Questions and Answers
Tourette Syndrome is equally prevalent in both males and females.
False
Over 50% of individuals with Tourette Syndrome also have attention deficit hyperactivity disorder or obsessive-compulsive disorder.
True
Prenatal maternal smoking does not contribute to the etiology of Tourette Syndrome.
False
The prevalence of Tourette Syndrome in children is estimated to be between 0.5% to 1%.
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Most patients with Tourette Syndrome can expect a poor outcome into adulthood.
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Mild cases of Tourette Syndrome always require specific treatment.
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The cardinal triad of idiopathic Parkinson's disease includes a rest tremor, cog-wheel rigidity, and dyskinesia.
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Impaired olfaction is a feature that can indicate the presence of Parkinson's disease years before motor symptoms appear.
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Cognitive impairment occurs in about 50% of patients with Parkinson's disease.
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Dementia with Lewy bodies is diagnosed if dementia begins more than 1 year after the onset of established Parkinson's disease.
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The clinical picture of Parkinson's disease dementia is typically that of a subcortical dementia.
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The major depressive disorder occurrence in Parkinson's disease is about 35%.
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Bradykinesia is less prominent than tremor in later-onset cases of Parkinson's disease associated with dementia.
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Constipation and sleep disturbances are common symptoms that can appear before the onset of motor symptoms in Parkinson's disease.
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Huntington's disease is a single gene, autosomal recessive disorder.
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Individuals with less than 30 CAG repeats in the huntingtin gene will develop Huntington's disease.
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In Huntington's disease, new mutations are common.
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Performance anxiety is not a significant issue for musicians.
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Dystonias are primarily caused by genetic mutations.
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The peak onset of tics typically occurs around the age of 12.
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Botulinum toxin injections are an effective treatment for dystonias.
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Genetic counseling is unnecessary for individuals affected by Huntington's disease.
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The majority of tics in children improve within 5 years.
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Pesticide exposure is considered a protective factor against Parkinson's disease.
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Depression occurs in less than 50% of individuals with Huntington's disease at some point.
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Use of beta-blockers is considered a risk factor for Parkinson's disease.
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Chorea is a motor abnormality specifically associated with Huntington's disease.
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The caudate nucleus undergoes atrophy and gliosis in Huntington's disease.
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The genetic risk polymorphism GBA is associated with Huntington's disease.
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Cognitive impairment in Huntington's disease can include decreased attention and impaired emotional recognition.
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Tobacco smoking is considered an environmental risk factor for Parkinson's disease.
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Depression is most common in the early and very advanced stages of Parkinson's disease.
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Delusions in Parkinson's disease are more frequent than visual hallucinations.
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The pathological hallmark of Parkinson's disease is the presence of Lewy bodies composed of beta-amyloid inclusions.
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Tobacco smoking is associated with an increased risk of developing Parkinson's disease.
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Clozapine and quetiapine are recommended antipsychotic medications for treating psychotic symptoms in Parkinson's disease.
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Increased age, cognitive impairment, and reduced visual acuity are associated with a higher occurrence of visual hallucinations in Parkinson's disease patients.
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Idiopathic Parkinson's disease primarily affects individuals under the age of 55 years.
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Pramipexole is primarily used as an antidepressant in Parkinson's disease.
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The mechanism causing depression in Parkinson's disease is well understood and correlates strongly with disease severity.
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Impulse control disorders, such as gambling, are often related to medication used in Parkinson's disease treatment.
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Study Notes
Parkinson's Disease
- Cardinal triad: rest tremor, cog-wheel rigidity, bradykinesia.
- Common psychiatric issues include cognitive impairment, depression, psychosis, and behavioral problems.
- Impaired olfaction can be an early indicator, occurring years before motor symptoms.
- Common non-motor symptoms: constipation, sleep disturbances.
- Diagnosis of dementia in Parkinson’s occurs when cognitive decline starts more than a year after motor symptoms onset.
- Synaptic dysfunction, oxidative stress, and neuroinflammation play roles in disease etiology.
Dementia in Parkinson's Disease
- Approximately 30% prevalence of cognitive impairment; up to 80% may develop dementia.
- Dementia types:
- Parkinson's disease dementia: develops >1 year after motor onset.
- Dementia with Lewy bodies: develops <1 year after motor onset.
- More prevalent in later-onset cases and when bradykinesia predominates.
Depression and Parkinson’s Disease
- Up to 35% of patients exhibit clinically significant depressive symptoms.
- Depression commonly occurs in early and advanced stages.
- Correlation between depression and frontal lobe abnormalities or disturbed dopaminergic mechanisms.
Tourette Syndrome
- Symptoms include overactivity, learning difficulties, emotional disturbances, and social issues.
- Common comorbidities: ADHD and obsessive-compulsive disorder (OCD), with over 50% having one.
- Prevalence: 0.5-1% in children, more common in males (3-4 times).
- Genetic link, with environmental factors like prenatal smoking and hypoxia being implicated.
Treatment and Outcome of Tourette Syndrome
- Mild cases may not require treatment; mild and behavioral interventions are primary methods.
- Effective management strategies include addressing comorbid psychiatric issues.
- Outcomes suggest two-thirds of patients improve or have lasting remission into early adulthood.
Psychiatric Manifestations in Parkinson's Disease
- Manifestations can include delirium, cognitive decline, depression, hallucinations, delusions, and sleep disorders.
- Visual hallucinations (20% occurrence) often linked to dopaminergic medication and related factors.
- Treatment considerations: using SSRIs cautiously to avoid cognitive impairment exacerbation.
Huntington's Disease
- Autosomal dominant disorder from expansion of CAG repeats in the HTT gene on chromosome 4.
- Greater than 40 CAG repeats lead to full penetrance.
- Anticipation phenomenon: earlier onset in subsequent generations.
- Cognitive impairment features: cognitive slowing, reduced attention, and poor emotional recognition.
Neuropathology of Huntington's Disease
- Primary atrophy affects the caudate nucleus and frontal lobes.
- MRI reveals caudate shrinkage correlating with motor and cognitive deficits.
- Presence of polyglutamine nuclear inclusions associated with HTT gene mutation.
Dystonias
- Uncontrolled focal muscle spasms lead to involuntary movements.
- Etiology varies including genetic mutations, infections, neurotoxicity, and drugs.
- Clinical examples: blepharospasm, torticollis, writer's cramp.
- Botulinum toxin injections are most effective treatment.
Tics
- Stereotyped movements prevalent in children, often triggered by emotional disturbances.
- Treatment includes behavioral interventions, exposure prevention, and occasionally atypical antipsychotics.
- 80-90% of childhood tics improve within 5 years, with common associations to OCD, ADHD, and anxiety disorders.
Risk Factors for Parkinson's Disease
- Genetic: mutations in genes like SCNA, LRRK2, GBA are significant.
- Environmental: pesticide exposure, head injury, rural living increase risks.
- Protective factors include coffee consumption and tobacco smoking.
Motor and Cognitive Features of Huntington's Disease
- Motor abnormalities: chorea, impaired voluntary movements, and bradykinesia.
- Cognitive impairment includes attention deficits and reduced planning abilities.
- Behavioral features range from depression to early loss of insight.
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Description
This quiz explores key aspects of Parkinson's disease, including its cardinal triad of symptoms, common psychiatric issues, and non-motor symptoms. Furthermore, it delves into the prevalence and types of dementia associated with Parkinson's, as well as the impact of depression on patients. Test your understanding of this complex neurodegenerative condition.
