Hallym University Kangnam Sacred Heart Hospital

*Dr. Yun Joong Kim (left) and Dr. Lars Lannfelt share views on Parkinson's disease.

Alzheimer's disease and Parkinson's disease are prototypes of neurodegenerative disorders caused by progressive neuronal cell deaths. It has been reported that about half of the dementia is caused by Alzheimer's disease and one percent of the elderly population over 60-years-old have Parkinson's disease. The Chosun Ilbo met Dr. Lars Lannfelt of Uppsala University and Dr. Yun Joong Kim of Hallym University who attended 1st Hallym-Uppsala International Symposium held in Lotte Hotel World in Seoul on October 9, 2008. Dr. Kim recently reported a susceptibility allele for Parkinson's disease among Koreans.

-Why are patients with neurodegenerative diseases like Parkinson's disease and Alzheimer's disease increasing?

Dr. Lannfelt: I would say it is because the life span of the human beings has increased. Increased recognition of neurodegenerative diseases due to remarkable improvement of imaging techniques and diagnostic accuracy have also contributed to increase of prevalence of neurodegenerative diseases. In Sweden, the press also plays a role in heightening the awareness of those neurodegenerative diseases to the public, and people visit hospitals at an early stage of the disease.

Dr. Kim: Unfortunately, we do not have accurate data on the prevalence of Alzheimer's disease or Parkinson's disease in the Korean population. However, in Korea it is quite sure that those patients are underdiagnosed or diagnosed in an advanced stage of the diseases. Therefore, treatment is usually delayed.

-An early diagnosis of the neurodegenerative diseases is not easy. What efforts have been exerted for early diagnosis?

Dr. Lannfelt: For the diagnosis of Alzheimer, a biochemical analysis of the CSF or imaging techniques of the brain has been developed.

Dr. Kim: Recently it has been found that those neurodegenerative diseases start much earlier than the patients become symptomatic. Mild cognitive impairment in Alzheimer's disease and REM-sleep behavior disorders in Parkinson's disease are admitted as an early or preclinical stage of those diseases.
-Why is research on genetic important?

Dr. Kim: It is impossible to reverse symptoms or stop disease progression in neurodegenerative disorders now. We expect that results on genetics research will provide clues to develop disease-modifying treatment. The result of G2385R polymorphism of LRRK2 on the risk for PD in our population is important because by controlling environment factors interacting with the allele we expect that the risk for Parkinson disease can be reduced in the future.

Dr. Lannfelt: Discovery of protein related to the disease can be a clue for the new drugs. I expect that the results on protofribil of beta-amyloid as a toxic species in Alzheimer's disease will be a breakthrough in the development of new drugs.

- Is there any preventive measures for the neurodegenerative diseases?

Dr. Lannfelt: Unfortunately, no. However, given that Alzheimer's disease is more common among boxers, we should avoid head injury. Although neurodegenerative diseases are neither preventable nor treatable, we do not have to be disappointed too much. With early diagnosis and proper management, leading a normal life is possible.

Dr. Kim: Among patients with Alzheimer's disease, cerebrovascular pathology is common. It is also known that stroke also increases the risk for Alzheimer's disease. Therefore controlling risk factors for stroke such as hypertension and diabetes will be helpful in prevention of Alzheimer's disease.

Note> Alzheimer's disease: A progressive neurodegenerative disease caused by accumulation of abnormal protein (beta amyloid or tau protein) in the brain and neuronal cell loss. Fifty percent of the dementia is caused by Alzheimer's diseases.

Parkinson's disease: A neurodegenerative disease caused by deficiency of dopamine in the midbrain. Parkinson's disease is characterized by tremor and slowness of movement. Two out of ten Parkinson's disease patients have dementia.

By Seung-Kyu Oh, Int'l Operations Team, HUMC