Explaining Parkinson’s disease

  Parkinson’s disease, also known as tremor palsy, is a common neurodegenerative disease with progressive, multiple and insidious onset, mainly characterized by slowing of movement, muscle tonicity, resting tremor and postural instability of gait.  With the aging of the society, environmental pollution and mental stress, the incidence of Parkinson’s disease is on the rise and younger, it is estimated that there are more than 2 million patients with Parkinson’s disease in China, of which the incidence of people over 65 years old is about 1.7%.  The risk factors for Parkinson’s disease are not yet fully defined. Previous studies have shown that genetics, family history, age, hyposmia, daytime sleepiness, and constipation are all high-risk factors, and there is a greater likelihood of progression to Parkinson’s disease if the above-mentioned manifestations are present early. In addition, although advanced age is a risk factor for Parkinson’s disease, it does not mean that young people will not suffer from the disease, if the onset of the disease is less than 40 years of age, it is juvenile Parkinson’s.  Parkinson’s disease is highlighted by motor symptoms, but non-motor symptoms can occur early and worsen as the disease progresses. Parkinson’s motor symptoms include: 1, motor retardation: slow movements in daily life such as dressing, washing, etc.; 2, resting tremor: involuntary shaking of the limbs, frequency 4-7 HZ, like “rubbing pills”, appearing at rest, disappearing during activity or sleep, aggravated by tension; 3, muscle ankylosis: increased muscle tone, muscle ankylosis such as “4. abnormal posture and gait: such as leaning forward, slightly bent knees, reduced arm swing of both upper limbs, panic gait (inability to stop suddenly) or freezing gait (inability to lift the legs to step).  Non-motor symptoms of Parkinson’s include: decreased sense of smell, constipation, abnormal behavior during sleep, autonomic dysfunction (urinary and bowel disorders, postural hypotension, abnormal heart rate), anxiety, depression, cognitive impairment, and pain. Most patients tend to visit the hospital because of motor symptoms that affect their work life. In fact, most patients are already in the middle and late stages of Parkinson’s disease, while some non-motor symptoms can appear in the early stages of the disease.  To diagnose Parkinson’s disease, it is necessary to combine medical history, physical examination, and ancillary tests to make a comprehensive judgment. Some patients have typical clinical symptoms and respond well to levodopa and other medications, so the diagnosis is relatively easy; on the contrary, some patients have a short onset time, motor symptoms are not obvious and have not undergone treatment, so the diagnosis is relatively difficult. If necessary, genetic tests may be performed to exclude other diseases.  Parkinson’s disease is a progressive, incurable neurological disorder, and no definitive treatment has been found to slow or stop the progression of the disease. The goal of current treatment is to control motor and non-motor symptoms, reduce functional disability, improve patient symptoms, and improve quality of life. Treatment can be divided into pharmacological and non-pharmacological treatments. There has been great progress in the field of pharmacotherapy, and there are different mechanisms of drugs for improving motor symptoms, including anticholinergic drugs, dopamine receptor agonists, dopamine precursors, monoamine oxidase B inhibitors, and COMT inhibitors, which can be chosen for different patients; for the emergence of non-motor symptoms can be treated symptomatically. It should be noted that it is very important for Parkinson’s patients to follow medical prescriptions and not to adjust medications arbitrarily because different drugs have different mechanisms of action, metabolic pathways, and peak blood concentrations, so the type, sequence, timing, and dose of medications will play an important role in drug absorption and symptom improvement. Non-pharmacological treatment includes strategies such as surgery (nucleus accumbens destruction, deep brain electrical stimulation), education and motor rehabilitation to help maintain function, increase confidence and training, and improve nutrition.  Although there is no cure for Parkinson’s disease, the drugs available to relieve symptoms and slow disease progression have been described as “the most dramatic successes in neurology,” resulting in near-normal life expectancy and improved quality of life for Parkinson’s patients. Therefore, patients diagnosed with this disease should maintain a normal mindset and not be discouraged, as long as we face it correctly and work together with our doctors and families, we will have the same happy life.