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Flashcards in Parkinson's Disease Deck (9)
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1
Q

What is the Definition of Parkinson’s

A

Neurodegenerative disease caused by the death of dopamine-containing cells in the substantial nigra (origin of dopaminergic afferents)

2
Q

What is the pathophysiology of Parkinson’s

A

Loss of dopaminergic, serotonergic and noradrenergic neurons.

3
Q

What are the THREE genes affected in Parkinson’s

A

1) Alpha Synuclein - autosomal dominant
. Major constituent of lewy bodies, too much or abnormal
2) LRRK2 - autosomal dominant
. Leucine-rich repeat kinase 2
3) Parkin - autosomal recessive
acts as a ubiquitin-protein ligase (protective)

4
Q

What complex can be missing in people with PD

A

Mitochondrial complex 1 (extracts energy from NADH)

5
Q

Name some autonomic non-motor symptoms

A

GI - constipation
Genitourinary - urinary urgency, erectile dysfunction
Cardiovascular - sympathetic denervation
Cognitive - slow thoughts, dementia
Sleep - rapid eye movement, restless legs
Mood - depression, psychosis
Pain - muscoskeletal, radicular neuropathic, dystonic

6
Q

What is the first line therapy

A

LEVODOPA - bradykinesia and rigidity, converted to dopamine via DOPA-decarboxylase

7
Q

What is the first line therapy in younger patients

A

Dopamine agonists - reduced motor complication, selective for D2 and D3 post synaptic receptors

8
Q

How do MAO’s work

How do COMT inhibitors work

A

Prevents degradation of dopamine

Prevents degradation of dopamine

9
Q

How does deep brains stimulation work

A

Permanent implantation of leads into subthalmic nucleus or globes pallid us, deliver high frequency electrical impulses