These special patients allow us to discover Parkinson's disease in advance!
June 21, 2019 Source: Academic Jingwei
Window._bd_share_config={ "common":{ "bdSnsKey":{ },"bdText":"","bdMini":"2","bdMiniList":false,"bdPic":"","bdStyle":" 0","bdSize":"16"},"share":{ }};with(document)0[(getElementsByTagName('head')[0]||body).appendChild(createElement('script')) .src='http://bdimg.share.baidu.com/static/api/js/share.js?v=89860593.js?cdnversion='+~(-new Date()/36e5)];Parkinson's disease is a very common neurodegenerative disease with an incidence of about 1 in 100 in people over 60 years of age. As the disease progresses, the patient may experience motor symptoms, including involuntary tremors of the hand, head, etc., slow movements, muscle stiffness, and even unstable posture.
The brain of the patient is already changing before these symptoms are manifested. Early screening for early intervention is a huge challenge in the treatment of Parkinson's disease.
A new study published in The Lancet Neurology, a medical journal, The Lancet Neurology, found a key signal in the patient's brain that could alert Parkinson's disease several years before the onset of motor symptoms. This finding is expected to bring new screening tools for Parkinson's disease and help identify the people at greatest risk.
This discovery is thanks to a rare set of cases. In the villages of northern Peloponnese, some villagers carry a very rare genetic mutation. As the population moved, the same mutations appeared in a small number of people in Italy, which is adjacent to the sea.
The mutated gene SNCA encodes a protein called "α-synuclein". An important pathological feature in the brains of patients with Parkinson's disease is the accumulation of alpha-synuclein in the affected brain. Although for most patients, it is not known what causes this protein aggregation, but very few cases are known to be genetic mutations. The carriers of these single-base mutations in the SNCA gene belong to the latter, and they are almost certain to develop Parkinson's disease in the future.
Researchers at King's College, University of London, spent more than two years searching for 14 SNCA mutation carriers from Greece and Italy and asked them to study in London. At the same time, the researchers also recruited dozens of non-hereditary Parkinson's patients and healthy volunteers, using their examination data as a reference.
Clinical evaluation of motor function and cognitive status showed that half of the 14 patients with hereditary Parkinson's disease had not developed a typical dyskinesia.
Brain imaging experiments have led researchers to notice two changes in these early patients. A change occurs in the brain of the dopamine system. This is not surprising, as the death of neurons that make dopamine has long been seen as an early pathological feature of Parkinson's disease.
(Related reading: Treating Parkinson's disease, why sometimes taking levodopa does not work?)
In addition to the dopamine system, another important neurotransmitter serotonin (also known as serotonin) system is also abnormal in the brain.
Not only that, but for the pathological staging of these pre-existing patients, "we found that the serotonin system changed earlier, before the first change in the dopamine system." Professor Marios Politis, the author of the study, summarized it.
â–²With the development of Parkinson's disease, brain imaging showed that the patient's serotonin function gradually decreased (Source: NEURODEGENERATION IMAGING GROUP, KING'S COLLEGE LONDON)
Based on these results, the researchers believe that the detection of changes in the serotonin system may be used to assist in screening high-risk populations of Parkinson's disease or as a marker of Parkinson's disease burden in clinical trials.
However, the researchers also mentioned the limitations of the current solution. For example, brain imaging requires PET scanning, so the cost is relatively high and it is difficult to implement. So, next, they need to develop scanning technology to get a more economical and convenient screening tool.
As new tools for brain imaging, assessment, and monitoring of symptoms continue to evolve, we expect scientists and physicians to effectively identify and prevent the disease before it develops symptoms.
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