Neurobiology of Disease 3 Flashcards
Out of neurodegerative and psychiatric illnesses, which one primarily features apoptosis or loss of neurones? (1)
Neurodegenerative
Out of neurodegerative and psychiatric illnesses, which one primarily features developmental defects? (1)
Psychiatric
Out of neurodegerative and psychiatric illnesses, which one shows changes in behaviour? (1)
Both can show changes in behaviour
Where is the pathology in upper motor neurone disorders? (1)
CNS or spinal cord
Give three examples of upper motor neurone disorders. (3)
- Stroke
- Multiple sclerosis
- ALS
Where is the pathology in lower motor neurone disorders? (1)
Outside the CNS
Give two examples of lower motor neurone disorders. (2)
Peripheral neuropathy
Myasthenia gravis
Where is the pathology usually situated in involuntary movement disorders? (1)
Basal ganglia
Give a common cerebellar pathology causing motor dysfunction. (1)
Tumour
Give three examples of involuntary movement disorders. (3)
- Parkinson’s disease
- Huntington’s disease
- Tremor
Is Parkinson’s disease neurodegenerative, developmental, or psychiatric? (1)
Neurodegenerative
At what age is Parkinson’s disease classed as early onset? (1)
40-60yrs
Is early onset Parkinson’s disease usually caused by…
a) genetic mutations
b) environmental factors
a) genetic mutations
Is early onset or late onset PD more prevalent? (1)
Late onset
At what age is Parkinson’s disease classed as late onset? (1)
> 85yrs
Is late onset PD usually caused by…
a) genetic mutations
b) environmental factors
Combination of both
Is PD more common in males or females? (1)
Males
(3:2 ratio)
Give five motor symptoms of Parkinson’s disease. (5)
- Slow movement (bradykinesia)
- Postural abnormalities (eg. rigid posture)
- Lack or rigidity of movement (akinesia)
- Mask-like expression
- Resting tremor
Give two psychological/cognitive symptoms of PD often seen in later stages. (2)
- Depression
- Dementia
Why is endocrine dysfunction often seen in Parkinson’s disease? (1)
Due to changes in the dopaminergic tuberoinfundibular pathway
Briefly describe the pathophysiology of Parkinson’s disease. (1)
Neurodegeneration of the extrapyramidal system (including the basal ganglia) due to loss of dopaminergic neurones in the substantia nigra.
Give three cellular mechanisms by which dopaminergic neurones in the substantia nigra may die in Parkinson’s disease. (3)
- Oxidative stress
- Mitochondrial dysfunction
- Proteosome dysfunction
Name the dopaminergic pathway which is disrupted in Parkinson’s disease. (1)
Nigrostriatal pathway
Complete the sentence relating to Parkinson’s disease. (2)
In PD, there is loss of ………………. neurones of the substantia nigra, resulting in less DA input to the ……………. of the basal ganglia.
dopaminergic
(dorsal) striatum
Describe the changes seen in brain slices of PD patients. (1)
Loss of pigmented neurones in substantia nigra pars compacta.
Name the pigment which normally makes the substantia nigra appear dark. (1)
Neuromelanin
Apart from the substantia nigra, name another brain area where large quantities of neuromelanin are found. (1)
Locus coeruleus
Briefly describe 5 neurotransmitter changes seen in Parkinson’s disease. (5)
Relate these to the brain areas where they are seen.
