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Parkinson's Disease

Bio 106
by

Vanessa Jimenez

on 3 December 2013

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Transcript of Parkinson's Disease

Parkinson's Disease
What is Parkinson's Disease?
chronic and degenerative disorder
Causes
Risk Factors
Symptoms
Motor Symptoms
Treatment
Medication
Personal Narrative
Q+A with Julie Belte, the daughter of Rey Hutter a Parkinson’s patient.

by Vanessa Jimenez, Catherine Belte, and Jabria Craft
Non - motor Symptoms
Therapy
Alternative Remedies
Surgery
Parkinson's
in the Media
Link between Parkinson's Disease and Alzheimer's
chronic = long - lasting effects
degenerative = affected organs or tissues deteriorate over time

affects 1/100 people over 60 years old
people can be diagnosed as young at 18 years old
rate of misdiagnosis is high because there is no biomarker for Parkinson's
estimated number of people living with the disease
U.S = 1 million
Worldwide = 5 million

Genetic Causes
Environmental Causes
Genetic Mutation
LRRK2 Gene
Case study demonstrating environmental causes
1980s
California
heroin users ingested a batch contaminated with a substance called
MPTP
they attained a form of Parkinson's disease
Advancing Age
Gender
Men have a higher risk than women
Head Injury
Pesticide Exposure
Bradykinesia
- slowness of movement
Rigidity
- unusual stiffness a limb or other body part
Resting tremor
- uncontrollable movement that affects the body when it's at rest
Postural instability
-problems standing and walking due to impaired balance and coordination
also called
"dopamine non-responsive"
Cognitive impairment -
decline in the ability to multi-task and concentrate as well as intellectual functioning
Mood disorders -
depression and anxiety
Difficulty sleeping - mainly in the REM stage
Hyposmia - loss of sense of smell
Speech & Swallowing problems
Purpose
regulate symptoms
increase dopamine levels
Common Medications
Carbidopa - levodopa (Parcopa)
considered the most effective
natural chemical that passes through brain and is converted to dopamine
prolonged use leads to tolerance and increase in tremors
Dopamine Agnostics
mimics dopamine effects
often taken as a supplemet to pacopa
MAO B Inhibitors
prevent breakdown of brain dopamine
enzyme
metabolizes brain dopamine
dangerous side effects - hallucinations & nausea
not normally taken with other medications
Therapy can help regain and maintain daily activities
Physical therapy - balance and stretching
Occupational therapy - helps complete daily tasks
ex. writing, changing, eating, and bathing
Lifestyle Changes
Diet
- fiber heavy to avoid constipation
Constipation
Movement change
-
increased exercise helps maintain fine motor skills
walking with care - PD can alter sense of balance
looking ahead instead of down and moving slowly to avoid falling

Alternative Practices
-
Yoga, Tai Chi, & Ballet increase flexibility and muscle memory
Acupuncture lessens pain of some symptoms
Dyskinesia
difficulty performing voluntary movement
it's a side effect of long-term therapy with levodopa
levodopa is made via biosynthesis
results from prolonged use of antipsychotics
movements look like smooth tics
finalistic movement - continue with an involuntary movement to mask it
no therapy yet - improves with reduction or redistribution of levotherapy
but it's followed by an increase in rigidity or tremors so it is not a solution
Dystonia
kind of dyskinesia
involuntary muscle movement
can involve the entire body or an isolated area
associated with pain (cramps)
normally occur when medications wear off and dopamine levels drop
My Father was 48 when he first experienced symptoms, hand shaking mostly. It was not until he was 53 that they officially diagnosed him. Upon hearing the diagnosis he was actually relieved that he finally knew what it was. They were previously giving him all kinds of tests trying to determine what it was. At one point, the doctor even suggested he go to a psychiatrist because he thought the symptoms could have been from going through the war in Poland. The day he was diagnosed he walked into the doctor's office and she said right away, I know you have Parkinsons.

How old was your Father when he was diagnosed with Parkinson's?

How old was he when he passed?
73 years old
About how long did he have parkinson's until it became incapacitating?

Within two years of being diagnosed, He had to close his business because he was unable to work and run it. It was the last 5 years of his life that things grew worse.

Did he receive any unique medications or procedures that were not per usual/standard?

