Parkinson's disease is the second most common age-related neurodegenerative disease. It typically has an onset around age 60 and is more common in men than women. Risk factors include certain environmental exposures as well as genetic factors. The disease is characterized by degeneration of dopaminergic neurons in the substantia nigra pars compacta and formation of intraneuronal inclusions called Lewy bodies. This leads to decreased dopamine levels in the striatum and impaired function of the basal ganglia, resulting in the motor symptoms of Parkinson's such as tremors and impaired movement.

1. PARKINSONS DISEASE
BY NAWA .M.S

2. • INTRODUCTION
• 2nd Most common age related neurodegenerative disease
• Mean age of onset ~60 yrs
• Frequency increases with age
• Lifetime risk:~3% for Men and ~2% for Women
• risk factors
• 1.) ENVIRONMENTAL FACTORS
• exposue to MPTP
pesticide exposure
• rural living
• farming
• drinking well water

3. • PROTECTIVE FACTORS
• caffeine
• cigarette
• nsaids
• use of calcium channel blockers
• 2.) GENETIC FACTORS
• HLA 6
• mutations in:
• SNCA
• GBA
• LRRK 2

4. • SNCA
• leads to:
• early age of onset
• faster progression of symptoms
• patients are responsive to levo dopa
• prominent cognitive impairment
• maybe a prion
• GBA
• imports protein glucocerebrosidase
• if decreased, it leads to impaired lysosomal function
• leads to increased activity of SNCA

5. • LRRK2
• tremor is more, typically leg tremor
• incomplete penetrance
• better prognosis
• SPINK1/PARKIN
• responsible for early onset and juvenile parkinsons disease

6. • PHYSIOLOGY OF
BASAL GANGLIA

9. • PATHOGENESIS
• Dopamine denervation
• ↑(INCRESED) firing of neurons in STN & GPi
• ↑(INCREASED) inhibition of thalamus
• ↓(DECREASED) activation of cortical motor system
• Development of Parkinsonian features

12. • PATHOLOGY
• HALL MARK FEATURES INCLUDE:
• Degeneration of dopaminergic neurons in SNPC
• Reduced striatal (Caudate nu. + Putamen) dopamine
• Intraneuronal inclusions stain for alpha-synuclein (Lewy Bodies)

14. • PARKISONS DISEASE TREATMENT (DRUGS USED IN
PARKISONS)

20. REFERENCES
• HARRISON’S MANUAL OF MEDICINE(20TH EDITION) BY
FAUCI, E’TAL..
• KUMAR AND CLARK’S CLINICAL MEDICINE(10TH EDITION)
BY PROFESSOR DAME PARVEEN J KUMAR, E’TAL..
• STEP UP TO MEDICINE(5TH EDITION) BY STEVEN AGABEGI
• NEUROLOGY PART 3 BY DR SHUBHAM UPADHYAY
• PATHOMA-FUNDAMENTALS OF PATHOLOGY(1ST EDITION)
BY HUSAIN A. SATTAR

21. • I KNOW YOU ARE TIRED KAH
• DO NOT WORRY, YOU WILL ONLY
REST IF YOU ARE ABLE TO LICK YOUR
ELBOW WITH YOUR TONGUE,
OTHERWISE LOVE THE MEDICINE.
• THANK YOU...