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Parkinson’s Disease (PD)
Diagnostic ImageCompendium
Human Anatomy
Presented by:
Introduction
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Chronic and progressive neurodegenerative disorder
AKA idiopathic parkinsonism, primary parkinsonism,
PD, or paralysis agitans
Affects 7 to 10 million people worldwide
Unknown etiology
Signs & Symptoms vary & worsen with time
Characterized by resting tremor, bradykinesia,
muscular rigidity, and postural instability
Medications only control symptoms, does not reverse
effects
Disease Manifestation
 Generally associated with tremor or trembling
of the arms and legs, stiffness and rigidity of
the muscles, and slowness of movement.
 Cognitive & behavioral problems may follow,
with dementia in advanced stages
 Includes sensory, sleep and emotional
problems.
Diagnosis
One or more of 4 most common motor
symptoms:
 Resting tremor
◦ Shaking when muscles are relaxed
 Bradykinesia
◦ Slow movement
 Postural instability
◦ Unstable when standing upright
 Rigidity
◦ Stiffness and inflexibility
Epidemiology
 PD may be caused by a combination of genetic
and environmental factors.
 Gene mutations could be involved
 Affects 1 to 2% of general population
 Risk Factors:
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Age over 60
Male
Family history of PD
Exposed to environmental toxins
Caucasian
 In 2009,VA added PD to list of diseases
associated with exposure to Agent Orange.
Pathology I
oDeterioration
deep within the
brain
oMalfunction
and death of
neurons in the
substancia nigra
o Lack of
dopamine essential to
movement and
coordination
Pathology II
The pars compacta
region of the
substancia nigra in the
normal brain appears
dark because
dopamine-producing
neurons are highly
pigmented (left). As
neurons die, the color
fades (right).
Histology 1
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The arrowed area shows degeneration in the substantia
nigra in the basal ganglia of the brain.
This structure controls smooth muscle movement.
When these nerve cells die, the amount of dopamine
production is affected
Image Source: Bsip, Cavallini James/Science Photo Library
Histology II
Later in the
disease, cells in
other portions of
the brain and
nervous system
also degenerate.
Treatment
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A variety of
medications can
provide symptoms
relief.
Levodopa, replenish
the brain’s dwindling
supply.
Anticholinergics may
control tremor and
rigidity.
Antiviral drug,
Amantadine also help
reduce symptoms.
Before and After Treatment
The graphic
shows
Parkinson's
brain activity
before and
after
dopamine
replacement
therapy.
Conclusion
o DP is a degenerative disorder
o Dopamine-producing brain cells
o No blood or laboratory tests
o NIH conducts animal research on and
therapies
o New protective drugs may delay,
prevent, or reverse the disease.
References
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World Parkinson Disease Association
http://www.wpda.org [Accessed 11/29/2011]
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European Parkinson's Disease Association
http://www.epda.eu.com [Accessed 11/29/2011]
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Michael J. Fox Foundation for Parkinson's Research
http://www.michaeljfox.org [Accessed 11/29/2011]
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National Institute of Neurological Disorders and Stroke.
Parkinson's Disease Information Page.
www.ninds.nih.gov/disorders/parkinsons_disease. [Accessed 11/29/2011]
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Dr. Burstein, Assistant Professor of Neurobiology and Anesthesia
at Harvard Medical School and Beth Israel Hospital
http://www.psych.ndsu.nodak.edu/mccourt/Psy486/Movement%20and%
20Movement%20Disorders/parkinson's%20disease.htm [Accessed
11/29/2011]
QUESTIONS ?
Michael J. Fox, Actor, PD patient and activist