Parkinson's disease results from the gradual destruction of the brain's dark-brain cells to produce dopamine, a neuro-hormone that is essential for controlling body movement. When the level of dopamine drops by more than 50%, a slowing down of gestures, a muscular stiffness and disabling tremors (in 2 out of 3 cases) appear. These characteristic symptoms of the disease are also often accompanied by a loss of manual dexterity, gait and vision disorders .
Parkinson's: still unknown causes
10% of cases of Parkinson's seem to have a genetic origin but the remaining 90% have no causes yet clearly identified. For several years, certain chemical pollutants have been singled out. In particular, it has been shown that intense exposure to pesticides and herbicides promotes the development of the disease.
In a July 2017 study published in the European Journal of Neurology, French researchers suggest that farmers have an increased risk of 18%. "But we must remain cautious because Parkinson's disease is multifactorial," said neurologist Alexis Elbaz, co-author of this study. The toxicity of certain solvents and heavy metals (mercury, lead ...) is also incriminated. Drugs , neuroleptic drugs and carbon monoxide poisoning are also mentioned.
A progressive evolution of the disease
Before the onset of the first symptoms, warning signs may occur: difficulty concentrating, sleep disturbance associated with intestinal disorders and impaired sense of smell. These can arise quite young, contrary to popular belief. Hence a feeling of misunderstanding in the patients.
"It was a shock to be diagnosed at the age of 45 in the midst of a professional ascent with head-on projects," says Christian, who has been doing so for a few years. Then the disease evolves at a different speed depending on the individual. Over time, the disability worsens both physically (loss of balance, difficulty swallowing ...) that on the psychological level (anxiety, apathy ...). "The feeling of isolation, of stigmatization is growing," says Florence Delamoye, Executive Director of France Parkinson.
Case-by-case treatments
Medications are always prescribed at the beginning to overcome the lack of dopamine and fade disorders. But in many patients, their effectiveness dulls little by little, not to mention the adverse side effects reported in 15% of patients (low blood pressure, hypersexuality, compulsive purchase, hyperactivity, bulimia ...). To better cope with disorders, a physical and orthophonic rehabilitation is often proposed in addition to improve motor symptoms, speech and swallowing difficulties.
Deep brain stimulation (SCP) , formerly reserved for advanced patients, is now being considered more and more early, after 4 to 5 years of taking medication. It involves sending electrical impulses into a specific area of the brain (the subthalamic nucleus) in order to modulate its activity to restore motor skills. For this purpose, two electrodes are implanted in the brain by neurosurgeons. These are connected to a pile placed under the skin, which must be changed every 5 to 10 years.
This revolutionary technique gives excellent results: tremors are reduced by 80% and muscle rigidity by about 70%. Drug doses can be reduced by half. "But not all Parkinson's can benefit," says Professor Philippe Damier, neurologist at the University Hospital of Nantes, one of Parkinson's expert centers in France. You must be under the age of 70 (ideally between the ages of 50 and 60), not suffer from blockages in movement and not be subject to falls, otherwise treatment may make the situation worse.
For events organized near you, on the occasion of World Parkinson's Day, April 11: www.franceparkinson.fr
