Parkinson's Disease

Question 1

What are the structures within the basal ganglia?

Answer 1

> Striatum (Caudate nucleus, Putamen)
Globus pallidus
Subthalamic nucleus
Substantia nigra

Question 2

What are the feature of the Cerebellar Loop?

Answer 2

> Involved in movement coordination
Updated using visual feedback
Lesions leads to tremours

Question 3

What are the features of the Basal Ganglia Loop?

Answer 3

> Involved in initiation and execution of intentional movements
Links actions together

Question 4

What movement disorders involve the Basal Ganglia?

Answer 4

> Parkinson’s disease
Huntington’s disease
Tourettes Syndrome

Question 5

What are the features of Parkinson’s disease?

Answer 5

> Increase output of indirect pathways (‘brakes’)
Decrease output on the direct pathway (‘accelerator’)
Results in poverty of self-initiated movement

Question 6

What is the neurological cause of Parkinson’s Disease?

Answer 6

Lesions from the basal ganglia to the substantia nigra

Question 7

What are the features of Huntington’s Disease?

Answer 7

> Excessive movement, chorea and contorted postures
Reduced output of indirect pathways (‘brakes’)
Normal output of direct pathways (‘accelerator’)
Shift in balance promotes movement in general

Question 8

What is the epidemiology of Parkinson’s Disease?

Answer 8

> 2% of over 60, 4% over 80
More common in men
Mean age of onset 60
10% early onset

Question 9

What is the impact of Dopamine on Parkinson’s Disease?

Answer 9

> Direct pathway has D1 receptors (excitatory)

> Indirect pathways has D2 receptors (inhibitory)

Question 10

What is the neuropathology of Parkinson’s Disease?

Answer 10

> No single cause

> Degeneration in motor pathways

Question 11

What are the motor symptoms of Parkinson’s Disease?

Answer 11

> Tremors
> Rigidity
> Bradykinesia (slowed movement)
> Walking difficulty
> Dyskinesia

Question 12

What are the non-motor symptoms of Parkinson’s Disease?

Answer 12

> Depression
> Sleep disturbance
> Autonomic dysfunction
> Hallucinations
> Impaired cognitive performance
> Cognitive decline

Question 13

What are the cognitive impairments found in Parkinson’s Disease?

Answer 13

> Impaired problem solving
Impaired set shifting
Fluctuations in attention
Slowed information processing

Question 14

What do the non-motor symptoms of Parkinson’s Disease indicate?

Answer 14

> Parkinson’s Disease affects movement only at late stages

> Dopamine hypothesis is not the only causal factor

Question 15

What are Lewy bodies?

Answer 15

Abnormal aggregates of protein inside nerve cells

Question 16

What is synuclein?

Answer 16

A major constituent of Lewy bodies

Question 17

How is synuclein related to Parkinson’s Disease?

Answer 17

> Parkinson’s includes impairment of cell protein disposal systems
Build up of synuclein
Accumulation may account for the cognitive deficits
May eventually destroy dopamine cells

Question 18

What are the sex differences observed in Parkinson’s Disease?

Answer 18

> Age of onset 2 years later in women
Premenopausal women respond better to treatment (or if on HRT)
Observed sex difference in nigrostriatal dopamine loss

Question 19

What did Haaxama et al (2007) find?

Answer 19

Parkinson’s Disease age of onset is 2 years later in women

Question 20

What did Gilles et al (2004) find?

Answer 20

> Rats
Sex difference in nigrostriatal dopamine loss in response to toxins
Removing testes in males was beneficial
Raising oestrogen levels in males was not beneficial

Question 21

What environmental factors effect Parkinson’s Disease?

Answer 21

> Stress (hypothalamic-pituitary axis

> Pesticides implicated