For Justin Neill, the first clue appeared in his left hand.
His typing began to slow, and he noticed his fingers seemed to drag over the keyboard.
He was 35, otherwise healthy and busy with work and daily life, so he dismissed the problem.
“I was just so busy with work. I was so busy with life,” says Justin, a technology operations manager in Los Angeles. “I thought, ‘Oh, it’s carpal tunnel, or maybe it’s a pinched nerve.’”
Not long afterward, a painful cramp tightened around his left foot. He assumed it was the result of a recent run.
It was his father who noticed the pattern: both problems were affecting the same side of Justin’s body. That realization finally persuaded him to seek answers.
He visited a chiropractor, an acupuncturist and a massage therapist, hoping one of them could explain what was happening. The answer ultimately came from a neurologist, one day after Justin’s 36th birthday.
“Three hours into the appointment, I heard the word ‘Parkinson’s’ for the first time,” Justin recalls. He had undergone brain scans and blood tests.
“Before then, I barely knew what Parkinson’s was. All I knew was that Michael J. Fox had it — old people and Michael J. Fox.”
The diagnosis seemed impossible.
California technology manager Justin Neill first noticed signs of Parkinson’s when he struggled to type at 36. A neurologist later told him he was among a growing group of people diagnosed with the disease 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 disorder.
“I was completely in denial and angry with my doctor. I said, ‘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 younger group of Parkinson’s patients whose cases continue to puzzle scientists.
People diagnosed with early-onset Parkinson’s often do not fit the condition’s usual age profile. In many cases, they also have no clear genetic explanation for their symptoms.
The disease develops when cells in a small brain region called the substantia nigra begin to die. Those cells produce dopamine, a chemical messenger essential for smooth, coordinated movement. As dopamine declines, patients may develop tremors, stiffness and increasingly slow or difficult movement.
Parkinson’s is most common among older adults, with the majority of diagnoses occurring after age 60. The number of Americans living with the disease is also rising steadily.
Yet the growing number of younger patients has raised concern among doctors and researchers. Increasingly, scientists suspect that in at least some cases, the biological processes behind the disease may begin decades before the first tremor, cramp or movement problem appears.
There is no single confirmed cause of Parkinson’s, but a growing body of research has connected the disease with environmental exposures, including pesticides and air pollution.
Earlier this year, researchers at UCLA examined chlorpyrifos, an insecticide once used on crops, forests and grassy locations such as golf courses.
After studying pesticide exposure among 800 people with Parkinson’s and testing the chemical in zebrafish — a widely used research model that shares roughly 70 percent of its genes with humans — the researchers reported that chlorpyrifos was associated with a 2.5-fold increase in Parkinson’s risk.
The findings have already prompted at least one lawsuit against Dow Chemical Company and its agricultural spinoff, Corteva Agriscience. Neither company has publicly commented on the new research. Historically, the chemical’s use has been defended when handled according to approved safety requirements.
Another notable study analyzed medical records involving approximately 18 million Americans. It found that people living within 500 feet of a dry-cleaning business had a 14 percent higher risk of developing Parkinson’s than those living several miles away.
The concern is heightened by the fact that many potential exposures are difficult to avoid — and any harm may occur years or even decades before the first noticeable symptom.
Justin believes his own illness may be connected to a chemical spill in a creek near 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, medications that help the brain produce and use dopamine.
The treatment made him so nauseated that he struggled to keep food down.
Doctors then switched him to a daily Neupro patch, which releases a dopamine agonist over a 24-hour period.
Justin spent years testing different medication combinations. One caused constant nausea, while another triggered an uncontrollable gambling habit. Eventually, he turned to deep brain stimulation, a major surgical treatment
Justin first recovered full movement in his hands. Over the following months, he rebuilt his fitness and flexibility and can now exercise regularly — and type once again
The patch reduced his stiffness and tremors, but it also produced a frightening and highly disruptive side effect: compulsive gambling.
“It was all I thought about. I’m someone who is really good with money, and I was gambling about $300 a day for months. It was just one dopamine hit after another,” he said.
By continuously stimulating dopamine receptors, the medication has been associated with impulsive behaviors such as excessive spending, compulsive sexual activity, 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,” the warning states. “Examples include unusual urges to gamble, strong urges to spend money, binge eating, or increased sexual urges and behaviors.”
Doctors gradually took him off the patch over several days, and the gambling stopped. But without dependable treatment, his Parkinson’s symptoms became overwhelming. He could not work, exercise or even move comfortably around his home.
“I couldn’t sleep at night. I felt completely stuck. I couldn’t move my arms and legs. It was two years of hell, not knowing whether I would ever get relief.”
Justin had avoided support groups because he feared seeing firsthand how severely the disease might progress. In 2020, however, he was desperate enough to seek help at a private clinic recommended by other patients.
A combination of Rytary, selegiline and Artane helped restore movement in both hands and finally allowed him to sleep through the night. But during a work trip last year, he found himself nearly unable to move while getting dressed.
“My body 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 procedure in which thin electrodes are implanted in the brain and connected to a pacemaker-like device placed near the collarbone or chest.
The implant sends electrical signals that interrupt the abnormal brain activity linked to 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 research into the disease
Justin now hopes to help other young people with Parkinson’s by sharing his experience and encouraging them to consider a range of treatment options
He now runs regularly and can cycle as far as 20 miles in a single outing. Boxing has also significantly eased the stiffness remaining 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 life would be better on the other side. I was ready to get my life back.”
Remarkably, Justin remained awake for much of the operation.
As doctors adjusted the stimulation, they asked him to repeat simple sentences and move his arms and legs so they could assess the device’s effect in real time.
The improvement was immediate. Over the past year, he has been able to cut his medication from 22 pills a day to only a few.
Today, Justin runs regularly and can ride his bike for up to 20 miles at a time. Boxing has further reduced the stiffness in his hands.
He is now focused on supporting other young adults living with Parkinson’s.
“I want to be there for people who have just been diagnosed and don’t know where to go or who to turn to,” he said.
“I definitely want to get married. I want to keep growing in my career. I love speaking to groups and helping people who may not have anyone else to rely on.”