如果这个理论是正确的，对帕金森病的认知就会彻底颠覆

Core Insights - Increasing evidence suggests that Parkinson's disease, the fastest-growing neurological disorder globally, may be divided into two distinct types: one originating in the brain and the other starting in the body and progressing to the brain [1][6][7] - This new understanding of the disease could lead to urgently needed new therapies [1][7] Group 1: Disease Understanding - Rapid Eye Movement Sleep Behavior Disorder (RBD) is a common sleep disorder that often precedes Parkinson's disease, with many patients experiencing RBD before diagnosis [2][5] - Research indicates that Parkinson's disease affects not only brain neurons but also those in the heart that control autonomic functions like heart rate and blood pressure [4][10] - The theory of "brain-first" and "body-first" Parkinson's disease was proposed, suggesting that the disease can start in different locations within the body [6][17] Group 2: Disease Prevalence and Impact - The incidence of Parkinson's disease is expected to rise dramatically, with projections indicating that by 2050, the number of global patients could reach 25.2 million, more than double the nearly 12 million in 2021 [8] - The disease is increasingly being referred to as an "epidemic" due to its rapid growth and the lack of effective treatments [8] Group 3: Research and Theories - The hypothesis that Parkinson's disease may originate from the gut and spread to the brain has gained support, with studies showing that misfolded alpha-synuclein proteins can be found in the gut and may contribute to the disease [14][22] - Research teams have found that patients with RBD show more significant loss of neurons in the heart and gut compared to those with only Parkinson's disease, suggesting a different progression pathway [16][22] Group 4: Clinical Implications - The two types of Parkinson's disease exhibit different clinical symptoms, with "body-first" patients more likely to experience autonomic dysfunction before motor symptoms, while "brain-first" patients show motor symptoms from the onset [24][25] - Understanding these differences could lead to new treatment pathways, focusing on molecular, genetic, or cellular differences as potential therapeutic targets [28][34] Group 5: Treatment Innovations - Current research is exploring the relationship between gut microbiota and Parkinson's disease symptoms, with findings indicating that certain gut bacteria may influence the disease's progression [29][30] - Fecal microbiota transplantation (FMT) has shown promise in reducing the dosage of traditional Parkinson's medication needed by patients, suggesting a potential new treatment avenue [32][34]