Parkinson’s Disease (PD) is a chronic, progressive neurodegenerative disorder characterized by the brain's decreased ability to produce dopamine, crucial for movement control. Despite the absence of a cure, various treatments can alleviate symptoms and enhance patients' quality of life. Dr. V.P. Singh, chairman of neurosurgery and neurosciences at Medanta, Gurugram, discusses the evolving treatment landscape in India.
Prevalence and Early Onset in India
PD is more common than often recognized and can manifest at any age, though it is traditionally linked to older adults. In India, PD usually appears around age 51, a decade earlier than in Western countries. This early onset impacts individuals during their prime working years, adding a significant societal and economic burden. Additionally, a shortage of neurologists, particularly in rural areas, leads to delayed diagnoses and inadequate initial treatments. For instance, a study in Gujarat found a prevalence rate of 42.3 per 100,000 people, highlighting the substantial burden of PD.
Symptoms and Onset Types
PD symptoms can vary by age group:
- Younger Onset PD: Affects individuals below 50 years and may include atypical symptoms such as tremor at rest, cognitive impairment, and sleep disturbances, often leading to misdiagnosis.
- Middle Age Onset PD: The most common form, emerging between 50 and 70 years, with early signs like hand tremors, handwriting difficulties, and changes in facial expressions.
- Late Onset PD: Diagnosed after age 70, often with a slower progression but more pronounced cognitive decline and dementia.
Advancing Treatments
India's PD management faces challenges such as medication affordability and specialist access. Nevertheless, advancements bring hope:
- Levodopa: Remains the primary treatment, increasing brain dopamine levels. However, its effectiveness can wane, causing symptom fluctuations.
- Deep Brain Stimulation (DBS): A surgical option involving brain electrode implantation to regulate abnormal electrical activity, significantly improving motor symptoms in advanced PD.
- Gene Therapy: An emerging field with potential to modify genes, slowing or preventing PD progression. Ongoing clinical trials may position India as a key player in future research.
Conclusion
Addressing PD in India requires improving early diagnosis, enhancing access to treatment, and supporting ongoing research to explore innovative therapies. The growing understanding of PD and its impact on younger populations necessitates targeted strategies to manage and mitigate the disease's effects on individuals and society.
SRIRAM’s
