Isifo sikaParkinson kunye neParkinsonism

Ujongo lweklinikhi

Isifo sikaParkinson

Isifo sikaParkinson (PD) sisifo se-neurodeergenerative esibonakaliswa ikakhulu kukulahleka kwe-dopamine neurons kwi-substantia nigra. Iimpawu zikhula ngokubanzi kwicala elinye lomzimba kancinci ngokuhamba kweminyaka kodwa ukukhula kunokwahluka ukusuka komnye umntu ukuya komnye ngenxa yeyantlukwano yesi sifo. Abantu abane-PD banokufumana ukungcangcazela, ingakumbi xa bephumle (okuchazwa njengepilisi yokungcangcazela kwezandla), i-bradykinesia, ukuqina kwemilenze, ukuhamba kunye neengxaki zokulinganisela. Ukuxhaphaka kumalunga neemeko ezingama-200 kwi-100,000 labemi, kwaye izehlo zimalunga neemeko ezingama-25 kwi-100,000 labemi, kodwa la manani angabonisa umahluko ukusuka komnye ummandla wehlabathi ukuya komnye.

Xa kubonakala ukubonakaliswa kwemoto, abantu abane-PD balahlekelwe ngaphezulu kwe-50% yeeseli ze-nigral dopamine ezibonisa ukuba utshintsho lwe-pathological lunokuqala kumashumi eminyaka ngaphambi kokuvela kweempawu zeklinikhi. Isigaba se-premotor sibonakaliswe kwiimeko ezininzi ngokubonakaliswa kwe-non-motor ezifana nokuphazamiseka kokuziphatha kokulala kwe-REM, ukungakhathali, ukuguquka kwemizwelo, ukuxhalaba, ukuqunjelwa kunye nokulahlekelwa kwe-olfaction.

Jonga inkcazo epheleleyo yePD

Unobangela we-PD mhlawumbi unezinto ezininzi, kunye neminikelo evela kwi-hereditary predisposition, i-toxins yendalo, kunye nokuguga. Kwiminyaka yakutshanje kuye kwacaca ukuba kukho igalelo lofuzo kwi-PD kunye neenguqu ezininzi zichongiwe (i-GBA, LRRK2, PRKN, SNCA), nangona kwimimandla emininzi yehlabathi kuphela iimeko ezincinci zichazwe ngemfuza.

Ukuxilongwa kuhlala kuklinikhi kwaye kusekelwe ekubonakalisweni kweemoto. I-Brain MRI okanye i-CT kunye ne-molecular imaging (okt yesithuthi se-dopamine kwi-striatum) ye-striatum inokwenziwa ukuxhasa uvavanyo lweklinikhi. Iimpawu zeklinikhi zePD ziquka zombini iimpawu zemoto (echazwe ngasentla), kunye nemiba engeyiyo imoto. Ezi mpawu zingezo-motor ziquka iimpawu ze-neuropsychiatric ezibandakanya ukuphazamiseka kwemizwelo kunye nokutshintsha kwengqondo; ukungasebenzi kwe-autonomic, intlungu kunye nemiba yokulala.

I-Levodopa iye yahlala isisiseko sonyango lwePD ngaphezu kweminyaka engama-50. Nangona kunjalo, emva kweminyaka embalwa yonyango kwaye ngokuyininzi ngenxa yokuqhubela phambili kwesi sifo, inzuzo ye-levodopa iyancipha kwaye iingxaki zemoto zivela kwizigulane ezininzi. Oku kuye kwakhokelela ekuqalisweni kwamanye amayeza amaninzi kuquka i-inhibitors ye-catechol-O-methyltransferase (COMT), i-monoamine oxidase uhlobo lwe-B (MAO-B) inhibitors kunye ne-dopamine agonists. Izithinteli ze-enzyme zisebenza ngokwandisa i-levodopa okanye i-dopamine isiqingatha sobomi ngelixa i-dopamine agonists ilingisa isenzo se-dopamine kwi-brain dopamine receptors.

