Lecture 3

Question 1

What is PD commonly misdiagnosed as

Answer 1

Multiple systems atrophy and progressive supranuclear palsy

Or drug induced symptoms can be similar

Question 2

Drug induced PD symptoms

Answer 2

Neuroleptic

Question 3

Neuroleptic

Answer 3

Antipsychotic agents, gastric motility inhibitors like metocloperamide, and catecholamines release modulators like reserpine and tetrabenazine

Question 4

What is the difference between PD and drug induced symptoms similar to PD

Answer 4

Tremor is less with drug induced symptoms

Question 5

Will drug induced PD symptoms go away

Answer 5

Yes eventually

Question 6

Difference between PD and MSA and PSP

Answer 6

They progress faster than PD and PD meds will only work for a short period of time on them

Question 7

What hormone do PD patients have low levels of

Answer 7

Dopamine

Question 8

Why do PD patients have low dopamine

Answer 8

SN that produces dopamine is destroyed

Question 9

Can dopamine levels be tested to check for PD

Answer 9

No because it is hard to test for

Question 10

DATscan

Answer 10

Visualizes dopamine transporter (DAT) in the putamen. Measuring DAT in neurons is an indirect way of quantifying the amount of dopamine in the neurons

Question 11

More DAT =

Answer 11

More dopamine

Question 12

Is there a lab test for PD

Answer 12

No

Question 13

What percent of PD is misdiagnosed

Answer 13

10-20%

Question 14

__ cases of PD per 100,000 individuals

Answer 14

100-300

Question 15

More than ___ cases of PD globally

Answer 15

6 million

Question 16

Twin studies showed high/low concordance rates for PD in monozygotic and dizygotic twins

Answer 16

Low

Question 17

What does it show that both twins don’t get PD

Answer 17

Strong non-genetic factors in causation of PD

Question 18

Environmental toxins that cause PD

Answer 18

MPTP (mitochondrial toxin) with structure similar to herbicide paraquat (insecticide)

Question 19

What areas is PD incidence highest in

Answer 19

Agricultural

Question 20

Do more men or women have PD

Answer 20

Men

Question 21

What continents is PD less prevalent in

Answer 21

Asian and African

Question 22

Smoking and PD

Answer 22

40-70% less likely in smokers

Question 23

Coffee and PD

Answer 23

Protective effect

Question 24

Early onset PD age

Answer 24

less than 40 years old

Question 25

Prevalance of early onset PD

Answer 25

5%

Question 26

What causes early onset PD

Answer 26

Genetic mutations

Question 27

Late onset PD age

Answer 27

Over 60 years

Question 28

Prevalance of late onset PD

Answer 28

95%

Question 29

a-synuclein mutation

Answer 29

(aSYN) single base pair mutation from alanine to threonine at position 53

Question 30

What is aSYN the main constitute of

Answer 30

Lewy body

Question 31

How is neuronal cell death caused by aSYN

Answer 31

Mutated aSYN forms fibrils

Question 32

How is PD risk increased genetically

Answer 32

Duplication and triplication of normal aSYN

Question 33

___ of aSYN is pathogenic

Answer 33

Overproduction

Question 34

Other genes besides aSYN that are involved in PD

Answer 34

Leucine-rich repeat kinase-2 (LRRK2), Parkin, and PINK1

Question 35

How do Leucine-rich repeat kinase-2 (LRRK2), Parkin, and PINK1 cause PD

Answer 35

They are involved in ubiquitination

Question 36

Ubitiquination

Answer 36

Marks old proteins and damaged organelles for destruction

Question 37

What happens if old proteins and damaged organelles are not marked for destruction

Answer 37

Accumulation of junk

Question 38

What does junk buildup in cells lead to

Answer 38

Damaged mitochondria

Question 39

What is caused when mitochondria are damaged

Answer 39

Decrease pH, ROS produced and cell death

Question 40

What does the gold standard treatment for PD do

Answer 40

Increase dopamine levels in the brain

Question 41

Can we inject dopamine to increase the levels

Answer 41

No, it does not cross the BBB

Question 42

Levodopa action

Answer 42

Levodopa crosses the BBB and once it is in the neurons it is converted to dopamine

Question 43

How can enzymes be used to increase dopamine

Answer 43

Preventing the destruction of dopamine in the synapse

Question 44

How many enzymes destroy dopamine in our body

Answer 44

Two

Question 45

Enzymes that destroy dopamine in our body

Answer 45

Monoamine oxidase type B (MAO-B) inhibitors | Catecholamine ortho-methyltransferase (COMT) inhibitors

Question 46

MAO-B inhibitors

Answer 46

Prevent breakdown of dopamine in the brain

Question 47

COMT inhibitors

Answer 47

Block the breakdown of dopamine in the periphery

Question 48

Ablation

Answer 48

Cutting or destroying a part of the body

Question 49

What is ablation used for in PD

Answer 49

Destroy GPi

Question 50

What is used to destroy the GPi in ablation

Answer 50

Surgical or chemicals like MPTP

Question 51

What symptoms does ablation help

Answer 51

Bradykinesia, akinesia, and rigidity

Question 52

Deep brain stimulation

Answer 52

Stimulate the subthalamic nuclei by electrical wires

Question 53

What will be the result of deep brain stimulation of the subthalamic nuclei

Answer 53

Increased GPi inhibition of the thalamus (will not stimulate movement --> reduces the tremor)

Question 54

How many electrical impulses are sent to the brain in deep brain stimulation

Answer 54

More than 100

Question 55

Future treatments for PD

Answer 55

1. Cell transplantation 2. Gene transfer 3. Trophic factors

Question 56

Cell transplantation

Answer 56

Dopamine producing cells are transplanted into the substantia nigra

Question 57

How is gene transfer done

Answer 57

Via virus, chemical mediated

Question 58

Trophic factors

Answer 58

Make neurons grow and divide (injected into the substantia nigra)