Parkinson's disease is usually considered a pathology of the elderly. It is indeed more common among older people. According to statistics, those who have crossed the bar at 60 years old suffer from it in 55 cases per 100,000 people; those who are over 85 years old are susceptible to such a nervous disorder even more often. At the same time, as doctors note, such a disease manifests itself with nonspecific signs long before the onset of the motor stage, when hands begin to tremble and stiffness in movements appears. AiF.ru asked experts about what you need to pay attention to and how you can prevent the development of Parkinson’s disease.
Features of the disease
“Parkinson’s disease today is one of the most common neurological diseases and one of the main causes of disability among middle-aged and elderly people. Parkinson’s disease is rare under the age of 50,” says Snezhana Milanova, Ph.D., doctor of the highest category, neurologist at the Belgorod Regional Clinical Hospital named after St. Joasaph .
“The main clinical signs of Parkinson's disease, that is, symptoms that allow a diagnosis, are slowness of movement plus one or two of the following three: muscle rigidity (increased muscle tone), resting tremor (for example, shaking of the limbs when static), problems with balance when changing body position,” notes Aigul Kamakinova, Ph.D. neurologist-parkinologist, chairman of the Interregional public organization of disabled people assisting patients with Parkinson's disease "Let's overcome together", employee of the department of neurology of the Russian National Research Medical University named after. N. I. Pirogova .
Experts note that the disease is more often diagnosed in men. And there are several explanations for this. “One version is the greater vulnerability of men, who are more often exposed to toxins. Another explanation may be the influence of sex hormones: female hormones - estrogens - have a strong protective effect, and androgens are more toxic for dopamine neurons,” says Snezhana Milanova.
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Early signs
“Parkinson's disease takes a long time to develop, and at first it can be unnoticed. Among the early ones, there are a number of non-motor signs, that is, not related to motor activity. They can appear 6-7, and sometimes 10-15 years before the first motor clinical symptoms. Patients begin to complain of completely different health problems: fatigue, constipation, depression, bladder problems, impaired sense of smell, restless leg syndrome.
There is no need to panic about the appearance of such signs, because people still turn to specialists with such problems: for constipation - to a gastroenterologist, for depression - to a psychotherapist, for bladder dysfunction - to a urologist. However, there is no need to delay it; patients are often brought to us for an appointment when they already have more pronounced symptoms: slowness of movement, problems with gait, changes in handwriting and hand tremors at rest. By the way, it is worth understanding that hand tremors are not at all a mandatory sign of parkinsonism; it happens that the pathology occurs without it at all,” notes Snezhana Milanova.
Secondary parkinsonism
The main clinical manifestations of parkinsonism are bradykinesia, muscle rigidity and postural tremor. Bradykinesia is a decrease in the number and speed of movements; patients become slow, their gesticulation gradually disappears, their facial expressions become poorer, and walking is no longer accompanied by accompanying hand movements. Muscle rigidity is a constant muscle tension that is first detected when attempting passive movements in a limb, and then becomes noticeable by constantly bending the limbs at the elbows and knees. Postural tremor is usually expressed in the hands and head, a fine tremor of which occurs at rest and disappears during motor acts. Over time, these symptoms lead to significant immobility of the patient and are accompanied by postural disorders (impaired coordination of movements, the ability to hold a certain position); characteristic personality changes occur, mnestic disturbances occur.
A distinctive feature of the clinic of secondary parkinsonism is the more rapid development of symptoms during the manifestation of the disease and their accelerated progression in the future. Symmetry of manifestations is typical, while in Parkinson's disease symptoms initially appear on one side and become bilateral only after some time. With the secondary nature of parkinsonism, its manifestations are combined with other symptoms of cerebral damage: pyramidal syndrome, cerebellar ataxia, early intellectual impairment, etc. In the patient's history, as a rule, there is an indication of the action of one or another etiofactor that preceded the appearance of parkinsonian syndrome (TBI, stroke, drug use). neuroleptics, encephalitis, etc.). In treatment, dopaminergic drugs are insignificantly effective, and elimination of the etiofactor sometimes contributes to a significant regression of parkinsonian manifestations.
