Parkinson's disease

Question 1

Define PD

Answer 1

Parkinson’s Disease is a chronic, progressive neurodegenerative disorder resulting from the degeneration of dopamine producing neurones in the substantia nigra of the basal ganglia

Question 2

What are the cardinal signs of PD?

Answer 2

Bradykinesia
Rigidity
Resting tremor
Postural Instability

Question 3

Give 5 key functions of the basal ganglia

Answer 3

preparation and planning
initiation and termination
sequencing and timing
Regulating muscle tone and inhibition of antagonistic/unnecessary movements
Well-learned motor skills and movement sequences

Question 4

What intervention is effective in assisting with initiation of movement for people with PD?

Answer 4

cueing

Question 5

What is the clinical criteria for a Parkinson’s diagnosis?

Answer 5

bradykinesia
diadodyskinesia
rigidity
resting tremor
postural instability
response to dopamine
replacement therapy
MRI (supportive only)

Question 6

When can you be 100% certain someone has PD?

Answer 6

via a post-mortem brain examination

Question 7

What is bradykinesia?

Answer 7

very slow movement

Question 8

What is diadodyskinesia?

Answer 8

progressive reduction of speed and amplitude of repetitive movements

Question 9

Give some signs and symptoms of PD (excluding the cardinal signs)

Answer 9

difficulty initiating and terminating movement
fatigue
freezing
‘Festinating’ gate pattern
sleep disorders
swallow dysfunction
anxiety and depression

Question 10

Name the 5 nuclei of the basal ganglia

Answer 10

Globus Pallidus
Caudate
putamen
subthalamic nuclei
substantia Nigra

Question 11

What is dopamine?

Answer 11

a neurotransmitter

Question 12

name some types of medications used to treat PD

Answer 12

Dopamine replacements
dopamine copycats
dopamine protectors

Question 13

What principles are used for enhancing function in patients with PD?

Answer 13

cueing
duel tasking
balance training
gait re-education
symptom specific exercises

Question 14

What happens if the direct pathway is active?

Answer 14

there is more movement

Question 15

What happens if the indirect pathway is involved?

Answer 15

there is less movement

Question 16

What is the main source of dopamine?

Answer 16

substantia nigra

Question 17

What does dopamine do to the direct pathway?

Answer 17

excites it -> makes it more efficient = more movement

Question 18

What does dopamine do to the indirect pathway?

Answer 18

inhibits it -> makes it less efficient =more movement

Question 19

What happens if there is less dopamine?

Answer 19

less movement

Question 20

What leads to a lack of dopamine production?

Answer 20

neurodegeneration in the substantia nigra in the basal ganglia

Question 21

What is cueing?

Answer 21

a type of treatment technique that uses visual, auditory or kinaesthetic feedback to allow a movement pattern to be accessed and used in a functional way

Question 22

What part of the brain has a primary role in the execution of movement?

Answer 22

Primary motor cortex

Question 23

What part of the brain is involved in internally generated, automatic movement?

Answer 23

The supplementary motor area

Question 24

What part of the brain is involved in sensory guided movement?

Answer 24

The premotor area