2023-06-21 05:21:21
98% of people with Parkinson’s disease are over 60… The main symptoms are hand tremor, stiffness, bradykinesia, and postural instability.
[대한경제=김호윤 기자] Parkinson’s disease is a neurodegenerative disease that mainly affects people over the age of 60. As dopamine neurons in the substantia nigra in our midbrain are destroyed, the neurotransmitter called neurotransmitter gradually disappears, resulting in behavioral disorders.
According to statistics from the Health Insurance Review and Assessment Service, the number of patients with Parkinson’s disease in Korea exceeded 120,000 last year, and compared to 105,882 in 2018, it has increased by 14% over the past five years. As for the gender ratio, as of 2022, there were 51,345 males (43%) and 69,202 females (57%), with a higher proportion of female patients. By age, 8,836 patients, or 7%, were in their 50s or younger, while 118,486 patients, or 98%, were in their 60s or older.
Kim Yeong-soo, Professor of Neurosurgery, Hallym University Dongtan Sacred Heart Hospital / Photo: Courtesy of Hallym University Medical Center
The main symptoms of Parkinson’s disease are hand tremors, rigidity that stiffens the body, bradykinesia that slows down movement, and gait disturbance, which are easy to confuse with normal aging.
Professor Kim Yeong-soo of the Department of Neurosurgery at Hallym University Dongtan Sacred Heart Hospital said, “Among the symptoms of Parkinson’s disease, tremor and stiffness are rare phenomena in normal aging. “It is difficult to go to the bathroom and eat because of hand tremors and stiffness, so you need to get treatment early,” he explained.
Because Parkinson’s disease is a degenerative disease, it appears slowly without any precursors. Symptoms begin when about 80% of the dopamine cells in the midbrain substantia nigra are lost, and the disease worsens as neurodegeneration progresses little by little as time goes on. In the beginning, symptoms of tremors or rigidity occur mainly on the right or left side of the body, and then gradually go to systemic symptoms, and then gait disturbance appears.
It is easy to confuse with a stroke because the symptoms usually appear on one side of the body. However, while a stroke suddenly completely paralyzes one side of the body and is accompanied by language impairment, Parkinson’s disease symptoms appear slowly and are also different from strokes in accompanying symptoms.
There are many symptoms that can suspect Parkinson’s disease, but since Parkinson’s disease can appear in various forms, a diagnosis by a Parkinson’s specialist is very important. The diagnosis of Parkinson’s disease is made by a neurologist’s precise examination, and recently accurate results have been obtained through a PET scan in the nuclear medicine department.
Parkinson’s disease can improve symptoms by trying drug treatment in the early stages, but if the disease progresses, it is possible to live a normal daily life only after surgical treatment.
Parkinson’s Disease Explanatory Image / Poster: Courtesy of Hallym University Medical Center (Source: Getty Image Bank)
In particular, many patients with Parkinson’s disease are concerned about side effects caused by long-term medication. If the drug is treated for more than 2 to 3 years quickly, the time for the effect to manifest is reduced and the effect may be reduced. In addition, dyskinesia, in which the body or face shakes and twists, may appear, so surgical treatment is considered.
Among the symptoms of Parkinson’s disease, even if drug treatment is given, only side effects occur and the tremor does not decrease, so there are cases where it becomes a problem in maintaining a job or social life. These patients may consider surgical treatment even in the early stages of the disease.
The most widely performed surgical treatment is deep brain stimulation. Worldwide, more than 10,000 cases of deep brain stimulation are performed every year, and more than 300 cases are performed in Korea. It is a normal behavior to control our behavior by passing neurotransmitters from the substantia nigra to the basal ganglia of the brain, but Parkinson’s disease occurs when this is disrupted.
In response, deep brain stimulation surgery restores damaged circuits to electrical action by inserting electrodes into the deep brain. Electrical stimulation is generated by installing a stimulation generator under the skin of the chest and connecting wires and electrodes to the deep brain. Since the electrodes are inserted into a very small nerve nucleus of about 5 to 6 mm, very sophisticated surgery is required. Although it is not a cure-all, the goal is to enable patients to live their daily lives on their own.
Deep brain stimulation is not recommended for patients with already severely advanced Parkinson’s disease. Parkinson’s disease is divided into grades 1 to 4 depending on the degree of progression. At the end of grade 2 to the beginning of grade 3, the surgical effect is good, but at the end of grade 3 or grade 4, it is difficult to see the effect.
In addition, patients with Parkinson’s disease who show non-motor symptoms are less likely to have surgery. Non-motor symptoms include depression, anxiety, cognitive decline, constipation, indigestion, sleep disorders, and hyperhidrosis. Non-motor symptoms usually appear after motor symptoms appear first. Non-motor symptoms appear because dopamine, a brain neurotransmitter, acts not only on the motor nervous system but also on the autonomic nervous system.
Professor Kim Young-soo said, “Parkinson’s disease is a disease caused by nerve aging, and if left unattended with the thought, ‘It will get better with time,’ the disease worsens and treatment becomes difficult.” As life becomes possible, it is important to consult with a specialist to decide on a treatment method and whether or not to undergo surgery.”
Reporter Kim Ho-yoon khy2751@
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