- Reduced DA in striatum
- Reduced DA in mesolimbic areas
- Reduced hypothalamic amines
- Reduced cortical noradrenaline and ACh
- Reduced neuropeptides (substance P) in striatum (and maybe also spinal neurones and interneurones)
What percentage reduction in dopaminergic neurotransmission to the striatum is required before motor symptoms are seen? (1)
60-70%
What effects are seen in Parkinson’s disease due to loss of dopamine in mesolimbic areas? (1)
Mood changes
What effects are seen in Parkinson’s disease due to loss of hypothalamic amines? (1)
Endocrine dysfunction
What effects are seen in Parkinson’s disease due to reduced cortical noradrenaline and ACh? (1)
Reduced cognition
What effects are seen in Parkinson’s disease which may be due to reduced neuropeptides in the striatum? (1)
Motor symptoms
Name a protein which is implicated in Parkinson’s disease. (1)
alpha-synuclein
Are a-synuclein aggregates causal or consequential of Parkinson’s disease? (1)
It is currently unknown
Describe the three components of the a-synuclein protein. (3)
- N-terminal
- Hydrophobic NAC region
- Acidic C-terminal
What is the function of the N-terminal of the a-synuclein protein? (1)
Interacts with membrane lipids
What is the function of the hydrophobic NAC region of the a-synuclein protein? (1)
Relevant for aggregation
What is the function of the acidic C-terminal of the a-synuclein protein? (1)
Involved in calcium binding
Very briefly describe (4 words) the normal role of the a-synuclein protein in cells. (1)
Synaptic function and exocytosis
Briefly describe the cascade of a-synuclein forming cytotoxic aggregates in cells. (6)
- Monomers (membrane-bound or free; can also be dimeric or tetrameric)
- Misfolding and/or hyperphosphorylation
- Oligomer
- Protofibrils
- Fibrils
- Lewy body
What is the structure called when the a-synuclein proteins aggregate? (1)
Lewy bodies
Very briefly, how do lewy bodies cause cell death? (2)
- They are cytotoxic
- They are unable to perform their normal functions
As well as motor dysfunction, what other aspect of PD might Lewy bodies contribute to? (1)
Dementia
Describe five normal, physiological roles of the alpha-synuclein protein in dopaminergic terminals at rest. (5)
- Inhibits DA synthesis (decreases TH phosphorylation)
- Aids in sequestration of cytosolic DA (increases amount of VMAT on vesicles)
- Prevents NT release through interactions with synaptic vesicles and SNARE proteins (prevents trafficking and docking)
- Facilitates recycling of synaptic vesicles by mediating membrane bending during endocytosis
- Maintains number of vesicles
Describe three normal, physiological roles of the alpha-synuclein protein in dopaminergic terminals during an action potential. (3)
- Following Ca influx, a-synuclein rapidly disperses from terminal
- Unimpeded vesicular trafficking and exocytosis
- Disinhibited TH and AADC, so DA can be replenished
Why does influx of calcium during an action potential cause alpha-synuclein to disengage from the membrane and disperse? (1)
Because alpha-synuclein interacts with the membrane in a calcium dependent manner.
Describe the effects that the loss of a-synuclein function has on dopaminergic axon terminals in Parkinson’s disease. (5)
- Increased DA synthesis (disinhibited TH and AADC)
- Decrease in VMAT levels
- Unregulated trafficking of synaptic vesicles
- Impaired endocytic vesicular recycling
- Decrease in size of vesicular pool
Describe how the distribution of dopamine in axon terminals is altered due to a-synuclein dysfunction in Parkinson’s disease. (2)
Increased cytosolic DA
with a reduction in DA in synaptic vesicles.
How does the increased cytosolic DA seen in Parkinson’s disease cause cell death? (3)
- DA auto-oxidises
- To produce reactive oxygen species
- And DA quinones
What would be the result of using miRNA to silence a-synuclein in neurones? (1)
Neurodegeneration
What does colocalisation suggest about the relationship between alpha-synuclein and glutamate in Parkinson’s disease? (1)
They are colocalised, suggesting that a-synuclein may be involved in glutamatergic neurotransmission, and therefore in PD, a-synuclein may alter glutamatergic function as well as DA function.
At the Drosophila NMJ, glutamate acts as the excitatory neurotransmission.
What is the effect of overexpressing a-synuclein at the Drosophila NMJ? (1)
What does this suggest about a-synuclein and how it affects glutamatergic function? (2)
Larger mEJP (miniature excitatory junctional potential)
Suggesting that a-synuclein may help to package glutamate into vesicles
Because overexpression results in more glutamate per vesicle
Briefly describe the proposed effects of a-synuclein on dopaminergic and glutamatergic activity. (2)
Hypodopaminergic activity
Hyperglutamatergic activity
The effects of a-synuclein on glutamate in Parkinson’s disease may be complicated.