At one point the doctors suggested he try an experimental drug. He took it for 6 months but was then advised not to take it because some patients had died as a result.

What was your personal reaction to the diagnosis and treatment process?

I remember when I first was told of the diagnosis, I ran to a dictionary to look up the disease. I was devastated at what I read. However, my Dad was very upbeat and remained that way through the entire course of the disease. The treatment process was really to introduce him to dopamine supplements and as the years passed they would just adjust the medication to what would suit him best. There was always the struggle of finding the exact combination of drugs that would help reduce the tremors and freezing but at the same time not over medicate him.

What would be your personal advice to others who have friends or family members suffering from Parkinson's?

To continue to love and treat them just like you did before. To be understanding and patient when things may take longer, i.e. eating, getting dressed, etc. To ensure them their loved one can live a long life with the disease. To remain positive, exercise and be your own health advocate. Also, I think it's very important not to overlook the caretaker. It can be just as hard, some days more difficult, than the patient himself. They should have breaks and utilize support groups.

Do you have a favorite memory of your father where he overcame the disease symptoms?

My strongest memory would be that I never once heard my Dad complain - not only in how he felt, was limited in movement, or that he had this debilitating disease. He never said "why me?". When I think of how many times we might say, oh I have a headache or my back aches, etc. He never said any of those things. He was a positive person and his faith was very strong. About ten years ago he wasn't doing very well so I flew to California to be with him in the hospital. The Doctors told my mom they thought he wouldn't come out of the hospital. Grammy found a new Dr. and they recommended that he be removed from all medication and then just placed on a reduced amount of one or two drugs. Papa made a complete turn around and it was right after he got out of the hospital that I arrived for my visit. He looked so good then and was happy to see me.

Twitter Campaign
Mayo Clinic and Michale J Fox Foundation temed up for a #parkinsonschat awareness campaign where twitter users ask questions about Parkinson's
Love & other Drugs
Maggie Murdock (Anne Hathaway) a young woman who suffers from Parkinson’s disease meets Jamie Randall (Jake Gyllenhaal) a pharmaceutical drug rep.

This movie depicts the daily struggles of having Parkinson's disease as well as how someone that is affected could handle their prognosis
Michael J. Fox
Fox has repeatedly been one of the most outspoken celebrities advocating for Parkinson’s research

Fox was diagnosed with Parkinson’s in 1991 later publically announcing it in 1998 along with a pledge to increase Parkinson’s research

In January of 2000 Fox created the Michael J. Fox Foundation: For Parkinson’s Research

Today the foundation is the largest non-profit funder of Parkinson’s drug development in the world

According to a study published in the journal "Acta Neuropathologica"

For more information on Parkinson's Disease go to
https://www.michaeljfox.org
1
Works Cited
1 - 5.
2
3
http://www.medicalook.com/Neurological_disorders/Parkinsons_disease.html

Lack of dopamine
http://www.medicalook.com/Neurological_disorders/Parkinsons_disease.html

4
5
" Bloch, Talia. "A Common Mutation Behind Parkinson's Disease May Have Other Side- Effects." The Jewish Daily Forward. N.p., 06 Aug. 2013. Web. 20 Nov. 2013.
<http://forward.com/articles/181760/a-common-mutation-behind-parkinsons- disease-may-ha/?p=all>.

"DBS :: Deep Brain Stimulation - Parkinson's." DBS :: Deep Brain Stimulation - Parkinson's. N.p., n.d. Web. 20 Nov. 2013.
<http://biomed.brown.edu/Courses/BI108/BI108_2008_Groups/group07/Parkinso ns.html>.

Healthy vs. Affected Cell. Digital image. N.p., n.d. Web. 19 Nov. 2013.
<http://www.medicalook.com/Neurological_disorders/Parkinsons_disease.html>.

"Michael J Fox Parkinson's Disease." YouTube. YouTube, 05 Apr. 2009. Web. 20 Nov. 2013.

Staff, Mayo Clinic. "Definition." Mayo Clinic. Mayo Foundation for Medical Education and Research, 11 May 2012. Web. 25 Nov. 2013.
<http://www.mayoclinic.com/health/parkinsons- disease/DS00295/DSECTION=treatments-and-drugs>.

