Parkinson's disease (PD) is the second most common neurodegenerative disease in middle-aged and elderly people after Alzheimer's disease, and is the "third health killer" of middle-aged and elderly people after cardiovascular and cerebrovascular diseases and tumors.

On April 4, the 11th "World Parkinson's Day", let's talk about this "geriatric disease".

Parkinson's specialists conduct health counseling activities. Photo courtesy of the Organizing Committee of Science Popularization and Education Activities

In China, there are about 350.<> million people with Parkinson's disease.

When it comes to Parkinson's, many people's first reaction is hand tremor.

In fact, shaking is not necessarily Parkinson's disease, it may also be essential tremor, which is manifested as tremor significantly worse when holding objects or pointing fingers at the target, but the action does not become "slow motion". Although essential tremor is not part of Parkinson's disease, people are more likely to develop Parkinson's disease than others. Hand tremors are not necessarily Parkinson's disease, and Parkinson's disease does not necessarily have hand tremors.

In addition to "shaking", what other easily overlooked symptoms are also Parkinson's?

Inflexible movements

Often feel that the limbs are stiff, the muscles are tight, inflexible, and the movement is slower, such as difficulty buttoning buttons and tying shoelaces, walking is smaller and slower, and the limb swing arm is reduced.

The sense of smell is "not working"

About 90% of people with Parkinson's disease develop early olfactory loss. Some people may experience loss of smell 3-7 years before motor symptoms appear. It is one of the typical early symptoms of Parkinson's disease patients.

Sleep is messy

Often yelling, punching and kicking while sleeping, which is a specific sleep disorder - REM sleep behavior disorder, also known as "dream motion disorder".

Writing becomes smaller

Long-term persistent writing is getting smaller, also known as "lowercase sign".

"Mask Face"

In the early stage, it is often manifested as a decrease in facial expressions, less smiles, reduced blinking and eye movements, and a "mask face" in the later stage.

The sound becomes quieter

Speech is low, slurred, the volume becomes lower, and the clarity decreases.

constipation

People often have difficulty having bowel movements if they do not eat special foods or medications. The study found that the incidence of constipation in patients with Parkinson's disease was 3 times higher than in patients with non-Parkinson's disease.

If the above symptoms occur, be careful of Parkinson's disease, if the above symptoms appear three or more at the same time, it is recommended to go to the hospital as soon as possible for further examination, early detection, early treatment, early benefit.

What treatments are currently available for Parkinson's?

Because Parkinson's disease, whether drugs or surgery, can only improve symptoms, can not stop the development of the disease, and cannot be cured, it often brings heavy financial burden and life pressure to patients and families.

Therefore, treatment is not only based on the present, but also needs to be managed over the long term to achieve long-term benefits.

Single-cell transcription of the differentiation process of midbrain dopaminergic neurons, etc. Photo courtesy of the Center for Excellence in Brain Science and Intelligent Technology, Chinese Academy of Sciences

Under normal circumstances, Parkinson's disease patients can effectively relieve symptoms and maintain stable conditions by taking drugs within 3-5 years after the onset, and patients can basically achieve the same effect as healthy people. This time is known as the "honeymoon phase" of Parkinson's disease drugs, and as the disease progresses, the efficacy of the drug (that is, the duration of action after each dose) gradually decreases, and further treatment can be performed through surgery.

Surgery is an important complement to drug therapy, and is currently mainly used in deep brain stimulation (DBS), the so-called brain pacemaker implantation, which is used to treat Parkinson's disease by implanting two electrodes in specific nerve nuclei in the brain. This treatment method is a minimally invasive surgery, which has been used to treat Parkinson's disease for more than 30 years, and the effect of improving symptoms is obvious, covering the whole course of the disease, and only need to replace the battery placed in the front chest position according to the specified time (domestic 20-25 years, imported for about 15 years).

With the development and progress of brain medicine. The emergence of "magnetic knife" has brought good news to patients with Parkinson's disease or drug-refractory essential tremor, which is mainly tremor.

