Hopp til hovedinnhold

Parkinsons sykdom (PS)

Sist revidert:
Sist revidert av:
Definisjon:
En progressiv, nevrodegenerativ dopaminmangelsykdom med gradvis symptomutvikling som responderer på dopaminerg behandling
Forekomst:
Prevalens er ca. 1% i aldersgruppen > 65 år i Norge
Symptomer:
Kardinalsymptomene er brady-/akinesi, hviletremor, rigiditet og postural instabilitet. Andre symptomer kan være søvnproblemer, depresjon, psykose, demensutvikling, impulskontrollforstyrrelser
Funn:
Sentrale kliniske funn er hviletremor, rigiditet, akinesi og postural instabilitet
Diagnostikk:
Kliniske diagnostiske kriterier. Tilleggsundersøkelser har mest betydning for vurdering av differensialdiagnostikk
Behandling:
Egenbehandling, fysioterapi, medikamentell behandling med levodopa; ev. COMT-hemmer, MAO-B-hemmer og/eller dopaminagonist. Behandling av komorbiditet
  • Nasjonal kompetansetjeneste for bevegelsesforstyrrelser (NKB) - nettside 
  1. Mygland Å, et al. Parkinsons sykdom. NEL Nevrologi. Sist revidert 07.11.2017. Sist oppdatert 28. okt. 2022. nevrologi.legehandboka.no  
  2. GBD 2016 Neurology Collaborators. Global, regional, and national burden of neurological disorders, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019. May;18(5):459–480. PMID: 30879893 PubMed  
  3. Tolosa E, Garrido A, Scholz SW, Poewe W. Challenges in the diagnosis of Parkinson's disease. Lancet Neurol. 2021;20(5):385-397. PubMed  
  4. Zhang Q, Chen W, Tan S, Lin T. Stem Cells for Modeling and Therapy of Parkinson's Disease. Hum Gene Ther 2017; 28(1): 85-98. pmid:27762639 PubMed  
  5. Armstrong MJ, Okun MS. Diagnosis and Treatment of Parkinson Disease: A Review. JAMA. 2020;323(6):548-560. PubMed  
  6. Parkinson J. An essay on the shaking palsy. London: Whittingham and Rowland, 1817. archive.org  
  7. Bega D. Parkinson's disease. BMJ Best Practice. Last updated 02.07.2018. bestpractice.bmj.com  
  8. Hawkes CH, Del Tredici K, Braak H. A timeline for Parkinson's disease. Parkinsonism Relat Disord 2010;16(2):79-84. PubMed  
  9. Espay AJ, Okun MS. Abandoning the Proteinopathy Paradigm in Parkinson Disease. JAMA Neurol 2023; 80: 123-124. doi:10.1001/jamaneurol.2022.4193 DOI  
  10. Jankovic J. Etiology and pathogenesis of Parkinson disease. UpToDate, last updated Dec 21, 2021. UpToDate  
  11. Blauwendraat C, Nalls MA, Singleton AB. The genetic architecture of Parkinson’s disease. Lancet Neurol. 2020;19(2):170–178. PMID: 31521533 PubMed  
  12. Sidransky E, Nalls MA, Aasly JO, et al. Multicenter analysis of glucocerebrosidase mutations in Parkinson's disease. N Engl J Med 2009; 361(17): 1651-61. Pmid: 19846850 PubMed  
  13. Kenborg L, Rugbjerg K, Lee PC, Ravnskjær L, Christensen J, Ritz B, Lassen CF. Head injury and risk for Parkinson disease: results from a Danish case-control study. Neurology. 2015 Mar 17;84(11):1098-103. PubMed  
  14. Goldman SM, Quinlan PJ, Ross GW, et al. Solvent exposures and Parkinson disease risk in twins. Ann Neurol 2012; 71(6): 776-84. pmid:22083847 PubMed  
  15. Schrag A, Bohlken J, Dammertz L, et al. Widening the Spectrum of Risk Factors, Comorbidities, and Prodromal Features of Parkinson Disease. JAMA Neurol. Published online November 07, 2022. PMID: 36342675 PubMed  
  16. Jiang W, Ju C, Jiang H, Zhang D. Dairy foods intake and risk of Parkinson's disease: a dose-response meta-analysis of prospective cohort studies. Eur J Epidemiol. 2014 Sep;29(9):613-9. Epub 2014 Jun 4. PMID: 24894826. PubMed  
