Cudurka Parkinson & Parkinsonism

Dulmarka Caafimaad

Cudurka Parkinson

Cudurka Parkinson (PD) waa cillad neerfayaasha ah oo lagu garto ugu horrayn luminta dareemayaasha dopamine ee ku jira substantia nigra. Calaamaduhu guud ahaan waxay ka soo baxaan hal dhinac oo jidhka ah si tartiib tartiib ah sannado badan laakiin horumarka ayaa ka duwanaan kara qof ilaa qof kale sababtoo ah kala duwanaanshaha cudurka. Dadka qaba PD waxaa laga yaabaa inay dareemaan gariir, badiyaa markay nasasho ku jiraan (oo lagu sifeeyo sida kiniin gariir gacmaha ah), bradykinesia, qallafsanaanta addimada, socodka iyo dhibaatooyinka dheelitirka. Baahsanaanta waa ku dhawaad 200 xaaladood 100,000kii qofba, dhacdaduna waa ilaa 25 kiis 100,000 oo qofba, laakiin tirooyinkan ayaa laga yaabaa inay muujiyaan kala duwanaanshiyaha gobol ka mid ah aduunka ilaa gobol kale.

Marka calaamadaha mootada ay soo baxaan, dadka qaba PD waxay lumiyeen in ka badan 50% unugyada dopamine nigral taasoo soo jeedinaysa in isbeddellada cilmu-nafsiga ay bilaaban karaan tobanaan sano ka hor muuqaalka calaamadaha bukaan-socodka. Marxaladda horudhaca ah waxaa lagu gartaa xaalado badan oo aan dhaqdhaqaaq lahayn sida REM- hurdo la'aanta dabeecadda, dareen-celinta, isbeddelka niyadda, welwelka, calool-istaagga iyo luminta urta.

Eeg sharraxaadda PD oo dhammaystiran

Sababta PD waxay u badan tahay inay tahay arrimo badan, oo ay ku jiraan tabarucyo ka imanaya saadaalinta dhaxalka, sunta deegaanka, iyo gabowga. Sanadihii la soo dhaafay waxa ay caddaatay in ay sidoo kale jirto wax ku biirinta hidde-sidaha PD iyo dhowr isbeddello ayaa la aqoonsaday (GBA, LRRK2, PRKN, SNCA), inkastoo inta badan gobollada adduunka kaliya kiisaska laga tirada badan yahay lagu sharraxay genetics.

Cilad-sheegashadu waxay ahaanaysaa mid caafimaad waxayna ku salaysan tahay muujinta dhaqdhaqaaqa. Maskaxda MRI ama CT iyo sawir-qaadista molecular (ie ee qaada dopamine-ka ee marin-biyoodka) ee marin-biyoodka ayaa laga yaabaa in la sameeyo si loo taageero qiimaynta bukaan-socodka. Astaamaha daawaynta ee PD waxaa ka mid ah labadaba calaamadaha mootada (kor lagu sifeeyay), iyo sidoo kale arrimaha aan socodka ahayn. Calaamadahaan aan dhaqdhaqaaqa lahayn waxaa ka mid ah calaamadaha neerfaha oo ay ku jiraan niyad-jabka iyo isbeddellada garashada; cillad iskeed ah, xanuun iyo arrimo hurdo.

Levodopa waxa ay ahaan jirtay rukunka daawaynta PD in ka badan 50 sano. Si kastaba ha noqotee, ka dib dhowr sano oo daaweyn ah oo inta badan ay sabab u tahay horumarka cudurka, faa'iidada levodopa ayaa soo gaabinaysa iyo dhibaatooyinka dhaqdhaqaaqa ayaa u muuqda bukaanno badan. Tani waxay keentay soo bandhigida daawooyin kale oo badan oo ay ku jiraan catechol-O-methyltransferase (COMT), monoamine oxidase nooca B (MAO-B) inhibitors iyo dopamine agonists. Enzyme blockers waxay u dhaqmaan inay kordhiyaan levodopa ama dopamine nuska nolosha halka agonists dopamine ay ku ekaadaan ficilka dopamine ee maskaxda dopamine reseptors.

