April 11th every year is ‘World Parkinson’s Day’ to increase interest in Parkinson’s disease. It is named after the British physician James Parkinson, who first reported the disease to academia in 1817. Parkinson’s disease is the second most common degenerative brain disease after dementia.
As one of the three major geriatric brain diseases, the incidence is steadily increasing due to the aging population. According to the Health Insurance Review and Assessment Service, the number of Parkinson’s disease patients increased by 16% over five years from 10716 in 2017 to 116,504 in 2021.
The symptoms of Parkinson’s disease include four major symptoms: stiff, trembling, stiff, slow, and unstable posture.
In addition, sleep disorders, mental function abnormalities, and sensory abnormalities may be accompanied, which may decrease the quality of life. Although no cure has been developed for Parkinson’s disease, daily life, social life, and work life can be carried out with drug treatment.
In addition, as it is a brain disease that is being studied most actively in the field of brain science, new drugs are continuously being developed, so the word ‘a hopeful disease’ is coming out. I learned about Parkinson’s disease from Professor Jeong Seon-ju, a neuroscientist at Asan Medical Center, Seoul.
◇ Occurs due to loss of nerve cells in the brain… Symptoms vary from patient to patient
Parkinson’s disease is a degenerative brain disease caused by the loss of various neurons including dopaminergic neurons in the brain. Previously, it was only recognized as a simple tremor or difficulty in walking, but the symptoms of this disease are very diverse.
Patients with motor symptoms such as tremor, which is a symptom of shaking parts of the body in a stable position, slow movement of the body, stiffness of muscles, gait disturbance caused by dragging the leg, and postural instability in which a person falls easily due to a bent posture Each appears in a different combination.
Symptoms that make patients and their families more difficult include dementia, anxiety, depression, hallucinations, sleep disturbances (insomnia, sleep talk), frequent urination, constipation, fatigue, autonomic disorders (orthostatic hypotension, sexual dysfunction, sweat secretion abnormal), etc. These are non-motor symptoms.
It is wise to see a neurologist as soon as possible if you experience any suspicious symptoms or if you are being pointed out. Recently, the incidence is increasing among middle-aged people under 50, and it is often found in people in their 20s and 30s. Even if you are young, if you have symptoms, it is important to see a specialist for treatment.
It is not yet clear why Parkinson’s disease develops. Environmental factors, such as pesticides such as herbicides and pesticides, and air pollutants such as nitrogen dioxide, have been reported to increase the risk of Parkinson’s disease, but it is not yet clear enough for all patients.
Although it is reported that it can be caused by genetic factors, it can only explain the occurrence of familial Parkinson’s disease patients, which accounts for less than 5% of patients with Parkinson’s disease due to gene mutation. Recently, medical scientists around the world are working hard to identify the causative role of genetic modification and to develop customized treatments for patients.
◇ Significant improvement of symptoms with medication and exercise
No treatment has been developed to prevent or slow the progression of Parkinson’s. When Parkinson’s disease is diagnosed, it is being treated with various drugs or surgery to replace dopamine, which is lacking in the brain. Among degenerative brain diseases, there is no disease in which symptoms are remarkably improved by drug treatment except for Parkinson’s disease.
Recently, there are patients who are reluctant to take medicine and rely on exercise or oriental medicine therapy, but Professor Jeong explains that it is the wrong treatment. When there is a lack of dopamine in the brain, disturbances in the neuronal functions, including motor circuits in the brain, and side effects may occur. It is not advisable not to take the drug because of the side effects of the drug.
If you strictly follow the dosage and usage of the Parkinson’s drug according to the doctor’s prescription, the patient who cannot get up will be able to walk, and the patient who cannot walk well will be able to run. If the effect of the drug decreases due to long-term drug treatment and the late exercise complications are severe, deep brain stimulation is performed.
Deep brain stimulation is a treatment that improves motor symptoms by attaching a machine to the subcutaneous tissue and applying electrical stimulation to the brain. It is usually performed before the age of 75, as the patient must be in good health to be eligible for surgery. It can improve the quality of life because it improves motor symptoms and motor complications in Parkinson’s disease by 75%.
Exercise is important for people with Parkinson’s disease. As the symptoms of Parkinson’s disease, the muscles in the body become stiff, the movement of the muscles becomes slow, and the posture becomes sloppy, so stretching and aerobic exercise for 1 to 2 hours every day is very helpful. If you do strength training together, you can expect a greater effect.
Parkinson’s disease patients are characterized by fatigue, weakness, and lack of energy, so it is good to thoroughly manage nutrition. You should eat a lot of fruits such as apples, strawberries, tangerines, oranges and kiwis, cabbage, broccoli, and green vegetables, which contain a lot of vitamins C and E, which are good for the brain. It is also good to eat nuts in moderation.
However, since protein reduces the effect of levodopa, a treatment for Parkinson’s disease, it is recommended to consume meat at least an hour apart from taking levodopa when eating meat. It is also a good idea to eat foods rich in fiber to combat constipation, a serious symptom of people with Parkinson’s disease.
Sleep disturbance is also a symptom that plagues patients with Parkinson’s disease. To solve insomnia, it is necessary to improve the sleeping environment. It is best to receive an appropriate amount of sunlight during the day, and it is better to refrain from watching TV, using mobile phones, or using the Internet 2-3 hours before sleep or after 8 pm.
REM sleep disorder is a symptom that many Parkinson’s disease patients and their spouses suffer. This is a symptom that occurs due to the loss of brain neurons due to Parkinson’s disease. It is necessary to take medication after consulting with your doctor.
As such, Parkinson’s disease patients complain of motor and non-motor symptoms in a very diverse way, so if you do not rely solely on drugs but actively try to bring improvement in daily life, your quality of life can be improved and the pain caused by the disease can be greatly reduced. can
Kwon Dae-ik medical journalist dkwon@hankookilbo.com
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