Knowing "Pa" is not afraid

Author: Huang Yiling, Wang Yanhua, Luhua Three Gorges University School of Basic Medicine

Illustration: Wang Huiping, School of Basic Medical Sciences, Three Gorges University

Reviewer: Hu Huojun, Chief Physician, First Clinical Medical College, Three Gorges University

Seventy-year-old Grandma Zhang has suffered from Parkinson's disease for six years, but she has been taking medicine all the time, which has been effective and she is still in good health. A few days ago, when Grandma Zhang was walking in the community, she suddenly danced in public with exaggerated movements and funny behavior, attracting many people to watch. Grandma Zhang felt very embarrassed and wanted to stop immediately, but her body was not obedient and she couldn't stop at all. Some people said that she was possessed by evil spirits. Faced with everyone's ridicule, Grandma Zhang felt very wronged, but who could understand her difficulties?

Why did the usually reserved and introverted Grandma Zhang suddenly start to dance? Was she possessed? The answer is of course not. Grandma Zhang's strange behavior is medically known as "dyskinesia", which is characterized by involuntary and uncontrollable twisting of the whole body. So what exactly is Parkinson's disease? Why does such a strange "dyskinesia" of dancing and waving appear?

1. What is Parkinson’s disease?

Parkinson's disease, also known as "tremor paralysis", is a common chronic disease that is more common in middle-aged and elderly people. It is caused by the degeneration and loss of dopaminergic neurons in the substantia nigra and the decreased ability of the remaining neurons to synthesize dopamine. In 1817, British doctor James Parkinson first described this disease, and the disease was named "Parkinson's disease". Dr. Parkinson's birthday is April 11. In order to commemorate him, April 11 of each year is designated as "World Parkinson's Disease Day".

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At present, Parkinson's disease has become the third largest killer that seriously threatens the physical and mental health of the elderly after "cardiovascular and cerebrovascular diseases" and "Alzheimer's disease". Among the elderly population over 65 years old, the prevalence of Parkinson's disease is about 1.7%. Data from the seventh national census in 2021 showed that the elderly population aged 65 and above reached 190 million. As the elderly population continues to increase, the number of people suffering from Parkinson's disease is also increasing.

2. What are the typical symptoms of Parkinson’s disease?

Parkinson's disease can be summarized in four words: shaking, slow, stiff, and falling. The specific manifestations are limb static tremor, slow movement, muscle stiffness, and easy falling. People who used to do things very quickly become slow and laborious when doing simple actions (such as picking up food, drinking water, brushing teeth, buttoning or shoe lacing, etc.) after the disease. It also becomes extremely difficult to get up and turn around. When walking, they have a panic gait, and their facial expressions are reduced, which is called "mask face". The sense of smell will also decrease, and symptoms such as anxiety, insomnia, and constipation will appear, causing great trouble to the patient's daily life.

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3. How to treat Parkinson’s disease?

Once Parkinson's disease is diagnosed, the preferred treatment is drug therapy. Early Parkinson's patients are more sensitive to drugs and can live like normal people after taking the medicine. As the disease progresses, the efficacy of the drugs gradually decreases. On the contrary, many serious complications will occur. For example, this Grandma Zhang has been taking a drug called "levodopa" for a long time. The treatment effect is very good, but after taking the medicine for a long time, a complication gradually appeared, which is the "dyskinesia" mentioned earlier, so she will dance with joy. Once this happens, it is difficult to achieve the ideal improvement effect even if the medication is adjusted. Then the question is, patients will have complications if they take the medicine for a long time, and they will have symptoms such as difficulty in movement if they do not take the medicine. The best choice to solve this dilemma is brain pacemaker surgery.

4. Black technology for treating Parkinson's disease - brain pacemaker surgery

Brain pacemaker surgery is currently the most advanced technology for the treatment of Parkinson's disease. The emergence of this treatment method has brought good news to patients who have not responded to drug treatment. Brain pacemaker surgery, also known as deep brain stimulation, implants electrodes in the brain to deliver high-frequency electrical stimulation to the relevant nerve nuclei that control movement, thereby achieving the purpose of alleviating movement disorders. This is somewhat similar to a "brain-computer interface" and can also be regarded as a kind of "electronic drug." The brain pacemaker treatment system mainly consists of three parts: stimulation electrodes, extension wires, and neurostimulators.

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Brain pacemaker surgery is a minimally invasive surgery with minimal brain damage, good efficacy and high safety. It is currently the preferred surgical method for treating Parkinson's disease. After turning on the brain pacemaker, the patient will find a completely different self: free to move, agile, full of blood, able to run, swim, climb mountains, dance square dance, and enjoy a wonderful life...

References

[1]Zhang ZX, Roman GC, Hong Z, et al.Parkinson's disease in China:prevalence in Beijing,Xian and Shanghai[J].Lancet, 2005, 365(9459):595-597.

[2] Parkinson's Disease and Movement Disorders Group of the Chinese Society of Neurology, Parkinson's Disease and Movement Disorders Specialty of the Chinese Society of Neurology. Diagnostic Criteria for Parkinson's Disease in China (2016 Edition) [J]. Chinese Journal of Neurology, 2016, 49(4): 268-271.