NP: Lecture 8 Motor disorders

Question 1

parkinson spectrum definitie

Answer 1

group of progressive neurodegenerative diseases which involve various motor symptoms (note: ook non-motor symptoms)

heet ook wel: parkinsonism, hyperkinetic-rigid syndrome

Question 2

etiology of parkinsonism

Answer 2

degeneration of dopamine producing neurons in part of the substantia nigra

Question 3

waar zijn substantia nigra deel van

Answer 3

basal ganglia

Question 4

wat doen substantia nigra

Answer 4

interact with thalamus and cortex.

Question 5

hoeveel van de DA neurons in SA breakdown?

Answer 5

50%, dus een hele hoop

Question 6

prevalence of pd

Answer 6

7-10 million people worldwide

Question 7

pd en gender

Answer 7

male meer dan female

Risk of developing PD is twice as high in men than women, but women have a higher mortality rate and faster progression of the disease.

Question 8

ouder dan 65 jaar is meer risico

Answer 8

oke logisch

Question 9

kijken naar model classifications van pd

Answer 9

oke

Question 10

hoe gaat de classification

Answer 10

hypokinetic-rigid syndrome -> parkinsons disease and atypical parkinsonism

parkinsons -> familial and ideopathic

atypical parkinsonism -> 6 types

Question 11

6 types of atypical parkinsonism

Answer 11

drug induced
vascular parkinsonism
multiple system atrophy
cortico-basal degeneration
lewy body dementia
progressive supranuclear paralysis

Question 12

2 classifications of parkinsonism

Answer 12

primary: on average more rapid progression
secundary; more limited reaction to specific drugs

Secondary parkinsonism is when symptoms similar to Parkinson disease are caused by certain medicines, a different nervous system disorder, or another illness. Parkinsonism refers to any condition that involves the types of movement problems seen in Parkinson disease.

Question 13

primary heeft…

Answer 13

shorter survival time
more prominent cognitive detoriation

Question 14

initial stage: hard to differentiate between the variants.

Answer 14

maar course of disease is crucial!

Question 15

4 motor symptoms

Answer 15

bradykinesia (= slowness!!!!)
rigidity
rest tremor
motor instability

Question 16

non-motor symptoms 3

Answer 16

fatigue/sleep disorder
pain
hypnosmia

Question 17

hoe classificeren van de severity

Answer 17

unified parkinson disease rating scale

Question 18

hoe bepaal je de stage

Answer 18

hoehn & yahr scale

Question 19

prevalence of co-occuring physical and mental health conditions is high across the autistic adults life span

Answer 19

oke

Question 20

bij autisme ook higher prevalence of…

Answer 20

dementia and parkinsonism and PD

Question 21

wat weten we nog niet over relatie tussen autisme en parkinson

Answer 21

1. Related to having an intellectual disability/specific genetic syndromes?
2. Related to medication use?
3. Is it actually parkinsonism or is similar to what we observe in autistic children?

Question 22

antwoorden op die vragen

Answer 22

16-33% van de mensen met autisme is positief voor PD. medication geen rol, age of onset is late adulthood.

Question 23

what does a clinical neuropsychologist do for these ppl

Answer 23

1. assess cog. impairment and neuropsychiatric problems
2. determining disease progression
3. determining impact prevention

Question 24

hoeveel already have impairments when they are diagnosed

Answer 24

24%

Question 25

wat meet je vooral tijdens testen voor pd

Answer 25

executive dysfunctions: visuospatial or problem with internal generation automatisms

ook:
attention
reduction of processing speed
problems with processing emotional information
learning new skills is hard

Question 26

neuropsychiatric problems bij pd

Answer 26

depression
anxiety
apathy
psychosis
impulsivity
sleep disorders

Question 27

…% of pd patients have at least 1 neuropsychiatric symptom. + waarom?

Answer 27

90%, omdat dit te maken heeft met dopamine levels

Question 28

prevalence depression bij pd

Answer 28

35-70%

Question 29

hoeveel hebben formal depressive mood disorder

Answer 29

17%

Question 30

wat is de differential diagnosis bij depressive symptoms

Answer 30

apathy, MCI, dementia

Question 31

hoeveel mensen met pd hebben anxiety

Answer 31

40-50%

Question 32

hoeveel mensen hebben formal anxiety disorder

Answer 32

30%

Question 33

tijdens welke momenten bij PD -> on of off -> hebben mensen vaak anxiety of depressive symptoms

Answer 33

depressive -> during off
anxiety -> during off or during transition on -> off

Question 34

en wat voor effect heeft anxiety op motor symptoms

Answer 34

anxiety kan leiden tot meer motor symptoms.

dus is vicieuze cirkel: anxiety <-> motor symptoms/off moments

Question 35

apathy =

Answer 35

Reduced motivation; reduced targeted behaviour; reduced
interest/emotions

Question 36

hoeveel mensen problemen met apathy

Answer 36

20-40% in pt without dementia
60% in pt with dementia

Question 37

differential diagnosis apathy bij PD

Answer 37

fatigue, depression, hypoactive delier, MCI, dementia

Question 38

PD dementia criteria

Answer 38

o PD diagnosis diagnosed before onset of dementia
o MMSE < 26
o Objectifiable cognitive impairment in 2+ domains that interfere with daily functioning
o Active retrieval impaired, recognition maintained

Question 39

prevalence van pd dementia

Answer 39

25-30% (After 10-20 years majority dementia)

Question 40

Asphasia, apraxia, agnosia less prevalent in PD dementia versus other
dementia’s

Answer 40

oke

Question 41

parkinson meds

Answer 41

levodopa, dopamine antagonists

Question 42

side effects parkinson meds

Answer 42

nacrolepsy to psychosis, hyperkinetic movements & dyskinesia.

Question 43

gait=

Answer 43

manier van lopen

Question 44

wat is een andere treatment voor PD

Answer 44

deep brain stimulation