Lecture 10 - Parkinson's Disease Flashcards
What type of disorder is Parkinson’s Disease?
A chronic, progressive movement disorder
What type of dysfunction does Parkinson’s Disease cause?
Basal ganglia dysfunction
What in the basal ganglia is affected?
The substantia nigra die
What is the importance of the substantia niagra?
They serve as a dopamine neurotransmitter which is important for movement related functions
How was Parkinson’s named in 5,000 BC by the Indian medical system?
“Kampayata” or “shaking palsy”
How did Chinese medicine contribute to the classification of Parkinson’s in 500 BC?
Described the symptoms and treatments
How did Ancient Roman physicians contribute to the classification of Parkinson’s?
Described symptoms, facial expressions, and various treatments
What essay did James Parkinson publish in 1817?
“An Essay on the Shaking Palsy”
Who made observations of people that characterized Parkinsonism symptoms in 1877?
Jean Martin Charcot
When were chemical differences in the brains of Parkinson’s patients identified?
1968
What became the gold standard treatment for Parkinson’s in 1968?
Levodopa
What transmitter to the basal ganglia produce?
Dopamine
What does dopamine enable the communication of?
The substantia nigra and corpus striatum
When does Parkinson’s clinically present?
When 50% to 70% of the dopaminergic neurons degenerate
What are dopaminergic neurons susceptible to in Parkinson’s?
Abnormalities in mitochondrial complex I
Aggregation of alpha synuclein
What occurs as a result of the abnormal protein handling and neuron death of dopaminergic neurons?
Lewy bodies
How can Lewy bodies be detected?
MRI scan
What is the greatest known genetic contributor to Parkinson’s disease?
LRRK2
What is the risk of Parkinson’s in a 59 year old with the LRRK2 mutation?
28%
What is the risk of Parkinson’s in a 69 year old with the LRRK2 mutation?
51%
What is the risk of Parkinson’s in a 79 year old with the LRRK2 mutation?
74%
How many American’s live with Parkinson’s?
One million
What percentage of persons ages 60 years and older does Parkinson’s effect?
1-2%
How many more times likely are men to have Parkinson’s than women?
One and a half times
Complications from Parkinson’s disease is ranked the ____ leading cause of death by the CDC?
14th
How many Americans are diagnosed with Parkinson’s disease per year?
50,000 to 60,000
What are the three types of Parkinson’s Disease?
Adult-onset, young-onset, and juvinille
What is the most common type of Parkinson’s Disease?
Adult-onset
What is the average age of Adult-onset Parkinson’s Disease?
60 years old
What is the age of onset in Young-onset Parkinson’s Disease?
21-40 years old
What is the age of onset in Juvenile Parkinson’s Disease?
Before the age of 21
What is the annual economic impact of Parkinson’s disease in the US according to the American Journal of Managed Care?
~10.8 billion
What is the cost of drugs commonly used to treat Parkinson’s per patient per year?
$2,500 - $6,000
How much does institutional care at an assisted-living facility or nursing home cost per person annually for Parkinson’s?
$100,000
What are some motor signs and symptoms of Parkinson’s?
Tremor Bradykinesia Rigid muscles Impaired posture and balance Loss of automatic movements Speech changes Writing changes
What is the main symptom associated with Parkinson’s?
Tremor
What is bradykinesia?
Slowing of movement
What type of writing changes occur as a result of Parkinson’s?
Micrographia
What is micrographia?
Smaller handwriting that trails off and gets smaller
What are some non-motor signs and symptoms associated with Parkinson’s?
Sleep Disturbances
Olfactory problems
Pain
Constipation
What kinds of sleep disturbances are associated with Parkinson’s?
RBD
Excessive Daytime Sleepiness
Sleep apnea or hyponea
Restless Leg Symptom
What is RBD?
A sleep disorder characterized by waking dreams where the individual acts out the dream.
What sleep disorder has a higher conversion into Parkinson’s?
RBD
What is Braak’s hypothesis?
The theory that non-motor symptoms are the most predictable and should be focused on to detect Parkinson’s to enable earlier intervention
Is there a cure to Parkinson’s?
No
What is the current recommended treatment for Parkinson’s?
Levodopa
How does levodopa work?
It is a dopamine replacement strategy. It is a precursor that is turned into dopamine in the body to increase dopamine levels
What symptoms does levodopa treat in Parkinson’s patients?
Stiffness
Tremors
Spasms
Poor muscle control
What are some limitations of levodopa?
The body easily adapts to treatment and gets lazy. It kills of needed dopamine cells because of the increase in dopamine and can further progress the disease
What are other types of medication used to treat Parkinson’s?
Dopamine agonist
COMT
MAO-B inhibitors
Amantadine
How is dopamine agonist used to treat Parkinson’s?
By tricking the brain into thinking it has received the dopamine it requires
How is COMT (Catechol-O-Methyl Transferase) used to treat Parkinson’s?
By prolonging the effect of levodopa by blocking its metabolism
How are MAO-B inhibitors used to treat Parkinson’s?
By blocking the enzyme that breaks down levadopa
How is amantadine used to treat Parkinson’s?
By promoting the release of dopamine from nerve terminals and blocking dopamine reuptake
What are some other non-medication treatments for Parkinson’s?
Nutrition
Stem cell therapy
Exercise
Deep brain stimulation
