The four major symptoms of Parkinson’s disease are spontaneous tremors, slow body movements, stiff joints and muscles in the limbs, and difficulty walking due to lack of balance. Getty Image Bank
April 11th is ‘World Parkinson’s Day’. In commemoration of the first report of the disease to the academic world in 1817 by British physician James Parkinson (1755-1824), his birthday (April 11) has been set as ‘World Parkinson’s Day’.
Parkinson’s disease is the most common brain disease in the elderly following dementia. Parkinson’s disease patients increased by 16% in 5 years from 100,716 in 2017 to 116,504 in 2021 (Health Insurance Review and Assessment Service). In particular, patients in their 70s and older account for 85% of all patients, and the number of patients is increasing due to the recent rapid aging of the population.
Heo Ryeong, professor of neurosurgery at Incheon St. Mary’s Hospital Brain Hospital, said, “It is a representative disease that threatens the lives of the elderly to the extent that it occurs in 1-2% of the elderly over 65 years of age.” said
Parkinson’s disease is caused by a lack of the neurotransmitter ‘dopamine’ produced in the brain. Dopamine is involved in our body movements. It is like a lubricant that makes a machine run well. Lack of dopamine makes our body stiff and sluggish, like a machine running out of lubrication.
The typical symptoms of Parkinson’s disease are tremors in the limbs, slow movement (brahidrosis), muscle stiffness, and gait disturbance. It progresses slowly, and there are no obvious symptoms in the early stages. This is why it is easy to regard Parkinson’s disease as a mere aging phenomenon. In particular, Parkinson’s disease often starts on one side first.
Parkinson’s disease causes frequent constipation as a symptom of the autonomic nervous system, inability to distinguish smells well, and sleep disturbances similar to drool during sleep. As the disease progresses, the stride becomes narrower when walking and falls easily. In the end, I have to lie down immobilized.
Jeong Ki-young, professor of neurology at Seoul National University Hospital, said, “If you have a sleep behavior disorder, such as talking or kicking while sleeping, the risk of getting Parkinson’s disease or Alzheimer’s disease (senile dementia) increases.” Years later, many of them might suffer from degenerative neurological diseases such as Parkinson’s disease and Alzheimer’s disease.”
In addition to physical problems, as the body cannot move as desired, it suffers from mental problems such as anxiety and depression, and is also exposed to ‘Parkinson’s dementia’.
Parkinson’s disease occurs when dopamine cells in the substantia nigra of the midbrain gradually decrease, but the exact pathogenesis mechanism is not known. However, some studies have shown that regarding 15% of patients are caused by genetic causes, and environmental influences or toxic substances are the cause.
The representative drug for Parkinson’s disease is levodopa. It is converted into dopamine in the brain and supplements the lack of dopamine. However, the effect of the drug lasts for regarding 5-7 years. After this period, the duration of the medicine becomes shorter and side effects such as dyskinesia (shaking the body once morest will) may occur.
If the effect of the drug decreases, ‘Deep Brain Stimulation (DBS)’ can be performed. It is a method of inserting a microscopic medical device into the brain and stimulating it with electricity in a specific part. When the electrical stimulation generating device is operated following surgery, electrical stimulation begins on the electrodes implanted in the brain, and the dyskinesia gradually disappears.
Baek Seon-ha, professor of neurosurgery at Seoul National University Hospital, said, “Many Parkinson’s disease patients who underwent deep brain stimulation are able to walk and maintain their quality of life even following more than 10 years.”
Recently, a device that continuously supplies levodopa, a key drug for Parkinson’s disease, for patients who cannot receive deep brain stimulation or is afraid of brain surgery has also been released. A treatment that injects medicine directly into the small intestine through the stomach will also be introduced.
It is also important to combine exercise therapy to strengthen muscle strength. It is not possible to completely reverse the already deformed posture, but it helps to maintain body function. In particular, it must be applied continuously to maintain the effect.
Daeik Kwon medical journalist dkwon@hankookilbo.com
