Parkinson’s Disease Patricia Miguel

What is Parkinson's Disease? (PD) Commonly referred to as a movement disorder because the overall affect is movement According to Parkinson’s Foundation, PD is neurodegenerative disorder in nerve cells that affects the dopamine that produces neurons in a certain part of the brain called substantia nigra The dopamine producing cells transmits signals between areas of the brain This disease is chronic and progresses over a certain period of time

Lack of Neurotransmitter Dopamine is reduced Synaptic cell has less neurons to transfer No problem with receptors or cell but with production of dopamine Not as mush neurotransmitters as a normal person

Substantia Nigra In the substantia nigra dopamine cells are suppose to be producing in there to help regulate daily movements The substantia nigra is where it all starts it is located in the midbrain and is the cause for all movement made. Its appearance is a high level of pigment with a healthy person but one with PD will have a diminished substantia nigra Dopamine is a neurotransmitter When there is a lack of the neurotransmitter of dopamine the cells in the SN tend to die and dopamine is not sent to the brain Dopamine is produced in the substantia nigra but with PD it affects the production causing the external symptoms of PD to happen with an individual

Overview of Substantia Nigra

Causes of Parkinson’s American Parkinson's Disease Association, labels Parkinson's disease as idiopathic because the cause is not 100% known APDA states that Parkinson's disease may most likely be due to either gene or environmental factors Parkinson's is not genetic but is a disease a person develops on their own. The gene mentioned only exists within a small percentage of the population(10%) Gene called LRRK2 Environmental factors are said to play a role as well Being exposed to metals and too many pesticides Repetitive head injuries Lack of dopamine (inhibitory) causes overstimulation by Ach(excitory) and symptoms happen because of it

Statistics Just like any other disease, Parkinson's can occur within any age group but many sources have typically stated it’s a disease for older adults Parkinson's News Today stated, that only 4% of people will get before the age of 50 and the remaining percentage happens within ages 60 & over Men have a higher ratio of getting than women Worldwide there are about 10 million people affected by this (Parkinson's News Today)

Statistics (cont.) U.S Only Worldwide

Symptoms The symptoms for Parkinson's disease consists of lack of motor and non-motor activities. Motor activities tend to be more common than non-motor and have a higher chance of helping diagnose a patient Cleveland Clinic stated that very common motor activities: Tremor Pill-rolling Involuntary shaking when at rest, mainly within the hands and feet Bradykinesia Disease had worsened if this occurs Slowness of movement Cant really do daily activities Rigidity Stiffness in limbs Prohibits on person to freely move their body Balance and coordination Other less common symptoms are Depression Speech change Little to no facial expression

How to be Diagnosed for Parkinson’s Surprisingly, no blood test, scan test or certain examination exists to determine if a person actually has Parkinson’s no “one way” testing According to Parkinson’s Foundation, a diagnosis of Parkinson's is for the doctor to observe the symptoms and through physical examination About 20% percent of people get misdiagnosed To be diagnosed it is best to go a neurologist

Stages of Parkinson’s According to Parkinson's Disease.net Stage One Stage Two Stage Three Still early So early and mild it is hard to diagnose Symptoms include tremor of the hand and sometimes rigidity Physicians wait to observe more of the symptoms to be exactly sure it is Parkinson's Still considered early and mild Can pick up years or months after stage one Rigidity of muscles that stiffen up limbs Walking and voluntary movement is bad Slowness of everything including daily activities Can still perform them but is time consuming Moderate Person should be diagnosed by now Loss of balance and slow movement Patient can still live independently but way harder to do things alone Have both rigidity and tremors Falls are common Balance is tested

Stages of Parkinson’s (Cont) Stage Four Stage Five Advanced severe Need around the clock assistance Can’t even get up from a chair Have higher chances of falling when alone At this stage they can experience hallucinations or delusions Severe Patient is considered disabled Can walk and stand unassisted but are not able to fully do it on their own Need a walker Can not live on their own Painful in limbs, feet, and back Need assistance with daily activities

Outcome for Parkinson’s Patient “Some people wind up in wheelchairs; others still run marathons. Some can't clasp a necklace, while others make necklaces by hand.”, the outcome of it simply depends on the person(The Michael J Fox Foundation) Not every Parkinson’s patient will experience the same symptoms in the same way Outcome for the patient is determined by the stages of Parkinson's There are currently 5 stages of this disease The stage a person is in is determined by the symptoms they are experiencing This disease is not fatal or deadly but the outcomes of it associate within the causes of death

Treatment No specific treatment will get rid of this disease it is uncurable Although Parkinson's Foundation states there are two treatments to help regulate it which is surgically and medications Medication can help lower symptoms ability but cant get rid of the disease A few medications are: Sinement-adds dopamine to brain Ropinirole- stimulates the dopamine receptor Anticholinergic- decreases rigidity and decreases signs and symptoms There are also surgical treatments that exist Deep brain stimulation- when the doctors surgically insert electrodes into a certain area of the brain to record the activity of the brain, then after that is done doctors implant and impulse generator to help impulse the brains motor function Duopa- a patient must have a hole incision into their stomach wall so a pump may pass through. After the hole is made in this process and a pump is inserted it will directly deliver duopa into the intestine of this person

DEEP BRAIN STIMULATION DUOPA

Sources “What Is Parkinson's?” Parkinson's Foundation, 17 Oct. 2018, www.parkinson.org/understanding- parkinsons/what-is-parkinsons. “Causes of Parkinson's | American Parkinson Disease Assoc.” APDA, www.apdaparkinson.org/what-is-parkinsons/causes/. “Parkinson's Disease Symptoms & Treatment.” Cleveland Clinic, my.clevelandclinic.org/health/diseases/8525-parkinsons-disease-an-overview “Parkinsons Disease Prognosis.” The Michael J. Fox Foundation for Parkinson's Research | Parkinson's Disease, www.michaeljfox.org/understanding-parkinsons/living-with- pd/topic.php?prognosis. “Parkinson's Disease Statistics.” Parkinson's News Today, Parkinson's News Today, parkinsonsnewstoday.com/parkinsons-disease-statistics/ https://www.youtube.com/watch?v=JJ6YB4674GQ What Are the Stages of Parkinson's Disease?” ParkinsonsDisease.net, parkinsonsdisease.net/basics/stages/