Parkinson's disease


Parkinson's disease skin symptoms
In Parkinson's disease, there are two main types of clinical manifestations. One is motor symptoms associated with damage to the dopaminergic system, and the other is non-motor symptoms related to damage of non-dopaminergic systems. The non-motor symptoms include olfactory dysfunction, sleep disorders, mood disorders, as well as cognitive and psychiatric behavioral disturbances. Additionally, there are dysfunctions of the autonomic nervous system, which manifest in the gastrointestinal tract mainly as constipation, and in the urinary system as urinary incontinence, urinary frequency, urinary retention, and sexual dysfunction. There also occurs orthostatic hypotension, along with changes in the skin. Some patients may experience abnormal increases or decreases in sweating and abnormal secretion of sebum in the facial area, which are specific skin symptoms of Parkinson's disease.


Late-stage symptoms of Parkinson's disease
Parkinson's disease is a progressively worsening neurodegenerative disorder of the nervous system, initially manifesting as bradykinesia, resting tremor, and other symptoms. As the disease progresses, the symptoms become increasingly severe. In the later stages, symptoms may include significant postural and gait abnormalities, such as obvious stooping and difficulty starting to walk, a phenomenon known as freezing, and turning around can also be difficult. Additionally, in the late stages, swallowing dysfunction may occur, leading to clinical signs such as coughing while drinking water and articulation disorders. Furthermore, individuals with Parkinson's disease are particularly prone to falling in the later stages due to impaired balance functions.


Initial symptoms of Parkinson's disease
The early symptoms of Parkinson's disease are divided into motor symptoms and non-motor symptoms. The onset of Parkinson's disease is relatively concealed and progresses gradually. The initial symptoms can be tremors, bradykinesia, or rigidity, occurring asymmetrically. It often starts in one upper limb and can initially appear in the lower limbs in a few cases, gradually extending to the limbs on the other side. Non-motor symptoms can occur at any stage of Parkinson's disease, including before motor symptoms arise, such as loss of smell, rapid eye movement sleep behavior disorder, constipation, and depression. These are often precursory symptoms of Parkinson’s disease, but such non-motor symptoms can also appear in other diseases, which can make them difficult to clearly distinguish.


Is Parkinson's disease progressing quickly?
Parkinson's disease is a degenerative disease of the nervous system that has a very concealed onset and progresses very slowly, making the progression of this disease not rapid. Patients can generally take care of themselves for about three to five years, or even five to ten years, without having to worry too much about this disease. This disease primarily causes patients to experience obvious bradykinesia, mask-like faces, drooling, resting tremors, and increased muscle tone among other clinical manifestations, which can significantly distress patients. However, the progression of this disease is relatively slow, and the signs and symptoms on the left and right sides of the body are also asymmetric. After effective pharmacological treatments, such as commonly used levodopa and dopamine receptor agonists, patients' symptoms can usually be well controlled and the progression is slow. If the disease progresses very quickly, it could potentially be Parkinsonian syndrome.


Parkinson's disease Braak staging
Parkinson's disease Braak staging is generally divided into five stages: Stage 1 refers to unilateral symptoms only, such as tremors or stiffness in one hand or one foot, with symptoms confined to one side of the body and not crossing the midline. Stage 2 refers to mild symptoms on both sides, such as tremors in both hands or throughout the body, but without impairment of balance. Stage 3 refers to more pronounced bilateral symptoms, such as difficulty lifting legs, taking small shuffling steps, leaning forward, or instability when holding a bowl while eating, but capable of living normally. Stage 4 refers to the loss of most of the ability for autonomous activity. Stage 5 refers to a complete loss of the ability to live independently.


Can Parkinson's disease be cured?
The core treatment for Parkinson's disease currently is pharmacotherapy, with surgical treatment serving as a supplement. Additionally, physical rehabilitation and psychological therapy are also recommended. The most effective drugs against Parkinson's at present include Levodopa, or compound Levodopa preparations. Other treatments include dopamine receptor agonists, monoamine oxidase inhibitors, amantadine, anticholinergic drugs, and catechol-O-methyl transferase inhibitors. Furthermore, there are treatments aimed at non-motor symptoms, such as psychiatric symptoms, cognitive impairments, autonomic dysfunctions, and sleep disorders. For drug treatments, it is advisable to start with a low dose and gradually increase to an appropriate dosage while maintaining the medication regimen. Currently, we cannot cure Parkinson's disease; we can only provide relief to the symptoms and slow the progression of the disease through comprehensive treatment. (The use of medications should be under the guidance of a doctor.)


What are the symptoms of Parkinson's disease?
The main symptoms of Parkinson's disease are divided into two major categories: motor symptoms and non-motor symptoms. The motor symptoms include bradykinesia and hypokinesia, specifically characterized by slow movement speed and reduced amplitude. In daily life, this results in clumsiness with actions such as difficulty standing up, small arm swings while walking, or even no swinging at all, a lack of facial expressions, and progressively smaller handwriting. The second type is resting tremor, which includes pill-rolling movements along with muscle rigidity and postural and gait imbalances, such as a panicked gait or taking very small steps that accelerate and become faster without the ability to stop or turn promptly. Non-motor symptoms include issues such as olfactory dysfunction, sleep disturbances, constipation, and depression.


The causes of Parkinson's disease
Parkinson's disease, also known as tremor paralysis, is a common neurodegenerative disorder. The cause of Parkinson's disease is not yet clear, but it may be related to several factors, such as aging, genetics, and environmental factors. Since Parkinson's disease is the result of multiple factors, including abnormal protein aggregation, oxidative stress, mitochondrial damage, inflammation, and excitotoxicity of glutamate, these elements lead to the loss of dopaminergic neurons in the substantia nigra of the midbrain and a reduction in dopamine neurotransmitters in the striatum. This ultimately results in the patient's bradykinesia, muscle rigidity, and resting tremor.


Methods of Diagnosing Parkinson's Disease
In the auxiliary examinations for Parkinson's disease, routine laboratory tests as well as CT and MRI scans of the head generally show no specific changes. However, in molecular imaging, PET CT can reveal a significant decrease in striatal dopamine transporter. For olfactory tests, over 80% of Parkinson's patients exhibit olfactory dysfunction. Doppler ultrasound can also detect a significant enhancement of the substantia nigra signal. Despite these advancements in auxiliary examinations, diagnosis in patients with Parkinson's disease still primarily relies on clinical evaluation. According to the 2015 criteria, the diagnostic standards are still based on clinical diagnosis, which includes two main points: first, bradykinesia, where voluntary movements are slow and the speed and amplitude of repetitive movements progressively decrease; second, at least one of the following two manifestations must be present: muscular rigidity or resting tremor.


What foods should be eaten for Parkinson's disease?
Parkinson's disease does not have any specific dietary restrictions, but the following aspects are recommended for patients: First, patients should consume more laxative vegetables and fruits, such as spinach, bananas, and celery, which help maintain the motility of the large intestine and promote bowel movements. Since many Parkinson's patients suffer from constipation, these foods can greatly improve their bowel movements and are recommended. Second, Parkinson's patients can also eat foods that nourish brain cells, such as pine nuts, walnuts, and pistachios. Third, patients may consume some plant oils, mainly olive oil, which can also play a good regulatory role. Fourth, Parkinson's patients should be cautious about the timing of protein intake in relation to their medication schedule, to avoid affecting the absorption of the medication.