DEFINITION
Parkinson's disease (paralysis agitans) or Parkinson's syndrome (Parkinsonism) is a disease / syndrome, due to disturbances in the basal ganglia caused by a decrease or absence of delivery of dopamine from the substantia nigra to the globus palidus / neostriatum (striatal dopamine deficiency).
Parkinson's disease is a progressive neurodegenerative disease that is closely related to age. This disease has a characteristic degeneration of dopaminergic neurons of substantia nigra pars compact, coupled with the inclusion intraplasma consisting of a protein called Lewy Bodies. In neurodegenerative parkinsonism also occurs in other brain regions including the locus ceruleus, raphe nuclei, nucleus basalis Meynert, hypothalamus, cortex cerebri, the motor nuclei of cranial nerves, the autonomic nervous system.
ETIOLOGY
Primary etiology of Parkinson's is unknown, There are some allegations, among them are: infection by a virus that non-conventional (yet unknown), an abnormal reaction to a virus that is common, exposure to toxic substances are not known, the occurrence of a premature or accelerated aging.
Parkinson's is caused by damage to brain cells, precisely in the substance nigre. A group of cells that regulate the movements that are not desired (involuntary). As a result, patients are not able to set up / resist movements that are not aware of. The mechanism of how the damage was not clear. Some of the things that allegedly could cause Parkinson's is as follows:
1. age:
The incidence increased from 10 per 10,000 population at the age of 50 to 200dari 10,000 population at the age of 80 years. It is associated with microglial reaction that affects neuronal damage, particularly in the substantia nigra, in Parkinson's disease.
2. geography:
Risk factors that affect this geographic difference in the numbers include the presence of genetic differences, immunity to disease and exposure to environmental factors.
3. Period:
Fluctuations in the number of people with Parkinson's disease may be associated with each period of episodic environmental exposure, such as the infection process, industrialization or lifestyle. Data from the Mayo Clinic in Minessota, no major changes in morbidity between tahun1935 until 1990. This may be due to environmental factors are relatively less effect on the incidence of Parkinson's disease.
Fluctuations in the number of people with Parkinson's disease may be associated with each period of episodic environmental exposure, such as the infection process, industrialization or lifestyle. Data from the Mayo Clinic in Minessota, no major changes in morbidity between tahun1935 until 1990. This may be due to environmental factors are relatively less effect on the incidence of Parkinson's disease.
4. genetic:
Studies suggest a genetic mutation that contributes to Parkinson's disease. Namely mutations in the gene asinuklein the long arm of chromosome 4 (PARK1) in patients with autosomal dominant Parkinsonism. In patients with autosome recessive parkinsonism, found deletions and point mutations in the parkinson gene (PARK2) on chromosome 6. It also found the existence of mitochondrial dysfunction. A history of Parkinson's disease in a family increases the risk factor of Parkinson's disease by 8.8 times in less than 70 years of age and 2.8 times at more than 70 years of age. Although very rare, if it is caused by heredity, symptoms of parkinsonism appear at a relatively young age. Cases of genetics in the USA very little, undiscovered genetic cases were examined in 100 patients. In Europe too. Research in Germany found zero results in 70patients. Classic example of a genetic cause has been found in families in Italy because of cases of the disease occurred at the age of 46 years.
5. Environmental factors
a. Xenobiotics is closely linked to exposure to pesticides that may cause damage to mitochondria.
b. job
More people with higher metal exposure and longer.
c. infection
Suspected influenza virus exposure intrautero predesposisi factors contributed to the damage Parkinson's disease substantia nigra. Animal studies indicate the presence of damage to the substantia nigra by Nocardiaastroides infection.
d. diet
High fat and calorie consumption increases oxidative stress, one of the mechanisms of neuronal damage in Parkinson's disease. In contrast, coffee is neuroprotective.
e. head trauma
Cranio cerebral injury could cause Parkinson's disease, although its role is still not clear
f. Stress and depression
Some research suggests depression may precede motor symptoms. Depression and stress associated with Parkinson's disease because of the stress