Dhawaanahan, daawaynta qalliinka iyo faleebada ayaa diyaar u ah si loo hagaajiyo maaraynta bukaannada xulashada leh ee leh dhibaatooyinka mootada. Qalliinka waxaa ka mid ah isticmaalka kicinta maskaxda qoto dheer ee xudunta subthalamic iyo globus pallidus internus. Isticmaalka faleebooyinka maandooriyaha waxay ku saleysan tahay suurtagalnimada in si joogto ah loo bixiyo levodopa ama apomorphine (dopamine agonist oo leh xiriir sare oo loo yaqaan 'dopamine reseptors'), oo la jaan qaadaya kicinta reseptor tonic ee dabiiciga ah ee ganglia basal.

Waxaa wax ku darsaday Marcelo Merello, MD
Agaasimaha, Waaxda Neuroscience
Qaybta Dhibaatooyinka Dhaqdhaqaaqa Madaxa
Machadka Cilmi-baarista Neerfaha Raul Carrea (FLENI)
Buenos Aires, Argentina

Cusbooneysiinta 2019 waxaa gacan ka geystay Angelo Antonini, MD, PhD
Professor, Department of Neuroscience
Jaamacadda Padua, Italy

Parkinsonism

Sifada qeexan ee parkinsonism waa bradykinesia, ama gaabis leh hoos u dhac iyo hoos u dhac dhaqdhaqaaqyada soo noqnoqda ("daal"). "Bradykinesia" khiyaano ah ayaa lagu soo warramey inay ku dhacdo dadka "waayeelka caadiga ah", laakiin tani waxay muujin kartaa gaabis aan gaar ahayn halkii bradykinesia sida lagu qeexay kor. Cudurka Parkinson waa sababta ugu badan ee neurodegenerative ee Parkinsonism. Sababaha kale waxaa ka mid ah atrophy habdhiska badan, curyaan supranuclear horusocod ah iyo hoos u dhaca corticobasal.

Eeg sharraxaadda Parkinsonism oo dhammaystiran

Xaaladahan kale ee neerfayaasha ayaa mararka qaarkood la isku soo ururiyaa iyadoo loo eegayo ereyga "parkinsonism atypical" ama "parkinson-plus syndromes". Si fiican ugama jawaabaan daawaynta dopaminergic waxayna guud ahaan leeyihiin saadaal ka sii xun marka loo eego cudurka Parkinson ee caadiga ah. Sababaha sii xumaanaya ee Parkinsonism-ka waxa laga yaabaa inay adagtahay in la ogaado marxaladaha ugu horeeya baadhitaanada kabida ahna waxa laga yaabaa inay qiimo xadidan tahay tusaale ahaan.

Parkinsonism waxa kale oo uu noqon karaa calaamado, taas oo ay sabab u tahay xididdada xididdada dhiigga ee kala duwan, daroogada la xidhiidha, caabuqa, sunta, qaabdhismeedka iyo sababaha kale ee labaad ee la yaqaan. Kuwaas oo ka mid ah, Parkinsonism-ka ay sababto maandooriyaha ayaa laga yaabaa inuu yahay kan ugu badan oo ay ku jiraan wakiilada xannibaya daaweeyayaasha dopamine-ka-dambe ee D2 oo leh xiriir sare (sida dawooyinka dhimirka iyo dawooyinka ka hortagga) iyo sodium valproate. Parkinsonism-ka xididdada dhiigga ("arteriosclerotic pseudoparkinsonism") waxay u janjeertaa inay xoogga saarto hoos u dhaca socodka socodka iyo cillad garasho la'aan.

Waxaa wax ku darsaday David John Burn, MD, FRCP, Professor, Unugga Cilmi-baarista Gabowga ee Clinical, Campus for Aging and Vitality, Jaamacadda Newcastle, Newcastle On Tyne, UK

Atrophy Nidaamka Badan (MSA)

Atrophy nadaamka badan (MSA) waa dhif iyo horusocod α-synucleinopathy oo la xidhiidha oligodendroglial ka mid ahaanshaha iyo luminta neuronal ee saameeya striatum, substantia nigra, pons, iyo cerebellum meelaha kale ee maskaxda. Kiliinikada, calaamadaha waxaa ka mid noqon kara Parkinsonism daran oo aan ka jawaabin levodopa, cerebellar ataxia, autonomic ama cillad la'aanta pyramidal ee isku darka isbeddelka ah.