Kutshanje, unyango lotyando kunye ne-infusion luye lwafumaneka ukuphucula ulawulo kwizigulana ezikhethiweyo ezineengxaki zeemoto. Utyando lubandakanya ukusetyenziswa kokuvuselela kwengqondo okunzulu kwe-subthalamic nucleus kunye neglobus pallidus internus. Ukusetyenziswa kwe-infusions yeziyobisi kusekelwe ekubeni kunokwenzeka ukuhambisa ngokuqhubekayo nokuba yi-levodopa okanye i-apomorphine (i-dopamine agonist ene-affinity ephezulu kwi-dopamine receptors), ixelisa ukuvuselela i-tonic receptor kwi-basal ganglia.

Ixhaswe nguMarcelo Merello, MD
UMlawuli, iSebe leNeuroscience
ICandelo leeNgxaki zokuPhumelela kweNtloko
Iziko loPhando lweNeurological Raul Carrea (FLENI)
EBuenos Aires, eArgentina

Uhlaziyo luka-2019 olunikwe ngu-Angelo Antonini, MD, PhD
Unjingalwazi, iSebe leNeuroscience
IYunivesithi yasePadua, eItali

Iparkinsonism

Isici esicacileyo se-parkinsonism yi-bradykinesia, okanye ukucotha kunye nokunciphisa kunye nokunciphisa ukunyakaza okuphindaphindiweyo ("ukukhathala"). I-subtle "bradykinesia" iye yaxelwa ukuba yenzeke "kubantu abadala abaqhelekileyo", kodwa oku kungabonakalisa ukucotha okungaqhelekanga kunokuba i-bradykinesia ichazwe ngasentla. Isifo sikaParkinson sesona sizathu sixhaphakileyo se-neurodeergenerative ye-parkinsonism. Ezinye izizathu ziquka i-multiple system atrophy, progressive supranuclear palsy kunye ne-corticobasal degeneration.

Jonga inkcazo epheleleyo yeparkinsonism

Ezi ezinye iimeko ze-neurodeergenerative ngamanye amaxesha zidityaniswa ndawonye phantsi kwegama elithi "atypical parkinsonism" okanye "parkinson-plus syndromes". Abaphenduli ngokunjalo kunyango lwe-dopaminergic kwaye ngokubanzi bane-prognosis embi kakhulu xa kuthelekiswa nesifo sika-Parkinson. Izizathu eziphazamisayo ze-parkinsonism kunokuba nzima ukuxilonga kumanqanaba okuqala kwaye uphando oluncedisayo lunokuba nexabiso elincinci kulo mzekelo.

I-Parkinsonism inokuba yimpawu, ngenxa yezizathu ezahlukeneyo ze-vascular, ezinxulumene neziyobisi, ezosulelayo, ezinobuthi, zesakhiwo kunye nezinye izizathu zesibini ezaziwayo. Kwezi, i-parkinsonism ebangelwa ngamachiza mhlawumbi iyona nto ixhaphakileyo kwaye iquka ii-arhente ezivimba i-post-synaptic dopamine receptors kunye ne-high affinity (efana ne-antipsychotic kunye ne-anti-emetic medication) kunye ne-sodium valproate. I-Vascular parkinsonism ("i-arteriosclerotic pseudoparkinsonism") ithande ukuba nokugxininiswa komzimba ophantsi kunye nokuphazamiseka kwe-gait kunye nokuphazamiseka kwengqondo okuhambelanayo.

Ixhaswe nguDavid John Burn, MD, FRCP, uNjingalwazi, iCandelo le-Clinical Aging Reserach Unit, iCampus yokuguga kunye ne-Vitality, iYunivesithi yaseNewcastle, eNewcastle Upon Tyne, e-UK.

