1 / 15

Parkinson’s Disease and Treatment

Parkinson’s Disease and Treatment. Shalla Hanson Medicinal Chemistry April 2009. Description of Disease. Parkinson’s disease (PD) is typically considered a chronic, progressive neurodegenerative movement disorder. However, it is now known to have variety of nonmotor symptoms as well.

kenna
Download Presentation

Parkinson’s Disease and Treatment

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Parkinson’s Disease and Treatment Shalla Hanson Medicinal Chemistry April 2009

  2. Description of Disease • Parkinson’s disease (PD) is typically considered a chronic, progressive neurodegenerative movement disorder. However, it is now known to have variety of nonmotor symptoms as well.

  3. Major Symptoms-TRAP • Tremor • Rigidity • Akinesia/Bradykinesia • Postural Instability Other motor symptoms include: • Gait • Dystonia • Hypophonia • Drooling • Dysphagia • Fatigue • Akathesia

  4. Nonmotor Symptoms • Mood—20-80% suffer from depression. • Behavior—indirectly, e.g., a result of dementia, depression. • Thinking-slowed reaction time and executive dysfunction • Sensation—impaired sense of smell • Excessive daytime sleep, insomnia, and REM sleep disturbances. • Vision problems • Impaired proprioception • Oily skin • Weight loss • Incontinence • Constipation • Drooling

  5. Primary Known Causes • Idiopathic—majority of cases • Genetic • Drug induced—Calcium Channel Blockers • Toxins—Supported by the geographically varied incidence • Head Trauma • Cerebral Anoxia

  6. Pathophysiology • Decreased stimulation of the motor cortex by the basal ganglia, usually due to the inadequate production and action of dopamine (produced in the dopaminergic neurons of the brain.) • The specific region affected seems to be the pars compacta in the substantianigra where there is a marked loss in dopaminergic cells. • We also see a considerably high activity in the cells of the Subthalamic nucleus, which inhibits movement. • High presence of Lewy bodies in dopaminergic cells.

  7. Diagnosis • PET Scan—decreased dopaminergic activity in the substantia nigra • Unified Parkinsons Disease Rating Scale—cognitive interview • Normal CT • Normal MRI

  8. History • PD was first described in detail by James Parkinson in 1817 in “An Essay on the Shaking Palsey.” • Carlsson in 1950, determined that dopamine was a neurotransmitter and was exceptionally concentrated in the basal ganglia. • Carlsson’s research later showed that Reserpine demonstrates a correlation between motor impairment and decreased dopamine levels. L-Dopa also given to animals which alleviated symptoms and initiated medicinal therapies for PD in 1967. • In California in 1980 a group of opiate addicts consumed MPTP N-methyl-4-phenyl-1,2,3,6-tetrahydropyridine, and revealed a pro-toxin, allowing another animal model of PD.

  9. Treatment • Education • Exercise • Nutrition • Psychiatric counseling

  10. Treatment • Oral Medication • L-Dopa (aka Levodopa) • Most popular treatment • Form of dopamine which is able to cross the BBB through transport in L-AA system and can then be metabolized to dopamine. • Sinemet = levodopa + carbidopa

  11. Treatment • Oral Medications • MAO-B Inhibitors • Selegiline = most common • Dopamine Agonists • Ropinirole • Apomorphine • Lisuride • COMT Inhibitors (Catachol-O-methyl transferaseInh.) • Tolcapone • Entacapone • Stalevo = levodopa, carbadopa, and entacapone

  12. Treatment • Surgical Procedures • Deep Brain Stimulation • Creating a lesion in the subthalamic nucleus or globus pallidus

  13. Current Research • Gene Therapy • GAD = Glutamic Acid Decarboxylase • Deep Brain Stimulation • Controlled Impulses • Pallidotomy-not enough data to assess results well • Subthalotomy—improvements in contralateral rigidity • Subthalamic Deep Brain Stimulation—mimics Levodopa

  14. Works Cited Britton, Thomas C. "NONMOTOR ASPECTS OF PARKINSON'S DISEASE." Current Medical Literature: Neurology 20 (2004): 45-50. "Parkinson's Disease." Current Medical Literature: Neurology 23 (2007): 44-48. Marceglia, Sara, and Alberto Priori. "Sex, genes, hormones and nigralneurodegeneration: two different Parkinson's diseases in males and in females." Future Neurology 2 (2007): 499-503. "Literature Review: Pathophysiology." Current Medical Literature: Parkinson's Disease 5 (2003): 59-61. "Literature Review: Medical Treatment." Current Medical Literature: Parkinson's Disease 5 (2003): 66-70. "Literature Review: Surgical Treatment." Current Medical Literature: Parkinson's Disease 5 (2003): 71-72.

More Related