Parkinson's disease is a neurodegenerative disease which cause usually at the onset of 65 and above.

2. Content
• Introduction
• Etiology
• Pathophysiology
• Symptoms
• Diagnosis
• Treatment

3. Introduction
Parkinsonism is a progressive neurodegenerative
disorder.
Figure 2. Dr. James Parkinson
(Parkinson Society Canada, 2015)
Figure 1. Claudius Galenus
(Whitney, 2014)
Figure 3. Jean-Martin Charcot
(Encyclopaedia Britannica, 2015)
Figure 4. Arvid Carllson
(Nobel Media AB, 2015)
AD175 AD 1817 AD 1862 AD 1950

4. Etiology
• Idiopathic
• Risk Factors
– Genetic Risk Factor
– Non Genetic Risk Factors
~ 15% people, shows family history
Depending on the gene mutation
Can cause PD
May increase the chance of getting PD
Environmental Toxins
MPTP, Pesticides, Heavy Metals
Aging
Damage to the Brain
Free Radicals (Reactive Oxygen Species)

5. Etiology
• Degradation of Dopaminergic Neuron
Figure 5. Factors affecting neuro degeneration (Benedetto, Au and Aschner, 2009).

6. Pathophysiology
 Striatum
 Controls movement
 Dopamine
 Inhibitory neurotransmitter in the basal ganglia
 Acetylcholine
 Excitatory neurotransmitter in the basal ganglia
 Without dopamine, inhibitory influences are lost and excitatory mechanisms
are unopposed 
 Neurons of basal ganglia are over stimulated 
 Excess muscle tone, tremors & rigidity
Figure 6. Brain structures related with
Parkinson’s Disease (Robert Cronshaw, 2014).

7. Symptoms
Figure 7. The symptoms and the management of Parkinson’s disease (Daniel Calder, 2014)

8. Diagnosis
• No specific test.
• Suggested method include:
• Neurologic examination
• Oculomotor examination
• Electroencephalograms (EEG)
• Single photon emission computed tomography
(SPECT)
Figure 8. Electroencephalogram
(Alexandra Ossola, 2015).
Figure 10. SPECT Scan (Neurology, 2001)Figure 9. SPECT (Siemens, 2015) .

9. Treatment
• Medications
• L-Dopa (e.g. benserazide, entacapone)
• D1 and D2 receptor agonists (e.g. Apomorphine,
bromocriptine)
• MAOB inhibitors (e.g. selegiline)
• COMT (catechol-O-methyl-transferase) inhibitors
(e.g Entacapone)
• Amantadine
• Anticholinergic drugs (e.g. benzatropine)
• Surgeries
• Deep Brain Stimulation
• Creating a lesion in the subthalamic nucleus

10. Reference
• Alexandra Ossola, (2015). Electroencephalograms. [image] Available at:
http://www.popsci.com/individual-brains-respond-differently-same-words [Accessed 14 Aug.
2015].
• Benedetto, A., Au, C. and Aschner, M. (2009). Manganese-Induced Dopaminergic
Neurodegeneration: Insights into Mechanisms and Genetics Shared with Parkinson’s Disease.
Chemical Reviews, 109(10), pp.4862-4884.
• Chaudhuri, K., Healy, D. and Schapira, A. (2006). Non-motor symptoms of Parkinson's
disease: diagnosis and management. The Lancet Neurology, 5(3), pp.235-245.
• Encyclopaedia Britannica, (2015). Jean-Martin Charcot. [image] Available at:
http://global.britannica.com/biography/Jean-Martin-Charcot [Accessed 13 Aug. 2015].
• Ferreira, J., Galitzky, M., Montastruc, J. and Rascol, O. (2000). Sleep attacks and Parkinson's
disease treatment. The Lancet, 355(9212), pp.1333-1334.
• Hughes, A., Daniel, S., Kilford, L. and Lees, A. (1992). Accuracy of clinical diagnosis of
idiopathic Parkinson's disease: a clinico-pathological study of 100 cases. Journal of
Neurology, Neurosurgery & Psychiatry, 55(3), pp.181-184.

11. Reference
• Neurology, (2001). SPECT Scan. [image] Available at:
http://www.neurology.org/content/56/suppl_5/S1.extract [Accessed 16 Aug. 2015].
• Nobel Media AB, (2015). Arvid Carllson. [image] Available at:
http://www.nobelprize.org/nobel_prizes/medicine/laureates/2000/carlsson-
facts.html [Accessed 13 Aug. 2015].
• Parkinson Society Canada, (2015). Dr. James Parkinson. [image] Available at:
http://www.parkinson.ca/atf/cf/%7B9EBD08A9-7886-4B2D-A1C4-
A131E7096BF8%7D/DrJamesParkinsonE.jpg [Accessed 13 Aug. 2015].
• Robert Cronshaw, (2014). Brain structures related with Parkinson’s Disease.
[image] Available at: https://www.oxford-royale.co.uk/articles/pain-pathologies-
perception.html [Accessed 15 Aug. 2015].
• Siemens, (2015). SPECT. [image] Available at:
http://www.healthcare.siemens.com/molecular-imaging/iq-spect-technology
[Accessed 15 Aug. 2015].
• Whitney, N. A., (2014). Claudius Galenus. [image] Available at:
http://whitneyamechi.hubpages.com/hub/The-Shaking-Palsy-An-Essay-on-
Parkinsons-Disease [Accessed 14 Aug. 2015].

12. Thank You !