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Parkinson's Disease
Scott Boline BrainU202-2012
James Parkinson-first clinical description of the syndrome
Notables with Parkinson Disease
Adolf HitlerMuhammed Ali
Micheal J. Fox-1961-same age as I amJames Doohan-Scottie
Jim Bakkus-Thurstan Howell IIIBob HoskinsVincent Price
Pope John Paul IIJanet Reno
Harriet-My Mother-in-law
I am sure there is someone you know and love whoHas or may have this disease.
Characteristics of Neurological Disorder
Parkinson's disease is a progressive disorder of the nervous system that affects your movement. It develops gradually, sometimes starting with a barely noticeable tremor in just one hand. But while tremor may be the most well-known sign of Parkinson's disease, the disorder also commonly causes stiffness or slowing of movement. (Mayo Clinic)
Brain Disease when symptoms evolve over 20 yrs. 5-10 % occur before age of 50
Early:Tremor- Diskinesia-not indicator of diseaseStiffness, slowness, difficulty walking- BradykinesiaSmall, Crowded handwritingStooped Posture“Masked” face frozen in serious expressionRigidity experienced by some people
Late: DimentiaEarly symptoms continue to manifest
1.5 million Americans50,000 new patients/yr27% attributed to genetic/heritability73% attributed to Environmental factors63 Average age of onset
Genetic Environment• SNCA (synuclein, alpha non A4
component of amyloid precursor): SNCA makes the protein alpha-synuclein. In brain cells of individuals with Parkinson's disease, this protein aggregates in clumps called Lewy bodies.
• Mutations in the SNCA gene are found in early-onset Parkinson's disease.
• PARK2 (Parkinson's disease autosomal recessive, juvenile 2): The PARK2 gene makes the protein parkin. Mutations of the PARK2 gene are mostly found in individuals with juvenile Parkinson's disease. Parkin normally helps cells break down and recycle proteins.
• PARK7 (Parkinson's disease autosomal recessive, early onset 7): PARK7 mutations are found in early-onset Parkinson's disease. The PARK7 gene makes the DJ-1 protein, which may protect cells from oxidative stress.
• PINK1 (PTEN-induced putative kinase 1): Mutations of this gene are found in early-onset Parkinson's disease. The exact function of the protein made by PINK1 is not known, but it may protect structures within the cell called mitochondria from stress.
• LRRK2 (leucine-rich repeat kinase 2): LRRK2 makes the protein dardarin. Mutations in the LRRK2 gene have been linked to late-onset Parkinson's disease.
.
•Living in Rural Area
•Farming
•Ranching
• Fishing
•Welding
•Drinking well water
•Exposure to Solvents
•Pesticides
•Insectacides
•Fungacides
Treatments for Disorder
Carbidopa-levodopa (Parcopa). LevodopaDopamine agonists
MAO B inhibitorsCatechol O-methyltransferase (COMT) inhibitorsAnticholinergicsAmantadine
Deep brain stimulation
N-Acetyl-Cystein (NAC) –slow the progressionParkinson's depletes an antioxidant in the brain called glutathione, so U of M researchers are now infusing a drug called N-Acetyl-Cystein (NAC) into the veins while patients are in the MRI machine. Then they monitor those antioxidant levels as more and more of the drug slowly flows into the brain. Minimal side effects, non-addictive.
In addition, lifestyle is also geared at treating the symptoms. Aerobic exercise, balance PT and stretching are prescribed.
Grow new neurons that release dopamine-using non embryonic or fetalsources.
Current Drugs
Brain implant
Latest research
Lifestyle
Stem Cell
Impact on Learning
Impulse-control disorders: Compulsions-gambling, shopping, eating, sex, hobbies
Punding-repetitive, purposeless
Novelty seeking trait: Preference for new and different things, instead of familiar things. increase with dopamine boosting drugs where trait is less without medication.
Memory: Short term problems
Ethical Issues
USA and Europe have different laws regarding ethics
Xenografts-transplanted animal tissue into humans
Stem cell sources
Sham Surgery Controls in Research
Paying research volunteers
Current Controversies
What is better: dopamine or dopamine agonists
How much dopamine
What is treatment of choice for newly diagnosed
Patients driving
Sources
http://www.myfoxtwincities.com/story/19043257/slowing-the-progression-of-parkinsons-with-mri-and-nac-treatment
http://www.youramazingbrain.org/brainchanges/parkinsonsnew.htm
http://onlinelibrary.wiley.com/journal/10.1111/%28ISSN%291467-8519
Mary Holmay: U of MN Center for Orphan Drug Research, Maguire Translational Research Bldg.
http://academic.sun.ac.za/stellmed/Articles/Internal_Medicine/AN11039.htm
http://journals.lww.com/smajournalonline/Fulltext/2004/12000/Great_Shakes__Famous_People_With_Parkinson_Disease.13.aspx
http://katekelsall.typepad.com/my_weblog/2008/08/the-controversy-surrounding-driving-with-parkinsons.html