Parkinson's Disease Guide

PARKINSON’S DISEASE
Presented by;
Fawad Bashir
Reg. no. 1540
3rd semester
Department of Pharmacy
Abasyn university
Islamabad campus
fawadbashir967@gmail.com

Parkinson’s disease,
Also known as idiopathic or primary parkinsonism,
hypokinetic rigid syndrome, paralysis agitans.

Parkinson's disease (PD) is a long-term
degenerative disorder of the central nervous
system that mainly affects the motor system.
Origin
late 19th century: named after James
Parkinson (1755–1824), English surgeon.

a progressive disease of the nervous system marked by
tremor, muscular rigidity, and slow, imprecise movement,
chiefly affecting middle-aged and elderly people.
It is associated with degeneration of the basal ganglia of
the brain and a deficiency of the neurotransmitter
dopamine.

SYMPTOMS
The symptoms generally come on slowly over
time. Early in the disease, the most obvious are
Shaking(tremors)
Rigidity
slowness of movement
difficulty with walking.

Thinking and behavioral problems may also
occur.
Dementia becomes common in the advanced
stages of the disease.
Depression and anxiety are also common
occurring in more than a third of people with
PD.
Other symptoms include
Sensory
sleep and emotional problems

CAUSE OF PARKINSON’S DISEASE.
The cause of Parkinson's disease is
generally unknown but believed to involve
both genetic and environmental factors.
Those with a family member affected are more
likely to get the disease themselves.
There is also an increased risk in people
exposed to certain pesticides and among
those who have had prior head injuries

VIDEO
DEMONSTRATION

BASAL GANGLIA
Mass of gray matter at the base of cerebral
hemisphere.
Basal Nuclei.

BASAL GANGLIA.
The Basal ganglia like the cerebellum constitute
another assessory motor system that function
usually not by itself but in close association with
the cerebral cortex and corticospinal motor
control system.

Infact , the basal ganglia receive most of the
input from cortex and almost all of their output
signals back to the cortex.

NORMAL MECHANISM FOR SMOOTH AND
COORDINATED MOVEMENT .
Cortex Basal
Ganglia
Thalamus
Back to cortex
Spinal Cord Muscles

`1
`


Caudate nucleus + caudate putamen , Called
Stratum.
INPUT
Cortex to stratum .
OUTPUT
Globus pallidus interna to Thalamus back to
cortex then to spinal cord.

Interaction:
By GLUT neurons and Gaba Neurons.
Which is inhibitory.
Most important is Substantia nigra.
Substance Black, part of basal ganglia.

`
Substantia nigra is most important because here
Dopaminergic neurons are present.
Release dopamine.
Receptors…D1 & D2 present at stratum.
Dopamine binds to D1, excitatory.
If binds to D2, inhibitory.

Dopamine release.
Binds to D1 receptor
Inhibits the GABA in Globus Pallidus , allowing
the thalamus to send stimulus to cortex and
cortex the send signals to spinal cord thus,
smooth movement be initiated.

B
In Parkinson’s disease, dopamine neurons die and we
have reduced dopamine in substantia nigra.
Pathogenesis involves
Apoptosis or necrosis of dopaminergic and result in
death of neurons.
Protein miss folding
Aggregation
Toxicity
Defective proteolysis
Mitochondrial dysfunction
Oxidative stress all result in reduce dopamine.

In Parkinson’s disease, Dopamine is not produce thus GABA
neurons is more energetic in stratum.
Secrete GABA.
Can’t inhibit Glutaminergic neurons.
It release glutamate which will stimulate GABA neurons in
Globus Pallidus interna.
D1 will have no dopamine and thus GABA in stratum is not
stimulated to inhibit GABANERGIC neurons in Globus pallidus
interna and result in overactive GABANERGIC neurons in
Globus pallidus interna to thalamus and we have excessive
inhibitory input to thalamus.

Inhibit thalamus causes suspension of thalamus communicational
pathway and thus output back to___________ don’t happen.
So movement is not SMOOTH.

PATHOLOGY
Demyelination
Neuronal loss
Pressure of Lewy bodies in soma of neurons

Risk factors:
GENETICS;
GBA.
SNGA.
PINK 1.
PARK 2.

PHARMACOLOGY
LEVODOPA…
Why we don’t use DOPAMINE instead levodopa?
…
DOPAMINE AGONIST:
Dopamine agonists are drugs that activate the
dopamine receptor. They mimic or copy the
function of dopamine in the brain.

Requip (ropinirole)
Mirapex (pramipexole), and
Neupro (rotigotine) are dopamine
agonists.
These medications may be taken alone or
in combination with Sinemet.
Generally, dopamine agonists are
prescribed first and levodopa is added if
the patient's symptoms cannot be
controlled sufficiently.

Anticholinergics (Artane, Cogentin)
Anticholinergics are used to restore the balance between
the two brain chemicals, dopamine and acetylcholine, by
reducing the amount of acetylcholine.
This acts to reduce tremor and muscle stiffness in people
with Parkinson's.
These medications, however, can impair memory and
thinking, especially in older people; therefore, they are
rarely used today.

Parkinson's Disease Guide

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