PD - Non-motor symptoms

Question 1

What are some non-motor symptoms of PD

Answer 1

Behavioral
Cognitive
Dysautonomia
Sensory Problems
Sleep disorders
Weight loss
Fatigue

Question 2

What is Bradyphrenia

Answer 2

slowness of thought

Question 3

What is Dysautonomia

Answer 3

How your body responds

Question 4

Behavioral ex: (PD)

Answer 4

Anxiety
Depression
A-Motivation
Apathy
Insomnia
Impulsivity
Obsessive Compulsive Symptoms

Question 5

Cognitive ex:

PD

Answer 5

Bradyphrenia
Confusion
Word finding difficulty
Memory loss
Dementia
Hallucinations
Psychosis

Question 6

Dysautonomia ex:

Answer 6

Chills/sweats 
Orthostatic Hypotension 
Sexual dysfn 
Constipation 
Urinary frequency & urgency
Seborrhea
Sialorrhea

Question 7

What is Seborrhea

Answer 7

common skin problem. It causes a red, itchy rash and white scales. When it affects the scalp, it is called “dandruff.
(PD)

Question 8

Sensory problem ex:

PD

Answer 8

Pain
Paraesthesia
Anosmia

Question 9

what is anosmia

Answer 9

The loss of the sense of smell, either total or partial

Question 10

Sleep disorder ex:

Answer 10

REM behavioral d/o

Vivid Dreams

Question 11

Fatigue and PD can be due to

Answer 11

↓ Respiratory Function

Question 12

BG projections to Frontal Lobe can effect with circuits

Answer 12

Dorsolateral Pre-frontal Circuit

Orbitofrontal Circuit

Anterior Cingulate Circuit

Question 13

Dorsolateral Pre-frontal Circuit affects

Answer 13

Executive Functions

• Higher order processing
• Problem solving
• Planning
• Prioritizing
• Conceptual shifts
• Multitasking
• Working memory

Question 14

Orbitofrontal Circuit affects

Answer 14

Mediates personality & socially appropriate behavior

• Apathy
• A-motivation
• Impulsivity
• Introversion

Question 15

Anterior Cingulate Circuit

affects

Answer 15

Depression

Anxiety

Question 16

Pain syndromes and PD

Answer 16

Back/Neck pain
Postural changes & DJD

Rigidity, dystonia, dyskinesia
Limb pain – Cramping; most common in shoulder & proximal arm
Rigidity, Dystonia, DJD

Restless Leg Syndrome – common in PD, can be unilateral, painful, relieved by activity or movement

“Off” Paraesthesia – sensory changes during “off period”

Question 17

Depression & PD

Answer 17

Depression – 50% of PD pts
1°: due to loss of dopamine neurons
2°: due in part to sensory deprivation from paucity of movement
Significant contributor to QOL issues
Usually responds to meds

can be primary b/c of lack of dopamine

Question 18

Dementia and PD

Answer 18

Risk is 4x higher in PD pts over a 3-5 year period than normals

Question 19

Hallucinations and PD

Answer 19

Usually visual in nature
Other psychiatric disorders usually present with audio or tactile hallucinations

Begins by seeing “dots”, then becomes “people” or “objects”
Be cautious in the use of medications to treat hallucinations b/c antipsychotic meds block dopamine
Can be very dangerous 🡪 risk for falls!!!
↑ Risk for caregiver burn-out

Question 20

Sleep disorders reasons why pts wry PD can’t fall asleep

Answer 20

RLS
Anxiety
Motor discomfort
Bladder issues

Question 21

PD and Sleep disorders: cant stay asleep

Answer 21

Depression
REM Behavior D/o
Bladder issues
Anxiety

Question 22

Sleep disorders: don’t sleep well (PD)

Answer 22

REM BD

Sleep apnea

Question 23

Potential Issues Caused by sleep d/o

Answer 23

Fatigue
Night time safety
↓ Motor & behavioral relaxation
Caregiver burn-out

Question 24

Psychosis and PD and risk factors

Answer 24

Dopamine-induced psychosis: features…

Vivid dreams & nightmares, disorientation, hallucinations, delusional thought

Increased risk of morbidity and nursing home placement

Risk Factors: poly-pharmacy, age, dementia, visual problems
Treat with atypical antipsychotics (i.e. Cholinesterase inhibitors)–> increasing cholinergic function found to improve cognition & behavior

Question 25

GI/GU Issueswith PD

Answer 25

Constipation
Worsens with ↓ exercise & dietary changes
Can affect L-Dopa absorption

Urinary Problems
Frequency > Urgency
Incontinence-> may need bladder management/training
Urgency ->falls
Can have dystonia of pelvic floor muscles
Can contribute to ↓ volume intake, worsening the orthostatic & constipation symptoms

Question 26

What are the 3 rating scales for PD

Answer 26

PD Progression Rating Scales

Unified PD Rating Scale (UPDRS)

Sit to Stand Test