Basal Ganglia 2 Flashcards
Supportive evidence for a Parkinson’s diagnosis is responsiveness to
Levodopa
Cell death in the Substantia Nigra is characteristic of
Parkinson’s Disease
The degree of cell death in the substantia nigra corrlates to the
Severity of symptoms
Neurons in the SubstantiaNigraof persons with PD contain
Lewy Bodies
Spherical masses within the cell body that contain abnormal aggregations of proteins: primarily α-synuclein, a cytosol protein found in many regions of the brain
Lewy Bodies
Normally involved in vesicle transport
α-synucleinis
What are the effects of dopamine loss on the:
- ) Direct Pathway
- ) Indirect Pathway
- ) Decreases facilitation of direct pathway
- ) Decrease inhibition of the indirect pathway
BOTH LESSEN MOVEMENT
What are three pharmacologic treatments for PD?
Dopamine agonists (L-DOPA), MAO inhibitors, Anticholinergics
Precursor for dopamine that crosses the blood brain barrier
L-Dopa
Cause a “honeymoon period” at first and then have on-off affects
-Can cause pathological gambling
Pharmaceutical treatments for PD
Used for advanced PD, or with L-dopa induced dyskinesia
Deep-brain stimulation
Most common surgical approach to PD. Thought to suppress excessive activity. For advanced and drug-resistant PD
Deep Brain Stimulation
Stimulated with deep-brain stimulation for the PD symptoms bradykinesia, rigidity, and tremor
GPi or Subthalamic nucleus
Stimulated by deep-brain stimulation for the tremor
VL
Is both neuroprotective and neurorestorative (after lesions) in PD patients
Exercise
Caused by stroke, tumor, infection, and exposure to toxins such as carbon monoxide or manganese
Secondary Parkinsonism
Also caused by dopamine-blocking agents such as anti-psychotics agents (anti-DA), and drugs used to treat gastrointestinal problems (metoclopramide and chlorperazine)
Secondary Parkinsonism
Other primary neurodegenerative syndromes that share characteristics of PD
Parkinsonism Plus Syndromes
Characterized by
- Lackof resting tremor
- Symmetrical symptoms 3.Early postural instability
- Lack of response to dopamine
Parkinsonism Plus Syndromes
Studies on Diagnostic Accuracy for PD show the clinical diagnosis is about
80%
Most common form of atypical Parkinsonism
Progressive Supranuclear Palsy
Neurodegenerative disorder that affects the ROSTRAL midbrain
Progressive Supranuclear Palsy
Distinguished from PD by imbalance, and trunk rigidity (vs limb rigidity in PD)
Progressive Supranuclear Palsy
Decreased range of vertical eye movement is often the first sign of
Progressive Supranuclear Palsy
Characteristic mouse-ears appearance secondary to cell loss in dorsal midbrain
Progressive Supranuclear Palsy
Progressive Supranuclear Palsy shows some relief from
-not a strong response
Dopaminergic therapies
Loss of striatal neurons and dopaminergic neurons in the substantia nigra pars compacta
Nigrostriatal Degeneration
Because striatal neurons are lost in Nigrostriatal degeneration, has no effect in treatment
Dopamine
Adult onset neurodegenerative syndromes characterized by Parkinsonism
Multiple System Atrophy
Nigrostriatal Degeneration is one type of
Multiple System Atrophy
Tremor unlikely, but not at rest, irregular and postural.
– Symmetrical onset more likely.
– Limited response to DA
Nigrostriatal degeneration
