The first warning sign appeared in Justin Neill’s left hand.
His typing slowed, and he noticed his fingers seemed to drag across the keyboard.
He was just 35, otherwise healthy and busy with work and daily life, so he dismissed it.
“I was just so busy with work. I was so busy with life. I thought, ‘Oh, it’s carpal tunnel, or maybe it’s a pinched nerve,’” says Justin, a technology operations manager in Los Angeles.
Soon afterward, a painful cramp tightened around his left foot. He assumed it was simply the result of having gone for a run.
It was his father who noticed the pattern: both problems were affecting the left side of Justin’s body. That realization finally convinced him to seek answers.
He visited a chiropractor, acupuncturist and masseuse, hoping one of them could explain what was happening. But it was a neurologist who delivered the alarming diagnosis, one day after Justin’s 36th birthday.
“Three hours into the appointment, I heard the word ‘Parkinson’s’ for the first time in my life,” Justin recalls. He had undergone brain scans and blood tests.
“Until then, I didn’t even know what Parkinson’s was. All I knew was that Michael J. Fox had it—that it affected old people and Michael J. Fox.”
The diagnosis seemed impossible.
California technology manager Justin Neill first noticed Parkinson’s symptoms when he struggled to type at 36. A neurologist later told him he was among a growing number of younger Americans diagnosed in their 30s and 40s
Justin had always been active, had experienced no other obvious warning signs and believed he was far too young to develop such a debilitating neurological condition.
“I was completely in denial, and I was angry with my doctor. I tried to explain, ‘I’m healthy. I run every day. I go to the gym. I don’t do drugs, I don’t drink. What the hell?’” says Justin, now 45.
His doctor explained that he was part of a group of younger patients whose Parkinson’s has left scientists searching for answers.
These patients are often described as having early-onset Parkinson’s disease. Their diagnoses remain difficult to explain: they are younger than the typical Parkinson’s population and have no obvious genetic cause for their symptoms.
Parkinson’s disease develops when cells in a small region of the brain called the substantia nigra begin to die. Those cells produce dopamine, a chemical messenger essential for smooth, controlled movement. As dopamine levels decline, patients may develop tremors, muscle stiffness and increasingly slow or difficult movements.
The disease is relatively common among older adults. Most patients are diagnosed after age 60, while the number of Americans living with Parkinson’s continues to rise.
But the increase in younger patients has alarmed doctors and researchers. They increasingly suspect that, in at least some cases, the disease may begin developing decades before the first symptoms appear.
There is no single proven cause of Parkinson’s. However, a growing body of research has linked the disease to environmental exposures, including pesticides and air pollution.
Earlier this year, UCLA scientists examined chlorpyrifos, an insecticide used on crops, forests and grassy areas such as golf courses.
After analyzing pesticide exposure among 800 people with Parkinson’s and testing the chemical in zebrafish—widely used in medical research because they share about 70 percent of their genes with humans—the researchers found that chlorpyrifos exposure was associated with a 2.5-fold increase in Parkinson’s risk.
The study has already prompted at least one lawsuit against Dow Chemical Company and its agricultural spin-off, Corteva Agriscience. Neither company has publicly commented on the new research. Historically, the companies have defended the chemical’s use when handled under proper conditions.
Another notable study analyzed health records belonging to roughly 18 million Americans. It found that people living within 500 feet of a dry cleaner had a 14 percent higher risk of developing Parkinson’s than those living several miles away.
The concern is that many of these environmental exposures are difficult to avoid—and that harm may begin years or even decades before the first tremor, cramp or other recognizable symptom.
Justin believes his own diagnosis may be connected to a chemical spill in the creek behind his childhood home. He says at least four other people on his block have also been diagnosed.
After receiving his diagnosis in 2017, Justin was prescribed carbidopa and levodopa, a combination of medicines that helps the brain convert and replace missing dopamine.
The medication, however, made him so nauseated that he was unable to keep food down.
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Doctors then switched him to a daily Neupro patch, which releases a dopamine agonist over 24 hours.
Justin spent years trying different medication combinations. One left him constantly nauseated, while another triggered an uncontrollable gambling habit. Eventually, he turned to deep brain stimulation surgery
Justin first regained full movement in his hands. Over the following months, he rebuilt his strength and flexibility and can now exercise regularly—and type once again
The patch eased his stiffness and tremors, but it also produced a frightening and unpredictable side effect: compulsive gambling.
“It was all I could think about. I’m someone who is very good with money, yet I was gambling around $300 a day for months. It was just one dopamine hit after another,” he said.
By continually stimulating dopamine receptors, the medication has been linked to impulsive and compulsive behaviors, including excessive spending, hypersexuality, binge eating and gambling.
The manufacturer acknowledges those risks on its website.
“Some patients using NEUPRO get urges to behave in a way that is unusual for them. Examples include unusual urges to gamble, strong urges to spend money, binge eating, or increased sexual urges and behaviors,” the website warning states.
Doctors gradually took him off the medication over several days, and the gambling stopped. But without a reliable treatment, his Parkinson’s symptoms returned. He could no longer work, exercise or move comfortably around his home.
“I couldn’t sleep at night. I felt completely stuck. I couldn’t move my arms or legs. It was two years of hell—not knowing whether I would ever get relief or how I would find it.”
Justin had avoided support groups because he feared seeing firsthand how severely the disease might progress. But in 2020, desperate for an answer, he sought help at a private clinic recommended by other patients.
A combination of Rytary, selegiline and Artane restored movement in both hands and, mercifully, allowed him to sleep through the night. But during a work trip last year, he found himself almost unable to move while getting dressed.
“My body just wouldn’t move. That was when I went to my doctor and said, ‘Okay, I think it’s time to explore alternative therapies.’”
Earlier this year, Justin underwent deep brain stimulation, a surgical treatment in which thin wires called electrodes are placed in the brain and connected to a pacemaker-like device implanted near the collarbone or chest.
The device sends electrical signals into the brain, helping block the abnormal activity responsible for Parkinson’s symptoms.
Actor Michael J. Fox was diagnosed with Parkinson’s at 29. Now 65, he has devoted much of his life and public platform to advancing Parkinson’s research
Justin now wants to share his experience with other younger Parkinson’s patients and encourage them to consider every appropriate treatment option
Justin now runs regularly and can cycle up to 20 miles in a single outing. Boxing has also significantly eased the remaining stiffness in his hands
“I think most people are frightened by the idea of surgery like that. I wasn’t frightened at all—I was excited. I knew there would be a better quality of life on the other side. I was ready to get my life back.”
Remarkably, he remained awake for much of the procedure.
Doctors adjusted the stimulation in real time, asking him to repeat simple sentences and move his arms and legs while they assessed its effects.
The improvement was immediate. Over the past year, Justin has reduced his medication from 22 pills a day to only a handful.
Today, he runs regularly and can bike up to 20 miles in one outing. Boxing has also greatly reduced the stiffness that remains in his hands.
Now Justin wants to use his experience to support other young people living with Parkinson’s.
“I want to be there for people who are newly diagnosed and don’t know where to go or who to turn to,” he said.
“I absolutely want to get married. I want to continue growing my career. I love speaking publicly and helping people who may feel they have no one else to turn to,” he says.