  17. Jankovic J, Tan EK. Parkinson's disease: etiopathogenesis and treatment. J Neurol Neurosurg Psychiatry 2020; 91:795. PubMed  
  18. Shen C, Guo Y, Luo W, et al. Serum urate and the risk of Parkinson's disease: results from a meta-analysis. Can J Neurol Sci 2013; 40(1): 73-9. pmid:23250131 PubMed  
  19. Postuma RB, Berg D, Stern M, et al. MDS clinical diagnostic criteria for Parkinson's disease. Mov Disord 2015; 30(12): 1591-601. pmid:26474316 PubMed  
  20. Dietrichs E, Alves G, Benjaminsen E, et al. Behandling av motoriske symptomer ved Parkinsons sykdom. Tidsskr Nor Legeforen 2023. doi: 10.4045/tidsskr.22.0804 DOI  
  21. Chou KL. Diagnosis and differential diagnosis of Parkinson disease. UpToDate. Sist oppdatert 05.09.2018. www.uptodate.com  
  22. Erro R, Picillo M, Vitale C, Amboni M, Moccia M, Santangelo G, Pellecchia MT, Barone P.. The non-motor side of the honeymoon period of Parkinson's disease and its relationship with quality of life: a 4-year longitudinal study. Eur J Neurol. 2016 Nov;23(11):1673-1679 . pmid:27435448 PubMed  
  23. Scott BM, Eisinger RS, Burns MR, et al. Co-occurrence of apathy and impulse control disorders in Parkinson disease. Neurology. 2020; 95(20) :e2769-e2780. PMID: 33004605 PubMed  
  24. Egan SJ, Laidlaw K, Starkstein S. Cognitive Behaviour Therapy for Depression and Anxiety in Parkinson's Disease. J Parkinsons Dis 2015; 5(3): 443-51. pmid:26406124 PubMed  
  25. Hiort YH, Pedersen KF, Dalen I, et al. Orthostatic hypotension in Parkinson disease A 7-year prospective population-based study. Neurology 2019; 93: 1526-34. pmid:31527282 PubMed  
  26. Marek K, Seibyl J, Eberly S, Oakes D, Shoulson I, Lang AE, Hyson C, Jennings D; Parkinson Study Group PRECEPT Investigators. Longitudinal follow-up of SWEDD subjects in the PRECEPT Study. Neurology. 2014 May 20;82(20):1791-7 . pmid:24759846 PubMed  
  27. Berardelli A, Wenning GK, Antonini A, et al. EFNS/MDS-ES/ENS corrected recommendations for the diagnosis of Parkinson's disease. Eur J Neurol 2013; 20(1): 16-34. pmid:23279440 PubMed  
  28. Ferreira JJ, Katzenschlager R, Bloem BR, et al. Summary of the recommendations of the EFNS/MDS-ES review on therapeutic management of Parkinson's disease. Eur J Neurol 2013; 20(1): 5-15. pmid:23279439 PubMed  
  29. Bahr R, Karlsson J, Ståhle A, et al. Aktivitetshåndboken (IS-1592): Kap. 36: Parkinsons sykdom. Fagbokforlaget: Helsedirektoratet, 2009. helsedirektoratet.no  
  30. Tambosco L, Percebois-Macadré L, Rapin A, et al. Effort training in Parkinson's disease: a systematic review. Ann Phys Rehabil Med. 2014 Mar;57(2):79-104. PMID: 24582335 PubMed  
  31. Uhrbrand A, Stenager E, Pedersen MS, et al. Parkinson's disease and intensive exercise therapy - a systematic review and meta-analysis of randomized controlled trials.. J Neurol Sci. 2015; 353(1-2): 9-19. pmid:25936252 PubMed  
  32. Shu HF, Yang T, Yu SX, et al. Aerobic exercise for Parkinson's disease: a systematic review and meta-analysis of randomized controlled trials.PLoS One. 2014 Jul 1;9(7):e100503. PMID: 24983753. PubMed  
  33. Roeder L, Costello JT, Smith SS, et al. Effects of Resistance Training on Measures of Muscular Strength in People with Parkinson's Disease: A Systematic Review and Meta-Analysis. PLoS One 2015. pmid:26146840 PubMed  
