The diagnosis is mainly clinical, ie based on the neurological examination, and can be supported by instrumental examinations
I learned that in addition to Parkinson’s disease, there are so-called parkinsonisms. How can one distinguish one from the other?
He answers Daniela Calandrellaneurologist, Grigioni Foundation for Parkinson’s disease (GO TO THE FORUM)
Parkinson’s disease the second most common neurodegenerative disease in the worldafter Alzheimer’s dementia, with a prevalence (over 6 million patients) that has more than doubled in the last thirty years. Age is the most important risk factor for the development of Parkinson’s and men are more susceptible than women. Understanding the pathogenesis and epidemiology of this disease has made great strides, but the causes still remain unknown and there is no cure or preventive therapy. Parkinson’s disease primarily a motor syndrome characterized by slowness (bradykinesia), tremor at rest and rigidity, as well as changes in posture and walking and associated with some non-motor symptoms such as the reduction of smell (hyposmia), constipation, urinary urgency, orthostatic hypotension (excessive lowering of blood pressure when standing upright), mood deflection and sleep disturbances. The diagnosis is mainly clinical, ie based on the neurological examination, and can be supported by instrumental examinations.
The biggest challenge, even for movement disorder specialists, differential diagnosis with atypical parkinsonisms. This term groups some neurodegenerative diseases in which parkinsonian syndrome is the main clinical feature, but which differ from Parkinson’s in presence of other symptoms, for example cognitive (such as dementia or hallucinations), dysautonomia (such as urinary incontinence), or symptoms such as gaze paralysis and dystonia, that is, a sustained muscle contraction that causes abnormal postures. They differ from idiopathic Parkinson’s disease especially for the fastest progression and for the response to dopaminergic therapy (levodopa and dopanimoagonists), which is absent or partial. So atypical parkinsonisms are generally more severe than Parkinson’s disease and mainly include multisystem atrophy, dementia with Lewy bodies, progressive supranuclear palsy and corticobasal degeneration. They are characterized by the intracellular deposition of proteins: multisystem atrophy, such as Parkinson’s disease, by the abnormal deposition of alpha-synuclein protein (and for this called synucleinopathy); progressive supranuclear palsy and corticobasal degeneration from the deposition of the protein value (tauopathy).
Secondary parkinsonisms, on the other hand, are not related to neurodegenerative diseases and include, for example, drug-induced parkinsonism and normotensive hydrocephalus parkinsonism (neurological pathology characterized by the accumulation of an excessive amount of fluid in the cerebral ventricles), which are considered treatable through the elimination of the triggering cause. Neuroimaging examsincluding brain MRI, dopamine transporter scintigraphy, and fluorodeoxyglucose positron emission tomography (PET) imaging (FDG) have improved diagnostic accuracy in the differentiation between Parkinson’s disease and parkinsonisms. Today scientific research on biomarkersincluding nerve tissues, neuroimaging exams e geneticshave the aim of making possible an early diagnosis and treatment of both Parkinson’s disease and atypical parkinsonisms in the future.
October 30, 2022 (change October 30, 2022 | 14:52)
© Time.News