An outdated sketch from 1886 by Sir William Richard Gowers remains among the most used and viewed depictions of Parkinson disease, despite great advancements in the understanding of the neurological disorder.

Now, UF neurologists Melissa Armstrong, M.D., and Michael S. Okun, M.D., have worked with a medical illustrator to create a new, more diverse representation of who is affected by Parkinson disease, and how. The image was unveiled recently in a new JAMA Neurology article.

“It was kind of shocking to look online and find that if you type into a web browser, ‘Parkinson disease image’ … still the most common image you see is this picture from 1886,” said Armstrong, an associate professor in the UF College of Medicine’s department of neurology.

“In that old sketch it’s a man who looks kind of frail — he’s hunched and he’s shaky. And while that was a really helpful picture and was part of how we learned about and understand Parkinson disease, it doesn’t really reflect what it’s like to live with Parkinson disease today.”

The new image, illustrated by Erica Rodriguez, depicts several ways that individuals can be impacted by Parkinson disease by showing a young, healthy woman with only a few symptoms; a man who is a little older with more symptoms (illustrating his “on” time, when medications are successfully treating symptoms, and “off” time when they aren’t); and an older man with more pronounced and advanced symptoms of the disease.

As the societal impact of Parkinson disease continues to grow, it is increasingly important for images to accurately represent the disease, Armstrong said. In 2016, the number of people worldwide with a Parkinson diagnosis was an estimated 6.1 million, more than double that in 1990.

“Improving the image to include a broad diversity of people with Parkinson can help enhance Parkinson disease recognition and enforce the reality that the modern people with Parkinson can have meaningful lives that are not universally limited by disease-related disability,” the authors stated.