  34. Mehrholz J, Kugler J, Storch A, et al. Treadmill training for patients with Parkinson's disease. Cochrane Database Syst Rev. 2015 Aug 22;8:CD007830. DOI: 10.1002/14651858.CD007830.pub4 DOI  
  35. Espay AJ, LeWitt PA, Hauser RA, et al. Neurogenic orthostatic hypotension and supine hypertension in Parkinson's disease and related synucleinopathies: prioritisation of treatment targets.. Lancet Neurol. 2016 Aug;15(9):954-66. pmid:27478953 PubMed  
  36. Tarsy D. Pharmacologic treatment of Parkinson disease. UpToDate. Literature review current through: Oct 2018. Topic last updated: Jul 10, 2018. www.uptodate.com  
  37. Garcia-Ruiz PJ. Impulse Control Disorders and Dopamine-Related Creativity: Pathogenesis and Mechanism, Short Review, and Hypothesis. Front Neurol. 2018;9:1041. Published 2018 Dec 6. PMID: 30574117 PubMed  
  38. Grall-Bronnec M, Victorri-Vigneau C, Donnio Y, et al. Dopamine Agonists and Impulse Control Disorders: A Complex Association. Drug Saf. 2018;41(1):19-75. PMID: 28861870 PubMed  
  39. Garcia-Ruiz PJ, Martinez Castrillo JC, Alonso-Canovas A, et al. Impulse control disorder in patients with Parkinson's disease under dopamine agonist therapy: a multicentre study. J Neurol Neurosurg Psychiatry. 2014; Aug;85. pmid:24434037 PubMed  
  40. Spindler MA, Hurtig HI. Initial pharmacologic treatment of Parkinson disease. UpToDate, last updated Nov 20, 2019. UpToDate  
  41. Aradi SD, Hauser RA. Medical Management and Prevention of Motor Complications in Parkinson's Disease. Neurotherapeutics. 2020;17(4):1339-1365. PubMed  
  42. Watts RL, Jankovic J, Waters C, Rajput A, Boroojerdi B, Rao J. Randomized, blind, controlled trial of transdermal rotigotine in early Parkinson disease. Neurology 2007; 68: 272-6. Neurology  
  43. Odin P, Ray Chaudhuri K, Slevin JT, et al. National Steering Committees. Collective physician perspectives on non-oral medication approaches for the management of clinically relevant unresolved issues in Parkinson's disease: Consensus from an international survey and discussion program. Parkinsonism Relat Disord. 2015 Oct;21(10):1133-44. pmid:26233582 PubMed  
  44. Vitek JL, Jain R, Chen L, et al. Subthalamic nucleus deep brain stimulation with a multiple independent constant current-controlled device in Parkinson's disease (INTREPID): a multicentre, double-blind, randomised, sham-controlled study. Lancet Neurol 2020; 19:491. PMID: 32470421 PubMed  
  45. Lilleeng B, Gjerstad M, Baardsen R, et al. The long-term development of non-motor problems after STN-DBS. Acta Neurol Scand. 2015 Oct;132(4):251-8. pmid:25752590 PubMed  
  46. Martinez-Fernandez R, Pelissier P, Quesada JL, et al. Postoperative apathy can neutralise benefits in quality of life after subthalamic stimulation for Parkinson's disease. J Neurol Neurosurg Psychiatry 2016; 87(3): 311-8. pmid:25934016 PubMed  
  47. Seppi K, Ray Chaudhuri K, Coelho M et al. The collaborators of the Parkinson's Disease Update on Non-Motor Symptoms Study Group on behalf of the Movement Disorders Society Evidence-Based Medicine Committee. Update on treatments for nonmotor symptoms of Parkinson's disease-an evidence-based medicine review. Mov Disord. 2019 Feb;34(2):180-198. doi: 10.1002/mds.27602. Epub 2019 Jan 17. Erratum in: Mov Disord. 2019 May;34(5):765. PMID: 30653247 PubMed  
  48. Richard IH, McDermott MP, Kurlan R, et al. A randomized, double-blind, placebo-controlled trial of antidepressants in Parkinson disease. Neurology 2012; : 10.1212/WNL.0b013e3182516244.
