L11 Parkinson's Disease

Question 1

What is parkinsons disease

Answer 1

Progressive neurological disease which causes disability of movement

Question 2

Statistics relating to age and population

Answer 2

1-2% over 60
90-95% idiopathic
5-10% gene mutation

Question 3

Motor Symptoms of Parkinsons

Answer 3

Resting tremor
Shuffling gait
Rigidity
Stooped posture
Bradykinesia (slow movement)

Question 4

Speech Symptoms

Answer 4

Poor Articulation
Dysarthia
Dysphagia
Muffled Speech
Monotone
Breathy hoarse voice
Vocal Changes

Question 5

Non Motor Symptoms

Answer 5

Cognitive impairment
Swallowing
Depression
Olfactory Dysfunction
Constipation
Bladder Instability
Sleep disturbance

Question 6

Location of Pathology for Parkinsons

Answer 6

Basal Ganglis: group of subcortical nuclei

Question 7

Explain Parkinsons Pathology

Answer 7

Loss of dopamingeric nigrstriatal neurons
Cell death of dopamine releasing neurons

Question 8

Explain Pathway of Pathology

Answer 8

Loss of dopamingeric neurons in substantia nigra

Loss of dopamine neurotransmission in nigrostriatal pathway to striatum

Movement dysfunction

Question 9

How do Lewy bodies form

Answer 9

A protein called alpha synuclein builds up and spreads through nervous system to form lewy bodies

Question 10

What are lewy bodies

Answer 10

Insoluble cytoplasmic inclusion in nigral dopaminegeric neurons

Contains a synuclein and ubiquated neurons

Question 11

Diagnosis of Parkinsons

Answer 11

Dominant Motor Symptoms

Absence of other neurological and cognitive deficits

Unified Parkinsons Rating Scale

PET scan

Response to dopamine therapy

Question 12

What is a PET scan

Answer 12

Positron emission tomography

a nuclear medicine imaging technique that produces a three dimensional image or picture of functional processes in the body

Question 13

Risk Factors causing Parkinsons disease

Answer 13

Risk Factors
Aging
-Exposure to environmental toxins
-Head trauma
- Inflammation
-Smoking and caffeine

Question 14

Molecular and Cellular changes causing PD

Answer 14

Abnormal Protein processing
Oxidative stress
Mitochondrial Dysfunction
Excitotoxicity
Apoptosis
Inflammation

Question 15

Drug Used Therapies

Answer 15

Dopamine Replacement - increases synthesis of dopamine

Dopamine Agonist - binds dopamine receptors to mimic the effects of dopamine

Monoamine Oxidase Inhibitor - inhibit breakdown of dopamine

Question 16

What is Levodopa

Answer 16

L- DOPA

Increases dopamine concentration in brain
80% respond positively

Eliminates symptoms
- bradykinesia and tremor and rigidity

Question 17

What is deep brain stimulation

Answer 17

Neurosurgical procedure that allows targeted circuit based neuromodulation

reduces motor symptoms

Impulse generator placed under collarbone or abdomen delivers electrical stimulation to motor control areas.

Question 18

Speech and Language therapy for PD

Answer 18

• Lee Silverman Voice Treatment: specialized training to help individuals with Parkinson’s disease amplify their voices
• Vocal energy conservation techniques
• Helping develop nonverbal communication skills
• Practicing exercises to help increase muscle strength
• Practicing movements to improve speech

Question 19

Occupational therapy for PD

Answer 19

• Arm and hand therapy
• Handwriting aids
• Home modification (Barrier-Free design)
• Driver evaluation and vehicle modification information
• Eating and dinnerware adaptations
• Workplace or work equipment modifications
• Leisure skill development
• Bathtub and toilet equipment use
• Dressing and grooming aids