April 11, 2024 is the 28th World Parkinson's Disease Day, and this year's theme is: "Living in Harmony, Better Life".
Parkinson's disease is one of the most common degenerative diseases of the nervous system. Zhao Ninghui, vice president and chief physician of the Second Affiliated Hospital of Kunming Medical University, introduced that Parkinson's disease is a degenerative disease of the central nervous system, and the clinical symptoms generally gradually worsen with the passage of time.
Epidemiological surveys show that the number of people with Parkinson's disease in mainland China accounts for about half of the world, and the prevalence of Parkinson's disease in the elderly population over 65 years old in mainland China is about 1.7%. It is estimated that by 2030, the number of Parkinson's disease patients in China will reach 4.9 million (about 8.7 million worldwide). The course of Parkinson's disease is long and irreversible, and the natural course of the disease is about 40 years, and the symptoms and characteristics of different disease stages are different, which will bring a heavy burden to the family and society.
What is Parkinson's disease?
"Parkinson's disease is a chronic, progressive disease in which the patient's condition progressively worsens over time. Although it is not fatal, it seriously affects the patient's ability to work and quality of life. Current scientific research has not found a clear cause of Parkinson's disease, so all current treatments are aimed at controlling symptoms. In the early stages, drugs are generally used to control it, and in the middle and later stages, surgical intervention can be used. "Parkinson's disease is the second most common neurodegenerative disease after Alzheimer's disease. ”
What causes Parkinson's disease? Zhao Ninghui said that the cause of Parkinson's disease has not yet been clarified, and it is believed that it may be related to genetic and environmental factors.
Because Parkinson's disease always starts quietly and is difficult to diagnose at an early stage, many patients do not know that they have the disease and are prone to miss the best time for treatment. According to the "2022 China Parkinson's Disease Diagnosis and Treatment and Quality of Life Report" jointly completed by the Parkinson's Disease Association and Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, more than 90% of Parkinson's disease patients need more than one year to be officially diagnosed.
What are the manifestations of Parkinson's disease?
Hand tremors are a common symptom of Parkinson's disease, but hand tremors in people with Parkinson's disease have their own characteristics. Patients often present with a pill-like tremor of the thumb and index finger 4 to 8 times per second.
Zhao Ninghui said that Parkinson's disease is more common in middle-aged and elderly people, and the older the age, the higher the risk of the disease. The main symptoms are resting tremor, that is, the usual hand tremors, hand pill-rubbing movements, etc.; muscle stiffness, Parkinson's disease patients usually lose their softness and body and become very stiff, at the initial stage, they feel that a limb movement is inflexible, there is a sense of stiffness, and gradually worsens, and even some daily life actions are difficult; if you pick up the patient's arm or leg and help him move the joints, you will obviously feel that his limbs are stiff, and it is very difficult to move his joints; In addition to buttoning and buttoning, it is much slower or not possible to complete smoothly than before, and one of the main symptoms is "lowercase syndrome" and "mask face", where characters become smaller and smaller.
Evidence suggests that the gut microbiota may also be involved in the pathogenesis of Parkinson's, with more than 80% of Parkinson's patients experiencing a variety of severe gastrointestinal symptoms such as constipation, nausea, and vomiting.
Zhao Ninghui pointed out that Parkinson's disease and intestinal microbiota are inextricably linked, which confirms that the intestinal microbiota-gut-brain axis plays an important role in the occurrence of Parkinson's disease. At present, more in-depth research is needed to uncover how the gut microbiota causes Parkinson's disease, which may be a breakthrough in the treatment of Parkinson's disease in the future.
How is Parkinson's disease treated?
According to the Guidelines for the Treatment of Parkinson's Disease in China (Fourth Edition), the treatment methods and means of Parkinson's disease include drug therapy, surgical treatment, botulinum toxin treatment, exercise therapy, psychological intervention, nursing care, etc. Among them, drug therapy is the first choice and the main treatment method in the whole treatment process. Surgical treatment is an effective supplement when medical treatment is inadequate, while exercise and rehabilitation therapy, psychological intervention and nursing care are suitable for the whole treatment of Parkinson's disease.
Zhao Ninghui said that in the early stage of Parkinson's disease, good results can often be achieved through drug treatment, but drug treatment cannot make patients achieve long-term relief of symptoms, and the stage of good drug efficacy is generally only 3 to 5 years. With the gradual increase in the dosage of the drug, the patient will develop "motor complications" - switching phenomenon, or dyskinesia, etc. If drug therapy is difficult to control, surgery can be considered, including deep brain nucleus destruction and brain pacemaker therapy, both of which can effectively improve the symptoms and motor complications of Parkinson's disease patients, and restore the original mobility and self-care ability of patients.
In recent years, the Second Affiliated Hospital of Kunming Medical University has given full play to the resource advantages of general hospitals, multidisciplinary joint cooperation, screening, diagnosis, evaluation, drug treatment, deep brain stimulation surgery and postoperative program control, integrated management of rehabilitation, and pioneered the joint outpatient clinic of neurology, neurosurgery and rehabilitation department (every Thursday afternoon) to realize the diagnosis and treatment mode of "multidisciplinary collaboration and whole-process management" of Parkinson's disease.
How can AI help Parkinson's patients?
The diagnosis of Parkinson's disease is not an easy task, according to reports, for specialists, the accuracy rate of Parkinson's diagnosis can reach 90%, while general practitioners may only have 70% accuracy. At the same time, Parkinson's disease requires a long-term management team and system to provide continuous and standardized treatment, thereby delaying the progression of the disease.
In recent years, with the development of deep learning technology, medical artificial intelligence (medical AI) has great potential in determining human health status based on retinal images and diagnosing potential ocular and systemic diseases.
Previously, a research team from University College London and Murphy Eye Hospital in London, with the help of artificial intelligence, identified a set of markers that can diagnose Parkinson's disease seven years before the onset of clinical symptoms, which can be identified by eye scans. The study was published in Neurology, the journal of the American Academy of Neurology.
Zhao Ninghui said that the application of artificial intelligence (AI) in the diagnosis and adjuvant treatment of Parkinson's disease has made remarkable progress and shows broad development prospects. He pointed out that in the diagnosis of Parkinson's disease, artificial intelligence helps to identify Parkinson's patients at an early stage and improve the accuracy of diagnosis. In terms of adjuvant treatment, AI can intelligently analyze patients' conditions and treatment responses to provide personalized treatment recommendations, including precise adjustment of drug dosages, formulation of rehabilitation training plans, and acceleration of new drug discovery and clinical trials.
Zhao Ninghui said: "Artificial intelligence has shown great potential and value in the diagnosis and adjuvant treatment of Parkinson's disease, and future development will pay more attention to precision, personalization and intelligence, so as to bring better treatment results and quality of life to patients." ”
Finally, Zhao Ninghui reminded that if normal people find that they find suspected manifestations of Parkinson's disease such as hand tremors, foot tremors, slow walking, slow activity, and body stiffness, they should seek medical attention from the neurology department as soon as possible to achieve early diagnosis and early treatment.
Chuncheng Evening News-Kaiping News reporter Zhao Weiwen Photo courtesy of the Second Affiliated Hospital of Kunming Medical University
First instance Cao Jie
Editor-in-charge: He Dan
Responsible proofreader Yuan Xi
Editor-in-chief: Yan Yun
Final Review: Editorial Board Member Li Rong