Parkinson’s disease, causes, types, treatments
Parkinson’s disease (EP) is characterized by neuronal and therefore progressive degenerative disorders, mainly attacking the central nervous system, and affecting, in particular, the major adult population that is around 60 – 70 years. In addition, the EP is associated with low levels of dopamine, although its specific cause is inheritance. However, the EP has 7 classifications developed in the disease known as Parkinsonisms, such as primary parkinson and secondary parkinson, indicated as the two main types of EP. Among its manifestations or symptoms, we can find involuntary movements in hands, head, trunk, legs and jaw, in addition to the stiffness and weakness in the muscles, then of the tremors and tics produced at the rate of maintaining the same position or, remainat rest for a long time. Bradiquinesia, Acinesia and Hypocinesia are associated with the slowing of the movements that affect the face.
It should be noted that the EP has no cure, but treatments that have been helpful to maintain control and quality of life in patients have been synthesized. There are various treatments to combat this disease, occupying the first place;The most effective treatment and the different drugs administered to regulate the dopaminergic function in the basal ganglia. On the other hand, pharmacology, surgery and non -pharmacological therapies are added are methods used for the treatment of EP, also surgical procedures are performed to treat symptoms.
Finally, the consequences of the EP, are associated with the quality of life (CV) of the patients and they are mainly caused as a result of the medications administered. Among the main consequences is insomnia, followed by depression, stress and social functions or the constant mood changes.
Introduction
Parkinson’s is characterized by neuronal degenerative conditions that are progressively presented, a set of dementia where environmental and genetic agents influence.
It is mainly characterized by the gradual loss of dopaminergic neurons of a substance called compact pars in the midbrain. In addition to intracellular inclusions that are also known as Lewy bodies, constituted by insoluble aggregates of abnormally folded alpha-synuclein protein.
The conditions of this disease can be found with greater incidence in people who are 60 years or oldThe most common neurodegenerative diseases, presenting in 1% of the population over 60 years, and their incidence grows by 5% in those over 85 years old. The characteristics presented in patients suffering from Parkinson comprise several affectations of motor capacities, including: hypoquinesia, aquinesia, hypertonia, brachinesia and tremor at rest.
Genetic transmission has the highest risk of condition, where the bearer has up to 6.5 of possibilities of developing it. Which makes it a disease with a generational transmission trend. This is carried out from the mutations in the GBA1 gene.
Parkinson and its main causes
According to the symptoms of this disease, they are placed as the second to affect the neurological system. In 1817, James Parkinson, an English doctor was the first to determine and diagnose different disorders in several patients.
First, Parkinson’s is related to some of the nerve cells that break down and die in the brain. It is also very associated with the decrease in dopamine levels, in this area there is a known black substance, the most affected separately of the brain.
Dopamine is the chemical messenger, in charge of transmitting signals from the black substance to the striated body. Other factors that affect, are, the formation of lewy bodies, DJ-1 and Pink-1 genes, also the mitochondria is part of contributing to the formation of this disorder, since it is related to oxidative stress causing damage to damage inDNA -free radicals, proteins and fats.
Inheritance is the first agent causing this disease and complemented with depression since the passage or transport of striatal dopamine is decreased, which increases hypoperfusion, such as stress -related hormones that this pathophysiopathology are associated.
Some effects of Parkinson are involuntary movements or known as movement disorders, head, trunk, legs and jaw, also increases muscles and produces weakness in muscle groups. (Riestra Rodríguez & Cárdenas Molina, 2011)
Parkinson’s manifestations:
The symptoms according to instability is one of the main effects due to the alteration of the posture, when walking inclined.
Another important manifestation is the tremors, which are presented by maintaining a specific position at the beginning of some activity. Frequently ICTs are produced at the time of being at rest repetitively, however, they are reduced when sleeping and increased with stress.
Basal nodes are those that are mainly related to movements that affect the patient with EP, correlating the thalamus and cortex.
Similarly, Bradiquinesia, Acinesia and Hypocinesia are related to the reduction of movements that affect the face and axial muscles, a freezing that is related to the disorder, which can change according to external stimuli, this in turn incapacitatespeople.
This disease decreases the quality of life of the people who suffer from it, because over time the movements are aggravated and with it, it affects the realization of daily activities.
Treatments
This disease has no cure, but there are treatments with which it can be given a control of it. Currently, the treatment of Parkinson’s disease consists of drug administration that increase dopaminergic function in basal ganglia. It should be noted that currently it was found that the administration of L-Dopa orally is the most effective treatment for Parkinson’s disease.
There are several methods for the treatment of Parkinson such as pharmacology that is the main treatment. In addition to surgery and non -pharmacological therapies.
Levodopa, is the most effective agent in the treatment of the disease, as mentioned above. Levodopa therapy can have a remarkable effect on all signs and symptoms. At the beginning of the disease, the degree of improvement in tremor, rigidity and bradyhinesia produced by carbidopa/levodopa can be almost complete. With long -term therapy with Levodop.
The efficacy of L-Dopa decreases after several years and, secondary effects such as visual hallucinations and other psychotic symptoms, sleep and confusion disorders begin to appear. To minimize this phenomenon, individuals often restrict the use of L-Dopa at times of the day in which they need therapeutic relief.
Recently, new levodopa formulations were approved aimed at treating wear. The prolonged liberation capsules of Rytary carbidopa-Levodop.
