Lecture 2 Flashcards
Where are abonormalities in the brain in PD patients
Brainstem region
Normal individuals have darkly pigmented neurons in the ___
Substantia nigra
What gives the neurons in the substantia nigra their dark color
They produce high levels of neuromelanin
What area of the substantia nigra is particularly dark
Pars compacta
What happens to the darkly pigmented neurons in PD
They progressively die
What is left behind when the cells of the substantia nigra are lost
Holes/voids
Name of circular structure of dead neurons
Lewy body
Major symptoms of PD
- Inability to initiate any voluntary movement
- Diminished facial expression (mask face)
- Lack of associated movement (ex: arms swinging when walking)
- Tremor at rest
Hypokinetic disorder
Low/slow movement
Why is there a tremor at rest
We don’t know
Is BG involved in non-motor functions
Yes
What pathways are the BG non-motor functions in
Prefrontal and limbic loops
Non-motor BG deficits
- Language
- Tourettes
- Vocal tics and grunts
- OCD
- Depression
- Anxiety
What drugs help BG non-motor defecits
Schizophrenia drugs
What do schizophrenia drugs act on
Dopaminergic neurons in the striatum
Are non-motor functions of the BG well understood
No
Motor symptoms of PD
- Bradykinesia
- Akinesia
- Rigidity
- Posture and balance
- Freezing gait
- Abnormal eye movement
- Tremor at rest
Bradykinesia
Slowness of movement, lack of fluidity, and lack of automaticity
Akinesia
Difficulty initiating movement
Rigidity
Cog-wheeling, plastic quality
Freezing gait
Freeze up when they have to make a movement decision (when turning a corner or approaching an object)
Abnormal eye movement
Impaired smooth pursuit, slow saccades (jerky eye movement)
Progression of tremor at rest
Starts unilateral in the fingers and hand (distal) but then progresses to proximal and bilateral
When do tremors increase
With arousal or stress
Does tremor respond to dopaminergic treatment
Variable response
__% of PD don’t have tremors
25%
PD without tremors progresses ___
Faster (tremors are good?)
What happens to tremor expression with disease progression
Decreases
Major non-motor symptoms of PD
- Sleep disorders
- Autonomic function
- Body pain
- Mood changes
- Cognitive impairments
Sleep disorders in PD
Acting out dreams, sleep fragmentation, excessive daytime sleepiness
Autonomic function issues in PD
Orthostatic hypotension, constipation, urinary urgency, excessive sweating
Why is there body pain in PD
We don’t know
Why are there mood changes in PD
Dysfunction in limbic lobe
Mood changes in PD
Depression and anxiety
___% of PD cases develop dementia within 10 years of PD onset
75%
