帕金森病

帕金森病(又称帕金森病、帕金森氏症、特发性帕金森病、原发性帕金森病、PD或震颤性麻痹)是一种中枢神经系统退行性疾病。帕金森病的运动症状是由黑质(中脑的一个区域)中产生多巴胺的细胞死亡引起的;这种细胞死亡的原因尚不清楚。在病程早期，最明显的症状与运动有关;这些症状包括颤抖、僵硬、行动迟缓以及行走和步态困难。随后，可能出现认知和行为问题，痴呆症通常发生在疾病的晚期。其他症状包括感觉、睡眠和情绪问题。帕金森病在老年人中更为常见，大多数病例发生在50岁以后。主要的运动症状统称为帕金森病，或“帕金森综合征”。帕金森病通常被定义为一种特发性帕金森综合征(病因不明)，尽管一些非典型病例具有遗传起源。 Many risk and protective factors have been investigated: the clearest evidence is for an increased risk of PD in people exposed to certain pesticides and a reduced risk in tobacco smokers. The pathology of the disease is characterized by the accumulation of a protein called alpha-synuclein into inclusions called Lewy bodies in neurons, and from insufficient formation and activity of dopamine produced in certain neurons within parts of the midbrain. Lewy bodies are the pathological hallmark of the idiopathic disorder, and the distribution of the Lewy bodies throughout the Parkinsonian brain varies from one individual to another. The anatomical distribution of the Lewy bodies is often directly related to the expression and degree of the clinical symptoms of each individual. Diagnosis of typical cases is mainly based on symptoms, with tests such as neuroimaging being used for confirmation. Modern treatments are effective at managing the early motor symptoms of the disease, mainly through the use of levodopa and dopamine agonists. As the disease progresses and dopaminergic neurons continue to be lost, a point eventually arrives at which these drugs become ineffective at treating the symptoms and at the same time produce a complication called dyskinesia, marked by involuntary writhing movements. Diet and some forms of rehabilitation have shown some effectiveness at alleviating symptoms. Surgery and deep brain stimulation have been used to reduce motor symptoms as a last resort in severe cases where drugs are ineffective. Research directions include investigations into new animal models of the disease and of the potential usefulness of gene therapy, stem cell transplants and neuroprotective agents. Medications to treat non-movement-related symptoms of PD, such as sleep disturbances and emotional problems, also exist. The disease is named after the English doctor James Parkinson, who published the first detailed description in An Essay on the Shaking Palsy in 1817. Several major organizations promote research and improvement of quality of life of those with the disease and their families. Public awareness campaigns include Parkinson's disease day (on the birthday of James Parkinson, April 11) and the use of a red tulip as the symbol of the disease. People with parkinsonism who have enhanced the public's awareness include Michael J. Fox and Muhammad Ali.