Parkinson's Disease/Dementia

Question 1

Parkinson’s

Answer 1

Hypokinetic (loss of muscle movement)
Motor symptoms related to dysfunction within the nigrostriatal dopaminergic pathways
Non-motor symptoms attributed to progressive impairment in other dopaminergic pathways

Question 2

Dopaminergic pathways

Answer 2

Frontostriatal circuits
Mesolimbic pathway

Question 3

Epidemiology

Answer 3

Peak onset around age 60
Rate of progression varies, mean time 7-8 years from time of diagnosis to becoming wheelchair-bound without medical treatment
Neuropsychological performance is a predictor of progression rate

Question 4

Dopamine

Answer 4

Involved in the control and coordination of body movements

Question 5

Causes

Answer 5

Loss of dopaminergic neurons in substantial nigra that affects dopaminergic pathways
Reduction in amount or dopamine results in difficulties controlling movement
Neuronal loss is slow - symptoms become noticeable after 80% of the nerve cells in the substantial nigra have been lost

Question 6

Symptoms

Answer 6

Motor symptoms - resting tremors, rigidity, bradykinesia (slowness of movement), shuffling gait, postural instability, dystonia (involuntary muscle contractions), speech difficulties
Non-motor symptoms - depression and anxiety, olfactory dysfunction, cognitive impairment, apathy, pain, fatigue, processing speed, working memory, planning and set shifting problems, sentence comprehension and naming problems

Question 7

Treatments

Answer 7

L-DOPA
Deep brain stimulation (DBS)

Question 8

L-DOPA

Answer 8

Precursor to dopamine that can pass the BBB, converted into dopamine in the brain
Moderate doses decrease motor symptoms
Effects of long-term usage aren’t good