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The National Institute of Mental Health and Neuro Sciences (NIMHANS) is concerned on the early onset of Parkinson’s disease in the wake of lack of drugs, expensive therapy options and no medical insurance access to treat the condition which is seen to affect the productive age group at 45 years.
We have been doing research in NIMHANS on Parkinson’s disease for the last 30 years which covers different aspects of genetics and clinical pathogens. We are constantly intrigued by the fact that whatever western data is available, they are not talking about the age of the patient but the age of onset of the PD. In our country, the onset of Parkinson's disease, in the younger age, is in the less than 45 years of age. Now, probably this is a genetic cause, there could be underlying genetic mechanisms which cause patients to develop earlier symptoms. There is a loss of dopamine in the brain’s nigrostriatal pathway, Prof.Pramod Kumar Pal, Professor, Department of Neurology at NIMHANS, told Pharmabiz.
This led us to undertake a clinical trial which has been published in ‘Parkinsonism and Related Disorders’. Our study sample is by far the largest with 2,035 patients who have been diagnosed and undergoing treat at our facility which is the neurology out patient department and Movement Disorder Clinic.
The study revealed that of the 550 women who were part of the clinical trial indicated that female patients manifested the disorder early in their life with tremors and rigidity, he added.
This calls for the need for not just new drugs to treat the condition, but the requirement for a lot of social support and economical assistance, specifically for the onset of Parkinson's disease in the younger age-group particularly. This segment of patients may have different types of manifestation indicating a lot of motor fluctuations and varied response to the medications. Either they respond well to medicine or might develop psychotic problems, sometimes what is an impulse control disorder or have lots of anxiety, depression, which they pass on to their caregivers or spouses. Now for those young employed patients there are also a lot of problems as it could take them away from the job and will not be able to return to work, Dr Pal noted.
We have now recently coming across some facts like that the medical insurance companies do not want to give any insurance to this category of patients. Therefore people need to be aware and the advocacy has to be done, said Dr Pal.
Among the treatment options there is deep brain simulation which is which is very expensive in India as is at least it costs Rs. 6 lakh in our hospital. Even the rechargeable battery needs to be made easily available and affordable to the patient. Those having early onset Parkinson's, patients have a long way to go as many of the cases survive for 20 years. So, there is an economic burden for the society. Therefore it is important for the government to take cognisance of the Parkinson disease onset among the younger age group and focus on medical –monetary support systems, said Dr Pal.
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