Brain: Refresh your awareness! It turns out that Parkinson's disease is not a disease, but two.

Parkinson's disease is characterized by abnormal intra-neural alpha-synine nucleoprotein aggregates, which can spread between cells in a similar way to prions.
, however, it is still uncertain where the initial alpha-synactal nucleoprotein aggregate originated.
most confusing of all, there is a very large difference in symptoms between people with Parkinson's disease, which has led scientists to speculate: Does Parkinson's include different subsypes? Recently, scientists from the Department of Nuclear Medicine and PET at Aarhus University Hospital in Denmark published a major study in Brain: Parkinson's disease is actually two diseases that can be classified as brain-first (top-down) and body-first (bottom-up) depending on the origin of alpha-synth nuclear protein aggregates.
alpha-synth nucleoprotein pathology, which is brain-first, first appears in the brain and then spreads to the surrounding autonomic nervous system;
in this study, researchers used advanced PET and MRI imaging techniques to examine people with Parkinson's disease, which also included people who had not yet been diagnosed but were at high risk of developing the disease.
found that damage to the dopamine system in the brain first occurred in some patients, followed by damage to the intestines and heart, while in others scans showed damage to the intestinal and cardiac nervous systems before damage to the brain and dopamine system.
XY diagram shows that the brain-first and body-first Parkinson's disease map (A) describes the FDOPA specific binding ratio (SBR) value on the x-axis and the late image 123I-MIBG H/M ratio on the y-axis.
healthy old age control data (HC) is shown in the upper right corner.
with Parkinson's disease with isolated REM sleep behavior disorder (iRBD) initially lose their cardiac MIBG signals, while their dopamine system is fairly intact.
iRBD patients are turned into new Parkinson's disease (PDRBD plus) associated with REM Sleep Behavior Disorder (RBD) due to the gradual damage to the dopamine system.
, the new Parkinson's disease (PDRBD-) without RBD initially manifests it as damage to the black symposome dopamine system, but later only as damage to the cardiac acpathic nervous system.
these two iRBD outliers may represent multiple system atrophy cases.
(B) FDOPA specific binding rate value is shown on the x-axis, and the colon 11C-donepezil SUVs are displayed on the y-axis.
, although the data vary widely, it is clear that you should go to the body first, and then to the brain.
the discovery of brain-first Parkinson's disease is significant.
may be relatively asymptomatic in the early stages of this variant of the disease, and the patient is not diagnosed with Parkinson's until after the ont of movement disorders.
by then, patients had lost more than half of their dopamine system, which poses a huge challenge to early treatment with the disease.
, many people thought the disease was relatively uniform and defined it according to classical movement disorders.
, the findings challenge the understanding of Parkinson's disease to date and provide a theoretical basis for targeted treatment based on disease patterns in individual patients.
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