Various etiological variants of parkinsonism are characterized by their own clinical features. Thus, parkinsonism after encephalitis is characterized by strong rigidity, the presence of pronounced vegetative manifestations and oculogyric crises; tremor is often absent. In posthypoxic parkinsonism, tremor, on the contrary, is pronounced. Vascular parkinsonism is accompanied by cognitive disorders and early formation of postural disorders; tremor is slightly expressed. Secondary parkinsonism in hydrocephalus is characterized by the dominance of the Hakim triad - dementia, ataxia, urinary incontinence; with corticobasal degeneration it is combined with cortical symptoms - apraxia, disorder of complex types of sensitivity, “alien” limb syndrome; in dementia with Lewy bodies, along with parkinsonism, cognitive impairment and mental disorders - psychosis, hallucinatory syndrome.
Development of the disease
“As Parkinsonism develops, it begins to manifest itself, as a rule, on one side. For example, slowness in the right hand. In this case, they begin to notice that the man has begun to shave more slowly, the process of brushing his teeth becomes longer, there is a slowness in cooking, and it is more difficult to fasten buttons. And here you need to see a doctor as quickly as possible,” Milanova emphasizes.
“Signs of Parkinson’s disease are usually first noticed by those around them (relatives, friends, colleagues), and not by the patient himself. In addition to slowness, you need to pay attention to an unreasonable decrease in mood, a tendency to depression in a previously positive person, weight loss not related to diet and oncology, asymmetrical movement of the arms when walking, when one arm is slightly bent at the elbow joint and lags behind when moving,” adds Aigul Kamakinova.
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Parkinsonism: other disorders that resemble Parkinson's disease
Parkinsonism: other disorders that resemble Parkinson's disease
Trembling hands, slowness, and an unsteady shuffling gait traditionally complete the portrait of an old man. But there are factors that cause this condition at a young age.
primary parkinsonism, parkinsonism, tremor, aging, treatment
Parkinsonism is a movement disorder syndrome that develops when dopaminergic pigment cells in the substantia nigra of the brain are damaged. In 70% of cases, parkinsonism is a manifestation of Parkinson's disease, which is inextricably linked with natural aging and hereditary predisposition, usually manifesting itself over the age of 60 years.
The other 30% are secondary forms of parkinsonism. In these cases, movement disorders develop as a result of exposure to various damaging factors on the central nervous system and can manifest themselves regardless of age.
A common cause of toxic brain damage and the development of secondary parkinsonism is the use of surrogate drugs containing manganese compounds, synthetic heroin (MFTI) and “ecstasy” (methylenedioxymethamphetamine).
Treatment
Parkinsonism currently has no cure. However, it is quite possible to keep it under control: the sooner a person sees a doctor, the better the results.
“If you identify symptoms of the disease, you need to consult a neurologist, preferably specializing in the diagnosis and treatment of extrapyramidal diseases (parkinsologist). To undergo a consultation with such a specialist under compulsory medical insurance (and it is provided for by the compulsory medical insurance program), you must receive a referral from a neurologist at the clinic at your place of residence.
Today, there are drugs that can quite effectively remove the symptoms of the disease: reduce stiffness, slowness, trembling. Sometimes, in cases where a patient with Parkinson's disease consults a doctor in the early stages of the development of the disease, while taking modern medications, it is possible to achieve such an effect that the patient looks almost healthy.
It is also important to note that patients can receive some medications for the treatment of Parkinson’s disease free of charge at the clinic at their place of residence, even without receiving a disability group,” said Nadezhda Dudchenko, neurologist, parkinologist at the Russian Gerontological Research and Clinical Center of the Russian National Research Medical University named after. N.I. Pirogova.
“It is important for patients to come for appointments on time and not attribute symptoms to age-related changes. Moreover, it is advisable to go to a highly specialized specialist, since not all drugs are indicated in different age groups. So, for example, if parkinsonism suddenly appeared at the age of 20, 30 or 40, there is no need to prescribe medications that are used in 70-year-olds. It is necessary to plan treatment for many years to make the patients’ lives comfortable. You also need to understand that any drug tends to wear out after a few years, you have to add two drugs, combine them, increase the dosage of the drug,” says Snezhana Milanova.
