Parkinsons Disease

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Parkinsons Disease

• By Angelica Fink, Danielle Meyering,
• Jennifer Thompson

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Parkinsons Disease

• Parkinson disease is a brain disorder.
• It occurs when certain neurons the brain,
  substantia nigra, die or become impaired. Nigral
  cells produce the hormone dopamine. Dopamine
  gives the body coordinated and smooth function of
  skeletal muscular movement. 

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Etiology

• The etiology of Parkinsnons disease is not
  clearly understood. There are however 3 main
  factors that are thought to contribute to the
  disease.

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Etiology

• Age related attrition and death of dopamine
  producing neurons (people who develop Parkinsons
  lose 70 -80 before onset of symptoms, normal
  loss over lifetime for non-Parkinsons people is
  9- 13 )
• Environmental factors- may be due to combination
  of ongoing aging process with exposure to
  environmental factors that accelerate the process
  of nigral cell death.
• Environmental factors include rural living,
  farming, drinking well water, exposure to
  pesticides. (pesticides cause oxidative stress
  and disrupt mitochondrial function- these are 2
  main processes involved in dopaminergic cell
  loss)
• Toxins MPTP (impurity found in illegal drugs)
  produces similar symptoms, but not classic
  Parkinsons

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Etiology Contd

• Genetic susceptibility to these environmental
  toxins. Low incidence in Africans and Asians.
  Family history also strong predictor ( evidence
  of genetic factor) Gene abnormalities have been
  detected in families with Parkinsons (long arm
  chromosome 6, the protein product of this gene
  parkin) promotes the degredation of specific
  neuronal proteins.
• So far 9 genetic abnormalities as of 2002 found
  to be associated with Parkinsons.

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Pathogenesis

• The process by which environmental agents,
  genetic abnormalities, or combo of both are
  thought to kill dopagminergic neurons in
  Parkinsons.

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Pathogenesis

• Mitochondrial disorders- still not fully
  understood, mitochondria in Parkinsons patients
  are compromised and function improperly. This
  leads to cell death and the making of toxins.
• Oxidative Stress- increased accumulation of free
  radicals which surround the brain cells and cause
  progression of the disease. The metabolism of
  dopamine causes free radical formation. Free
  radicals that are influential in disease
  progression are superoxide, hydroxyl, peroxide,
  nitric oxide. Iron is also thought to play a
  role.

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Mitochondrial Disorders and Oxidative Stress
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Abnormality in Clean-up Recycling

• Abnormal protein processing-abnormalities in
  genes that function in clean-up and recycling of
  damaged proteins that occur through everyday
  functioning.

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Clinical Manifestations

• Early Stages
• Client will feel fatigued, achy, and Malaise
  (discomfort)
• 70 of Clients will notice slight tremors in the
  hands or feet usually on one side of the body.
• Client will experience muscle rigidity and
  immobility of the hands.

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Progression of the Disease

• Weakness of throat and face muscles making it
  difficult for the client to swallow, and talk.
  Stiffness of the facial muscles can lead to a
  fixed facial expression.
• Posture Instability
• The client will experience difficulty walking,
  and an increase risk of falling due to gait
  disturbance.
• Client will also experience an increase in excess
  saliva, weakening of voice volume, rapid and
  stuttering voice.
• Bradykinesia (slow movement)
• Increase in tremors which generally progress to
  tremors over all extremities.

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Treatment

• Current treatments (medications) are used to
  suppress the signs and symptoms of the disease.
• Majority of the medications used to treat PD work
  by influencing dopamine. (Dopamine is important
  in mobility, coordination, and behavior)
• There are six categories of medications for PD
• 1. Levodopa (most potent last prescribed)
• 2. Dopamine Agonists
• 3. COMT (Catechol-Ortho-Methyl Transferase)
  Inhibitors
• 4. MAO (MonoAmine Oxidase) Inhibitors uses
  first
• 5. Amantadine used first
• 6. Anticholinergics

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Treatments Contd.

• Exercise, healthy eating habits, and low stress,
  can help with the treatment of PD.
• Clients with severe symptoms may need treatment
  provided by Speech, and Physical Therapists.
• Deep Brain Stimulation is also a strong treatment
  for PD. It does not relieve all of the symptoms,
  which rule out patients eligible for
  this procedure. An implantable device and
  electrodes are placed that produce electrical
  impulses. The electrical impulse jams the
  unwanted PD impulse, allowing for normal movement
  of impulses.
• There is no current cure for Parkinsons Disease.