DATE
October 13, 2023
CATEGORY
Blog
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Neurological conditions impact millions of people globally, causing disability and premature deaths. These are disorders that affect the nervous system, including the brain, spinal cord, and nerves and can manifest in diverse ways. They encompass a wide range of disorders, including Alzheimer’s disease, Parkinson’s disease, dementia, and epilepsy. Although some progress has been made in terms of treatments in the developed world, the MENA region is still trailing in finding ways to manage these debilitating conditions.
Research and data published mostly focus on the populations within high-income countries in Europe and North America. They fail to represent regions, such as the Middle East, North Africa, and South Asia, where, due to various cultural and socioeconomic situations, movement disorders such as Parkinson’s disease are neglected and treatment landscapes are underdeveloped and underserved.
Parkinson’s disease (PD) is a major neurological disease characterized by severe locomotor impairments, including bradykinesia, tremor, and rigidity. It occurs when nerve cells in the brain, specifically in an area called the substantia nigra, become damaged or die, which produces a brain chemical known as dopamine that is important for controlling movement. The cause of Parkinson’s disease remains unknown, but it has long been hypothesized that exposure to environmental risk factors may be one cause, along with an inherited susceptibility. Further, age is the biggest risk factor for Parkinson’s disease, with the median age of onset being 60. It is the second most occurring neurological condition worldwide; however, its prevalence varies in different countries due to the cultural, lifestyle, genetic, healthcare system, and other differences. Research has revealed that with a rapidly growing elderly population across the MENA region, the prevalence of Parkinson’s disease will escalate in the coming years.
Burden of Parkinson’s Disease in the MENA Region
Epidemiology studies are crucial in determining the disease burden and estimating the prevalence of Parkinson’s disease. A global burden study by Safiri et al. (2019) revealed an age-standardized point prevalence of 82.6 per 100,000 population and a death rate of 5.3 in the MENA region for Parkinson’s disease, showing an increase from 1990 to 2019 by 15.4% and 2.3%, respectively. The three countries with the highest estimated age-standardized point prevalence of Parkinson’s disease in 2019 were Qatar (119.3), the United Arab Emirates (116.0) and Oman (112.5). Yemen (63.6), Afghanistan (69.3), and Sudan (69.7) had the three lowest rates, likely due to scarcity of data. Another study by Moradinazar et al. (2023), utilizing the global burden study from 1990 to 2019, reported that the overall prevalence rate of Parkinson’s disease in the MENA region increased by 1.36%.
There are only a few global studies that talk about the epidemiology scenario, burden, and clinical manifestations of Parkinson’s disease in the MENA region. These studies fail to consider regional-specific patterns, including the age of onset, the occurrence of motor fluctuations, cognitive dysfunction, and rates of impulse control disorders. Exogenous factors, such as regional differences in the availability and use of Parkinson’s disease medications, add to the heterogeneity of Parkinson’s disease across treatment locales.
Clinical Diagnosis and Management Scenario of Parkinson’s Disease
At present, there is no definitive test for Parkinson’s disease; however, there are various symptoms and diagnostic tests used in combination. Making an accurate diagnosis of Parkinson’s – particularly in its early stages – is difficult and requires skilled practitioners.
The current treatment landscape consists of several medications, although none reverse the effects of the disease. Levodopa is the gold standard for treating motor symptoms; besides other medications belonging to the classes MAO-B inhibitors, COMT inhibitors, amantadine, anticholinergics, and adenosine A2A antagonists are also used. The goal of these medications is to lessen motor symptoms or the symptoms that affect movement in people with Parkinson’s disease. It is common for people with the disease to take various Parkinson’s disease medications – all at different doses and at different times of day – to manage symptoms.
Most patients receive care at either general neurology or general medicine clinics. While basic care and medication are available, more sophisticated treatments for advanced diseases, such as interventional therapies for advanced Parkinson’s disease, health infrastructures, screening programs, and early detection, are lacking due to limited funding, education, and resources.
Unveiling the Gaps and Unmet Needs of Parkinson’s Disease in the MENA Region
With the prevalence and burden of Parkinson’s disease is rising, it has become a prime concern in less developed regions. Recognizing the major gaps and unmet needs is imperative to tackle this increasing burden and to prioritize research and public health policies to alleviate this problem.
Recently, the International Parkinson and Movement Disorder Society (MDS) operated a Middle East task force survey to identify the unmet needs of Parkinson’s disease in the MENA region. The following factors were identified as the major unmet needs in the MENA region:
- The need for more movement disorder specialists
- Establishing multidisciplinary care
- Requirement for accurate epidemiologic data
- Implementing educational programs
- Availability of drugs and advanced therapies
- Well-developed healthcare resources and infrastructure
- An increased level of awareness among the general population and healthcare professionals.
Initiatives That Could Reduce the Burden of Parkinson’s Disease in the Future
As per the WHO, global disability and death due to Parkinson’s disease are rapidly increasing. In May 2022, the World Health Assembly endorsed the Intersectoral global action plan on epilepsy and other neurological disorders 2022–2031. The action plan has been adopted to address the challenges and gaps in providing care and services for people with Parkinson’s and other neurological disorders worldwide.
Based on the survey conducted, the International Parkinson and Movement Disorder Society (MDS) Task Force for the Middle East suggested initiatives for increasing awareness and providing educational opportunities. A Middle East Working Group (MEWG) has been created to provide a forum for discussion of movement disorder topics of interest for Middle East members and to direct education efforts when assigned by the Asian and Oceanian Leadership.
These crucial steps taken by organizations could be a major factor in development. Further, addressing the Parkinson’s disease unmet needs requires concerted efforts from healthcare professionals, governmental bodies, non-profit organizations, patient advocacy groups, and the broader community. Planning and implementing programs to support the elderly, improving regional access to care facilities and treatments, allocating more resources for research to understand the underlying risk factors, and developing Parkinson’s disease therapies would greatly reduce the disease burden in the MENA region.
Source: Delveinsight http://www.delveinsight.com/