Parkinson's disease has been called this way since Dr. James Parkinson first described it in 1817. But this disease has already become so established in our modern societies that, for example, in our country, the RAE's own dictionary has incorporated the word párkinson as another noun in our common vocabulary.
More than six million people worldwide and close to two hundred thousand in Spain suffer from this disease, a neurodegenerative disorder that affects the nervous system in a chronic and progressive manner.
It is the second most prevalent disease today after Alzheimer's -another distinguished surname that has become a common name- and also belongs to the so-called movement disorders.
Parkinson's is characterized by the loss or degeneration of neurons in the so-called black substance of the brain, a structure located in the middle part of it. This loss causes a lack of various neurotransmitters in the body, particularly dopamine, a substance that transmits information necessary for us to carry out movements normally.
The neurologist Àngels Bayés, director of the Parkinson's and Movement Disorders Unit of the Quirónsalud Teknon Institute of Neurosciences, provides the cross and the face of the current moment of the disease: the ultimate causes that cause it are not yet known and no treatments are available to stop it, but in recent decades much progress has been made in understanding the multiple processes that occur in the brain and that lead to neuronal degeneration.
Parkinson's is characterized by complex and varied symptoms. It has non-motor symptoms -cognitive, psychiatric or sleep-related problems, among others- and motor symptoms -stiffness, tremor or alteration of normal body movements-, which are essential for diagnosis.
Some treatments make it possible to improve both motor and non-motor symptoms, as well as the quality of life of patients. In the first line are, for example, levodopa, a series of dopamine activators and some specific inhibitors. These treatments make it possible to stop the symptoms and stabilize the disease for a few years. But when the disease progresses and abnormal muscle movements, uncontrolled movements or falls appear, it is necessary to resort to second-line treatments, which manage to significantly improve these motor fluctuations.
In recent years, extraordinarily useful tools have appeared in the fight against Parkinson's. One of them is the STAT-ON, a device or holter that makes it possible to better measure motor fluctuations and helps the patient to self-aware of their symptoms and in dialogue with the doctor to manage their own disease.
The technique of high intensity focal ultrasound (HIFU) is also on the rise. This is a promising technique that can improve the motor symptoms of the disease on one side of the body, and is especially indicated for a selected group of patients who have a tremor that is resistant to drugs or does not improve sufficiently with conventional treatment.
Complementary therapies such as physiotherapy, cognitive stimulation or speech therapy, as well as physical exercise, should always be present from the first years of the disease. New techniques such as non-invasive transcranial magnetic stimulation may contribute to the improvement of motor symptoms resistant to treatment.
Parkinson's usually manifests itself after the age of fifty. Since it is considered that the causes can be very diverse - a combination of genetic, environmental and physical deterioration factors - the disease affects people in very different ways. Given the striking symptoms of the disease, only its diagnosis causes a high emotional impact on those affected and their families.
Dr. Bayés warns in this regard that emotional disorders can be prevented and are treatable. In addition to drug treatment, there are psychoeducational programs and psychotherapy, which should be used.
We must learn to manage the disease and live with it, reducing the burden on the patient and their loved ones and improving, as far as possible, the quality of life of all of them.