Eeg sharraxaadda MSA oo dhammaystiran

Marka loo eego badiba calaamadaha cudurka Parkinsonian ama cerebellar bukaanada waxaa loo kala saaraa nooc-hoosaadka MSA-P ama MSA-C, siday u kala horreeyaan. Da'da celceliska da'da calaamaduhu waa 56.2 ± 8.4 sano iyada oo aan wax farqi ah u lahayn qaybinta jinsiga, iyo badbaadada dhexdhexaadka ah waa 6 ilaa 10 sano (9.8 sano). Kahor calaamada mootada bilawga 20-75% bukaanada ayaa la kulma marxalad prodromal ah kaas oo socda dhowr bilood ilaa sanado waxaana lagu gartaa cillad iskeed ah oo saameeya wadnaha iyo xididada, neefsashada, urogenital, caloosha, iyo hawlaha sudomotor. Intaa waxaa dheer, khalkhalka habdhaqanka hurdada ee dhaq-dhaqaaqa indhaha ee degdega ah (RBD) ayaa si joogta ah loogu arkaa marxaladda hore ee α-synucleinopathies iyada oo in ka badan kala badh bukaannada ay soo sheegaan RBD ka hor inta aan la bilaabin mootada waxayna ku jiraan ilaa 88% bukaannada laga helay MSA macquul ah. Ilaa hadda, etiology-ga MSA wali waa mid la fahmi karo, haddana is-dhexgal adag oo ay ku jiraan saadaalin hidde-sidaha iyo arrimaha deegaanka ayaa la soo jeediyay si loo kiciyo bilawga cudurka iyo horumarka, sida isku-darka qoyska ee raacaya qaab-dhismeed madax-bannaan ama qaab dhaxal-reeb ah ayaa laga soo sheegay qoysas badan oo Yurub iyo Jabbaan ah. Si kastaba ha ahaatee, MSA waxaa inta badan loo arkaa inay si teel-teel ah u dhacdo.

Waqtigan xaadirka ah, ikhtiyaarrada daawaynta waxay diiradda saaraan calaamadaha iyo calaamadaha gaarka ah, oo ay ku jiraan daawooyinka si kor loogu qaado cadaadiska dhiigga ama si loo yareeyo calaamadaha Parkinsonism (heerka jawaabta ku-meel-gaarka ah ee 1-3 sano ee 38%), daawooyinka daciifnimada, daryeelka kaadiheysta, daaweynta jimicsiga iyo daaweynta hadalka.

Waxaa qoray Gregor Wenning, MD, PhD, Professor of Clinical Neurbiology, Jaamacadda Caafimaadka ee Innsbruck, Austria (Julaay 2019)

Curyaaminta Supranuclear Palsy (PSP)

Cudurka Wadnaha ee Horumarsan (PSP) waa cudur neerfaha ku dhaca dadka waaweyn oo leh cudur neerfaha ah oo afar-celcelis ah (4R-) ah oo ku dhaca neerfayaasha, oligodendrocytes iyo astrocytes. Isku-xidhka neerfayaasha ee PSP waxay ku badan yihiin jirridda maskaxda iyo ganglia-da hoose iyo heer ka hooseeya cortices-ka hore iyo kuwa ku meel gaarka ah iyo cerebellum. Jidhyada isku-xidhan ee oligodendroglial way kala duwan yihiin. Astrocytes-ka tufted ee Tau-positive waxay xaqiijinayaan ogaanshaha. Qaybinta kala duwan ee anatomical-ka ee cudurka tau waxay u muuqataa inay go'aamiso muujinta caafimaad ee aadka u kala duwan ee PSP.

