Parkinson’s: Sleep, smell and constipation disorders can predict the disease 15 years in advance

Parkinson's: Sleep, smell and constipation disorders can predict the disease 15 years in advance

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Restless sleep, loss of ability to distinguish odors and constipation. What do these so different ailments have in common? Under specific conditions, they can play an important role in early detection of Parkinson’s, the second most common degenerative disease (after Alzheimer’s) and the fastest growing of all neurological diseases (6 million people affected worldwide, of which about 400,000 in Italy alone). “If you have all three symptoms, especially if you have never suffered from it before, the probability of getting Parkinson’s can be very high, similar to that of developing lung cancer for cigarette smokers”, underlines from the 9th congress of the Italian Parkinson’s Society and Movement Disorders/LIMPE-DISMOV ETS in Padua, Angelo Antonini, head of the Study Center for Neurodegeneration (CESNE) of the University of Padua and of the Parkinson’s disease and Movement Disorders Unit University Hospital of Padua.

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Parkinson’s disease

Parkinson’s disease typically occurs over the age of 65 and is characterized by a dramatic decrease in the brain of dopamine, a neurotransmitter essential for movement control. From the marrow to the brain, accumulations of alpha-synuclein begin to appear, a protein that helps nerve cells communicate. If the latter no longer works properly, it tends to form aggregates which can accumulate not only in the brain but also in other tissues, causing the death of nerve cells. “We also found these pathological aggregates in the stomach and duodenal bulb of patients at the onset of the motor symptoms caused by the disease. They had probably been there for a long time ”, he tells Salute Antonini”.

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SOS indicators

Today – underlines the expert – through the SOS indicators (acronym for Sleep-Smell-Constipation) and the tools available, it is possible to identify the symptoms of the disease easily and even 10-15 years before the onset of motor disturbances such as tremor, rigidity and motor slowdown become clinically evident: “So, why not start structuring significant prevention strategies also on this pathology? This is why we are launching the campaign ‘You can prevent Parkinson’s’”.

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Among them, sleep disturbance is a highly predictive symptom. So much so that, even if it occurs on its own, that is, without the smell and constipation disturbances, it is already an alarm bell in itself. “Just recently, it was documented that people who are very restless sleepers, i.e. with sudden movements of their arms and legs, and who talk animatedly during REM sleep, are more likely to have developed Parkinson’s or related diseases within of 10-20 years – continues the expert -. Even the loss of the ability to distinguish odors can appear 10-15 years before the movement disorders and, usually, those who experience this symptom also develop constipation. The latter is a very common disorder but, if associated with the other two or at least with one of the two and if it appears around the age of 40-50 in people who had normal intestinal function, it can predict the risk of Parkinson’s quite accurately” . So when is it worth worrying? “If these disturbances appear significantly between the ages of 40 and 55, it could mean that there is an ongoing pathological process – concludes Antonini – And in order to ascertain it, very simple laboratory tests can be carried out, such as blood sampling and a mini-sample of the skin, up to gastroscopy”.

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