  49. Rodnitzky RL. Cognitive impairment and dementia in Parkinson disease. UpToDate, last updated Apr 15, 2020. UpToDate  
  50. Pagano G, Rengo G, Pasqualetti G, et al. Cholinesterase inhibitors for Parkinson`s disease: a systematic review and meta-analysis. J Neurol Neurosurg Psychiatry. 2015 Jul;86(7):767-73. Pmid: 25224676.
  51. Nasjonal faglig retningslinje om demens. Helsedirektoratet. Utgitt 18.08.2017. IS-2658. V3.1 publisert 17.12.2017. helsedirektoratet.no  
  52. Stefani A, Högl B. Sleep in Parkinson's disease. Neuropsychopharmacology. 2020;45(1):121-128. PubMed  
  53. Ylikoski A, Martikainen K, Sarkanen T, Partinen M. Parkinson's disease and narcolepsy-like symptoms. Sleepmedicine. Published Online: January 23, 2015 . doi:http://dx.doi.org/10.1016/j.sleep.2014.12.010
  54. Asahina M, Vichayanrat E, Low DA, et al. Autonomic dysfunction in parkinsonian disorders: assessment and pathophysiology. J Neurol Neurosurg Psychiatry 2013; 84: 674-80. PMID: 22942216 PubMed  
  55. Pena JIbarretxe-Bilbao NGarcia-Gorostiaga I, et al. Improving functional disability and cognition in Parkinson disease: Randomized controlled trial. Neurology. 2014 Oct 31. pii: 10.1212/WNL.0000000000001043 .
  56. Ascherio A, Schwarzschild MA. The epidemiology of Parkinson's disease: risk factors and prevention. Lancet Neurol 2016; 15(12): 1257-1272. pmid:27751556 PubMed  
  57. Leung IH, Walton CC, Hallock H, et al. Cognitive training in Parkinson disease: A systematic review and meta-analysis. Neurology 2015. PMID: 26519540 PubMed  
  58. Dahm, K. Reinar, L M. Effekten av fysioterapi for pasienter med Parkinsons sykdom. Rapport fra Kunnskapssenteret nr 21 - 2009.
  59. Kordower JH. Gene therapy for Parkinson's disease: still a hot topic?. Neuropsychopharmacology 2015; 40(1): 255-6. pmid:25482182 PubMed  
  60. Morizane A, Takahashi J. Cell therapy for Parkinson's disease. Neurol Med Chir (Tokyo) 2016; 56(3): 102-109. pmid:26912295 PubMed  
  61. Liebert A, Bicknell B, Laakso EL, et al. Improvements in clinical signs of Parkinson's disease using photobiomodulation: a prospective proof-of-concept study. BMC Neurol. 2021 Jul 2;21(1):256. PMID: 34215216 PubMed  
  62. Fox SH, Katzenschlager R, Lim SY, et al. International Parkinson and movement disorder society evidence-based medicine review: Update on treatments for the motor symptoms of Parkinson's disease. Mov Disord 2018 Aug; 33(8): 1248-1266. pmid:29570866 PubMed  
  63. Hu XW, Qin SM, Li D, et al. Elevated homocysteine levels in levodopa-treated idiopathic Parkinson's disease: a meta-analysis. Acta Neurol Scand 2013; 128(2): 73-82. pmid:23432663 PubMed  
  64. Williams-Gray CH, Mason SL, Evans JR, et al. The CamPaIGN study of Parkinson`s disease: 10-year outlook in an incident population-based cohort. J Neurol Neurosurg Psychiatry. 2013 Jul 23. PMID: 23781007. PubMed  
  65. Morgan JC, Currie LJ, Harrison MB, et al. Mortality in levodopa-treated Parkinson's disease. Parkinsons Dis 2014; 2014: 426976. pmid:24616821 PubMed  
  • Terje Johannessen, professor i allmennmedisin, Trondheim
  • Rune Midgard, spesialist i nevrologi, Molde

Tidligere fagmedarbeidere

  • Einar Einarsen, spesialist i allmennmedisin, Helgeland Rehab, Sømna
  • Espen Dietrichs, professor og avdelingsoverlege, Universitetet i Oslo og Nevrologisk avdeling, Rikshospitalet, Oslo