ParkinsonDisease2-18-11 - Parkinson Disease Tshona Corbin...

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Parkinson Disease Tshona Corbin What it is: a progressive neurodegenerative disorder associated with a loss of dopaminergic nigrostriatal neurons; classic features include resting tremor, rigidity, bradykinesia, and postural instability Pathophysiology: The major neuropathologic finding is a loss of pigmented dopaminergic neurons in the substantia nigra and the presence of Lewy bodies. Motor symptoms of the disease do not emerge until 60-80% of the dopaminergic neurons have been lost. Lewy bodies-concentric, eosinophilic, cytoplasmic inclusions with dense cores and peripheral halos; found within the pigmented neurons of the substantia nigra (characteristic, but not pathognomonic of disease). May be found in other diseases besides Parkinson. Newer studies suggest that the Lewy-body pathology in Parkinson disease begins in the olfactory bulb and lower brainstem, then ascend the brainstem to involve the midbrain and nigrostriatal dopaminergic neurons. To understand the effect of dopamine loss on motor pathways of the basal ganglia, look at the schematics on the link; I couldn’t get them to copy over. In summary, dopamine from nigrostriatal neurons activates the direct pathway and inhibits the indirect pathway. Frequency: one of the most common neurological disorders, with up to 1% of the population over the age of 60 years. Average prevalence estimates are 120/100,000. The disease is 1.5x more common in men. Average age of onset is 60 years, with increasing incidence with age.
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