11.13 Parkinson-Plus Syndromes Flashcards
What are some red flags that indicate a dx other than PD?
- Early postural instability/abn postures
- rapid progression
- respiratory dysfunction
- labile
- signs of cerebellar, corticospinal, voluntary gaze dysfunction
What IS Parkinson-Plus?
Collective name for primary neurodegenerative dz that causes s/s similar to PD
What are the Parkinson-Plus syndromes?
- Progressive supranuclear palsy
- Dementia with Lewy bodies
- Multiple system atrophy
- CTE
Which of the Parkinson-plus syndromes is associated with accumulation of tau?
Progressive supranuclear palsy
CTE =
Chronic
Traumatic
Encephalopathy
What is CTE caused by?
Repetitive head injuries (concussions)
What are the common non-motor changes seen with CTE?
- Mood changes
- Depression
- Cognitive issues
What sort of physiological changes come about with CTE?
- atrophy of cerebral hemispheres with brain volume loss
- Eventually affects the amygdala and hippocampus
How does a diffuse axonal injury occur and what does it affect?
- Shockwave from head trauma goes through the brain (connection between cell bodies and axons)
- Affects all neurons in the cortex
- Get shearing of axons away from cell bodies
What happens when there is shearing of axons from cell bodies in the CNS? How does this kill neurons?
GLUTAMATE CASCADE
- kills neurons via excitotoxicity
- CNS white matter forms a scar
Why is a scar in the CNS white matter problematic?
- axons can’t cross the scar
- get lots of inflammation
What does CTE cause the accumulation of?
Tau (hyperphosphorylation)
Dementia is a late presentation of this Parkinson-plus syndrome
Lewy body dementia
What is accumulated in Lewy body dementia?
Insoluble phosphorylated alpha-synuclein proteins all over the brain
Alpha-synuclein is (intracellular/extracellular)
Intracellular
