Pathophysiology of parkinsons disease

Etiology, pathogenesis, sign and symptoms of parkinsons disease

1. Pathophysiology Parkinson’s Disease Nem Kumar Jain MS (Pharm.) Pharmacology & Toxicology Assistant Professor, School of Pharmacy ITM University Gwalior

2. Parkinson’s Disease Neuro degenerative Disorder marked by Hypokinetic movement disorder that is caused by loss of dopaminergic neurons from the substantia nigra (specially pars compacta region)

3. Parkinson’s Disease Parkinson's disease was first medically described as a neurological syndrome by James Parkinson  in 1817

4. Slow but progressive, adult onset disorder (after age of 50) Characterized by clinical presentations like Bradykinesia : slow movement or Akinesia : absence of movement Loss of normal arm swing while walking, decreased blinking of eyelids Loss of ability to swallow Slight change in speech pattern Legs freeze up Shuffling or propulsive gait: short step Prone to fall Tremors: Involuntary shakiness Commonly in hands and arm, unilateral in beginning Pin rolling movement of thumb and first finger Occurs most often at rest (resting tremor) May involve diaphragm, lips, tongue and jaw Increase with stress Diminishes with movement Rigidity: stiffness increased resistance to passive movement, increased muscle tone Cogwheel jerky slow movement Stooped posture Blank expression Postural instability Problem with balance Prone to fall Parkinson’s Disease (pd)

5. Autonomic disturbances Constipation Urinal urgency Drooling Increased perspiration Oily skin Parkinson’s Disease (pd)

6. Genetic: hereditary, gene mutation, gauchers disease (deficiency of glucocerebrosidase enzyme) Environmental : Toxins: Carbon monoxide, cyanide, magnesium and mercury overexposure Pesticides, herbicides Head trauma or injury Drug induced: anti psychotic drugs Encephalitis or infection arteriosclerosis Etiology

7. PD is associated with protein accumulation and aggregation, mitochondrial abnormalities, and neuronal loss in the substantia nigra and elsewhere in the brain Accumulation of intracellular inclusion ie , Lewy body ( misfolded alpha sinuclein protein) Mitochondrial damage Oxidative stress Dopaminergic Neuron cell death Difficulty in controlling and initiating movement pathogenesis