Dopamine receptor agonists have substantially longer action durations than those of Levodopa in clinical use;They are often used in the management of dose -related fluctuations in the motor state and can be useful for preventing motor complications.
Two receptor agonists DA administered orally are commonly used for the treatment of EP: Ropinirol and Pramipexol. The two are absorbed well oral and have similar therapeutic actions.
Pramipexol, ropinirol and rotigotine can cause hallucinosis or confusion, very similar to that seen with levodopa, and can cause nausea and orthostatic hypotension. They should be started at low doses and slowly valued to minimize these effects. Many doctors prefer an agonist as initial therapy in younger patients to reduce the appearance of motor complications. In older patients or with substantial comorbidity, levodopa/carbidopa is generally better tolerated.
As pharmacologically treated patients are soon resistant to L-Dopa and related treatments, other strategies have been explored. It has been proposed that the excess activity of the subthalamic nucleus has a fundamental role in the disease of the disease.
More recently, it has been shown that deep brain stimulation, with a stimulating electrode in the subtalamic nucleus, it is an effective treatment for advanced Parkinson’s disease. With adequate stimulation frequencies, the function of the subtalamic nucleus is influenced and symptoms are relieved, at least temporarily. The cellular mechanisms and circuits by which the high frequency stimulation of this brain area relieves the symptoms of Parkinson’s disease are not yet known.
Cell transplantation remains an area of interest in treatment. This method is based on the expectation that such. Parkinson’s disease is especially suitable for cell or stem cell treatments, since it implies the loss of a cell population very localized in the adult brain.
Among the surgical procedures used to treat symptoms are included: Palidotomy and deep cerebral neuromodulation (NCP). These 2 are the ones that have given the best results as treatment. Another important treatment for this is physical exercise, which has proven to be very effective for the treatment of motor symptoms of Parkinson’s disease, mainly balance and posture. The treatment of Parkinson’s disease in addition to pharmacological treatment must always be accompanied by non -pharmacological.
Finally, very important efforts are being made to take advantage of the growing knowledge of the genetic and pathophysiological bases of Parkinson’s disease to develop treatments that, fundamentally, delay their progression.
Parkinson types
Parkinson’s disease is divided into 7 categories known as the different types of Parkinsonism that have been discovered so far, which are mentioned below.
- Primary Parkinsonism: it is the best known worldwide, therefore, it is the most frequently presented. Receive the alternative names of idiopathic Parkinson or agitating paralysis. Although it manifests itself in older adults, it is currently common to diagnose it in young individuals. (Parra, Fernández, & Martínez, 2014)
- Secondary Parkinsonism: it is called Symptomatic Parkinson. This type of Parkinsonism occupies the second among the most recognized, its diagnosis is directly derived, as a consequence of the administered drugs or, of toxic substances, in the same way, it is linked to other disorders that the disease produces andThe same way, the brain region that is directly related to the midbrain and the black substance of the brain. (Parra, Fernández, & Martínez, 2014)
- Postencephalic Parkinsonism: it is very rare, and it is mainly due to strokes, trauma, tumors or infectious processes, it can also be diagnosed by eye problems, an imbalance in the nervous system and personality changes. (Carvajal García-Pando & Velasco Martín, 2004) Likewise, it is related to lethargic encephalitis and as a result of being one of the rarest types, post-stencephalic parkinsonism, shows very low survival rates. (Parra, Fernández, & Martínez, 2014)
- Parkinsonism plus: this other type of Parkinsonism, which is characterized by multiple systemic atrophy, lateral sclerosis, progressive supranuclear paralysis and damage to Lewy’s bodies, all this, related or linked to neuronal systematic deterioration that patients suffer withEP Plus.
Youth Parkinsonism:
The manifestations occur in patients from 20 to 40 years of age, producing tremors, rigidity and even Bradiquinesia, having better conditions compared to older adults, this because, young people have more appropriate conditions to support the symptoms of the disease. Likewise, its causes are mainly attributed to genetics.
Iatrogenic parkinsonism:
It is known, since its main cause is the use in large amounts of anti -paminergic psychotics. Among the drugs that result in this type of EP are haloperidol, chlorpromazine, antidepressants and phenotiazines, etc.
Pseudoparkinsonism:
Disorders producing dementia, cranioesephalic damage and different types of traumas. The tremors are rarely presented.
Consequences and quality of life
The consequences of the EP, refer to the quality of life (CV) of the patients after being diagnosed and treated against it. Likewise, due to pharmacological treatment, patients present complications due to its side effects, which, as has been said, has a greater effect on the CV.
Therefore, when talking about the CV, the vision that patients have about their health status and what will be when they meet the regime are reflected. The most common consequences or manifestations of Parkinson’s quality are depression, stress, social and interrelational functions, which imply, mood changes, and sleep disorders, in which the main and the mostCommon is insomnia, where at least 60% of patients with Parkinson are affected.
Just as negative manifestations may occur due to the treatment against this disease, these manifestations, in this case insomnia, can have multiple adverse consequences, such as frustration associated with long nights of insomnia and derived from this, day fatigue. Likewise, the difficulty in paying attention, concentrating and, finally, the executive operation.
At present, the way to solve this problem has been investigated and although various studies have been carried out and many of them have shown potential to solve this, no treatment has been described as an effective to treat insomnia and in patients with Parkinson’s disease.
Conclusions
This information investigated and that we have analyzed, has allowed us to improve our knowledge related to the disease, since it is currently very common not only in our country, but, in various parts of the world, being an important factor that affects us to develop in the manneroptimal.
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