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BMSC - Neuroanatomy > PD - Potential Therapies > Flashcards

PD - Potential Therapies Flashcards

1
Q

Give examples of potential therapies for PD

A 
Adenosine A2A receptor antagonists 
Neural Transplant
Stem cell transplant 
Deep brain stimulation and surgery 
Gene therapy
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2
Q

Where are adenosine A2A receptors found?

A

Striatum

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3
Q

How does A2A oppose D2 effects?

A

Decreases DA affinity for D2

Activates signalling cascades which are normally inhibited by d2

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4
Q

Why may adenosine A2A receptor antagonists be useful in PD?

A

Block the effects which are in opposition of D2

To reinstate thalamocrtoical motor stimulatory activity

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5
Q

Give an example of an A2A receptor antagonist

A

SCH58261

KW-6002

KF17837

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6
Q

What findings from rat models support the idea of adenosine A2A receptor antagonists as suitable therapy?

A

SCH58261 - increased basal locomotion

KW-6002 reversed haloperidol induced akinesia

KF17837 improved jaw movemetns, muscle tone and tremor in PD models

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7
Q

Which natural adenosine A2A receptor antagonist has been studied?

A

Caffeine

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8
Q

What is the effect of caffeine in PD rodent models?

A

Protects against DA toxicity in rodents and reverses MPTP-induced loss of DA neurons

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9
Q

What are the systemic effects of adenosine A2A receptor antagonists?

A

Inflammation, ischaemic

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10
Q

What are the CNS effects of adenosine A2A receptor antagonists?

A

Psychosis

Insomnia

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11
Q

Explain the concept of neural transplant to treat PD

A

Replace the lsot DA neurons but injection of foetal midbrain neurons to the substantia nigra pars compacta

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12
Q

What are the clinical findings of foetal neuron transplants?

A

Maintain function and improve symptoms for up to 15 years

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13
Q

Why are neural transplants not used more commonly?

A

Ethics

Not a renewable solve

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14
Q

Compare animal model findings to human findings of neural transplant

A

More success in animal models

Variable success in actual patients

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15
Q

Explain the concept of stem cell transplant to treat PD

A

Get embryonic stem cells and induce them to replicate into DA neurons
Theoretically this should replace lost neurons

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16
Q

What is the downside to stem cell transplant

A

May lead to tumour formation or tissue rejection

17
Q

What is deep brain stimulation?

A

Use of a stereotactic frame to insert a needle to the target area - normally the STN

Stimulator box inserted into the subclavicular space

18
Q

What is deep brain stimulation generally used for?

A

Adjunct therapy for intractable tremor or long term levodopa

19
Q

What are the advantages of deep brain stimulation?

A

Better control
Longer relief time than medications
Reduced dose of meds needed
Relief from pain and insomnia

20
Q

What are the acute disadv of deep brain stimulation?

A

Tingling
Speech problems
Dizziness and balance

21
Q

What are the chronic disadv of deep brain stimulation?

A

Loss of strength
Depression
Also side note the electode could break like in ur head

22
Q

What is the most common surgery performed in PD?

A

Pallidotomy

23
Q

Which symptoms does a pallidotomy improve

A

Tremor
Rigidity
Bradykinesia

24
Q

Which structure is removed in a pallidotomy?

A

The globus pallidus interna

25
Q

Explain the concept of gene therapy as a treatment for PD

A

Use viral vectors to introduce a protein to specific brain region which increases GABA levels
The increased GABA then inhibits the effects of a BG output

Such as tremor, ridigity and bradykinesia

26
Q

Why gene therapy over surgery?

A

Less invasive

27
Q

What are the main side effects of gene therapy?

A

No serious side effects

But only small studies done so far!

28
Q

How does GDNF delivery help PD?

A

Prevents DA neuron loss in neurotoxin exposure

BMSC - Neuroanatomy (17 decks)

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