Eeg sharraxaadda tartanka PSP

Muujinta caafimaad ee ugu badan ee PSP waxaa loo yaqaan Richardson's syndrome, ie isku darka xasiloonidarada dambe ee gaabinaysa sacadaha tooska ah iyo curyaanka aragga toosan ee supranuclear ka ah koorsada hore ee bukaan socodka. Muujinta labaad ee ugu caansan waa PSP oo leh Parkinsonism-ka ugu sarreeya, ie akinetic-rigid syndrome oo soo koraya cilladda dhaqdhaqaaqa indhaha ee supranuclear marxalad cudur dambe. Calaamadaha kale ee kiliinikada ee PSP waxaa ka mid ah qaboojinta socodka oo sii socota, soo bandhigida hore ee hore, xanuunka hadalka/afka ee u badan, iyo corticobasal syndrome, iyo kuwo kale.

PSP waa cudur teel teel ah, oo leh kala duwanaanshiyaha caadiga ah ee MAPT oo ah khatarta ugu muhiimsan. PSP waxay caadi ahaan muujisaa calamadaha caafimaad ee ugu horreeya ka dib da'da 40, oo leh 66 sano celcelis ahaan. Celcelis ahaan wakhtiga badbaadada laga bilaabo bilawga cudurka ilaa dhimashada waa 7.9 sano, oo leh oof wareenka hamiga sababtoo ah dysphagia bulbar waa sababta ugu badan. Ma jirto daawo la ansixiyay oo loo heli karo PSP. Daawooyinka lagu taliyay ee ka baxsan calaamada, daaweynta jimicsiga iyo daawaynta hadalka waxay bixiyaan horumar xadidan oo ku meel gaar ah hawlaha dhaqdhaqaaqa.

Baahida ugu muhiimsan ee aan la daboolin ee cilmi-baarista PSP waa dabeecadda xaaladaha prodromal ee soo jeedinaya PSP, sawir-qaadista ama biomarkers si ay si dhab ah u baaraan oo ay ula socdaan cudurka, iyo horumarinta daaweyn caafimaad oo wax ka beddeleysa cudurka.

Waxaa qoray Günter Höglinger, MD, Guddoomiye, Waaxda Neurology, Hannover Medical School, Hannover, Germany (Julaay 2019)

Cudurka Corticobasal Syndrome / Degeneration (CBS/CBD)

Cudurka Corticobasal syndrome (CBS) waa cudur kiliinikada ah, kaas oo ka tirsan kooxda calaamadaha parkinsonian-ka ee aan caadiga ahayn. CBS waxaa lagu gartaa parkinsonism-ka akinetic-adag ee horumarsan, apraxia ideomotor, tusaale ahaan, awood la'aanta in la sameeyo dhaqdhaqaaqyo xirfad leh marka la amro, oo inta badan lagu daro dystonia, myoclonus, dareenka cortical luminta, iyo ifafaalaha addimada shisheeye, halkaas oo bukaannadu ay dareemaan in addimadoodu aysan iyaga ka tirsanayn oo ay xakamayso awood dibadeed.

Eeg sharraxaadda tartanka CBS/CBD

Waxaa jira sababo badan oo CBS ah. Sababta ugu badan waa corticobasal degeneration (CBD), oo ah tauopathy 4-ku-celcelis ah (4R). Baaritaanka kala duwan waxaa ka mid ah curyaanka supranuclear-ka ee horumarsan (PSP), cudurka Alzheimers iyo frontotemporal lobar degeneration (FTD) oo leh TDP-43 oo ku jira, kaas oo sidoo kale caafimaad ahaan u soo bixi kara sida CBS. Kiisaska CBS badankood waxay si aan kala go 'lahayn u dhacaan, laakiin CBS-ka qoyska ayaa la arkay. Tan dambe, isbeddellada hidda-wadaha progranulin (GRN) ayaa ah sababta ugu badan ee keenta CBS-ka qoyska. Adduunka oo dhan, isbeddellada progranulin aad bay u naadir yihiin. Daaweynta CBS waxay weli tahay calaamad muujinaysa tiro sii kordheysa oo tijaabooyin caafimaad ah oo diiradda saaraya xaaladdan.