Give two ways by which a-synuclein is proposed to increase glutamatergic neurotransmission. (2)
- Increase glutamate release from astrocytes
- Excessive activation of NMDARs on postsynaptic neurones
How could Parkinson’s disease be diagnosed using PET/SPECT imaging? (3)
- Use radioligand (CIT, cocaine analogue)
- Binds to presynaptic DAT
- Will see reduced signal
Explain why, during PET/SPECT imaging for Parkinson’s disease, using a DAT ligand would show a reduced signal but using a D2 ligand would not. (2)
Reduced DAT due to loss of dopaminergic neurones
however D2 found on postsynaptic neurones, which remain relatively unchanged.
What percentage of patients with PD have a first degree relative with PD? (1)
15%
Familial early onset Parkinson’s disease accounts for what percentage of PD cases? (1)
10-20%
Name five loci/genes which may be a risk factor for Parkinson’s disease. (5)
PARK1
PARK2
PARK4
PARK6
PARK7
Mutations in the PARK1 gene may play a role in Parkinson’s disease.
What protein does this gene encode? (1)
SNCA (a-synuclein)
Mutations in the PARK1 gene may play a role in Parkinson’s disease.
What phenotype is typically seen with mutations in this gene? (3)
Early onset PD
with Lewy bodies
and marked rigidity
Mutations in the PARK1 gene may play a role in Parkinson’s disease.
Give five mutations in this gene which confer risk for PD. (5)
A53T
A30P
E46K
H50Q
G15D
Mutations in the PARK1 gene may play a role in Parkinson’s disease.
PARK1 encodes the protein alpha-synuclein.
Name another loci/gene which encodes alpha-synuclein which may confer risk of PD. (1)
PARK4
PARK1 and PARK4 genes both encode a-synuclein and confer risk of PD.
What is the difference between the PARK4 and PARK1 genes? (2)
Different alleles
PARK4 is a triplication of the gene
Mutations in the PARK2 gene may play a role in Parkinson’s disease.
What protein is encoded by PARK2? (1)
Parkin
Mutations in the PARK1 gene may play a role in Parkinson’s disease.
What is the inheritance pattern of PARK1 mutations in PD? (1)
Autosomal dominant
Mutations in the PARK2 gene may play a role in Parkinson’s disease.
PARK2 encodes Parkin protein.
What is the role of the Parkin protein? (4)
Part of a ubiquitin proteasome
And acts as a protease
to regulate mitochondrial quality
through mitophagy and mitochondrial biogenesis.
Mutations in the PARK2 gene may play a role in Parkinson’s disease.
What is the inheritance pattern of PARK2 mutations in PD? (1)
Autosomal recessive
Mutations in the PARK2 gene may play a role in Parkinson’s disease.
Describe the PD phenotype seen in patients with PARK2 mutations. (3)
Early onset PD
restricted to SN cell loss
without Lewy bodies
Mutations in the PARK6 gene may play a role in Parkinson’s disease.
Which protein is encoded by PARK6? (1)
PINK-1
(PTEN-induced kinase-1)
Mutations in the PARK6 gene may play a role in Parkinson’s disease.
What is the inheritance pattern of PARK6 in PD? (1)
Autosomal recessive
Mutations in the PARK6 gene may play a role in Parkinson’s disease.
PARK6 encodes PINK-1 protein.
What is the role of PINK-1 protein? (3)
Mitochondrial serine/threonine protein-kinase
which recruits parkin to depolarised mitochondria
for mitophagy
Mutations in the PARK7 gene may play a role in Parkinson’s disease.
What protein does PARK7 encode? (1)
DJ-1
Mutations in the PARK7 gene may play a role in Parkinson’s disease.
What is the inheritance pattern of the PARK7 mutation in PD? (1)
Autosomal recessive
Mutations in the PARK7 gene may play a role in Parkinson’s disease.
PARK7 encodes the DJ-1 protein.
What is the role of this protein? (2)
Involved in oxidative stress response
and mitochondrial function.
Give two genes which increase risk of sporadic Parkinsonism. (2)
Leucine-rich repeat kinase 2 (LRRK2)
SNCA