I-Multiple System Atrophy (MSA)

I-Multiple system atrophy (MSA) yi-α-synucleinopathy enqabileyo kwaye eqhubekayo ehambelana ne-oligodendroglial inclusions kunye nokulahlekelwa kwe-neuronal echaphazela i-striatum, i-substantia nigra, i-pons, kunye ne-cerebellum phakathi kwezinye iindawo zengqondo. Ngokweklinikhi, iimpawu zingabandakanya i-parkinsonism enzima engaphenduliyo kwi-levodopa, i-cerebellar ataxia, i-autonomic okanye i-pyramidal dysfunction in variable variable.

Jonga inkcazo epheleleyo yeMSA

Ngokuxhomekeke kwi-parkinsonian okanye iimpawu ze-cerebellar izigulane zihlelwa zibe yi-subtype ye-MSA-P okanye i-MSA-C, ngokulandelanayo. Ubudala obuphakathi ekuqaleni kweempawu zemoto ngama-56.2 ± 8.4 iminyaka kungekho mahluko ekusasazeni ngokwesondo, kwaye ukusinda okuphakathi yiminyaka emi-6 ukuya kwe-10 (iminyaka eyi-9.8). Ngaphambi kokuba i-motor symptom iqale i-20-75% yezigulane zifumana isigaba se-prodromal esihlala kwiinyanga ezininzi ukuya kwiminyaka kwaye sibonakala ngokusilela kokuzimela okuchaphazela i-cardiovascular, breathing, urogenital, gastrointestinal, kunye nemisebenzi ye-sudomotor. Ukongezelela, ukuphazamiseka kokuziphatha kokulala kwamehlo okukhawulezayo (RBD) kubonwa rhoqo kwi-premotor stage ye-α-synucleinopathies kunye nesiqingatha sezigulane ezibika i-RBD ngaphambi kokuqala kwemoto kwaye ikhona kwi-88% yezigulane ezifunyanwe ukuba zine-MSA enokwenzeka. Ukuza kuthi ga ngoku, i-etiology ye-MSA ayikabikho, ukanti intsebenziswano entsonkothileyo ebandakanya ukuthambekela kofuzo kunye nezinto zokusingqongileyo kucetyiswa ukuba kuqhutyelwe ukuqaliswa kwesifo kunye nokuqhubela phambili, njengoko ukuhlanganiswa kosapho okulandela i-autosomal eyongamileyo okanye ipatheni yelifa kuye kwaxelwa kwiintsapho ezininzi zaseYurophu naseJapan. Nangona kunjalo, i-MSA ithathwa ngokuba yenzeka manqaphanqapha.

Okwangoku, iinketho zonyango zijolise kwiimpawu ezithile kunye neempawu, kwaye ziquka amayeza okunyusa uxinzelelo lwegazi okanye ukunciphisa iimpawu zeParkinsonism (izinga lokuphendula okwethutyana kwi-1-3 iminyaka kwi-38%), iziyobisi ezingenamandla, ukunakekelwa kwe-bladder, i-physiotherapy kunye nonyango lwentetho.

Ibhalwe nguGregor Wenning, MD, PhD, uNjingalwazi weClinical Neurbiology, Medical University of Innsbruck, Austria (Julayi 2019)

Inkqubela phambili yokuHamba kwePransukraine (PP)

I-Progressive Supranuclear Palsy (PSP) yingxaki ye-neurodeergenerative yabantu abadala-iqala kunye ne-cerebral-repeat ezine (4R-) tau pathology kwi-neurons, i-oligodendrocytes kunye ne-astrocytes. I-Neurofibrillary tangles kwi-PSP ibaluleke kakhulu kwisiqu sobuchopho kunye ne-basal ganglia kunye neqondo elincinci kwi-cortices yangaphambili kunye neyexesha kunye ne-cerebellum. Imizimba edibeneyo ye-Oligodendroglial ikhona ngokungafaniyo. I-Tau-positive tufted astrocytes iqinisekisa ukuxilongwa. Ukwahluka kokwahluka kwe-anatomical ye-tau pathology kubonakala kumisela ukubonakaliswa kweklinikhi eguquguqukayo kakhulu ye-PSP.

