PARKINSONS DISEASES

[ PD ]
By
DR. ROMMANAH AZMI
PM 013/09
WHAT IS PD?
Also known as paralysis agitans or shaking palsy
age-related deterioration of certain nerve
systems, which affects your movement, balance,
and muscle control.
one of the most common movement disorders,
affecting 1% of people older than 60 years. PD is
about 1.5 times more common in men than in
women, and it becomes more common as you
age.
first described in 1817 by James Parkinson, a
British doctor who published a paper on what he
called "the shaking palsy."



In PD, brain cells deteriorate (or degenerate) in
an area of the brain called the substantia nigra.
From the substantia nigra, specific nerve cells
tracts connect to another part of the brain called
the corpus striatum, where the neurotransmitter
(a chemical messenger in the brain) called
dopamine is released. Dopamine is an important
neurotransmitter and alterations in its
concentration can lead to different medical
problems.
The loss of these specific brain cells and decline in
dopamine concentration are the cornerstone of
signs and symptoms of PD as well as the target
for treatment. The biological mechanism
responsible for the brain cell loss has not been
identified.




PD RISK FACTORS
Advancing age
Sex
Family history
Declining oestrogen levels
Agricultural work
Genetic factors
Low levels of vitamin B folate
Head trauma
SYMPTOMS
Tremors
Bradykinesia
Akinesia
Digestion problems
Depression
Low blood pressure
Temperature sensitivity
Leg discomfort
Balance

PD DIAGNOSIS
Genetic testing
Genetic testing allows for genetic counseling
where couples can find out if they are carriers of
the mutated genes and, therefore, how likely
they are to pass them on to their children.
Neuroimaging
Single-photon emission computed
tomography (SPECT) is used along with a radio
labeled compound. The compound will bind onto
dopamine receptors and can be viewed using
SPECT. This method allows the measurement of
the amount of dopamine releasing neurons. PET
scans are also useful and provide 3D images of
the brain which allows one to analyze the
unique brain of each patient.

Olfactory system testing
Used by the body to detect smell. Testing this
system can be an indicator of Parkinsonism. It
usually involves the patient smelling a variety of
odors, and then making a choice from a variety
of possible answers for each one.
Autonomic system testing
Regulates processes in the body such as
cardiovascular, respiratory and digestive
function. It is also involved in salivation,
perspiration, dialation of the pupils, discharge
of urine, and erection. It involves examining
breathing, heart rate, reflexes and
thermoregulation (reaction to temperature).
MEDICATIONS
Selegiline (Eldepryl) gives a neuro -
protective effect for dopamine neurons.
Symptomatic therapy
Amantadine (Symadine, Symmetrel)
Levodopa - carbidopa (Sinemet)
Nicotine Found To Protect Against Parkinson's-Like
Brain Damage
ScienceDaily (Aug. 7, 2006) New research suggests
that nicotine treatment protects against the same
type of brain damage that occurs in Parkinsons
disease. The research was conducted in laboratory
animals treated with MPTP, an agent that
produces a gradual loss of brain function
characteristic of Parkinsons. Experimental
animals receiving chronic administration of
nicotine over a period of six months had 25
percent less damage from the MPTP treatment
than those not receiving nicotine. This protective
effect may explain the lower incidence of
Parkinsons disease among smokers. The results
also suggest that nicotine may be useful as a
potential therapy in the treatment of early-stage
Parkinsons patients.

There is NO known way to prevent PD.
Research has shown that people who eat
more fruits and vegetables, high-fiber
foods, fish, and omega-3 rich oils
(sometimes known as the Mediterranean
diet) and who eat less red meat and dairy
may have some protection against
Parkinson's disease. But the reason for this
is still being studied.