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FBN > Parkinson's disease > Flashcards

Parkinson's disease Flashcards

1
Q

List the differences between psychiatric and neurodegenerative disorders?

A

ND- loss of neurones, disrupted motor functions, some behaviour changes maybe
PS- no loss of neurones, some structural changes, changes in behaviour

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2
Q

List 3 upper motor neurone disorders

A

MS, stroke, amyotrophic lateral sclerosis

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3
Q

List 3 lower motor neurone disorders

A

MG, poliomyelitis, peripheral neuropathy

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4
Q

List 4 involuntary movement disorders

A

Parkinson’s
Huntington’s
Dystonia
Tremor

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5
Q

List one cerebellar disorder

A

Tremor-loss of balance/co ordination

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6
Q

Which part of the brain allows us to perform normal motor functions?

A

Basal ganglia
Movement programming
Decide when, where to act, put in action learned motor plans.

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7
Q

Describe the process of movement programming

A

Stimuli to move, assemble motor plans, select motor plans from memory stores, assemble appropriate sequence, execute motor plan, initiate, run sequence, terminate

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8
Q

Define Parkinson’s disease

A

Neurodegenerative disease of extrapyramidal system where pigmented presynaptic nerve terminals die in substantia niagra pars compacta (SNPC)
- loss of striatal dopamine
- inability to perform normal motor function
Little change in post synaptic dopamine receptors

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9
Q

What are the signs and symptoms of Parkinson’s?

A 
Shuffling gait
Mask like face
Akinesia
Rigiidty
Tremor
Postural abnormalities
Bradykinesia
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10
Q

What are the later stages of Parkinson’s?

A

dementia, endocrine dysfunction due to a decrease in hypothalamic amines, dementia

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11
Q

Which pathways are associated with Schizophrenia

A

Mesolimbic

Mesocortical

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12
Q

Which pathways are associated with prolactin release?

A

Tubuleroinfundibular pathway

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13
Q

Which pathway is associated with Parkinson’s

A

Nigrostriatal

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14
Q

Which neurotransmitter changes are associated with Parkinsons’s

A
  • Loss of striatal dopamine (60-70% of symptoms)
  • Loss of dopamine in mesolimbic areas
  • Decrease in hypothalamic amines
  • Cortical NA and Ach decrease- dementia and cognitive defects
  • Neuropeptides in striatum decrease (CCK-8, substance P, enkephalins)
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15
Q

What are the causes of sporadic Parkinson’s disease?

A

Unknown
Oxidative stress
Mitochondrial/proteasome dysfunction

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16
Q

What are the causes of familial Parkinson’s disease?

A

PARK 1 mutation- codes alpha synuclein- in Lewy bodies
PARK2 mutation- codes Parkin- part of ubiquitin proteasome
LRRK2 gene mutation (leucine rich repeat kinase 2 gene)

17
Q

What are the other causes of Parkinson’s?

A

Drug induced neurodegeneraton MTTP
Drug induced symptoms- dopamine antagonists eg anti psychotics in schizophrenia Phenothazine
Viral encephalitis

18
Q

What is the main drug treatment for Parkinson’s

A

L DOPA + CARBIDOPA
Dopamine precursor and DOPA Decarboxylase inhibitor
LDOPA crosses BBB, converted to dopamine in brain

19
Q

What are the side effects of L DOPA

A

Choreic movement
Nausea, anorexia
Psychotic effects
Stops working after 10-15 years

20
Q

What is the second option?

A

Dopamine agonists eg Bromocriptine, Ropinirole

acts on D2 receptors- which are inhibitory and in basal ganglia

21
Q

What is the third option?

A

Monoamine oxidase inhibitors eg Selegiline
given with L DOPA
COMT inhibitors- Entacapone
only use with L DOPA

22
Q

Which drugs can be used to increase dopamine release

A

Amantidine

23
Q

Which drugs can be used to control tremor?

A

Muscarinic receptor antagonists

24
Q

Outline the main drugs used to treat Parkinson’s

SALAD

A 
Selegiline
Amantidine
L DOPA and Carbidopa
Anti cholinergic drugs
Dopamine agonists
25
Q

Describe Tourette’s disorder

A

tic disorder
affects 1/1000 people
Transient, long term- odd movements, inappropriate behaviour
Altered basal ganglia function- uncontrolled motor movements

26
Q

Which drugs can be used if Tourettes is causing harm?

A

Dopamine receptor antagonists

27
Q

Outline Huntington’s disease

A

Autosomal dominant, affects 0.01% of pop
Symptoms: dyskinesia, lower motor impairment, depression, dementia, psych component
due to loss of GABA (inhibitory) not dopamine
Increased BG activity- choreic movements, opposite symptoms to Parkinson’s
Cause: Mutant Huntington’s gene- 36 repeats of CAG coding for glutamine
Huntington protein assoc with neuronal cytoskeleton and vesicles
Upregulate BDNF transcription
BDNF loss- apoptosis of GABA neurones
Treat: decrease dopamine function Tetrabenazine

FBN (31 decks)

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