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Neuro Rehab > Basal ganglia disorders > Flashcards

Basal ganglia disorders Flashcards

1
Q

Huntington Disease (HD)

A

ages the indirect pathway (no brakes!)
Autosomal dominant; age of onset is 3rd to 4th decade

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2
Q

Huntington Disease (HD) impairments

A

Chorea, oculomotor problems, dystonia, ataxia, dysarthria, dysphagia, cognitive issues

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3
Q

Parkinson Disease (PD)

A

Damages the direct pathway (no accelerator!)
Symptoms develop after age 50 years

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4
Q

Parkinson Disease (PD) impairments

A

Bradykinesia, cogwheel rigidity, postural instability, poor balance, poor coordination, depression, cognitive issues

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5
Q

neurotransmitter for Cortical motor areas produce excitation of the striatum

A

Glutamate

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6
Q

neurotransmitter for Substantia nigra to the striatum adjusts the signals to the output nuclei

A

dopamine

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7
Q

Basal ganglia inhibits 3 areas:

A

Motor thalamus, Pedunculopontine tegmental nucleus (PPN) and midbrain locomotor region

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8
Q

Basal ganglia chart

A
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9
Q

•Loss of dopamine to putamen causes

A
  • Reduces activity in motor areas of the cerebral cortex
  • Decreases voluntary movements
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10
Q

Loss of acetylcholine-producing cells in PPN disinhibits the reticulospinal tracts

A

•Excessive contraction of postural muscles

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11
Q

Toxic Parkinsonism

A

Agent orange, pesticides, permethrin, CO, synthetic heroin MPTP

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12
Q

Rigidity

A

increased muscle tone with resistance to passive stretch

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13
Q

Cogwheel Rigidity

A

your muscle will be stiff, like in other forms of rigidity. But you might also have tremors in the same muscle when it’s at rest.

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14
Q

Festinating gait

A

decrease in step length and heel strike resulting in small steps and shuffling

INCREASED step cadence

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15
Q

Freezing gait

A

abrupt stopping of movement without intention to do so

Often triggered by visual stimuli

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16
Q

Resting tremor

A

involuntary, rhythmic shaking movement

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17
Q

Bradykinesia

A

slowed bodily movements; including slowed alternating movements such as finger tapping, making a fist, hand dexterity, and gait

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18
Q

Hypokinesia

A

less movement: often seen in facial expressions

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19
Q

Diagnosis requires 2 of 4 cardinal features

A

Tremor

Rigidity

Akinesia (hypokinesia and bradykinesia)

Postural instability/impaired balance or coordinationSubtle onset; including flexed posture of head, shoulders, and hips

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20
Q

Basal Ganglia Loops

A

Motor Channel, Oculomotor channel, Emotional/Limbic Channel

21
Q

Motor Channel associated with

A

movement in both PD and HD

22
Q

Oculomotor channel associated with

A

regulation of eye movements

23
Q

Emotional/Limbic Channel

A

limbic cortex, hippocampal, and amygdala connections

24
Q

Prefrontal Channel

A

cognition

25
Q

Stage 1 Parkinson’s impacts in CNS

A
  • Lesions in the olfactory bulb, dorsal IX/X nucleus of brainstem
  • Decreased smell and taste
26
Q

Stage 2 Parkinson’s impacts in CNS

A
  • Lesions in pontine tegmentum (locus coeruleus, reticular formation, raphe nuclei)
  • Alertness, posture, awareness of environment
27
Q

Stage 3 Parkinson’s impacts in CNS

A
  • Involvement of nigrostriatal system (substantia nigra)
  • Voluntary movement
28
Q

Stage 4 Parkinson’s impacts in CNS

A
  • Lesions in hypothalamus, thalamus and cortex (temporal)
  • Language, planning, sensory integration
29
Q

Stage 5 Parkinson’s impacts in CNS

A
  • Sensory association areas of neocortex and prefrontal neocortex
  • Risk-reward judgements, personality, emotional regulation
30
Q

Stage 6 Parkinson’s impacts in CNS

A

•First-order association areas of neocortex

31
Q

Postural Control

A

ability to achieve, maintain, and regain balance

32
Q

Postural Instability causes in PD

A
  • PD causes smaller functional limits of stability (LOS)
  • Narrowing of BOS
  • Abnormal coactivation response results in rigid body and inability to access postural synergies (ankle or hip strategies)
  • Difficulty regulating feed-forward or anticipatory responses; responses are slowed
33
Q

Huntington’s Disease symptoms

A
  • development of emotional, behavioral, and psychiatric abnormalities;
  • loss of previously acquired intellectual or cognitive functioning;
  • movement abnormalities (motor disturbances).
34
Q

Huntington’s disease pathophysiology

A
  • Degeneration of striatum and cerebral cortex
  • Decreases signals from basal ganglia output nuclei
  • Disinhibition of the motor thalamus and PPN
  • Excessive motor output from cerebral cortex
35
Q

Chorea

A

•involuntary, rapid, irregular, jerky movements that may affect the face, arms, legs, or trunk.

36
Q

Dementia

A

•gradual loss of thought processing and acquired intellectual abilities.

37
Q

Disorientation

A

•There may be impairment of memory, abstract thinking, and judgment; improper perceptions of time, place, or identity.

38
Q

Personality disintegration

A

•increased agitation and personality changes

39
Q

Dysphagia

A

present in both PD and HD

40
Q

Athetosis

A

•is characterized by slow, involuntary, writhing, twisting, “wormlike” movements.

Greater involvement in distal UE

41
Q

Aerobic Exercise benefits for HD

A

•Improves fitness and motor function

42
Q

Supervised gait training

A
  • Improves spatiotemporal factors
  • Improves walking speed and step length
43
Q

Balance Training & Exercise

A
  • Improves balance but does not reduce falls
  • Core stability for control. Application of principles of strength and coordination
44
Q

Physical Activity and Exercise Outcomes in Huntington Disease (PACE-HD)

A

Used to track progress in HD patients

Checks if

45
Q

FOGS

A

Is a cognitive screening tool

  • F= Family story
  • O= Orientation. Person, Place, Time
  • G= General information. Current events, President, etc
  • S= Spelling. Ask to spell “word” forward and backward
46
Q

Montreal Cognitive Assessment

A
  • Quick test
  • Available in 36 languages
  • <26 indicates cognitive impairment
  • Sensitive for patient with HD
47
Q
A
48
Q
A

Neuro Rehab (11 decks)

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