Jonga ukhuphiswano lwenkcazo yePSP

Olona phawu lubalaseleyo lwezonyango lwe-PSP lubizwa ngokuba yi-Richardson's syndrome, okt indibaniselwano yokungazinzi kwangasemva kunye nokucotha kwee-saccades ezithe nkqo kunye nokukhubazeka kokujonga kwi-supranuclear kwikhosi yokuqala yeklinikhi. Olona phawu lwesibini luxhaphakileyo yi-PSP eneParkinsonism ephambili, okt i-akinetic-rigid syndrome ephuhla ukungasebenzi kakuhle kwemoto ye-supranuclear ocular kwinqanaba lesifo lamva. Ezinye izibonakaliso zeklinikhi ze-PSP zibandakanya ukuhamba ngokunyuka kwesantya, umboniso ophambili ophambili, intetho / ukuphazamiseka kolwimi, kunye nesifo se-corticobasal, phakathi kwabanye.

I-PSP sisifo esingaqhelekanga, kunye neentlobo eziqhelekileyo kwi-MAPT ibe yeyona nto ibalulekileyo yomngcipheko. I-PSP ibonisa iimpawu zayo zokuqala zeklinikhi kunye neempawu emva kweminyaka engama-40, kunye neminyaka engama-66 ngokomndilili. I-avareji yexesha lokusinda ukusuka ekuqaleni kwesifo ukuya ekufeni yi-7.9 yrs., kunye ne-aspiration pneumonia ngenxa ye-bulbar dysphagia ibe ngunobangela oqhelekileyo. Akukho chiza livunyiweyo elifumanekayo le-PSP. Amayeza anconyiweyo angekho kwileyibhile, i-physiotherapy kunye nonyango lwentetho lubonelela ngokuphuculwa okulinganiselweyo kunye nokwexeshana kwimisebenzi yeemoto.

Ezona mfuno zibalulekileyo ezingafezekiyo kuphando lwe-PSP kukubonakaliswa kweemeko zeprodromal ezicebisa i-PSP, umfanekiso okanye i-biomarkers ye-fluid ukuxilonga nokulandela umkhondo wesi sifo, kunye nokuphuhliswa konyango olunentsingiselo yokuguqula isifo.

Ibhalwe nguGünter Höglinger, MD, uSihlalo, iSebe leNeurology, iSikolo sezoNyango saseHannover, eHannover, eJamani (Julayi 2019)

I-Corticobasal Syndrome / Ukuncipha (CBS/CBD)

I-Corticobasal syndrome (CBS) sisifo seklinikhi, esikwiqela le-atypical parkinsonian syndromes. I-CBS ibonakaliswa yi-progressive asymmetric akinetic-rigid parkinsonism, i-ideomotor apraxia, oko kukuthi, ukungakwazi ukwenza izenzo zobuchule xa uyalela, okuhlala kudityaniswa ne-dystonia, i-myoclonus, i-cortical sensory loss, kunye ne-alien limb phenomenon, apho izigulane zinoluvo lokuba ilungu lazo alilo lazo kwaye lilawulwa ngamandla angaphandle.

Jonga inkcazo yokhuphiswano ye-CBS/CBD

Kukho izizathu ezininzi ze-CBS. Eyona nto ixhaphakileyo yi-corticobasal degeneration (CBD), i-4-repeat (4R) tauopathy. Ukuxilongwa okwahlukileyo kuquka i-progressive supranuclear palsy (PSP), isifo sika-Alzheimer kunye ne-frontotemporal lobar degeneration (FTD) ene-TDP-43 inclusions, enokuthi ivele ngokwezonyango njenge-CBS. Uninzi lweemeko ze-CBS zenzeka ngamaxesha athile, kodwa i-CBS yosapho iye yabonwa. Kwixesha lokugqibela, i-progranulin gene (GRN) mutations zezona zinto zixhaphakileyo ze-CBS yosapho. Kwihlabathi liphela, i-progranulin mutations ayiqhelekanga kakhulu. Unyango lwe-CBS luhlala luneempawu kunye nenani elikhulayo lezilingo zeklinikhi ezigxile kule meko.

