To celebrate World Parkinson’s Day, 11 April was chosen, the birth date of James Parkinson, the English doctor who in 1817 described “agitating paralysis” for the first time. There are several events around the world that raise awareness of this disease it affects about 400,000 people in Italybut this number is estimated to increase, leading to 6,000 new cases each year over the next 15 years, half of which are affected in working age.
In fact, one of the most worrying aspects concerns the age of onset of the disease which has dropped considerably, disproving the “cliché” according to which the disease mainly affects the elderly. The evidence indicates that half of the cases arise between 40 and 58 years, 25% between 20 and 40 years, while only the remaining 25% concerns patients over 80. “The new evidence on Parkinson’s disease – specifies Alberto Albanese, manager Neurology of the Humanitas Clinical Institute and Humanitas University professor – they point out an increase in young forms, with onset between 21 and 40 years: in the last 60 years it has gone from a frequency of 1% to peaks of over 18%, with a general average of about 5% “.
The disease can be traced back to the progressive death of neurons located in the “black substance”, a small area of the brain which, through dopamine, controls the movements of the body. Often, however, by the time the diagnosis is received, at least 60% of the dopaminergic cells in the brain have already degenerated.
But there are gods symptoms that can warn us and help us anticipate diagnoses and therapies? “To diagnose the disease in the pre-symptomatic phase, attention must be paid to non-specific clinical manifestations: such as olfactory deficit, depression and, above all, behavioral disturbance during REM sleep: about 60% of patients who scream, kick and pull fists develops the disease within 10-12 years – says Alfredo Berardelli, president of the Italian Society of Neurology (Sin) – Starting treatment at an early stage of the disease or better still in the pre-symptomatic phase is important both to control symptoms and to slow down the evolution of the disease itself. In these phases, in fact, dopaminergic drugs or neuroprotective drugs (under study) could really modify the course “.
Care is one of the great challenges of the future
The great challenge of the research is to identify subjects at risk, in which the disease has not yet occurred, to develop prevention programs (screening) and delay its onset; in parallel, to develop “Disease Modifying” therapies that act on the progression of the disease, with modalities and times that are undoubtedly variable from individual to individual and from disease to disease