Introduction to Parkinson's Disease

Question 1

Where does the destruction of neurones take place in Parkinson’s Disease?

Answer 1

Substantia nigra.

Question 2

How many substantia nigra do you have?

Answer 2

2.

Question 3

Where are the substantia nigra found?

Answer 3

One on each side of the Basal ganglia.

Question 4

State 1 function of the basal ganglia?

Answer 4

Controls movement. Connects to the motor cortex.

Question 5

What part of the substantia nigra is affected in Parkinson’s Disease?

Answer 5

Pars compacta.

Question 6

What pathway is affected in Parkinson’s Disease?

Answer 6

Nigrostriatal pathway

Question 7

The Nigrostriatal pathway connects what to what?

Answer 7

Pars compacta to the striatum (more specifically the putamen).

Question 8

What colour highlights the substantia nigra?

Answer 8

Black.

Question 9

State 2 signs/symptoms of Parkinson’s disease.

Answer 9

Psychiatric e.g. depression. Sleep disturbances. Autonomic dysfunction e.g. hypotension. Reduced olfactory sense e.g. change of smell.

Question 10

State 2 complications of Parkinson’s disease.

Answer 10

Freezing phenomenon e.g. bradykinesia, akinesia (pauses in movement). Falls. Dystonia (painful posturing). Dementia.

Question 11

State 3 motor features of Parkinson’s Disease.

Answer 11

Tremor. Rigidity. Akinesia (loss of power of voluntary movement). Postural changes (stooped). Stare.

Question 12

What is the mneumonic?

Answer 12

TRAPS.

Question 13

State 3 non-motor features of Parkinson’s Disease.

Answer 13

Changes in sense of smell. Sleep difficulties. Cognitive impairment. Depression/ anxiety. Mood disturbances. Reduced motor learning ability. Constipation.

Question 14

What stages do you experience problems with smell?

Answer 14

Stages 1 + 2.

Question 15

What stages do you experience problems with sleep or motor impairments?

Answer 15

Stages 3 + 4.

Question 16

What stages do you experience problems with your cognitive ability?

Answer 16

Stages 5 + 6.

Question 17

State a way Parkinson’s Disease is diagnosed.

Answer 17

Clinical presentation e.g. resting tremors. Postmortem autopsy e.g. loss of pigmented dopaminergic neurones of substantia nigra pars compacta.

Question 18

Name a gene linked to Parkinson’s Disease.

Answer 18

PINK 1. Parkin. Alpha synuclein genes.

Question 19

State 3 of the treatments used to treat Parkinson’s Disease.

Answer 19

Dopamine agonists. Dopamine replacement. MAO-B inhibitors. COMT inhibitors. Anticholinergic inhibitors. Amantadine (anti-viral). Surgery.

Question 20

State 2 dopamine agonists.

Answer 20

Bromocriptine. Pramipexole. Ropinirole.

Question 21

State a MAO-inhibitor.

Answer 21

Selegiline.

Question 22

State a COMT inhibitor.

Answer 22

Entacapone. Tolcapone.

Question 23

State an anticholinergic.

Answer 23

Benztropine.

Question 24

What does an anticholinergic do?

Answer 24

Restores neurochemical balance.

Question 25

What does deep brain stimulation do in treating Parkinson’s Disease?

Answer 25

Stimulates the basal ganglia - increase output and reduce motor symptoms.