Ibhalwe nguGiorgia Sciacca, MD, PhD, iYunivesithi yaseCatania, eCatania, eItali (ngoMeyi 2026)

I-Dementia eneMizimba kaLewy (DLB)

I-Dementia ene-Lewy body (DLB) yeyona dementia yesibini ixhaphakileyo ye-neurodegenerative dementia, emva kwesifo se-Alzheimer, esichazwa kukuvela kunye kwe-dementia kunye neempawu ze-parkinsonian. Ukuxhaphaka kwe-DLB kuyanda ngokukhula. Malunga ne-0.3–24.4% yabantu abadala abane-dementia bane-DLB, ebalelwa malunga ne-4% ukuya kwi-10% kuzo zonke iimeko ze-dementia.

Ngokwe-pathologically, i-DLB kunye nesifo sikaParkinson zabelana ngokuba kukho imizimba yeLewy ene-alpha-synuclein ebuchotsheni. Kwi-DLB zifumaneka kwiindawo ze-neocortical kunye ne-limbic, ukongeza kwimpawu yesifo sikaParkinson yokuwohloka kwe-nigral.

Jonga inkcazo yeDLB yokhuphiswano

Iimpawu eziphambili zeklinikhi ze-DLB ziquka i-motor parkinsonism edibene nokuguquguquka okubonakalayo kwengqondo, ingakumbi okuchaphazela ukuphaphama nokusebenza kwengqondo, ukusilela kwikhono le-visuospatial kunye nomsebenzi wokuphatha kwangaphambili, ukubona izinto ezingaqhelekanga, kunye ne-REM sleep behavior disorder (RBD). Iimpawu zeklinikhi ezixhasayo ziquka ukubakho kovakalelo olunzulu kwiiarhente ze-antipsychotic, iziqephu ze-syncopal okanye ezinye iziqephu zexesha elifutshane zokungaphenduli kunye nokungasebenzi kakuhle kwe-autonomic. Okuphawulekayo kukuba, i-dementia—ngokwenkcazo—luphawu oluphambili, kunye neempawu ze-parkinsonia ezivela ngaxeshanye okanye kungakapheli unyaka omnye wokuqala kokwehla kwengqondo. Ke ngoko, i-DLB kufuneka ifunyaniswe xa i-dementia yenzeka ngaphambi okanye ngaxeshanye ne-parkinsonism. Ngokwahlukileyo koko, igama elithi Parkinson's disease dementia (PDD) ligcinelwe ukuchaza i-dementia eyenzeka kumxholo we-PD eqinisekisiweyo kunye nokuqala kokwehla kwengqondo emva kokuqala kweempawu ze-motor.

Kwimeko yeklinikhi, igama elifanelekileyo kakhulu sisifo somzimba sikaLewy. Kwizifundo zophando, apho kufuneka kwahlulwe khona phakathi kwe-DLB kunye ne-PDD, umthetho okhoyo wonyaka omnye phakathi kokuqala kwe-dementia kunye ne-parkinsonism usacetyiswa.

Ibhalwe nguGiorgia Sciacca, MD, PhD, iYunivesithi yaseCatania, eCatania, eItali (ngoMeyi 2026)

Iingcebiso eziphambili

impatho

Uphononongo lwe-MDS oluSekwe kuBubungqina boNyango luchaza iinketho zonyango kusetyenziswa indlela engqongqo yemethodological.

Jonga iingcebiso ze-EBM

Research

IPhepha leNgcaciso yoMgaqo-nkqubo we-MDS: “Phando ngezona zinto ziphambili kuPhando lwe-Gait kunye noPhakamiso loLingano kwiSifo sika-Parkinson”

Funda iphepha

izixhobo

Ukwenziwa kweklinikhi kunye nophando kwisifo sikaParkinson

Nceda ulinde ngelixa siqokelela iziphumo zakho.

Uvavanyo lweziphumo zoNyango

Uvavanyo lweziphumo zeklinikhi eziphantsi kwe-MDS, izikali zokulinganisa eziguqulelweyo, kunye noluhlu lwezinye izixhobo ezicetyiswayo.

