Parkinson’s disease

Parkinson’s disease is a chronic neurodegenerative disorder that affects movement and coordination. It is associated with the loss of neurons in a brain region called the substantia nigra, leading to a decrease in dopamine levels, a neurotransmitter responsible for movement control.

Parkinson’s disease affects approximately 1–2% of individuals over the age of 65, with over 6 million cases reported globally. The risk of developing the disease increases with age.

Symptoms that indicate the need for diagnosis and treatment

• Tremor: often the first and most noticeable symptom. Tremor refers to involuntary movements, usually beginning in the hands or fingers, especially at rest or under stress.
• Bradykinesia (slowness of movement): a decrease in the speed and amplitude of movements, making everyday tasks more difficult.
• Rigidity: increased muscle stiffness that restricts movement, often leaving the individual “frozen” in certain body positions.
• Impaired balance and coordination: patients face a constant risk of falls and injuries.
• Speech and writing changes: speech may become quiet and monotone, accompanied by slower thinking processes. Handwriting often becomes smaller under a condition known as micrographia.
• Psychiatric symptoms: depression, anxiety, and persistent worry without clear cause.
• Somatic symptoms: excessive sweating, tingling in extremities, increased production of skin oils, constipation, urinary disorders, and, less commonly, sexual dysfunction.
• Cognitive impairments: memory loss, quick fatigue, and persistent feelings of exhaustion.

Diagnostic and treatment methods in international clinics

Diagnosis

The diagnosis of Parkinson’s disease is primarily based on patient history, clinical examination, symptom evaluation, and laboratory and instrumental methods. Key diagnostic tools include:

• Neurological examination: assessment of motor functions, reflexes, and coordination tests
• Blood tests: to exclude other conditions
• Imaging studies: CT, MRI, and PET scans
• Electroencephalography (EEG)
• Genetic testing
• Positive response to dopaminergic therapy

Treatment

Since Parkinson’s disease is currently incurable, treatment focuses on symptom relief and improving quality of life. The main approaches include:

1. Medication therapy:

• Levodopa: a metabolic precursor of dopamine, the cornerstone of treatment.
• Additional medications: dopamine agonists, MAO-B inhibitors, levodopa metabolism inhibitors, and adenosine blockers are used to control symptoms and complement primary therapy.

2. Surgical intervention:

• Deep brain stimulation (DBS): a relatively new treatment involving targeted electrical stimulation of brain areas responsible for dopamine production. While the earlier approach involved intentional damage and scarring of brain tissue, today deep brain stimulation (DBS) is considered a gentler and safer method, with its effects being reversible. DBS is indicated for patients in advanced stages of the disease or when medications fail to control tremors.
• Thalamotomy and pallidotomy: targeted destruction of the thalamic nuclei or globus pallidus to reduce tremor symptoms. These procedures are irreversible.
• Stereotactic ablation: the destruction of specific brain areas responsible for disease symptoms. Stereotactic systems allow precise ablation while preserving healthy tissue, minimizing unnecessary trauma.

3. Physiotherapy and rehabilitation:

• Personalized physiotherapy programs enhance mobility, reduce muscle rigidity, improve muscle nutrition, and positively impact spatial coordination and balance.
• Occupational therapy: helps patients adapt to daily life.

4. Psychological support:

Psychotherapy and support groups assist with emotional challenges and provide a supportive environment for coping with the disease.

Innovations in global clinics

Alpha-synuclein protein is a specific marker of Parkinson’s disease and it is used in international clinics for diagnostic verification. To detect it, cerebrospinal fluid is analyzed.

The study of skin nerves through biopsy is another innovative test used to confirm the disease.

Although not all methods are widely implemented, international clinics actively conduct scientific research and clinical trials, including stem cell transplantation, the approach of introducing stem cells into brain tissue to replace defective neurons.

Vaccination with PD01A has shown promise in reducing abnormal protein accumulation in brain tissue and improving overall condition in test groups for patients with Parkinson’s disease.

Gene therapy offers a promising treatment direction by introducing a growth factor for dopamine-producing neurons into the patient’s body.