Parkinson's disease is the most common movement disorder affecting people in their adult life between the ages of 40 and 70. It is a chronic neurodegenerative disease that occurs when the loss of neurons in the substantia nigra leads to a drop in dopamine production and the appearance of accumulations of the protein "alpha-synuclein" in various areas of the brain. The disease progressively causes more severe forms of akinesia, malfunctioning of various motor and vegetative functions, stiffening of the muscles, tremors and mental disorders (mainly of a depressive, anxious and cognitive nature) that limit and wear down the patient's quality of life. To date, there is no cure for Parkinson's disease and the main treatments are only capable of limiting the symptoms. For this reason, scientific research has launched a vast front of investigations aimed at identifying new therapeutic strategies, increasing expectations and quality of life as well as maintaining an adequate level of social inclusion of patients and their families.
In this regard, a study (Brown et al, 2021) conducted by researchers at the University of Sheffield and Luxembourg highlighted the role of the mutation of the Pink1 gene in the processes that determine the manifestation of Parkinson's disease. The deactivation of this gene would determine, in fact, an abrupt decline in the processes of neurogenesis of dopaminergic neurons and the consequent deficit of the networks that contribute to the regulation of postural reflexes, the inhibition of motor activity (dopaminergic nigrostriate system), the expression and emotional regulation (mesolimbic system) and cognitive functions (mesocortical system).
In addition, Italian researchers (Gialluisi et al. 2021) have succeeded in sequencing the genome of 500 patients affected by the disease and in identifying 26 genes involved in the pathogenesis of Parkinson's disease, 16 of which, expressed mainly in the midbrain, have been associated for the first time with the processes that determine its manifestation and progression.
Although the results of these investigations require further study and confirmation, the results obtained so far help to clarify the heterogeneous and complex genetics of this disease, the knowledge of which is crucial to achieve an early diagnosis (if not preventive) and more effective and decisive treatments. In this last area, it is worth mentioning that researchers at the University of Milan (Chiricozzi et al, 2021) have designed an oligosaccharide (called OligoGM1) which, when injected into mice, has proved capable of crossing the blood-brain barrier and ensuring a rapid recovery of motor and biological functions.
In such a complex scenario, the psychologist is crucial for the development of interventions aimed at the management of stress (which is known to worsen the symptoms of the disease such as tremors), anxiety, sleep disorders (whose implications on the management of emotions, mood, memory and in general on the functionality of the prefrontal cortex, the seat of all neurocognitive functions of higher order are known), the development of life skills and the strengthening of protective factors of individual and family resilience (D'Urso, 2020).
In conclusion, it has become imperative to address this disease with a biopsychosocial approach that allows the development of integrated strategies for the management of patients that are effective because they aim, even in crisis situations such as that resulting from the COVID-19 pandemic, at their complete physical, mental and social well-being.
Bibliography
Brown, S.J., Boussaad, I., Jarazo, J. et al. PINK1 deficiency impairs adult neurogenesis of dopaminergic neurons. Sci Rep 11, 6617 (2021). https://doi.org/10.1038/s41598-021-84278-7
Chiricozzi, E., Di Biase, E., Lunghi, G. et al. Turning the spotlight on the oligosaccharide chain of GM1 ganglioside. Glycoconj J 38, 101–117 (2021).
D’Urso, G., Il Morbo di Parkinson, la Deep Brain Stimulation e lo sviluppo di strategie di intervento integrato nella gestione della malattia, State of Mind. Il giornale delle Scienze psicologiche. Id Articolo 179778 pubblicato il 25 novembre 2020
Gialluisi, A., Reccia, M.G., Modugno, N. et al. Identification of sixteen novel candidate genes for late onset Parkinson’s disease. Mol Neurodegeneration 16, 35 (2021). https://doi.org/10.1186/s13024-021-00455-2
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