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Parkinson's disease
Uni of Notts, Neurobiology of disease, second year, topic 3
| Term | Definition |
|---|---|
| Neurodegeneration | Progressive loss of neurons via apoptosis, leading to impaired function such as motor, behavioural, or cognitive deficits |
| How neurodegenerative & psychiatric disorders differ | No obvious neuron loss, involve some functional & structural changes. May include developmental defects but will always cause behavioural changes |
| Role of α-synuclein in Parkinson’s disease | Misfolded α-synuclein aggregates into toxic fibrils forming Lewy bodies, contributing to neurodegeneration & neuroinflammation |
| Structure of α-synuclein *Example: no need to memorise* | Small intrinsically disordered protein with amphipathic N-terminus, hydrophobic NAC region (aggregation-prone N-acetylcysteine), & acidic C-terminus |
| Disorder description of Parkinson's | Progressive neurodegenerative involuntary movement disorder with increasing prevalence with age |
| Epidemiology of Parkinson’s | Affects all races equally, ~50% more common in males, second most disabling condition in elderly after osteoarthritis |
| Main motor symptoms of Parkinson’s (remember at least 5) | Bradykinesia, rigidity (akinesia), tremor at rest, postural abnormalities, reduced facial expression, speech disorders, & asymmetrical motor |
| later-stage symptoms of Parkinson’s | Depression, dementia, endocrine dysfunction |
| Primary neurochemical cause of Parkinson’s | Loss of dopamine in the caudal nigrostriatal pathway affecting basal ganglia function |
| How neurotransmitter loss progresses in Parkinson’s | Dopamine is lost in mesolimbic pathways, then hypothalamic, then cortical noradrenaline & ACh systems. Finally neuropeptides are lost from spinal & interneurons in the striatum |
| Neuromelanin & its purpose in diagnosing Parkinson's | Pigment in dopaminergic neurons giving dark colour; its loss reflects degeneration of these neurons |
| How Parkinson's is detected using imagery | PET imaging with DAT ligands shows reduced presynaptic dopamine transporters, but not post-synaptic D2-like receptors |
| Lewy bodies | Intracellular aggregate cores of α-synuclein fibrils disrupting neuronal function & causing dementia in 50% of patients |
| How α-synuclein affects synaptic function | Disrupts vesicle trafficking, inhibits dopamine synthesis enzymes (TH, AADC),& inhibits VMAT then facilitates synaptic vesicle recycling |
| How dopamine accumulation causes neuronal damage | Cytosolic dopamine auto-oxidises to form ROS & redox-positive DA quinones, causing oxidative stress & toxicity |
| Genetic causes of Parkinson's | Rare mutations from familial relations with Parkinson's (e.g. SNCA, LRRK2) lead to protein aggregation or mitochondrial dysfunction |
| Drug-related environmental factors | MPTP from contaminated opioids is converted to MPP+ by MAO-B leading to mitochondrial toxicity. Herbicides like paraquat cause oxidative stress to dopaminergic neurones |
| How L-DOPA is used to treat Parkinson's | Crosses BBB & converted to dopamine in the brain (DA can't cross the BBB) to restore signalling |
| Carbidopa | Administered with DOPA to inhibit peripheral AADC, preventing dopamine formation outside the brain leading to peripheral effects like nausea, anorexia or low blood pressure |
| Side effects of L-DOPA treament | Can still have unwanted side effects like rapid fluctuations between Parkinson's phenotype & peripheral side effects. Side effects worsen progressively if used longterm |
| Alternative treatments used in Parkinson’s | D2-like agonists (e.g. ropinirole), MAO-B/COMT inhibitors (administered with DOPA), & newer adenosine/muscarinic drugs. Potentially neurodegeneration reversing treatments |
| 4 types of movement disorder | Upper motor-neuron: Weakness, spasticity, hyperflexia Lower motor-neuron: Weakness, atrophy, hypoflexia Involuntary movement: Uncontrolled movements Cerebellar: poor coordination, ataxia, balance deficits |