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