Behavioral Economy Consulting Firm
Parkinson
Parkinson ...
Described for the first time in 1817 by an English doctor who gave it its name, Parkinson's disease is a degenerative disorder of the central nervous system. The areas specifically affected are the dopamine producing neurons (dopaminergic system).
A disease of the dopaminergic system
Brain region that degenerates in Parkinson's disease. Three Lewy bodies (one in the center, very characteristic) which confirm the diagnosis of Parkinson's disease. It is in these bodies that we find iron and aluminum in abnormally high quantities.
Dopamine is a neurotransmitter, a molecule responsible for transmitting information between neurons. When the production or circulation of dopamine is reduced, nerve cells communicate poorly. This results in many disorders, including those of Parkinson's disease.
Described for the first time in 1817 by an English doctor who gave it its name, Parkinson's disease is a degenerative disorder of the central nervous system. The areas specifically affected are the dopamine producing neurons (dopaminergic system).
A disease of the dopaminergic system
Brain region that degenerates in Parkinson's disease. Three Lewy bodies (one in the center, very characteristic) which confirm the diagnosis of Parkinson's disease. It is in these bodies that we find iron and aluminum in abnormally high quantities.
Dopamine is a neurotransmitter, a molecule responsible for transmitting information between neurons. When the production or circulation of dopamine is reduced, nerve cells communicate poorly. This results in many disorders, including those of Parkinson's disease.
Symptoms and course
The three main symptoms making it possible to establish a first diagnosis are akinesia (slowness and difficulty of movement), muscular hypertonia (so-called “extra pyramidal” rigidity, affecting both the spine and the limbs) and tremors (at rest, regularly at 4 to 7 cycles per second).
In addition to these three major disorders, Parkinson's disease manifests itself in secondary symptoms: pain, cramps, tingling, constipation, urgent urination, drop in blood pressure when lifting too suddenly (orthostatic hypotension), sweating and profuse salivations, anxiety, depression, irritability, mania.
Five stages of evolution
Stage I:
First one-sided signs, not interfering with daily life.
Stage II:
Still unilateral signs, but causing discomfort.
Stage III:
Bilateral signs, modified posture, no serious handicap, complete autonomy.
Stage IV:
More severe handicap, walking still possible, limited autonomy.
Stage V:
Impossible to walk (wheelchair, bed rest), complete loss of autonomy.
The life expectancy of patients is variable. In the best cases (late onset, early identification, effective treatment), the lifespan may be normal, i.e. identical to the population average.
Peak frequency around 70
Rare before 45 years, Parkinson's disease affects older people: 1% of the population is affected after 65 years, and the peak frequency is around 70 years.
There are approximately 100,000 patients in France, and 8,000 new cases are declared each year. With the aging of the baby boom generation and the regular gains in life expectancy, the epidemiological peak is before us.
Men are slightly more affected than women.
Genetic and environmental causes
Transplant of embryonic neurons in the brain (thalamus) in order to eventually restore a normal level of dopamine, the deficient neurotransmitter in people with Parkinson's disease.
The causes of Parkinson's disease probably involve an interaction between genes and the environment.
Several avenues are being studied: exposure to heavy metals, pesticides and herbicides, shock to the head (head trauma as in boxers), cerebral micro-infarction, neurotoxins which could be of viral origin…
Several predisposing genes have been identified, first in cases (very rare) of the early form of the disease, occurring before the age of 50, sometimes even before the age of 40. But the most common form (more than 95% of cases) has not yet revealed all of its genetic secrets, and family or twin studies do not show very high heritability.
Innovative brain stimulation treatments
L-Dopa (levodopa or dopaminergic treatment) is the reference therapy, effective on the symptomatic triad. But it often leads to side effects of motor fluctuation, which other molecules sometimes used in therapy do not have (dopamine agonists).
Deep brain stimulation (high frequency intervention on the subthalamic nucleus) has been used successfully for fifteen years in the treatment of Parkinson's disease. Tremor resistant to drug treatment and motor complications related to levodopa are the main indications for this neurosurgical treatment. More recently cortical stimulation (electrode on the dura mater at the level of the motor cortex) has been developed, which is less invasive and gives results comparable to deep brain stimulation on the symptoms of the patients.
information:
The three main symptoms making it possible to establish a first diagnosis are akinesia (slowness and difficulty of movement), muscular hypertonia (so-called “extra pyramidal” rigidity, affecting both the spine and the limbs) and tremors (at rest, regularly at 4 to 7 cycles per second).
In addition to these three major disorders, Parkinson's disease manifests itself in secondary symptoms: pain, cramps, tingling, constipation, urgent urination, drop in blood pressure when lifting too suddenly (orthostatic hypotension), sweating and profuse salivations, anxiety, depression, irritability, mania.
Five stages of evolution
Stage I:
First one-sided signs, not interfering with daily life.
Stage II:
Still unilateral signs, but causing discomfort.
Stage III:
Bilateral signs, modified posture, no serious handicap, complete autonomy.
Stage IV:
More severe handicap, walking still possible, limited autonomy.
Stage V:
Impossible to walk (wheelchair, bed rest), complete loss of autonomy.
The life expectancy of patients is variable. In the best cases (late onset, early identification, effective treatment), the lifespan may be normal, i.e. identical to the population average.
Peak frequency around 70
Rare before 45 years, Parkinson's disease affects older people: 1% of the population is affected after 65 years, and the peak frequency is around 70 years.
There are approximately 100,000 patients in France, and 8,000 new cases are declared each year. With the aging of the baby boom generation and the regular gains in life expectancy, the epidemiological peak is before us.
Men are slightly more affected than women.
Genetic and environmental causes
Transplant of embryonic neurons in the brain (thalamus) in order to eventually restore a normal level of dopamine, the deficient neurotransmitter in people with Parkinson's disease.
The causes of Parkinson's disease probably involve an interaction between genes and the environment.
Several avenues are being studied: exposure to heavy metals, pesticides and herbicides, shock to the head (head trauma as in boxers), cerebral micro-infarction, neurotoxins which could be of viral origin…
Several predisposing genes have been identified, first in cases (very rare) of the early form of the disease, occurring before the age of 50, sometimes even before the age of 40. But the most common form (more than 95% of cases) has not yet revealed all of its genetic secrets, and family or twin studies do not show very high heritability.
Innovative brain stimulation treatments
L-Dopa (levodopa or dopaminergic treatment) is the reference therapy, effective on the symptomatic triad. But it often leads to side effects of motor fluctuation, which other molecules sometimes used in therapy do not have (dopamine agonists).
Deep brain stimulation (high frequency intervention on the subthalamic nucleus) has been used successfully for fifteen years in the treatment of Parkinson's disease. Tremor resistant to drug treatment and motor complications related to levodopa are the main indications for this neurosurgical treatment. More recently cortical stimulation (electrode on the dura mater at the level of the motor cortex) has been developed, which is less invasive and gives results comparable to deep brain stimulation on the symptoms of the patients.
information:
http://www.inserm.fr
http://www.franceparkinson.fr/