2023-06-26 23:27:22
[헬스코리아뉴스 / 임해리] 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. Compared to 105,882 in 2018, this is a 14% increase over the past five years. As for the sex ratio of patients, 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 people under the age of 50 accounted for 7%, while those over 60 accounted for 93% of all patients, or 118,486 people.
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.
Hallym University Dongtan Sacred Heart Hospital Neurosurgery Professor Kim Young-soo 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.
Hallym University Dongtan Sacred Heart Hospital Neurosurgery Professor Kim Young-soo explains Parkinson’s disease in a recent interview with Health Korea News.
Initially, symptoms of tremors or stiffness on one side of the body … confused with a stroke
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 by. 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 disorders appear.
It is easy to confuse with a stroke because the symptoms usually appear on one side of the body. However, a stroke suddenly completely paralyzes one side of the body one day and is accompanied by language impairment, whereas 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, an accurate diagnosis by a specialist is necessary. 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.
Consider surgical treatment if the disease is advanced
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.
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. At this time, 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. More than 10,000 cases of deep brain stimulation are performed every year worldwide, 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.
Deep brain stimulation involves implanting electrodes into the deep brain to restore damaged circuits to electrical action. 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.
Not recommended for patients with severe disease
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.
Parkinson’s disease patients with non-motor symptoms also have poor surgical results. This means that it is effective only for patients with movement symptoms. 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.
The professor 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 much as this becomes possible, it is important to consult with a specialist to decide on the treatment method and whether or not to undergo surgery.”
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