April 11th is World Parkinson’s Day. It was established in 1817 to commemorate the British doctor James Parkinson, who first reported in academia that patients with characteristic features such as hand tremor, slouching posture, gait abnormality, and muscle spasm were ‘tremor paralysis’.
| Parkinson’s disease is a degenerative brain disease in which motor control disorders and non-motor symptoms caused by a deficiency of dopamine, a neurotransmitter in the brain, appear. Dopamine, which is produced in nerve cells in the brain and transmits chemical signals between cells, is responsible for regulating the motor function of the body. |
In the case of Parkinson’s disease, the exact cause has not been identified so far, but the possibility of aging, genetics, toxic substances, and environmental factors is being considered.
In Korea, according to the annual number of Parkinson’s disease patients of the National Health Insurance Review and Assessment Service Statistics of Diseases of Interest, it increased by 8.85% from 115,679 in 2017 to 125,927 in 2020, and as of 2020, female (67.8%) was male ( 32.2%), and it was found most in the elderly in the order of 80s or older, 70s, and 60s.
In the early stages of Parkinson’s disease, tremor symptoms appear in regarding 70% of cases. In the popular drama ‘Wise Doctor Life Season 2’, which aired last year, there is a scene where the main character’s mother, a neurosurgeon, complained of symptoms, but she ignored it and was diagnosed with Parkinson’s disease. As such, the diagnosis of Parkinson’s disease may be delayed if the initial tremor is neglected, so special attention is required.
In Parkinson’s disease, muscle tension increases, causing stiff resistance when bending and extending the joint, slowing body movements and reducing the amplitude of movement, leading to frequent walking. In addition, unstable posture can lead to frequent falls, and neuropsychiatric symptoms such as anxiety, depression, and hallucinations can appear.
It can be confused with dementia due to various symptoms, but in the case of dementia, cognitive decline such as memory loss and speech impairment appears first, and as the disease progresses, gait disturbance and muscle stiffness appear.
In the case of typical Parkinson’s disease, symptoms and neurological examination alone are sufficient to make a diagnosis, but since there are many secondary Parkinson’s disease or atypical Parkinson’s disease with similar symptoms, blood tests, magnetic resonance imaging (MRI), density and dopamine transporter density and Imaging tests of the brain such as positron emission tomography (PET), which measure distribution, can be performed. After the diagnosis of Parkinson’s disease, drug treatment to relieve and control symptoms is carried out.
If Parkinson’s disease progresses rapidly, it may become impossible to live without the help of others within two to three years. Since symptoms rarely improve once onset, it is known that Parkinson’s disease continues to progress and worsens over time. However, with early diagnosis and appropriate treatment, recovery is difficult, but in some cases, daily life can be maintained for more than 20 years.
Although it is difficult to treat, medications, rehabilitation, and surgery are sometimes used to delay the progression of the disease. In particular, patients with Parkinson’s disease complain a lot of pain because they have muscle stiffness. In addition, radiofrequency therapy is used when it is difficult to expect any more effects due to long-term medication and rehabilitation treatment.
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| Department of Neurology, Daedong Hospital, ‘Kang Tae-ho’ |
Tae-Ho Kang, head of the Department of Neurology at Daedong Hospital, said, “Parkinson’s disease does not have a definite preventive factor as it can be seen as one of the degenerative diseases of the brain. If you have a physical examination and body abnormalities appear, it is best to visit a medical institution and consult with a specialist.”
On the other hand, it is important for Parkinson’s disease patients to stop smoking and avoid alcohol, a balanced diet, moderate exercise, and psychological stability in addition to regular medication and exercise. In particular, Parkinson’s patients with large behavioral restrictions are easily constipated, so it is essential to eat a balanced diet with vegetables, fruits, and an appropriate amount of protein, and to drink enough water. It is also known that performing bare-handed gymnastics, walking, and joint exercise regularly 2-3 times a day is also helpful.