Brain "Magnetic Wave Knife" is also known as "Magnetic Resonance Guided Focused Ultrasound (MRgFUS)" brain therapy system. The treatment system integrates focused ultrasound and magnetic resonance imaging (MRI), first accurately locates the treatment target through magnetic resonance imaging (MRI), and then uses high-intensity focused ultrasound to ablate the lesion to achieve the treatment purpose, because there is no need for incision or opening on the skull, which greatly reduces the patient's pain during the treatment.

The patient remains awake and can communicate with the doctor at all times. Photo courtesy of Shanghai International Medical Center

Experts say the innovative treatment can change patients' perception of the need for craniotomy for brain surgery, reduce patients' fear of surgery, and reduce the cost of family hospitalization and postoperative recovery.

Professor Sun Bomin, director of the Department of Functional Neurosurgery and director of the Center for Brain-Computer Interface and Neuromodulation at Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, said that although compared with previous disfiguration surgery and minimally invasive brain pacemaker surgery, the clinical application of brain "magnetic wave knife" in China is still very short, but from the actual use point of view, the acceptance of patients is very high.

What kind of patients are suitable for "Magnetic Knife" treatment?

According to Professor Sun Bomin, according to the international guidelines for the treatment of Parkinson's disease by "magnetic wave knife", this treatment method has obvious control and treatment effect for patients with unilateral symptoms and tremor-based.

The non-invasive brain "magnetic knife" can be continuously corrected and adjusted during the treatment process to ensure precision and safety. Photo courtesy of Shanghai International Medical Center

Therefore, Parkinson's disease patients must strictly manage their daily life, actively participate in rehabilitation training, and combine the reasonable norms, rehabilitation methods and drugs of rehabilitation therapists and clinicians to make Parkinson's disease develop in a benign track.

What should I pay attention to when caring for someone with Parkinson's disease?

1. Strict medication:

The medication scheme for Parkinson's disease pays attention to individualization, precision, and specialized treatment, and cannot increase or decrease the dose of drugs at will, and the clinical symptomatic basis needs to be strictly controlled for drug adjustment.

2. Be particular about your diet:

Eat a balanced diet with a varied diet and should be based on plant-based foods.

Food processing is as simple as possible, choose more local and seasonal vegetables and fruits, and avoid the loss of trace elements and antioxidants. Cooking food is mainly vegetable oil, reduce animal oil intake.

3. Focus on rehabilitation exercises:

Patients with Parkinson's disease can carry out rehabilitation or exercise training according to different mobility disorders under the premise of ensuring safety.

For example, dancing, tai chi, walking, five-bird play, eight dan jin, yoga, etc., can not only delay aging, but also improve posture stability and walking ability.

4. Pay attention to the patient's mental problems:

As family members, patients with Parkinson's disease should be encouraged to speak and communicate more, allow them to express their true needs, and channel negative emotions in time. If the psychiatric symptoms worsen, seek medical attention promptly.

Is Parkinson's only in older adults?

Although Parkinson's disease is more common in the elderly, there has been a trend of younger development in recent years, and studies have shown that the age of onset of some patients is earlier than 50 years old, accounting for 5%~10% of Parkinson's disease.

Although the cause of primary Parkinson's disease is not fully understood, it is generally believed to be mainly related to a combination of aging, genetics and environment. Secondary Parkinson's disease is mostly caused by encephalitis, cerebral arteriosclerosis, or manganese and carbon monoxide poisoning.

How to prevent Parkinson's?

Exercise appropriately at usual times to relieve muscle pressure, increase muscle elasticity and activity, help maintain a good mood, and promote nighttime sleep.

On the basis of a light diet, eat more easily digestible, less salt and less oily foods, eat more fruits to increase intestinal peristalsis, and promote digestion.

People with a family history of Parkinson's disease should avoid jobs that require long-term exposure to pesticides and pesticides, as well as prolonged exposure to heavy metals such as manganese and mercury. When contact is necessary, be sure to protect it.

Avoid or reduce the use of drugs that induce tremor paralysis.

Finally, if there are symptoms related to Parkinson's disease, it is important to pay attention to it and seek medical attention in time.

Author: Li Jiajia Li Qiuying

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