Jonga iinkcukacha »

MDGene Database

Isishwankathelo sedatha epapashiweyo malunga neenguqu zemfuza ezibangelayo.
✪ SIMAHLA KUMALUNGU E-MDS

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Prodromal PD Calculator

Ikhatyhuleyitha yonyango yomngcipheko weprodromal kwiparkinsonism.
✪ AMALUNGU KUPHELA

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Iinyani kwizigulane zakho

Ulwazi olusisiseko malunga nezihloko zokuphazamiseka kwentshukumo, eziguqulela kwiilwimi ezingama-90+.

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ulwazi

Ukhetho loMhleli: Amaphepha acetyiswayo

Amaphepha ereferensi aluncedo malunga nesifo sikaParkinson kunye ne-parkinsonism, egcinwe yiBhodi yoHlelo lweWebhusayithi ye-MDS.

Umyalelo wevidiyo: Ndenza Njani?

Kwijenali yeMovement Disorders Clinical Practice.

Jonga imizekelo: Amatyala eVidiyo

Bhrawuza indawo yokugcina izinto ezingaphezu kwama-2,000 zeemeko zevidiyo ezivela kwiijenali ze-MDS, kuquka neentetho ezahlukeneyo zeeparkinsonisms.
✪ AMALUNGU KUPHELA

Jonga iimeko

Education

Umsebenzi weSiseko

Iingoma zeKharityhulam yeSifo sikaParsinson

Ukuqhubela phambili ngamanqanaba ama-4 obuchule ngezi seti zezifundo zigcinwe. Fumana ubuchule kwiikhonsepthi zamva nje kunye nezona zibalaseleyo zokuqonda ngokubanzi kwesi sifo sinzima.

Umkhondo iinkcukacha

Izinto ezisisiseko: Isifo sikaParkinson

Fumana uhlaziyo lwesifo se-neurological esikhula ngokukhawuleza, kubandakanywa neempawu ze-neuropathological; inkcazo yayo yeklinikhi eyahlukeneyo; ulawulo lwangoku lwe-pharmacological and non-pharmacological; kunye nonyango oluphambili kunye neengxaki zabo.

Jonga ikhosi

Izinto ezisisiseko: Indlela yeParkinsonism

Isikhokelo esifutshane, esisebenzayo sokuxilongwa kunye nokunyangwa kwe-parkinsonisms, kubandakanywa iiflegi ezibomvu zokuxilonga, iindlela zokukhutshwa, kunye neengcebiso zokuqaphela iimpawu zeklinikhi ezifihlakeleyo.

Jonga ikhosi

IiKhosi zamva nje

Nceda ulinde ngelixa siqokelela iziphumo zakho.

Jonga zonke iikhosi

IiProjekthi ze-MDS & neNtsebenziswano

Amaqela e-MDS

Amaqela ophando oluntu asebenzela ukujongana nemiba kwisifo sikaParkinson kunye ne-parkinsonisms

Nceda ulinde ngelixa siqokelela iziphumo zakho.

IQela loFundo lweSifo seParkinson lokuQala

IQela loFundo lwe-Progressive Supranuclear Palsy (PSP)

Iqela leSifundo seAtrophy yeeNkqubo ezininzi

Amandla oMsebenzi kuHlaziyo lweSikali soHlelo oluManyeneyo lwe-MSA

Iqela leSifo seParkinson eliNgekho kwiMoto

Iqela loPhando lweMpilo-ntle

Usuku lweHlabathi lweParkinson

Unyaka ngamnye ngo-Epreli 11, i-MDS ibhiyozela uSuku lweHlabathi lweParksinon ngokuhlanganisa uluntu lwePD - abanakekeli, abaphandi, izigulane kunye nokunye. Funda ngakumbi ngesi siganeko sikhethekileyo sehlabathi.

Funda nzulu

Isifo sikaParkinson kunye neParkinsonism

Ujongo lweklinikhi