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New explanations for the development of Parkinson's
Parkinson's is a relatively widespread neurodegenerative disease, the causes of which remain largely unclear to date and for which treatment options are very limited. If a certain nerve that connects the brain to the abdominal cavity is cut, the risk of developing Parkinson's disease drops, according to the current report by the German Society for Neurology (DGN). This speaks for a connection between the brain and the digestive tract, which plays a role in the development of the disease.
According to the DGN, a new study from Scandinavia supports the hypothesis that there is a connection between the abdomen and the brain, which is crucial in the development of Parkinson's disease. The development of the disease is therefore at least partially from the digestive tract. This finding could also open up new therapeutic approaches in the future. The Scandinavian researchers have published their results in the journal "Neurology".
More than 4 million Parkinson's patients worldwide
Parkinson's disease is one of the most common neurodegenerative diseases after Alzheimer's. Around 4.1 million people worldwide are affected and more than 280,000 people with Parkinson's live in Germany alone, according to the DGN. In the course of the disease, the cells in the brain die, which are important for controlling body movements. Massive motor impairments are the long-term consequence. Before the motor symptoms begin, however, the patients usually suffer from indefinite symptoms for years, the experts explain. For example, later Parkinson's patients would have constipation and sleep disorders about twice as often as the general population.
Parkinson's disease spreads through the nerve pathways
"The new study supports the hypothesis that Parkinson's disease arises in the stomach and spreads to the brain via the nerve pathways," explains DGN expert Professor Daniela Berg, director of the Clinic for Neurology on the Kiel campus of the Schleswig-Holstein University Hospital. Although the study had no immediate consequences for the therapy, it made it clear that the physicians "have chosen the right path when researching new treatment options."
Connection between the digestive tract and the brain
For some time now, research has focused on the possible connection between the gut and brain in Parkinson's. The corresponding model for the course of the disease is called the ascent hypothesis. It is believed that Parkinson's begins at least partially in the digestive tract. The hypothesis was significantly developed by the Frankfurt neuroanatomist Professor Heiko Braak, who has been working at the Center for Biomedical Research at the University Hospital in Ulm since 2009, reports the DGN. It was confirmed in the animal model by the research group around the director of the Clinic for Neurology at the TU Dresden, Professor Heinz Reichmann.
Misfolded protein molecules enter the brain via the vagus nerve
A key role in the relatively new model of the course of the disease is played by the misfolded protein molecule Alpha-Synuklein, which is typically deposited in the diseased brain cells in Parkinson's disease. According to the DGN, the deposits of Alpha-Synuklein also arise in the nervous system of the stomach and intestines (possibly due to the influence of environmental toxins). According to the ascent hypothesis, the deposits reach the brain via the vagus nerve and its ramifications. From previous studies on mice it is already known that cutting the nerve (vagotomy) at least delays the course of the disease, the DGN continues.
Data from patients with vagotomy were evaluated
In the current study, data from all patients who had undergone vagotomy was analyzed from the Swedish national health database, which was previously used more often to treat gastric ulcers because the vagus nerve also controls gastric acid production. The scientists looked for possible connections between the complete or partial severing of the vagus nerve and the frequency of Parkinson's disease. They found that out of 9,430 patients with a vagotomy, a total of 101 contracted Parkinson's, which corresponds to a share of 1.07 percent. In the general population, however, the disease rate was 1.28 percent. The DGN reports that this trend has become even clearer when focusing on patients with a complete severance of the vagus nerve. "Compared to the control group, the risk of developing Parkinson's was 22 percent lower after a complete vagotomy, and even 41 percent if the procedure was at least five years ago," said the DGN.
Hope for new therapeutic approaches
Although no new therapy can be derived from the new study results at the present time, the better understanding of the course of cell dying will also benefit the patient in the long term, of course, because Parkinson's can be treated earlier, explains DGN expert Prof. Daniela Berg. In addition, new therapeutic approaches to prevent the misfolded protein from spreading could now be tested in studies. "Of course, the success of these therapeutic approaches has to be waited for," adds the expert. (fp)