Mr. Park Jung Soo (62, male, pseudonym) often finds that taxis have already passed when he tries to hail one. His movements are excruciatingly slow, and his body feels weighed down as if wearing heavy armor. Daily life has become an uphill battle for him. Mr. Park has Parkinson’s disease.
On Wednesday, medical experts reported that Parkinson’s disease is a chronic, degenerative disorder resulting from the loss of dopamine-producing neurons in the brain. As these movement-controlling brain cells deteriorate, the synthesis and secretion of dopamine gradually diminish, leading to abnormal body movements.
Data from the Health Insurance Review and Assessment Service reveals that the number of Parkinson’s patients in South Korea exceeded 120,000 in 2022, a 14% increase from 105,882 in 2018. The 2022 figures show a higher prevalence among women, with 69,202 female patients (57%) compared to 51,345 male patients (43%).
By age group, only 7% (8,836) of patients were under 50, while a staggering 98% (118,486) were 60 or older. The prevalence increases with age, affecting about 1% of individuals over 65.
As a degenerative condition, Parkinson’s creeps in slowly without warning signs. Initial symptoms typically include hand tremors, stiffness, bradykinesia (slowed movement), and gait disturbances, often mistaken for normal aging.
Professor Kim Young Su of Hallym University Dongtan Sacred Heart Hospital’s Department of Neurosurgery noted, “Tremors and stiffness are uncommon in normal aging. Elderly patients often experience rapid neurodegeneration, making medication management challenging. Early intervention is crucial.”
Symptoms usually manifest when about 80% of dopamine-producing cells have been lost. The condition progressively worsens as neurodegeneration continues. Initially, tremors or stiffness may affect one side of the body before spreading bilaterally, leading to gait disturbances.
The asymmetrical onset of symptoms can lead to confusion with stroke. However, a stroke typically causes sudden paralysis on one side of the body with accompanying speech impairments, whereas Parkinson’s develops gradually and presents with distinct accompanying symptoms.
Many patients experience prodromal symptoms years before the characteristic signs of Parkinson’s appear. These include talking in their sleep, depression, reduced sense of smell, constipation, altered gait or posture, and a lack of facial expression.
Diagnosis involves a specialist’s thorough medical history and neurological examination. MRI scans may be performed to rule out other brain disorders, as MRI findings are typically normal in Parkinson’s disease.
Treatment typically involves dopamine agonists or medications containing levodopa, which the brain converts to dopamine. However, about 40% of patients on levodopa experience “wearing-off” effects after 4 to 5 years of use.
The wearing-off occurs when medication effects diminish before the next dose, sometimes as early as 2 to 3 years into treatment. Additionally, abnormal movements like shaking or twisting of the body or face may arise, requiring surgical treatment.
One widely performed surgical procedure is deep brain stimulation (DBS). Over 10,000 DBS procedures are conducted worldwide annually, with more than 300 in South Korea. DBS involves inserting electrodes into the brain’s deep structures to restore damaged circuits.
A pulse generator implanted under the chest skin is wired to electrodes in the brain, which generate the stimulation. This intricate procedure requires precise placement of electrodes in neural nuclei measuring just 5 to 6 mm in diameter. While DBS is not a cure, it aims to help patients regain independence in daily activities.
Although treatment to revive dopamine-producing cells or halt their loss doesn’t exist yet, ongoing research is focused on developing such therapies. Medical professionals warn against the “wait and see” approach, as it can lead to disease progression and complicate treatment.
Professor Kim Han Jun of Seoul National University Hospital’s Department of Neurology emphasized, “Parkinson’s treatment is an ongoing process. Treatment strategies must be continually adjusted based on the patient’s condition. Regular neurologist consultations are vital to determine the most appropriate treatment for each stage of the disease.”