Schwarz, Randy. "#parkinsonschat 4/16/13." Storify. Mayo Clinic, n.d. Web. 20 Nov. 2013.
<http://storify.com/randyschwarz/parkinsonschat-4-16-13>.

TheFreeDictionary.com. N.p., n.d. Web. 10 Nov. 2013. <http://medical- dictionary.thefreedictionary.com/disease>.

Understanding Parkinson's." Michael J. Fox Foundation for Parkinson's Research. Michael J. Fox Foundation, n.d. Web. 20 Nov 2013.
<https://www.michaeljfox.org/understanding-parkinsons/index.html>.

Whiteman, Honor. "Depression linked to higher Parkinson's risk." Medical News Today. MediLexicon, Intl., 3 Oct. 2013. Web. 25 Nov. 2013.
<http://www.medicalnewstoday.com/articles/266866>

Whiteman, Honor. "Fungus 'may cause symptoms of Parkinson's disease'." Medical News Today. MediLexicon, Intl., 16 Nov. 2013. Web. 25 Nov. 2013.
<http://www.medicalnewstoday.com/articles/268848>

Whiteman, Honor. "Study uncovers link between Alzheimer's and Parkinson's." Medical News Today. MediLexicon, Intl., 25 Oct. 2013. Web. 25 Nov. 2013.
<http://www.medicalnewstoday.com/articles/267885>
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6 - 8.
7
8
9
9.
For patients with advanced Parkison's
Does not serve as a cure but a positive supplement to the medication
Deep Brain Stimulaton (DBS)
Electrodes -
implanted into regions of brain
connected to a generator implanted in your chest that sends electrical pulses to the brain
Bonus
- 1.) electrical current helps with PD symptoms
2.) Helps with PD medication side effects
Side Effects
-
infection, stroke, and brain hemorrhage
http://biomed.brown.edu/Courses/BI108/BI108_2008_Groups/group07/Parkinsons.html

10
10
10.
11
11.
Risk of PD after Depression: Study
We conducted a retrospective study of a matched cohort of 23,180 participants (4,634 patients with depression and 18,544 control patients) who were selected from the NHIRD. Patients were observed for a maximum of 10 years to determine the rates of new-onset PD, and Cox regression was used to identify the predictors of PD. We also examined the risk of PD after excluding patients who were diagnosed with PD within 2 or 5 years after their depression diagnosis. A logistic regression model was used to identify risk factors associated with PD onset in patients with depression.

Methods
During the 10-year follow-up period, 66 patients with depression (1.42%) and 97 control patients (0.52%) were diagnosed with PD. After adjusting for age and sex, patients with depression were
3.24
times more likely to develop PD (95% confidence interval 2.36–4.44, p < 0.001) compared with the control patients. After excluding patients who were diagnosed with PD within 2 or 5 years after their depression diagnosis, patients with depression had a higher hazard ratio for developing PD than the control patients. The odds ratios for age (1.09) and difficult-to-treat depression (2.18) showed that each is an independent risk factor for PD in patients with depression.

Results:
The likelihood of developing PD is greater among patients with depression than patients without depression. Depression may be an independent risk factor for PD

Conclusion:
12.
12
13
Background:
Researchers investigated the protein "Tau"
Define "Tau" as a soluble protein in the brain that binds to microtubules helping support neuronal function
The normal function of tau is supported by phosphorylation - a process that switches protein enzymes on and off and regulates their function and activity.

Link:
Researchers found that the "tau" protein can become abnormal and cause tangles in diseased brains
The tangles (tauopathies) are linked to cognitive impairment found in Alzheimer's
The tangles are also linked to 20% of Parkinson's cases
LKKR2:
Tangles are a result of a mutated LKKR2 enzyme
Through the use of mammalian studies - researchers found that a mutated LKKR2 adds significantly more phosphate groups than a standard one
Researchers found the sites where the phosphates were being added (T149 and T153)
same alterations as Alzheimer's Disease
Conclusion
LRRK2 directly phosphorylates tau at T149 and T153 in vitro
"These studies are the first of their kind and provide compelling evidence that LRRK2 and tau interact in a disease-relevant manner."
13.
enzyme
mutation is the main cause of PD
encodes a protein that is largely present in the cytoplasm
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