Parkinson's Disease Overview Quiz

Parkinson's Disease Overview

• Parkinson's disease (PD) is a common and complex neurological disorder primarily affecting movement.
• Prevalence has doubled in the past 25 years.
• Global estimates in 2019 exceeded 8.5 million individuals.
• PD caused over 329,000 deaths in 2019, a significant increase from 2000.
• 14 per 100,000 people in the total population experience PD annually.
• 160 per 100,000 people aged 65 years or older develop PD annually (Hirtz et al., 2007).
• Around 153,000 people live with Parkinson's in the UK, making it the fastest-growing neurological condition.
• Symptoms include motor symptoms, non-motor symptoms, and clinical symptoms with a specific time course.
• Individuals may experience the onset of non-motor symptoms 10-20 years before motor symptoms begin.

Motor Symptoms

• Bradykinesia (slow movement): Slowness of walking, reduced arm swing/stride length, reduced facial expression ("masked face"), softening or slurring of speech, and smaller handwriting.
• Muscular rigidity: Stiffness of limbs, sometimes accompanied by pain.
• Rest tremor: Tremor present in a limb at rest, tremor while holding a posture or during action. Tremors are usually asymmetrical.
• Imbalance: Loss of balance reflexes.

Non-Motor Symptoms

• Autonomic dysfunction: Orthostatic hypotension, urogenital dysfunction, constipation, and intolerance to heat or cold.
• Neuropsychiatric disorders: Fatigue, anhedonia (inability to experience pleasure), depression, anxiety, and dementia.
• Sensory disorders: Pain, colour vision deficits, and abnormal sensation.
• Sleep disorders: Sleep fragmentation, insomnia, REM sleep behaviour disorder (RBD), and sleep attacks.
• Loss of sense of smell.

Pathology

• Two key pathological hallmarks:
  • Loss of neurons, predominantly dopaminergic, in the substantia nigra.
  • Accumulation of intracellular inclusions called Lewy bodies, composed of alpha-synuclein protein.
• Neuromelanin pigmentation loss approximately 70% on onset.
• Impairment in the clearance of Lewy bodies, showing reduction in autophagy and the accumulation of the protein.

Causes of Parkinson's Disease

• Predominantly sporadic (95%).
• Idiopathic (unknown cause in most cases).
• Specific environmental triggers.
• Genetic predisposition (5%).
• Examples of environmental factors: Pesticide exposure, MPTP exposure, influenza (Spanish flu) exposure, repeated head trauma

Types of Parkinson's Disease

• Idiopathic (unknown cause).
• Vascular Parkinsonism.
• Drug-induced Parkinsonism.
• Multiple System Atrophy.
• Progressive Supranuclear Palsy.

Treatment

• Primarily symptomatic.
• Pharmacologic treatment: Levodopa/carbidopa (essential medicine).
• Non-pharmacologic treatment: Surgical interventions (deep brain stimulation).

Additional Therapies

• Stem cell therapy involves replacing cells in the basal ganglia to correct underlying dopamine level issues.
• Occupational therapy helps individuals perform daily activities (ADLs).
• Physiotherapy improves movement and exercise.
• Speech and Language Therapy (SALT) addresses communication and swallowing difficulties.
• Beyond medication: balanced diet including whole grains, vegetables, fruits, milk, and dairy products; protein-rich foods; nuts, olive oil, fish and eggs for beneficial fats;
• Quality standards and guidelines are available (e.g., NICE guidelines).

Test your knowledge on Parkinson's disease, including its characteristics, prevalence, and treatment options. This quiz covers statistics, medications, and symptom classifications related to the disorder. Enhance your understanding of this neurological condition through challenging questions.