(PM3B) Parkinson's disease Flashcards
What is Parkinson’s disease?
Common + complex neurological disorder
Affects mainly movement
What are the types of motor symptoms experienced by those with Parkinson’s disease?
(1) Bradykinesia – slow movement
(2) Muscular rigidity
(3) Rest tremor
(4) Imbalance
What is bradykinesia?
Slow movement –associated with Parkinson’s disease
- Reduced armswing + stride length
- Reduced facial reaction
- Soft/ slurred speech
- Smaller handwriting
What is muscular rigidity?
Stiffness of limbs
Sometimes associated with pain
Associated with Parkinson’s disease
What is a rest tremor?
Tremor in one limb with limb at rest
Tremor with holding posture
Asymmetric tremor
What is imbalance?
Loss of balance reflex
Associated with Parkinson’s disease
What are some non-motor symptoms of Parkinson’s disease?
(1) Autonomic dysfunction
- Constipation/ temperature intolerance
(2) Sleep disorders
- Insomnia/ sleep attacks or sleep fragmentation
(3) Neuropsychiatric disorders
- Fatigue/ dementia/ depression/ anxiety
(4) Sensory disorders
- Pain/ colour vision deficits/ abnormal sensations
What neuropathological difference is there in those with Parkinson’s disease?
Loss of cells in the substantia nigra
Why does dopamine have a role in the development of Parkinson’s disease?
Essential for control of movement
Acts as a neurotransmitter in the substantia nigra
What are two key pathological hallmarks of Parkinson’s disease?
(1) Loss of (predominantly) dopaminergic neurones in the Substantia nigra
(2) Accumulation of intracellular inclusions (Lewy bodies) comprised of alpha synuclein
What molecules comprise Lewy bodies?
Intracellular inclusions
Proteins
Alpha synuclein
What percentage of cases of Parkinson’s disease development are considered sporadic?
95%
What are some of the causes of Parkinson’s disease?
Unknown
Could be idiopathic or sporadic
95% seem to be sporadic
Some links between pesticide and MPTP exposure (toxins)
Also associated with influenza exposure + repeated head trauma
What is an example of a gene that has been linked with Parkinson’s disease?
PINK1/ PARK 2/ PARK 7/ SNCA
State a non-pharmacological therapy for Parkinson’s disease.
Surgical intervention
State some pharmacological therapies for Parkinson’s disease.
(1) Symptomatic relief – e.g. dopamine
(2) Disease modifying therapies
Where does DDC convert L-DOPA?
~90% in intestinal wall
How are dopamine pathway treatments effective for Parkinson’s disease?
Ensure majority of L-DOPA enters brain unchanged for conversion to dopamine
What is the first line treatment for symptomatic relief of Parkinson’s disease?
Dopamine pathway treatment
L-DOPA
e.g. carbidopa/levodopa (co-careldopa)
What symptomatic treatment is also approved for Parkinson’s disease?
Pramipexole
Dopamine-receptor agonist
What are some potential side effects of dopamine pathway treatment?
Acute effect – psychosis
Chronic effect –dyskinesia (excess movements)
Why is a surgical intervention not possible for most patients with Parkinson’s disease?
Very expensive
What is the most common surgical intervention for Parkinson’s disease?
Electrode on globus pallidus + subthalamic nucleus
Regulated by a pulse generator
Describe the use of stem cell therapy in Parkinson’s disease.
Replacement of cells in the basal ganglia
Correction of underlying cause of reduced dopamine levels
Often carried out in Sweden
Name a therapy which can slow the development of Parkinson’s disease
There are none
