1 Parkinson’s Disease pg241;247 Pinel +lecture Parkinson Disease First described by James Parkinson in 1817-English Physician (b.1755 d.1824) 1805 wrote ‘Observations on the Nature and Cure of Gout’ 1817 wrote ‘Essay on the Shaking Palsy’ secured his place in history! (No Likeness of Parkinson in existence) One of the most common, most studied and best understood disorders of movement Parkinson’s own description of condition is probably still the best and most complete: ‘…… ‘…… ‘…… ‘……involuntary tremulous motion, with lessened muscular power, involuntary tremulous motion, with lessened muscular power, involuntary tremulous motion, with lessened muscular power, involuntary tremulous motion, with lessened muscular power, in parts not in action and even when supported, with a propensit in parts not in action and even when supported, with a propensit in parts not in action and even when supported, with a propensit in parts not in action and even when supported, with a propensity y y y to bend the trunk forward, and to pass from walking to a to bend the trunk forward, and to pass from walking to a to bend the trunk forward, and to pass from walking to a to bend the trunk forward, and to pass from walking to a running pace, the senses and intellects being uninjured running pace, the senses and intellects being uninjured running pace, the senses and intellects being uninjured running pace, the senses and intellects being uninjured’ Symptoms are: Paucity of spontaneous movement- insufficiency of movement Akinesia- no movements Bradykinesia- very slow movements Increased muscle tone- rigidity Resting Tremor - @4-5Hz- ‘pill rolling’ Shuffling gait and flexed posture, impaired balance Mask-like expression Parkinson Disease is first example of a brain disorder resulting from a deficiency of a single neurotransmitter Dopamine Oleh Horynekiewicz found brains of Parkinson disease sufferers were deficient in DA in striatum. 1955-Arvid Carlson-80% brains dopamine in basal ganglia
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Parkinson’s Disease pg241;247 Pinel +lecture
Parkinson DiseaseFirst described by James Parkinson in 1817-English
Physician (b.1755 d.1824)
1805 wrote ‘Observations on the Nature and Cure of Gout’
1817 wrote ‘Essay on the Shaking Palsy’secured his place in history!
(No Likeness of Parkinson in existence)
One of the most common, most studied and best understood disorders of movement
Parkinson’s own description of condition is probably still the best and most complete:
‘……‘……‘……‘……involuntary tremulous motion, with lessened muscular power, involuntary tremulous motion, with lessened muscular power, involuntary tremulous motion, with lessened muscular power, involuntary tremulous motion, with lessened muscular power,
in parts not in action and even when supported, with a propensitin parts not in action and even when supported, with a propensitin parts not in action and even when supported, with a propensitin parts not in action and even when supported, with a propensity y y y
to bend the trunk forward, and to pass from walking to a to bend the trunk forward, and to pass from walking to a to bend the trunk forward, and to pass from walking to a to bend the trunk forward, and to pass from walking to a
running pace, the senses and intellects being uninjuredrunning pace, the senses and intellects being uninjuredrunning pace, the senses and intellects being uninjuredrunning pace, the senses and intellects being uninjured’’’’
Symptoms are:
Paucity of spontaneous movement- insufficiency of movement
Akinesia- no movements
Bradykinesia- very slow movements
Increased muscle tone- rigidity
Resting Tremor - @4-5Hz- ‘pill rolling’
Shuffling gait and flexed posture, impaired balance
Mask-like expression
Parkinson Disease is first example of a brain disorderresulting from a deficiency of a single neurotransmitter
Dopamine
Oleh Horynekiewicz found brains of Parkinson disease sufferers were deficient in DA in striatum.
1955-Arvid Carlson-80% brains dopamine in basal ganglia
2
basal ganglia-four nuclei
striatumcaudate
putamen
Globus pallidus Substantia nigra
Subthalamic nuclei
major inputs fromcortex, thalamus,brainstem
projection…
Major output
1960’s Parkinson disease shown to be result of degenerationof dopaminergic neurones within the substantia nigra pars
compacta
The Basal Ganglia
DA
Walter Brikmeyer and Horyenkiewicz found that IV L-dihydroxyphenylalanine (L-DOPA- a dopamine precursor) provided a dramatic albeit brief reversal of symptoms!
George Cotzias showed that gradual increases in oral L-DOPA provided significant and continuous benefits
Beneficial effects of L-DOPA only last for ~ 5 yrs side effects increase-motor response fluctuations and
