PARKINSON’S DISEASE

1. PARKINSON’S DISEASE Sarah Newport

2. Background • Historians have found evidence of the disease as far back as 5000 B.C. (Ayurveda, an ancient Indian medical practice) • “Kampatava” • It was first described in “An Essay on the Shaking Palsy" in 1817 by English physician James Parkinson • 1861:French neurologist Jean Martin Charcot distinguished the disease from other neurological conditions and deemed it "Parkinson's disease." • http://www.youtube.com/watch?v=eYMyEqRb2cw

3. Brief overview • Parkinson's disease (PD) is a neurological condition • Chronic and progressive movement disorder • Degeneration of the basal ganglia -Substantial Nigra =>Nigrostriatal pathway => Corpus Striatum

4. Biochemistry of PD

5. Causes of parkinson’s disease • Mainly idiopathic ! (aforementioned massive loss of cell activity) L-tyrosine >>> L-dopa >>> Dopamine Progression of Parkinson's as seen on PET scans=>

6. Causes of pd (cont.) • Neurotransmitter dopamine serves many functions including the influence of movement, learning, attention, and emotion • reduced dopamine receptor activity linked to PD symptoms (brain produces tremors, decreased mobility) • Parkinson's patients have a loss of 80 percent or more of dopamine-producing cells in the substantianigra • The reduction in dopamine leads to cell damage (cell damage does not initially reduce dopamine formation) • patients with PD show increased brain levels of iron, especially in the SN, and decreased levels of ferritin, which serves as a protective mechanism • when dopamine is not properly formed, the toxic element Superoxide ion can form instead, resulting in oxidative damage to mitochondria (energy producing organelles of the cell), causing death of the cell

7. More on pd pathogenesis • Genetic influence -some people have an inherited susceptibility to the disease that may be influenced by environmental factors: -Toxic causes -Head trauma -Drug induced

8. Pd symptoms • Cardinal motor symptoms: -tremor -rigidity -slowness of movement -postural instability

9. Other pd symptoms • Neuropsychiatric disorders of speech, cognition, mood, behavior, and thought • Depression and anxiety are common in patients. Dementia or confusion can develop in the later stages of Parkinson’s disease. Some patients experience a decreased sense of smell. • Sleeping problems • ANS

10. epidemiology • 2nd most common neurodegenerative disorder to Alzheimer’s • .3% of population in industrialized countries • >6 million people worldwide, even more undiagnosed • >1 million Americans • Primarily strikes ages 50+ • Average onset age=60 yrs • Prevalence and incidence increase with age • Rare amongst the very young and old • M>F • Generally more PD cases of Whites than Latinos or Blacks in the United States

11. diagnosis • There is no one particular test that can be done to diagnose Parkinson's Disease • Diagnostic techniques range from genetic testing, testing of the olfactory and autonomic system, neurophysiological testing and neuroimaging.

12. treatment • There is no known cure for Parkinson’s • Therefore, treatment is symptomatic • Quality of life deteriorates quickly if treatment is not instituted at or shortly after diagnosis • Medications and/ or surgery can provide symptom relief, to an extent -Pharmacological: Levodopa (L-DOPA), dopamine agonists, MAO-B inhibitors • drugs for Parkinson's Disease can be both a cure and eventual cause of symptoms

13. Treatment cont. • broad-based management: patient and family education, support group services, general wellness maintenance, and nutrition • Living with Parkinson's disease: denial, helplessness, anger, fear, withdrawal from social circles are coping mechanisms • Depression is very common in patients with PD • Utilization of psychological services proven helpful • Palliative care

14. EPDA Charter for People with Parkinson's Disease

15. Getting personal

16. That’s about it