Neurodegenerative Disorders - DA disorders: Parkinsons's Disease & Huntington's Disease Flashcards
Motor Symptoms of DA Disorders - Ballismus/Chorea
Dyskinetic, Hyperkinetic.
Large amplitude involuntary movements affecting limbs more distally (ballismus) or more proximally (chorea).
Motor Symptoms of DA Disorders - Tremors
Involuntary movement, Dyskinetic, Hyperkinetic.
Resting, Action or Intention.
Intention: thinking about doing a movement, followed by a action tremor.
Motor Symptoms of DA Disorders -
Athetosis
Involuntary movement, Dyskinetic, Hyperkinetic.
Slow, continuous, involuntary writhing movement that prevents maintenance of a stable posture.
Motor Symptoms of DA Disorders - Bradykinesia
Involuntary movement, Dyskinetic, Hypokinetic.
Slow movements.
Motor Symptoms of DA Disorders - Akinesia
Involuntary movement, Dyskinetic, Hypokinetic.
No movements.
Hypokinetic Disorders (4)
Parkinson’s Disease
Secondary Parkinsonism
Cortico-basal Degeneration
Progressive Supranuclear Palsy
Hyperkinetic Disorders (2)
Huntington’s Disease
Tic Disorders
Primary Parkinson’s Disease - Definition
Idiopathic, progressive disease, where nigrostriatal cells degenerate, leading to impaired function in various systems.
Affects Substantia Nigra -> Decrease in DA.
Secondary Parkinsonism - Definition
Drug and toxic related Parkinson’s. Non-progressive. Similar symptoms as PD, not as severe. Motor and behavioral symptoms related to dementia, rather than loss of nigrostriatal neurons. Usually around 20-30 y.o.
Parkinson’s Disease - Motor, Psychiatric and Internal Organs
Motor: All patients will have Bradykinesia, Resting tremor and Rigidity (extrapyramidal hypertonia).
Psychiatric: depression, apathy, dementia…
Internal organs: Cardiorespiratory (difficulty to adapt to increased aerobic activity), digestive system (decreased DA -> weaker contractions)
Associated symptoms of Parkinson’s Disease (7)
Cardiopathic denervation
Depression
Sleep disorders (due to resting tremor)
Cognitive disorders (mostly memory and attention)
Coordination disorders (dysmetria and dysdiadochokinesia)
Difficulties in reasoning (aCC) and online correction processes (automatic reactions, cerebellum)
Hallucinations and other schizophrenic symptoms (medication)
Pathways Related to Associated Symptoms of PD
SN ->(DA) STN ->(GABA) DCN <-> CB
Decrease in DA decreases activity of cerebellum (automatic reactions, movement coordination)
SN -> (DA) VTA -> aCC
Decrease in DA decreases aCC activity (reasoning, attention, memory consolidation)
Freezing of Gait - Definition and Pathways
Difficulty in movement initiation, combined with deficit in online correction, leads to patient stop walking as unexpected event occurs.
STN -> DCN very disrupted.
SN -> STN -> DCN -> CB
Gets worse if patient has anxiety.
Decrease in DA -> SN -> VTA -> aCC
aCC not able to inhibit AM.
Classification of PD (Stage 0,1,1.5, 2, 2.5, 3, 4, 5)
0: degeneration of SN, without symptoms
1: unilateral symptoms B-T-R
1,5: unilateral symptoms and axial involvement (trunk)
2: bilateral symptoms without balance impairment
2,5: Mild bilateral disease with recovery on pull test
3: Balance impairment. Mild to moderate disease. Physically independent.
4: Severe disability. Still able to walk or stand.
5: Wheelchair or bedridden
Pharmacological Treatment
Neuroprotective treatment
DA agonists
MAO inhibitors (inhibit reuptake of DA)
Stemcell therapy (illegal and ineffective)
