Neurodegenerative diseases Flashcards

1
Q

What is neurodegeneration?

A

= progressive loss of neurons

  • Can affect both CNS and PNS
  • Begin at any stage of life, but most common with aging, but some with childhood and from birth
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2
Q

What are exmaples of early and late age onset of neurodegenerative diseases?

A

Earlier age of onset = greater genetic contribution

Later age of onset = more likely to be sporadic disease

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3
Q

How are neurodegenerative diseases highly heterogenous?

A

Some diseases are really umbrella terms

  • Conditions with overlapping phenotypes but distinct causes

Some diseases are inheritably pleiotropic

  • Symptoms manifest differently in different people
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4
Q

What is a neurons “achilles heel”?

A

= distance between axon terminal and nucleus

  • Weak point as things have to be transported such a long way
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5
Q

What is the common cycle in a neurodegenerative disease?

A
  1. Molecular impairment somewhere in the cell
  2. Decreased transmission at synapse
  3. “dying back” of neurites
  4. Cell death
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6
Q

What are some common features of neurodegenerative diseases?

A
  • Protein aggregation
  • Lysosomal dysfunction
  • Mitochondrial dysfunction
  • Associated inflammation via activation of gilia
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7
Q

Why are neurodegenerative diseases hard to diagnose and cure?

A

Diseases rarely show signs and symptoms until long after the neurodegeneration has begun

  • Early treatment is impossible
  • Therapeutic challenge is considerable

For CNS disorders, studies of affected tissue is very difficult until death

Remain uncurable

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8
Q

What is Alzhiemer’s?

A

Most common neurodegenerative disease and common cause of dementia

Age of onset over 65, 10% start from age 30 onwards (early onset cases)

50% of people aged 85% have this

AD is not a normal part of ageing - it’s a disorder

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9
Q

What is dementia?

A

= decline in memory and other cognitive functions that impair quality of life

They are distinct from normal cognitive lapses like loosing keys and forgetting a name

  • Alzheimer’s included not recognising family, sudden changes in personality, getting lost

*normal ageing = gradual decline in normal cognition and changes in personality*

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10
Q

What are the pathological hallmarks of alzheimers?

A

Brain shrinkage

  • Shrinkage of cerebral cortex
  • Enlarged ventricles
  • Shrinkage of hippocampus - memory part

Proteinopathies

  • Amyloid plaques
    • Extracellular and enriched in AB peptides
  • Neurofibrillary tangles
    • Intracellular and enriched in Tau protein
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11
Q

What are the causes of Dementia/alzheimer’s?

Amyloid hypothesis

A

AB = peptide produced by the cleavage of transmembrane protein, APP by proteases

  • Mutations to three proteins involved in AB peptide processing are known to cause rare early onset forms of Alzheimer’s
    • APP
    • PSEN1
    • PSEN2

*Amyloid hypothesis of AD - plaques are the major cause of AD

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12
Q

What are the causes of Dementia/alzheimer’s?

Tau hypothesis

A

Tau normally binds to microtubules in axons

  • If it becomes hyperphosphorylated causes tangles and destabilised microtubules

Microtubules give shape and structure, positioning of organelles in dendrites but they also are motorways for transporting vesicular cargo

*Tau hypothesis of late onset of AD of neurofibrillary tangles (before plaques)

Tau upstream of AB

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13
Q

What are the risk factors for alzheimers?

A
  • Down syndrome
  • Gender (more in women)
  • Low education
  • Head injury
  • Smoking and drinking
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14
Q

What is parkinson’s disease?

A

Onset usually 60-65, 10% before 45

Incurable

A movement disorder with 4 cardinal features:

  • Resting tremor
  • Bradykinesia (slow movement)
  • Rigidity
  • Postural instability (fall over)

Non-motor symptoms

  • Depression and anxiety
  • Loss of smell
  • Sleep disorders
  • Constipation
  • Dementia
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15
Q

What are the pathological hallmarks of parkinson’s disease?

A

Loss of dopaminergic neurons of the substantia nigra

  • (other brain regions are still affected with the different symptoms)

Proteinopathy

  • Lewy bodies - intracellular and enriched in a synuclein protein
    • Increase in a-synuclein is pathogenic
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16
Q

What are the genetic causes of Parkinson’s?

A

Early onset recessive mitochondrial conditions

  • Mitochondria have finite lifespan due to oxidative stress so they are removed by mitophagy before damage occurs
  • Loss of function mutations 2 proteins central to activating mitophagy cause early onset PD

Late onset autosomal dominant PD

  • SNCA gene amplification study confirms that a-synuclein is pathogenic

Mutations that cause PD-plus conditions - very rare

17
Q

What is GCase?

A

A lysosomal enzyme which is encoded by GBA

  • When you have less activity of GCase - lysosome becomes impaired itself - lead to reduction in autophagy and a-synuclein will accumulate –> are pathogenic
  • **if you don’t have less activity of GCase but have high levels of a-synuclein
    • A-synuclein will inhibit the translocation of Gcase into the lysosome –> impaired lysosome and leads to cell death

Problems in autophagy will lead to mitochondrial dysfunction –> decrease in mitophagy

18
Q

What are the risk factors to Parkinsons?

A
  • Red hair
  • Head injury
  • Not smoking, not consuming caffeine
  • Exposure to metals
  • Exposure to pesticides and herbicides
19
Q

What is neuroinflammation?

A

= activation of immune system within the nervous system

  • Activation of micro gilia in the brain
20
Q

What can reactive microgila be?

A

Protective of neurons

  • Anti-inflammatory
  • Normal removal of unhealthy cells

Damaging of neurons

  • Pro-inflammatory
  • Response to pathogens

**ageing induces a shift towards production of damaging reactive microglia, due to changes in microglial gene expression