[Clinical characteristics and trends in research of Parkinson's disease and parkinsonism in Japan].
Parkinson's disease (PD) is one of the major neurological diseases affecting elderly subjects. Presumed prevalence of PD is 80-100 per 100 thousands and it is estimated that there are approximately 100 thousands patients in Japan. From a statistic on age distribution of patients visiting doctors, it is estimated that patients with ages at 75-79(639/100,000) and 80-84(632/100,000) are highest in number. Juvenile parkinsonism is a syndrome with parkinsonian motor symptoms and dystonia developing before and after ten years of age. Reports on this syndrome have been accumulated in Japan and gene abnormality in a enzyme relating to dopamine metabolism was discovered in the hereditary progressive dystonia with marked diurnal fluctuation (Segawa). Among symptomatic parkinsonism, cerebrovascular parkinsonism is mainly due to multiple infarction in the basal ganglia or Binswanger's disease in Japan, and both conditions develops parkinsonism, pseudobulbar palsy and dementia progressively. Diffuse Lewy body disease and a unique type of progressive supranuclear palsy presenting a disorder designated "pure akinesia" were studied mainly in Japan. In drug therapies of PD, it has been argued why the maintenance dose of levodopa or dopamine agonists was generally low in Japan. In addition to constitution and drug metabolism, attitude of Japanese people to worry side effects more than merit with beneficial effects by a drug may have inevitably lead to low maintenance dose. Development of new drugs have been undertaken in parallel with US and Europe. Talipexole hydrochloride has been on market in Japan recently, but MAO-B inhibitors and COMT inhibitors are in final stages to wait evaluations by the governmental committee.
Yanagisawa
N
N
Department of Medicine (Neurology), Shinshu University School of Medicine.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001381:Azepines; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D018491:Dopamine Agonists; D005260:Female; D006801:Humans; D007223:Infant; D007564:Japan; D007980:Levodopa / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D008996:Monoamine Oxidase Inhibitors; D010300:Parkinson Disease / Q000188:drug therapy / Q000453:epidemiology
D001381:Azepines; D018491:Dopamine Agonists; D008996:Monoamine Oxidase Inhibitors; D007980:Levodopa; C024763:talipexole