Kinematic-based BoNT-A Bilateral Upper Limb PD Therapy

Inclusion Criteria: * PD individuals diagnosed by UK Brain Bank Criteria with stage H\&Y2-3 disease * PD participants who are naïve to PD medications will be grouped into the "De novo" PD group * PD participants stable on a low dose of Levodopa or on their PD medications for at least 3 months prior to their study enrolment will be grouped into the "L-dopa" PD group * Participants who are botulinum toxin naïve for tremor management * Patients will be screened for pregnancy by the physician * Individuals with PD will be eligible for the study only if tremor is their primary and most bothersome symptom as determined by clinical exam and patient report denoting tremor-dominant phenotype * Participants must be able to provide informed consent and to complete all study assessment scales and tasks. Exclusion Criteria: * History of stroke * History of ALS or Myasthenia Gravis * History of COPD or emphysema * Underlying arm muscle weakness or any related compartmental muscle syndrome * Offending medications (Lithium, valproate, steroids, amiodarone, beta-adrenergic agonists (e.g. salbutamol). * Persons prescribed zonisamide * History of allergic or side effect reaction to botulinum toxin * Contraindications per the BoNT-A drug monograph * Women reporting that they are pregnant