Parkinson’s disease is traditionally understood as a neurodegenerative disease that starts in the brain. Although this may be correct in some cases, more and more evidence suggests that this disease is actually two diseases, with a variation starting in the intestine.
In a new brain imaging study, researchers found that in some Parkinson’s patients, the damage to the nervous system begins in the enteric nervous system. then Reach the brain.
In other patients, the disease appears to first appear in the brain.
Per Borghammer, a neuroscientist at Aarhus University in Denmark, said: “Until now, many people still think the disease is relatively uniform and define it based on classic movement disorders.”
“But at the same time, we are puzzled as to why there is such a big difference between the symptoms of patients. With this new knowledge, the different symptoms are more meaningful, and this is a point of view that should be studied in the future.”
Although the new study is small (only 37 people with Parkinson’s disease or who are considered at risk, between the ages of 50 and 85), the researchers say that their study subjects are large enough. Advanced imaging techniques such as PET and MRI can be used to prove very different imaging.
In this study, a large number of participants also suffer from REM sleep disorder, which is closely related to the disease. The research team found that this particular problem leads people to realize their dreams and often indicates the priority development of Parkinson’s disease.
Researchers suspect that this may be because the pathology of the disease first shifted from the intestine to a part of the brain closely related to REM sleep, and then developed into the substantia nigra, which is the birthplace of brain-derived Parkinson’s disease.
The study uses REM sleep disorders to determine who is at risk of developing Parkinson’s disease and believes that this may be a sign of neurodegeneration. Brain scans and other assessments of physical health and nerve function create features that clearly illustrate two different biological signals.
This actually means that the disease may have two variants, each of which starts in a different part of the body and then develops in a slightly different way.
The author claims that these two different manifestations are Parkinson’s disease, which is the first nature of the body and Parkinson’s disease, which is the first nature of the brain.
Borghammer said: “Previous research has shown that there may be more than one type of Parkinson’s disease, but it was not clearly proven until this study was specifically designed to clarify this issue.”
“The knowledge we have now provides hope for better and more targeted treatment of Parkinson’s disease patients in the future.”
About two centuries ago, the intestine was first associated with Parkinson’s disease. Today, constipation is considered one of the most common symptoms of the disease, but it was not until 2003, after careful study of the cadaver, that neuroanatomist Heiko Braak proposed the intestinal origin of Parkinson’s disease.
Since then, further research has produced different opinions. Although some animal studies have shown that Parkinson’s biomarkers can be transmitted from the gut to the brain, autopsy studies on humans have shown that these represent only a few cases.
In a study of more than 600 cadavers, researchers did not find a case of “intestinal only” Parkinson’s disease. Found that all of these originated in the brain.
But this does not mean that it does not participate in the intestinal nervous system, that is, the enteric nervous system. The gastrointestinal tract is huge, and some researchers believe that hundreds of microscope slides will be needed to rule out local intestinal lesions “with any degree of confidence.”
Finding evidence of bowel priority cases that progress in a similar way has proven difficult, but this new study suggests that there may be a middle ground in mixed results.
The author predicts from the current trajectory that all patients, no matter how Parkinson’s disease begins, will eventually cause severe damage to their sympathetic nervous system.
This means that both variants ultimately look very similar-whether it is the dopamine system in the brain that first begins to degenerate, or the peripheral nervous system.
Understanding these two variants can help us determine the initial stages of Parkinson’s disease earlier-at least the variant that is preferred for the human body.
Berghammer said: “The next step is to check whether Parkinson’s disease can be treated by treating the intestine with fecal transplants or other methods that affect the microbiome.”
If this physical origin of Parkinson’s disease does exist, then we may be able to stop the disease before it reaches the brain. Once it enters our minds, it is difficult to control.
Unfortunately, by the time the first variant of the brain begins to show symptoms, cognitive decline is far away. Berghammer said that by then, they have lost more than half of their dopamine system, which means slowing the disease will be more difficult.
The research was published in brain.