Waxaa qoray Giorgia Sciacca, MD, PhD, Jaamacadda Catania, Catania, Talyaaniga (Maajo 2026)

Waallida oo leh Lewy Bodies (DLB)

Waallida oo leh Lewy body (DLB) waa waallida neerfaha ee labaad ee ugu badan ee soo noqnoqda, marka laga reebo cudurka Alzheimer, oo lagu qeexo isku-dhafka waallida iyo astaamaha parkinsonian. Heerka DLB wuu kordhaa marka da'da la gaaro. Qiyaastii 0.3-24.4% dadka waayeelka ah ee qaba waallida waxay qabaan DLB, taasoo u dhiganta qiyaastii 4% ilaa 10% dhammaan kiisaska waallida.

Cudurrada DLB iyo Parkinson waxay wadaagaan in maskaxda ay ku jiraan unugyada Lewy ee alpha-synuclein-positive. DLB waxaa laga helaa meelaha neocortical iyo limbic, marka lagu daro astaamaha cudurka Parkinson ee baabi'inta nigral.

Fiiri sharraxaadda tartanka DLB

Astaamaha caafimaad ee ugu muhiimsan ee DLB waxaa ka mid ah parkinsonism-ka dhaqdhaqaaqa oo ay weheliso isbeddellada garashada ee muuqda gaar ahaan kuwa saameeya feejignaanta iyo waxqabadka garashada, yaraanta awoodda muuqaalka iyo sidoo kale shaqada fulinta ee hore, riyooyinka soo noqnoqda, iyo khalkhalka dabeecadda hurdada ee REM (RBD). Astaamaha caafimaad ee taageerada leh waxaa ka mid ah jiritaanka xasaasiyad qoto dheer oo loo qabo wakiilada dhimirka, dhacdooyinka syncopal ama dhacdooyin kale oo ku meel gaar ah oo aan jawaab celin lahayn iyo cillad madax-bannaan oo daran. Waxaa xusid mudan, waallidu waa - qeexitaan ahaan - astaamaha asaasiga ah, iyadoo calaamadaha parkinsonian ay soo baxayaan isla mar ama hal sano gudahood marka ay bilaabato hoos u dhaca garashada. Sidaa darteed, DLB waa in la ogaadaa marka waallidu dhacdo ka hor ama isla mar ahaantaana la socoto parkinsonism. Taas bedelkeeda, ereyga waallida cudurka Parkinson (PDD) waxaa loo qoondeeyay in lagu qeexo waallida oo dhacda marka PD si fiican loo aasaasay iyadoo bilawga hoos u dhaca garashada ka dib marka ay bilaabato calaamadaha dhaqdhaqaaqa.

Xaaladda caafimaad, ereyga ugu habboon waa cudurka Lewy. Daraasadaha cilmi-baarista, oo loo baahan yahay in lagu kala saaro DLB iyo PDD, ayaa weli lagu talinayaa in lagu dhaqmo xeerka 1-sano ee jira ee u dhexeeya bilowga waallida iyo cudurka parkinsonism.

Waxaa qoray Giorgia Sciacca, MD, PhD, Jaamacadda Catania, Catania, Talyaaniga (Maajo 2026)

Talooyin Muhiim ah

Daaweynta

Dib u eegista daawaynta ee Caddaynta ku Salaysan ee MDS waxay qeexaysaa ikhtiyaarada daawaynta iyadoo la adeegsanayo hab habaysan oo adag.

Eeg talooyinka EBM

Research

Warqadda Cad ee MDS: "Mudnaanta Cilmi-baarista ee Socodka iyo Dheelitirka Rabshadaha ee Cudurka Parkinson"

Akhri warqad

Tools

Wixii ku saabsan ku celcelinta kiliinikada iyo cilmi baarista cudurka Parkinson

Fadlan sug inta aan uruurinayno natiijadaada.

Qiimaynta Natiijooyinka Caafimaad

Qiimaynta natiijada caafimaad ee ay MDS leedahay, cabbirada qiimaynta la turjumay, iyo liiska agabyada kale ee lagu taliyay.

