Parkinson's Disease and Other Movement Disorders

Question 1

what are the functions of the basal ganglia? (4)

Answer 1

• connect the motor cortex with the midbrain
• receive input from the neocortex, including the motor cortex and limbic cortex
• receive from the nigrostriatal dopamine pathway from the substantia nigra
• output back to the motor cortex and substantia nigra

Question 2

what is the nigrostriatal pathway important for?

Answer 2

smooth movements

Question 3

what are the subcomponents of the basal ganglia? (9)

Answer 3

• caudate nucleus
• putamen
• globus pallidus pars interna (GPi)
• globus pallidus pars externa (GPe)
• subthalamic nucleus
• substantia nigra pars compacta (SNc)
• substantia nigra pars reticulata (SNr)
• intralaminar thalamic nuclei
• ventral pallidum

Question 4

what causes Parkinson’s Disease? What does this result in?

Answer 4

• caused by loss of dopamine cells in the substantia nigra and their input to the basal ganglia
• results in muscular rigidity and difficulty initiating and performing movements

Question 5

what are the symptoms associated with Parkinsonism? (4)

Answer 5

• resting tremor
• rigidity
• akinesia (lack of movement) or bradykinesia (very slow movement)
• postural instability

Question 6

what are the characteristics of Parkinson’s Disease? (3)

Answer 6

• typically idiopathic (no known cause)
• Lewy Bodies in substantia nigra
• have resting tremor, rigidity, bradykinesia, postural instability, hypophonia, masked facies, micrographic, shuffling gait, and stooped posture

Question 7

what are the common neuropsychological deficits seen in PD? (6)

Answer 7

• bradykinesia/bradyphrenia
• visuoperceptual/visuoconstructional impairments
• attention/executive impairments
• memory problems (retrieval deficit)
• intractable depression
• Parkinson’s Disease Dementia

Question 8

what does corticobasal degeneration cause? (3)

Answer 8

• apraxia
• alien limb
• aphasia

Question 9

what does progressive supranuclear palsy cause?

Answer 9

problems with gaze resulting in increased risk of falling

Question 10

what are the characteristics of Huntington’s Disease? (3)

Answer 10

• autosomal dominant disease
• destroys cells in the caudate putamen
• results in involuntary and exaggerated movements

Question 11

what are the characteristics of Tourettes’s Syndrome? (2)

Answer 11

• related to damage to the caudate putamen

- results in unwanted tics and vocalization

Question 12

what do the caudate nucleus and putamen make up?

Answer 12

the striatum

Question 13

what doe the putamen, globus pallidus pars interna, and globus pallidus pars externa make up?

Answer 13

the lentiform nucleus

Question 14

indirect pathway

Answer 14

inhibits the action of the cortex (Parkinson’s)

Question 15

direct pathway

Answer 15

excited action of the cortex (Huntington’s)

Question 16

what are the treatment options for movement disorders? (3)

Answer 16

• L-dopa (primarily for PD)
• deep brain stimulation (insert probe into substantia nigra to cause more activity and increase movement)
• ablation treatments (taking out some inhibitory pathways to help with movement)

Question 17

what are the signs that a patient might not do well after deep brain stimulation? (5)

Answer 17

• signs of dementia
• neuropsychological deficits prior to PD
• hallucinations (not due to L-dopa)
• poor health generally
• smaller hippocampi