Detect and treat Parkinson's early
Parkinson's is a previously incurable disease, the causes of which are poorly understood. However, science has recently made some progress here. At the annual congress of the German Society for Neurology (DGN) in Leipzig, neurologist Prof. Daniela Berg from the University Hospital Schleswig-Holstein reports on the latest developments in Parkinson's research and possible future approaches to therapy.
"There is not only one Parkinson's disease - there are many," said Prof. Daniela Berg at the start of the DGN annual congress in Leipzig. In current studies, the neurologist is tracking down the possible different triggers of Parkinson's disease, whereby both genes and environmental factors are the focus of her research. The hope is that by determining the causes at the earliest possible stage, those affected can be better helped in the future, reports the German Society for Neurology.
400,000 Parkinson's patients in Germany
At the start of the DGN's annual congress, Prof. Berg presented the latest scientific findings on the causes of the disease and discussed how Parkinson's patients can benefit from it. According to the DGN, more than 400,000 people in this country are affected by Parkinson's, with a slowdown in movement, small gait, speech disorders, tremors and stiffness being typical signs of the disease. Further indications of the onset of Parkinson's disease are "abnormalities in movement such as decreased swinging of an arm when walking, disorders of fine motor skills or a changed typeface", said the DGN announcement.
Parkison's signs are sometimes unspecific
If the limbs tremor noticeably, many older people in particular think directly of Parkinson's disease. But "not every tremor means Parkinson's," emphasizes Prof. Berg. In fact, the majority of people who tremble don't have Parkinson's. If, in addition to abnormalities in the movement, there are other symptoms such as a reduced sense of smell, a dream sleep disorder, changes in urination, constipation or depression, these can be important indicators for an early diagnosis, explains the expert.
Unspecific symptoms complicate the diagnosis
Although many of the complaints "at first glance seem to have nothing to do with what is commonly understood as Parkinson's," they can "indicate the presence of Parkinson's disease," emphasizes Prof. Da, however, the symptoms are so non-specific are often not suspected of Parkinson's and it takes many years for the disease to be recognized. The reason for these unspecific symptoms is the fact that Parkinson's disease gradually spreads throughout the entire nervous system.
Does Parkinson's develop in the digestive tract?
According to Prof. Berg, new studies “support the hypothesis that Parkinson's disease develops in the stomach / intestine and travels to the brain via the nerve pathways.” The misfolded protein molecule alpha-synuclein, which is deposited in the diseased nerve cells, plays a key role here. If neurons have Parkinson's disease, they can infect other nerve cells, the neurologist continues. The disease-typical deposits of alpha-synuclein can also be detected outside the brain, for example in the intestine, in the salivary glands or in the skin.
Detect Parkinson's from skin samples
In addition, a recently published “Study by Marburg and Würzburg neuroscientists in high-risk patients was able to demonstrate the disease using a skin sample before the onset of motor symptoms,” reports the DGN. The test enables Parkinson's patients to be identified at an early stage and offered to participate in clinical studies that examine how the disease can be prevented from progressing.
Disease is often advanced at diagnosis
So far, the dilemma of Parkinson's diagnostics has been that when the first motor symptoms begin, more than 50 percent of the dopaminergic neurons in the midbrain have died, according to the DGN. The disease process would then run for years to decades. However, based on the specific constellation of movement disorders and non-motor symptoms, it can be possible to recognize the disease much earlier. "Anyone who discovers subtle changes in their arm movements, fine motor skills or typeface should be able to be examined neurologically," the expert recommends.
Early diagnosis is crucial for the treatment options
According to the DGN, early diagnosis has far-reaching consequences for the therapy. Because recent research results would show that patients in the initial phase of the disease benefit from therapy with dopamine or dopamine-like substances. At the time of diagnosis, however, there is often a considerable deficiency in the messenger substance dopamine, which the brain can only compensate for a certain time. Here, “therapeutic dopamine relieves the brain, helps it work regularly, like oil in an engine, which contributes to better mobility,” explains Prof. Berg.
New treatment approaches for Parkinson's
Based on the therapies available today, even after many years of the disease, Parkinson's patients can generally live less restrictedly than 15 to 20 years ago, reports the neurologist. In addition, centers that deal with the research and therapy of Parkinson's disease are also offering therapeutic approaches for the first time as part of studies, which attack the causes of nerve cell death and are intended to prevent the spread of the disease process to still healthy nerve cells, according to the expert further. These are, for example, studies for familial, i.e. inheritable, forms of Parkinson's disease and vaccination studies. The approach of a "Parkinson's vaccine" is based on an antibody against the protein alpha-synuclein, which could nip the spread of the disease in the bud.
Possibilities of your own influence
Last but not least, according to the expert, there are increasing indications that the sick can themselves have a positive influence on the course of the disease. Lifestyle factors such as sufficient physical activity and the consumption of foods that contain vitamins and polyphenols such as coffee, green / black tea or red berries are helpful. The implementation of these findings could also be important for prevention. Several studies have clearly shown that people in old age develop Parkinson's disease less frequently if they engage in adequate physical activity from middle adulthood. (fp)