is a chronic degenerative disorder of the central nervous system that produces movement problems.
Primary or Idiopathic PD is thought to have ________ & ____________ factors.
-5% of cases are familial or inherited -13 genes associated with PD, all play a role in dopamine-secreting cell function
-oxidative stress & free radicals in mitochrondria, herbicides & pesticides, well water, the synthetic narcotic MPTP
-not true PD -has symptoms of PD
Secondary Parkinsonism appears with other medical problems such as:
-encephalitis/meningitis -stroke -vascular disease -exposure to toxins -antipsychotic medications -overdose of narcotics -repeated chronic head trauma (ex: boxers)
-age (over 60) -gender (M>F) -genetic -exposure to environmental toxins
-disruption of extrapyramidal motor system
Extrapyramidal tracts are associated with _________ ________, which plays a role in movement
A component of the basal ganglia is the ____________ __________
Normal substantia nigra are filled with _________-secreting neurons. In PD, many of these neurons are destroyed or stop working.
inhibitory neurotransmitter, helps control movements
Decreased levels of dopamine cause remaining neurons to be _______ __________.
Decreased levels of dopamine results in movement & postural abnormalities such as:
-resting tremors -rigidity/increase muscle tone -trouble intiating movement -stooped posture
Besides decreased dopamine, what two other things are common in PD:
1. damage to norepinephrine-secreting neurons -affects ANS: constipation, skin & urinary problems, sexual dysfunction 2. presence of Lewy bodies in the brain -clumps of proteins found in the brains of most PD patients -dementia & memory loss
-extremely rare -symptoms begin before the age of 20
Early Onset Parkinson’s Disease
-still fairly rare, usually an inherited form of PD -symptoms begin between 20-40 years old
Juvenile Parkinson’s Disease & Early Onset Parkinson’s Disease
-respond well to levodopa -but often experience more severe side effects (such as dyskinesia)
Parkinson’s Disease Cure
similar to general population
most people lead fulfilling lives after Dx
PD in Advanced Stages
risk of fall-related injuries, infections such as pneumonia, & choking increases & can lead to death
lead to deterioration of the brain & eventually death, but not always
-medications -deep brain stimulation -PT, OT, Speech -Dietary modification to avoid constipation -massage -yoga -tai chi -exercise in general
Problems with Medications
-“waning off” or decreased effectiveness of the medication (especially Levodopa) after prolonged use causing continual need to increase dosage -severe side effects such as dyskinesisa, dry mouth, blurred vision, urinary retention, confusion, and hallucinations -interact badly with other medications that may be useful, like anti-depressants.
-converted into dopamine in the body -unfortunately, when given by itself the body converts Levodopa too soon & the resulting dopamine can’t cross the blood brain barrier -when given with Carbidopa, Levodopa can cross the BBB in its medication form & then is transformed into dopamine by the brain making it much more effective
Deep Brain Stimulation
-surgical procedure that places an electrode near the motor areas of the brain -stimulation is controlled by a pacemaker place in the upper chest under the skin -used most often in advanced PD patients with unstable medication responses
PT & OT
commonly used to improve muscular function, gait & balance, assist with ADLs & help maintain overall health
are used to help with speaking & swallowing problems