Neurodegenerative Diseases

Question 1

Parkinson’s Disease - Mean Age of Onset

Answer 1

60

Frequency increases with aging, but cases can be seen in patients in their 20s and younger.

Question 2

Parkinson’s Disease - 4 Cardinal Signs

Answer 2

Resting Tremor
Rigidity
Bradykinesia
Gait Impairment/Postural Instability

Question 3

Parkinson’s Disease - Other features

Answer 3

Gait freezing
Speech difficulty
Autonomic disturbances
Sensory alterations
Mood disorders
Sleep Dysfunction
Cognitive Impairment
Dementia

Question 4

Parkinson’s Disease - Pathology Hallmarks

Answer 4

Degeneration of dopaminergic neurons in the SNc
Reduced striatal dopamine
Lewy Bodies (Intracytoplasmic proteinaceous inclusions)

Question 5

Ventral Striatum

Answer 5

Nucleus Accumbens

Olfactory Tubercle

Question 6

Dorsal Striatum

Answer 6

Caudate Nucleus

Putamen

Question 7

Primary protein in a Lewy Body

Answer 7

Alpha Synuclein

Question 8

What can precede the classic motor features of Parkinson’s Disease?

Answer 8

Constipation
Anosmia
REM Behavior Sleep Disorder
Cardiac Denervation

Lewy body pathology begins in peripheral autonomic nervous system, olfactory system and dorsal motor nucleus of the vagus nerve. Spreads to upper brainstem and cerebral hemispheres (Braak staging). Dopaminergic symptoms happen mid-disease.