energy failure and hence predispose the pars compacta to toxic insults and increase its susceptibility to cell death.68 Oxidative stress may be caused by an increase in the number of reactive species including hydrogen ions, superoxide, peroxyl radicals, nitric oxide, and hydroxyl radicals.

Hence, the internal globus pallidus is common to both pathways (Fig.

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