Motor Disorders 1

Question 1

What is the definition of Parkinson spectrum?

Answer 1

A group of neurodegenerative diseases which involve various motor symptoms

Question 2

How is the Parkinson spectrum divided? (only first part)

Answer 2

Hypokinetic-rigid syndrome > Parkinson and atypical forms of parkinsonism

Question 3

How is Parkinson’s disease (pd) divided in the Parkinson spectrum?

Answer 3

Family type and idiopathic type (cause unknown)

Question 4

How are atypical types of Parkinsonism further divided in the Parkinson spectrum?

Answer 4

Multiple system atrophy

Vascular

drug-induced

corticobasal degeneration/corticobasal syndrome

dementia w/lewy bodies

progressive supranuclear palsy

Question 5

How is multiple system atrophy caused?

Answer 5

Abnormal accumulation of alpha-synuclein protein in cells- Synucleinopathy that affects the autonomic nervous system, substantia nigra and at times the cerebellum

Question 6

How is vascular Parkinsonism caused?

Answer 6

multiple and usually very small strokes, lower body parkinsonism

Question 7

How is corticobasal syndrome caused?

Answer 7

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

Question 8

How is Dementia w/ Lewy bodies caused?

Answer 8

An abnormal accumulation of alpha-synuclein protein in brain cells- synucleinopathy

Question 9

How is progressive supranuclear palsy caused?

Answer 9

Tau protein buildup- tauopathy affecting the frontal lobes, brainstem, cerebellum and substantia nigra

Question 10

How is pd caused?

Answer 10

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

Question 11

When does your likelihood increase of getting pd?

Answer 11

> 65

Question 12

In which places is the prevalence of pd highest?

Answer 12

North America, Western Europe and Eastern Asia (+ south and southeast)

Question 13

When is pd of “early onset”?

Answer 13

<50

Question 14

What are three reasons why pd is expected to increase?

Answer 14

Aging population, increased life expectancy and industrialization/pollution

Question 15

What is different between pd and atypical forms?

Answer 15

On average there is a more rapid progression in atypical (shorter survival time and more prominent cognitive deterioration)

Less reaction to drugs in atypical

Question 16

What does the general clinical picture of Parkinson look like?

Answer 16

Motor: Bradykinesia (slowness of movement), rigidity, rest tremor and postural instability

Non-motor: fatigue/sleep disorders, sensory/pain, autonomic, neuropsychiatric and cognitive impairment

Question 17

Which two types of dominant symptom pd’s are there?

Answer 17

Tremor dominant and postural dominant

Question 18

What does the Unified Parkinson disease rating scale (UPDRS) determine?

Answer 18

Severity of pd

Question 19

What does the Hoehn & Yahr Scale (HY Scale) determine?

Answer 19

What stage you are in

Question 20

What are some neurobiological observations with SPECT in pd?

Answer 20

Caudate and Putamen activation decrease

Question 21

What were the findings of the studies in the lecture on Autism <> pd?

Answer 21

12-33% of autistic pps screen positively for parkinsonism

Question 22

What are some cognitive problems often seen in pd?

Answer 22

Attentional problems, reduction in processing speed, executive dysfunction and problems with learning new skills

Question 23

What are common psychiatric symptoms/disorders with pd?

Answer 23

Anxiety, depression, apathy, psychosis, impulsivity and sleep disorders

Question 24

What are drugs used for pd? side-effects?

Answer 24

levodopa/dopamine antagonist

side-effects: nacrolepsy to psychosis, hyperkinetic movements & dyskinesia

Question 25

Which treatment can be used other than drugs for pd? For what is it most useful?

Answer 25

Deep brain stimulation, motor symptoms