[골프타임즈] Parkinson’s disease is a neurodegenerative brain disease characterized by symptoms such as slow movement, tremor at rest, muscle stiffness, shuffling, and bent posture. It was first discovered at the end of the 19th century and occurs most often in people over the age of 60. It occurs in 1 in 1,000 people, and in Korea, the risk is higher than that of other races because they have the onset gene. Parkinson’s syndrome is one of the three major senile brain diseases along with dementia and stroke.
Parkinson’s syndrome is a term that refers to all cases of Parkinson’s symptoms. Degeneration of dopaminergic neurons is called Parkinson’s disease. Parkinson’s syndrome is a broader concept. It is largely divided into two types, neurodegenerative and secondary, and most occur in neurodegenerative form. This is caused by abnormal proteins accumulating in nerve cells and causing necrosis, and includes Parkinson’s disease, progressive supranuclear palsy, multiple system atrophy, cerebellar atrophy, Lewy body dementia, and hypocortical hypoplasia.
The most common of these is Parkinson’s disease. Periodic examinations are important as 6.2 million people are diagnosed annually and 117,000 die. In particular, the cause is not clearly identified, and it is difficult to know exactly with just one test, so repeated tests are needed.
What is known so far is that an abnormal protein called alpha synuclein accumulates in brain cells, but it is not clear why this phenomenon occurs.
Alpha synuclein starts to build up in the brainstem, which connects the brain and body. When this reaches the substantia nigra of the midbrain and destroys more than 50-70% of the brain cells, externally observable symptoms appear. Acute Parkinson’s disease can also occur when the substantia nigra is artificially destroyed, and it is typically destroyed due to drug toxicity. The substantia nigra produces dopamine, and dopamine stimulates the brain to make precise movements, compensate for a sense of achievement, and control movements.
This causes hand tremors, slow movements, bent posture, and muscle stiffness. However, when alpha synuclein is present only in the lower part of the brain, it may not be accompanied by any symptoms or may appear non-motor. For example, they may have REM sleep disorders or have difficulty smelling due to damage to the olfactory cortex. Due to REM sleep disorder, dream actions are actually performed by moving the limbs. In general, the brainstem blocks the signal and does not move, but in patients with Parkinson’s disease, the brainstem is damaged and cannot be controlled, so they move as they are.
When dopamine production is reduced by less than 70%, Parkinson’s symptoms appear. At first, they cannot properly perform movements that require precision, such as chopsticks and writing, and their walking speed decreases and they do not shake their arms well when walking. Tremors may be seen when standing still, slow and narrow movements may be seen, and the movement of facial muscles may be reduced, resulting in expressionlessness. This can sometimes be accompanied by depression. The facial muscles are not controlled, so saliva flows or the volume of the voice decreases.
In the past, it was thought to be a disease with only movement symptoms, but in reality, various abnormalities occur in addition to movement. Depression, dementia, and hallucinations were experienced in 40% of all patients, and difficulties in swallowing, dysarthria, orthostatic hypotension, constipation, and hyperhidrosis were also seen due to autonomic dysfunction. Even with the most common hand tremor, the symptoms are initially only on one side, such as the left or right hand, and then the range gradually widens, with symptoms occurring on the other side as well.
Therefore, it is important to differentiate Parkinson’s disease from similar diseases such as essential tremor through screening and apply treatment accordingly. Since there is not just one cause or symptom, it is important to consider all three factors: brain, mind, and body, and preventive management to prevent secondary diseases such as dementia. As time passes, it becomes more serious, so it is important to prepare even if there is no abnormality on the outside.
Help : Joo-Hong Park, Director of Soul Oriental Medicine Clinic
Reporter Moon Jeong-ho [email protected]
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