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Related Concept Videos

Parkinson Disease l: Introduction01:24

Parkinson Disease l: Introduction

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Parkinson’s disease is a chronic, progressive neurodegenerative disorder that primarily affects movement. It is characterized by motor symptoms such as resting tremors, muscle rigidity, bradykinesia (slowness of movement), and postural instability. Patients may notice hand tremors at rest, stiffness during movement, or a shuffling gait. In addition to motor features, non-motor symptoms include sleep disturbances, mood and behavioral changes, constipation, and cognitive impairment, all of...
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Neurodegenerative disorders, such as Parkinson's Disease (PD), involve the gradual and irreversible destruction of neurons in particular brain areas. These disorders exhibit standard features like proteinopathies, selective vulnerability of some neurons, and an interaction of intrinsic properties, genetics, and environmental influences in neural injury.
Parkinson's Disease is primarily a result of the loss of dopaminergic neurons in the substantia nigra pars compacta. The cornerstone of...
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Neurodegenerative disorders are progressive diseases that cause irreversible damage and loss to neurons in specific brain areas. Examples of these disorders include Parkinson's disease, Alzheimer's disease, Multiple Sclerosis (MS), and Amyotrophic Lateral Sclerosis (ALS). These disorders share characteristics such as proteinopathies, selective neuronal vulnerability, and a complex interplay between genetic and environmental factors. The primary therapeutic goal for these conditions is...
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Parkinson Disease ll: Pathophysiology01:24

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Parkinson disease (PD) is a progressive neurodegenerative disorder primarily affecting movement, with additional non-motor features. Its pathophysiology involves complex interactions among genetic susceptibility, environmental exposures, and cellular dysfunction, including dopaminergic neuron loss, protein aggregation, and mitochondrial impairment.Selective NeurodegenerationA key feature is the degeneration of dopaminergic neurons in the substantia nigra pars compacta, leading to reduced...
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Huntington disease or HD is a progressive, fatal neurodegenerative disorder inherited in an autosomal dominant pattern.PathophysiologyIt is caused by expansion of the CAG trinucleotide repeat in the HTT gene on chromosome 4 (4p16.3), producing an abnormal huntingtin protein with an expanded polyglutamine tract. This misfolded protein disrupts cellular function, leading to neuronal death. Normal alleles have ≤26 repeats, 27–35 are intermediate (risk of expansion), 36–39 show...
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Digestion begins with a cephalic phase that prepares the digestive system to receive food. When our brain processes visual or olfactory information about food, it triggers impulses in the cranial nerves innervating the salivary glands and stomach to prepare for food.
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Ole Isacson: Development of New Therapies for Parkinson's Disease
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Parkinson's disease beyond 20 years.

Roberto Cilia1, Emanuele Cereda2, Catherine Klersy3

  • 1Parkinson Institute, Istituti Clinici di Perfezionamento, Milano, Italy.

Journal of Neurology, Neurosurgery, and Psychiatry
|October 5, 2014
PubMed
Summary

Parkinson's disease (PD) progression is significantly influenced by age at onset and disease duration, impacting motor and non-motor symptoms over 20 years. Non-levodopa-responsive axial symptoms predict major outcomes in advanced PD.

Keywords:
PARKINSON'S DISEASE

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Area of Science:

  • Neurology
  • Clinical Neuroscience
  • Neurodegenerative Diseases

Background:

  • Limited data exists on Parkinson's disease (PD) clinical features beyond 20 years post-onset.
  • Understanding long-term PD progression is crucial for patient management and care.

Purpose of the Study:

  • To characterize Parkinson's disease (PD) 20 years after onset.
  • To investigate the influence of age at onset and disease duration on clinical presentation.
  • To identify predictors of adverse outcomes in patients with advanced PD.

Main Methods:

  • Retrospective and prospective longitudinal study design.
  • Analysis of 401 patients with PD duration ≥20 years, stratified by disease duration and age at onset.
  • Prospective follow-up of 320 patients for outcomes including mortality, institutionalization, and fractures.

Main Results:

  • Older age at onset and longer disease duration independently correlated with increased motor and non-motor disability.
  • Frequent outcomes in long-term PD included death, wheelchair/bed confinement, and fractures.
  • Male gender, older age, dysphagia, orthostatic hypotension, postural instability, fractures, and institutionalization predicted mortality.

Conclusions:

  • Age at onset and disease duration are independent determinants of PD clinical features after 20 years.
  • Non-motor symptoms are more influenced by age at onset than disease duration.
  • Non-levodopa-responsive axial symptoms are key predictors of adverse outcomes in advanced Parkinson's disease.