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KMID : 1123920230370050139
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Korean Journal of Oriental Physiology and Pathology
2023 Volume.37 No. 5 p.139 ~ p.147
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Mibyeong, Prodromal Parkinson's Disease, and Dopaminergic Circadian Rhythm Impairment
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Cho Jung-Hyo
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Abstract
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Awareness of Mibyeong, a key concept in preventive Korean medicine, leads to preventive health care by focusing on clinical symptoms and risk factors that appear before disease, as well as improving health by changing one's circadian rhythm and lifestyle. Parkinson's disease motor symptoms, such as bradykinesia, tremor, rigidity, and postural instability, appear after more than half of the dopaminergic neurons in the substantia nigra are lost. Non-motor symptoms such as hyposmia, sleep disturbance, depression, fatigue, and foveal visual impairment, on the other hand, appear from the prodromal stage of Parkinson's disease. Dopamine is secreted in different areas of the brain under circadian control and is known to interact closely with circadian clock genes. The loss of normal dopaminergic rhythm in the midbrain, striatum, retina, and olfactory bulbs has recently been linked to Parkinson's disease non-motor symptoms such as circadian disruption, REM sleep behavior disorder, foveal vision loss, and hyposmia. Furthermore, circadian disruption is linked to several pathological mechanisms of Parkinson's disease, hastening disease progression. There is a growing awareness that early diagnosis and preventive measures of Parkinson’s disease should be prioritized. Parkinson's disease must be prevented at the prodromal stage through increased awareness and active preventive treatment.
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KEYWORD
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Parkinson’s disease, Prodromal phase, Mibyeong, Dopamine, Circadian rhythm
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