Fiiri faahfaahinta

Xogta MDSGene

Dulmarka xogta la daabacay ee ku saabsan isbeddellada hidda-wadaha ee sababa.
✪ BILAASH XUBNAHA MDS

Fiiri faahfaahinta

Xisaabiyaha PD Prodromal

Xisaabiyaha caafimaadka ee khatarta prodromal ee parkinsonism.
✪ XUBNAHA KALIYA

Fiiri faahfaahinta

Xaqiiqooyinka Bukaan-socodkaaga

Macluumaadka aasaasiga ah ee ku saabsan mawduucyada khalkhalka dhaqdhaqaaqa, kuwaas oo u turjumaya 90+ luqadood.

Fiiri faahfaahinta

Information

Xulashada tifaftiraha: Waraaqaha lagu taliyay

Waraaqaha tixraaca ee faa'iidada leh ee ku saabsan cudurka Parkinson iyo baarkinsonismka, oo ay hagaajiyeen Guddiga Tafatirka Mareegaha MDS.

Tilmaamaha Fiidiyowga: Sideen Sameyaa

Laga soo bilaabo Dhaqdhaqaaqa Dhaqdhaqaaqa Dhaqdhaqaaqa Caafimaadka Joornaal.

Eeg Tusaalooyinka: Kiisaska Video

Ka baadh kaydka in ka badan 2,000 oo kiis oo muuqaal ah oo laga helay joornaalada MDS, oo ay ku jiraan bandhigyo kala duwan oo Parkinsonisms ah.
✪ XUBNAHA KALIYA

Daawo kiisaska

Education

Shaqada Koorsada aasaasiga ah

Raadraaca Manhajka Cudurka Parksinson

Horumar ilaa 4 heerar khibrad ah oo leh koorsadan la soo xulay. U hel aqoonta ugu dambeesay uguna goyn fikradaha geesta si loo fahmo guud ee cudurkan adag.

Faahfaahinta lasoco

Aasaaska: Cudurka Parkinson

La soco wixii ku saabsan cudurka neerfaha ee ugu dhaqsaha badan, oo ay ku jiraan astaamaha neerfaha; soo bandhigideeda caafimaad ee kala duwan; Maaraynta dawooyinka iyo kuwa aan dawooyinka ahayn ee hadda jira; iyo daawaynta horumarsan iyo dhibaatooyinkooda.

Daawo koorsada

Aasaaska: Habka Parkinsonism

Hage gaaban, oo wax ku ool ah oo ku saabsan ogaanshaha iyo daawaynta Parkinsonisms, oo ay ku jiraan calaamadaha gaduudan ee ogaanshaha, shuruudaha ka saarida, iyo talooyinka lagu aqoonsanayo tilmaamo caafimaad oo daahsoon.

Daawo koorsada

Koorsooyinkii ugu dambeeyay

Fadlan sug inta aan uruurinayno natiijadaada.

Eeg dhammaan koorsooyinka

Mashaariicda MDS & Iskaashiga

Kooxaha MDS

Kooxaha cilmi-baarista bulshada ee ka shaqeeya inay wax ka qabtaan arrimaha cudurka Parkinson iyo Parkinsonisms

Fadlan sug inta aan uruurinayno natiijadaada.

Bilowga Hore Kooxda Daraasada Cudurrada Parkinson

Kooxda Daraasada Curyaaminta Supranuclear Progressive Supranuclear Study (PSP)

Kooxda Daraasaadka Atrophy Nidaamyada Badan

Kooxda Hawlgelinta ee Midaysan ee MSA Qiimaynta Dib-u-eegista

Kooxda Daraasada Cudurada Parkinson ee aan Mootada ahayn

Kooxda Daraasadda Caafimaadka

Maalinta Parkinson ee Adduunka

Sannad kasta Abriil 11, MDS waxay u dabbaaldegtaa Maalinta Parksinon's Adduunka iyada oo isu keenta bulshada PD - daryeel-bixiyeyaasha, cilmi-baarayaasha, bukaannada iyo in ka badan. Wax badan ka baro dhacdadan gaarka ah ee caalamiga ah.

Wax dheeri ah baro

Cudurka Parkinson & Parkinsonism

Dulmarka Caafimaad