“Being diagnosed with Parkinson’s disease does not mean that the patient will soon forget his spouse’s name or the way to the next store. At the onset of the disease, significant impairment of cognitive functions usually does not occur. Severe memory and attention impairments may occur in approximately half of patients in the later stages of the disease. Nevertheless, in all patients with motor disorders, especially if Parkinson's disease is suspected, the doctor must conduct at least a minimal assessment of memory, attention, and spatial thinking. At your appointment, a specialist in movement disorders (Parkinsologist) will certainly inquire about the presence of problems with the gastrointestinal tract, cardiovascular and genitourinary systems, sleep and wakefulness disorders, etc. It is necessary to understand that Parkinson’s disease is a neurodegenerative disease that is characterized by a number of motor and non-motor manifestations,” notes Nadezhda Dudchenko.
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New treatments for Parkinson's disease
Doctors in Germany now have new and effective methods for treating parkinsonism. Innovative technologies are based on advanced scientific developments. Advanced techniques do not injure brain tissue and have minimal side effects.
Transcranial magnetic stimulation
Recently, non-invasive transcranial magnetic stimulation of the brain has been used with great success. Thanks to electromagnetic induction, weak electric currents are created that activate neurons in the desired areas of the brain. Magnetic brain stimulation in combination with drug treatment gives excellent results and gives hope to many patients. An even better effect occurs with its secondary use. This method should not be used by pregnant women or patients with pacemakers.
Stem cell treatment
Stem cell treatment is a new technique that is becoming more popular every year, as it has proven itself well. Stem cells are taken from a healthy person and the stem cells are grown, differentiating them into the desired ones. In German clinics, stem cell treatment is carried out in two ways - with endolumbar puncture (within 4-5 outpatient days) and with surgical replantation (within 10 days). The results are inspiring. Only in 10% there is no result; in other cases of its use, the patient feels significant relief, problems with gait disappear, and tremor decreases.
Ultrasound treatment method
This is one of the innovative methods for treating parkinsonism. The targeted area of the brain receives a targeted stream of ultrasound beams, which in this case replace a surgical scalpel or a hollow needle. The great advantage of this technology is that neighboring tissues are kept healthy and the patient is not irradiated. The procedure is performed using an MRI system, which in real time shows the degree of heating of a given point and visualizes it on the screen. The patient feels improvement already during the procedure itself. Usually one session of ultrasound treatment is sufficient.
Prevention
Of course, issues of preventing pathology, especially in the presence of nonspecific signs of the disease in the early stages, are extremely relevant for young people. “I have my own observation, because I have been dealing with this problem for 18 years. This disease comes to people who are very responsible and demanding, especially to themselves, as a rule, with high intelligence, very anxious and restless for any reason against the background of external calm. Thus, these people daily create chronic microstress for themselves, which leads the brain to premature wear of neurons. Therefore, it is impossible to talk about specific prevention when the cause of the disease is unknown,” notes Aigul Kamakinova.
“My recommendations for prevention are exercise, moderate exercise (swimming, running, walking, dancing is very useful), reducing excess body weight, fighting stress, because for many patients with Parkinsonism, the trigger mechanism for the disease was stress, consumption of fresh vegetables and fruits. Drinking one cup of natural coffee per day is a protective factor. It’s worth drinking more water: up to 2 liters a day,” shares Snezhana Milanova.
“Particular attention should be paid to sleep at night. Relatively recently, it was found that only during sleep a special system operates in the brain, which ensures the removal of metabolic products and toxic proteins, the accumulation of which causes the development of a number of neurodegenerative diseases, including Parkinson’s disease and Alzheimer’s disease. Currently, research in this area is still underway, but I believe that soon it will be possible to say with confidence that healthy sleep is the prevention of neurodegeneration,” adds Nadezhda Dudchenko.
In general, as experts note, if a person is already sick, he will have to get used to a strict daily routine. Snezhana Milanova emphasizes that parkinsonism is a regimented disease that requires strict adherence to a schedule: taking medications at the same time, eating at the same time, physical activity on a schedule. Therefore, it is worth paying more attention to yourself from a young age, switching to a healthy and reasonable lifestyle, and if you have suspicious symptoms, contact a specialist early in order to maintain your health and level of comfort in life at the usual level.
