Neurodegenerative Disorders

Question 1

Parkinson’s disease

Answer 1

Main motor symptoms:
- Extrapyramidal hypertonia (rigidity)
- Involuntary movements (resting tremor)
- Slowness of voluntary movements and automatic reactions (bradykinesia)

Main cognitive/behavioural symptoms:
- Sleep disorders
- Declarative memory loss
- Severe attention deficit
- Anhedonia (inability to feel pleasure)
- Psychotic episodes

Pathophysiology:
1. Accumulation of alpha-synuclein in nigrostriatal neurons forming Lewy bodies
2. Increase toxicity, due to alpha-synuclein
3. Decrease of mitochondrial, lysosomal transport and microtubular transport
4. Decrease of DA production and conduction from SNc to Striatum

Question 2

Parkinson’s disease additional systemic symptoms

Answer 2

• Denervating cardiopathy (Cardiovascular)
• Decreased ventilation, due to decreased chest mobility, impacting performance and participation (Respiratory)
• Severe attention deficit, impacting memory, reasoning, planning, and overall decision-making (Cognitive)
• Depression, anxiety (Mental health related)
• Hallucinations and oder schizophrenic (Psychiatric)

Question 3

Huntington’s disease

Answer 3

Main motor symptoms:
- Chorea (irregular, jerky, inv contract°)
- Cachexia

Main cognitive/behavioural symptoms:
- Progressive dementia
- Depression
- Anxiety
- Anhedonia

Pathophysiology:
- Apoptosis of neurons in CAU and PUT
- Evolving to apoptosis across the cerebral cortex, GP, THA, STN, SNc/r, and cerebellum

Question 4

Multiple sclerosis - Description

Answer 4

• Progressive and idiopathic
  Autoimmune
• Damage of myelin surrounding axons
• Symptoms according to the origin in supratentorial, infratentorial or spinal cord related disturbance

Question 5

Relapsing Remitting Multiple Sclerosis (RRMS)

Answer 5

• Clearly defined attacks (relapses)
• Followed by a partial or complete recovery (remissions)
• There is no apparent progression of the symptoms

Question 6

Primary progressive multiple scleroses (PPMS)

Answer 6

• Continuous worsening of symptoms
• Without period of relapse nor remission

Question 7

Secondary progressive multiple sclerosis (SPMS)

Answer 7

Marked by continuous progression after CIS or RRMS

Question 8

Clinical isolated syndrome (CIS)

Answer 8

• First episode of demyelination leads to focal symptoms
• Does not classify as MS

Question 9

Progressive multifocal leukoenccephalopathy (PML)

Answer 9

Progressive demyelinating

Pathophysiology:
1. Immunosuppression
2. JCV (John Cunningham virus) reactivation
3. Infection of oligodendrocytes
4. Progressive myelin destruction

Main symptoms:
- Generalized muscle weakness
- Impairment of balance and gait
- Dysarthrophonia
- Visual deficit
- Coordination deficit

Question 10

Amyotrophic lateral sclerosis (ALS)

Answer 10

Fast progressive NDD

Apoptosis of first and second motoneurons

Lead to progressive muscle weakness

Physiotherapy - Improvement of functionality and reduction of complications (articular and respiratory)