Motor Disorders 1 Flashcards
What is the definition of Parkinson spectrum?
A group of neurodegenerative diseases which involve various motor symptoms
How is the Parkinson spectrum divided? (only first part)
Hypokinetic-rigid syndrome > Parkinson and atypical forms of parkinsonism
How is Parkinson’s disease (pd) divided in the Parkinson spectrum?
Family type and idiopathic type (cause unknown)
How are atypical types of Parkinsonism further divided in the Parkinson spectrum?
Multiple system atrophy
Vascular
drug-induced
corticobasal degeneration/corticobasal syndrome
dementia w/lewy bodies
progressive supranuclear palsy
How is multiple system atrophy caused?
Abnormal accumulation of alpha-synuclein protein in cells- Synucleinopathy that affects the autonomic nervous system, substantia nigra and at times the cerebellum
How is vascular Parkinsonism caused?
multiple and usually very small strokes, lower body parkinsonism
How is corticobasal syndrome caused?
Tau protein buildup- tauopathy that typically affects one side of the body more than the other and makes it difficult for patients to see and navigate through space
How is Dementia w/ Lewy bodies caused?
An abnormal accumulation of alpha-synuclein protein in brain cells- synucleinopathy
How is progressive supranuclear palsy caused?
Tau protein buildup- tauopathy affecting the frontal lobes, brainstem, cerebellum and substantia nigra
How is pd caused?
Degeneration of dopamine (DA) producing neurons in part of the substantia nigra (which is part of the basal ganglia and interacts with the thalamus and cortex). Around 50% of the DA neurons break down
When does your likelihood increase of getting pd?
> 65
In which places is the prevalence of pd highest?
North America, Western Europe and Eastern Asia (+ south and southeast)
When is pd of “early onset”?
<50
What are three reasons why pd is expected to increase?
Aging population, increased life expectancy and industrialization/pollution
What is different between pd and atypical forms?
On average there is a more rapid progression in atypical (shorter survival time and more prominent cognitive deterioration)
Less reaction to drugs in atypical
What does the general clinical picture of Parkinson look like?
Motor: Bradykinesia (slowness of movement), rigidity, rest tremor and postural instability
Non-motor: fatigue/sleep disorders, sensory/pain, autonomic, neuropsychiatric and cognitive impairment
Which two types of dominant symptom pd’s are there?
Tremor dominant and postural dominant
What does the Unified Parkinson disease rating scale (UPDRS) determine?
Severity of pd
What does the Hoehn & Yahr Scale (HY Scale) determine?
What stage you are in
What are some neurobiological observations with SPECT in pd?
Caudate and Putamen activation decrease
What were the findings of the studies in the lecture on Autism <> pd?
12-33% of autistic pps screen positively for parkinsonism
What are some cognitive problems often seen in pd?
Attentional problems, reduction in processing speed, executive dysfunction and problems with learning new skills
What are common psychiatric symptoms/disorders with pd?
Anxiety, depression, apathy, psychosis, impulsivity and sleep disorders
What are drugs used for pd? side-effects?
levodopa/dopamine antagonist
side-effects: nacrolepsy to psychosis, hyperkinetic movements & dyskinesia
Which treatment can be used other than drugs for pd? For what is it most useful?
Deep brain stimulation, motor symptoms
