Parkinsons

Question 1

Symptoms of parkinsons

Answer 1

rigidity (akinesia) , bradykinesia, poor posture, mask like expression, tremors

LATE STAGE - endocrine dysfunction, depression, dementia

Question 2

Descibe how we would usually initiate a movement from the basal ganglia + how this is disrupted in parkinsons

Answer 2

1. stimulus
2. assemble a motor plan from memory store
3. execute motor plan
4. initiate, run and sequence

parkinsons can assmeble motor plan just cant execute, run or sequence them

Question 3

which dopamine pathway is involved in parkinsons

Answer 3

nigrostriatal

Question 4

how much degeneration do you need in parkinsons before symptoms occur

Answer 4

70%

Question 5

Describe the causes of the psychological, endocrine and motor symptoms of parkinsons

Answer 5

psych - lack of dopamine in mesolimbic areas, lack of cortical NA and ACh
motor - dopamine in the striatum decreased, neuropeptides in the striatum decreased
endocrine - decreased hypothalmic amines

Question 6

name two types of imaging you can use to diagnose parkinsons and how they work

Answer 6

PET and SPECT

allow us to visualise and qualtify dopaminergic neurones

Question 7

List the 4 main causes of cell death in parkinsons and where it occurs

Answer 7

oxidative stress
mitochondrial dysfunction
proteosoms dysfunction
lewy bodies

Question 8

What are lewy bodies and name the genes that can cause them

Answer 8

eosinophilic inclusions with a-syncuclein core. - contributes to dementia in 50% parkinson patients
PARK1 gene codes for a- synuclein

Question 9

what is carbidopa

Answer 9

peripheral DOPA decarboxylase inhibitor

Question 10

1. list 5 unwanted effects from L Dopa treatment of parkinsons
2. what is the effect of long term parkinson treatment

Answer 10

choreic movement (violent) 
dose can wear off at the end of the day 
nausea and anorexia 
hypotension
psyhotic effects 

rapid decline in control, by 10-15 years treatment not effective

Question 11

What are bromocriptine, ropinirole, rotigotive and why are they effective

Answer 11

dopamine agonists (D2)
post synaptic D receptors not altered

Question 12

Why do you use a D2 agonist not a D1

Answer 12

D2 receptors are mainly found in the basalganglia

Question 13

What are Deprenyl and Entacapone and how to they work

Answer 13

MAO inhibitor and COMT inhibitor.

COMT and MAO break down dopamine (in any order)

Question 14

Name the 4 types of drugs that treat parkinsons + one that controls the tremor

Answer 14

• L Dopa, MAOi, Dopamine agonists, amantidine,

- M antag controls tremor

Question 15

How do the different D1 and D2 receptors in striatum cause parkinson symptoms

Answer 15

D2 receptors inhibitory on the inhibitory movement pathway. by knocking out the dopaminergic neurones less inhibition of the inhib pathway therefor increased anti movement

D1 receptors are excitatory of the pro pathway therefor by knocking them out decreased pro movement

Question 16

How does mutations in PARK2 gene cause parkinsons and what type of parkinsons does it cause

Answer 16

codes for parkin which is part of the ubiquitin proteosome, cause early onset parkinsons NO lewy bodies

Question 17

Mutations in LRRK2 gene can lead to

Answer 17

parkinsons

Question 18

Name two drug induced causes of parkinsons

Answer 18

antipsychotics and MPTP (fake heroin)

Question 19

Causes of huntingtons

Answer 19

mutant huntingtons gene, upreg BDNF, DNF loss

Question 20

How is huntingtons treated?

Answer 20

not effective, some improvement by decreasing dopamine function

Question 21

What causes tourettes and how is it treated

Answer 21

altered basal ganglia function

dopamine receptor antagonist