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Parkinson Disease Late-Onset

PD


Presentation

  • The most common sporadic form of Parkinson disease manifests around age 60; however, young-onset and even juvenile presentations are seen.[ncbi.nlm.nih.gov]
  • Challenges of Young Onset Disease First of all, those with young onset disease don’t necessarily present the same way as their older counterparts.[verywell.com]
  • 26 Oct 2001 Scientists at the Icelandic genomics company DeCode Genetics, working with colleagues at the National University Hospital in Reykjavik, have presented at last week's meeting of the American Society for Human Genetics in San Diego a poster[alzforum.org]
  • Before presentation he had been prescribed co-beneldopa 62.5 mg three times a day with some symptomatic benefit.[jnnp.bmj.com]
  • PARK2 – caused by an autosomal recessive mutation (that is to say, two copies of the variant DNA must be present) in the Parkin gene on chromosome 6q25.2–q27 (Gene name: PRKN; Gene ID: 5071 ), resulting in a higher risk of juvenile onset, atypical form[scienceofparkinsons.com]
Hunting
  • For what it's worth....I just got a book called "A Patient- Expert Walks You Through Everything You Need to Know and Do the First Year Parkinson's Disease" by Jackie Hunt Christensen. I am finding it very informative.[healthunlocked.com]
Short Arm
  • The “3” means chromosome 3, the “p” means p-arm (short arm) while q indicates the long arm of the chromosome. And the “22” refers to “region 2, band 2”. This is read as “two two”, not as “twenty-two”. Last “1” represents “sub-band 1”.[scienceofparkinsons.com]
Postural Instability
  • instability Resting tremor Rigid posture Shuffling gait Visual hallucinations[datagenno.com]
  • Results : Overall, 92% of the patients with late onset Parkinson’s disease had resting tremor, and postural instability was less frequently found in 21% of patients.[journal.fk.unpad.ac.id]
  • Parkinsonism refers to all clinical states characterized by tremor, muscle rigidity, slowed movement (bradykinesia) and often postural instability. Parkinson disease is the primary and most common form of parkinsonism.[ncbi.nlm.nih.gov]
  • instability with gait difficulty (PIGD).[psychiatryadvisor.com]
  • Other characteristic symptoms of Parkinson disease include rigidity or stiffness of the limbs and torso, slow movement (bradykinesia) or an inability to move (akinesia), and impaired balance and coordination (postural instability).[icdlist.com]
Resting Tremor
  • Results : Overall, 92% of the patients with late onset Parkinson’s disease had resting tremor, and postural instability was less frequently found in 21% of patients.[journal.fk.unpad.ac.id]
  • tremor Rigid posture Shuffling gait Visual hallucinations[datagenno.com]
  • Symptoms of the disease include resting tremor, bradykinesia and rigidity.[tocris.com]
  • The common motor symptoms include muscle rigidity, rest tremor, bradykinesia (slow body movements), and postural instability, and are the same in both forms of the disease.[thedoctorwillseeyounow.com]
Micrographia
  • Insidious onset Progressive disorder Genitourinary Urinary urgency Neurologic Abnormality Aggregation of SNCA-immunopositive inclusions Bradykinesia Dementia Depression Dysarthria Dysautonomia Dystonia Intracellular Lewy bodies Loss of dopaminergic neurons Micrographia[datagenno.com]
  • A change in handwriting may be a sign of Parkinson's disease called micrographia Small, cramped handwriting.. What is normal? Sometimes writing can change as you get older, if you have stiff hands or fingers or poor vision.[parkinson.org]
  • […] swing excessive salivation feelings of depression or anxiety increase in dandruff or oily skin lack of facial expression ( hypomimia ) less frequent blinking and swallowing lowered voice volume ( hypophonia ) slight foot drag small cramped handwriting ( micrographia[medbroadcast.com]
  • Loss of fine hand movements can lead to cramped handwriting (micrographia) and may make eating difficult. Bradykinesia: Slowness of voluntary movement. Over time, it may become difficult to initiate movement and to complete movement.[medicinenet.com]
Shuffling Gait
  • Examination was consistent with Parkinson’s disease, with a typical shuffling gait, bilateral cogwheel rigidity, and mild tremor, but no pyramidal or cerebellar signs.[jnnp.bmj.com]
  • Primary symptoms include: Tremor Stiffness Slowness Impaired balance Shuffling gait later in the disease Some secondary symptoms include: Anxiety Depression Dementia Most people with Parkinson's disease are diagnosed when they are 60 years old or older[medicinenet.com]
Monotonous Speech
  • speech Neuronal loss and gliosis in the substantia nigra Parkinsonism Postural instability Resting tremor Rigid posture Shuffling gait Visual hallucinations[datagenno.com]

Treatment

  • Early onset patients also suffer an increased rate of dystonia initially and during treatment. With regards to management, younger patients have an increased rate of dyskinesias in response to L-DOPA treatment.[verywell.com]
  • […] of Parkinson's disease NTCELL , choroid plexus cells for treatment of Parkinson's disease R-HSC-001, bone marrow-derived mesenchymal stem cells for Parkinson's disease Stem cell-derived dopaminergic neurons to treat Parkinson's disease Embryonic/Adult[malacards.org]
  • Treatment for young onset Parkinson’s To date, there is no known cure or way to prevent Parkinson’s disease. However, research is ongoing and remarkable progress is being made.[apdaparkinson.org]
  • Volunteers are vitally needed for clinical studies, which are the last and critical stage of research before new treatments are brought to market.[michaeljfox.org]
  • Topics covered include: Differential diagnosis and epidemiology Drug-induced parkinsonism and gait apraxia The drug treatment of elderly patients Cognitive impairment in elderly patients with Parkinson's disease The multidisciplinary rehabilitation team[books.google.com]

Prognosis

  • HOME › UNDERSTANDING PARKINSON'S › Living with Parkinson's Parkinson's Disease Prognosis A diagnosis of Parkinson's disease is life-changing. But breathe. You are not alone.[michaeljfox.org]
  • One is a disease called Wilson’s disease, as the single most common neurological symptom in it is parkinsonism and its treatment can significantly improve a patient’s prognosis.[thedoctorwillseeyounow.com]
  • Both Lewy body dementia and Parkinson disease dementia have a progressive course with a poor prognosis. Dementia should not be confused with delirium, although cognition is disordered in both.[msdmanuals.com]
  • What is the prognosis and life expectancy for Parkinson's disease? The severity of Parkinson's disease symptoms and signs vary greatly from person to peson, and it is not possible to predict how quickly the disease will progress.[medicinenet.com]
  • A more benign prognosis should not be assumed when these milestones occur in relatively youthful patients. In a more general sense, this perspective of the entire disease course contributes to strategic thinking on pharmacological treatment.[academic.oup.com]

Etiology

  • These data suggest that depression in patients with early-onset PD may have a different etiology than in patients with late-onset PD. 1989 by the American Academy of Neurology AAN Members: Sign in with your AAN member credentials (e-mail or 6-digit Member[neurology.org]
  • In a companion paper published in the same issue of JAMA, Duke researchers suggest that multiple genes are involved in the etiology of late-onset Parkinson's.[corporate.dukehealth.org]
  • Schapira AH, Jenner P: Etiology and pathogenesis of Parkinson’s disease. Mov Disord 2011;26:1049–1055. Bekris LM, Mata IF, Zabetian CP: The genetics of Parkinson disease. J Geriatr Psychiatry Neurol 2010;23:228–242.[karger.com]
  • Cigarette smoking and protection from Parkinson’s disease: false association or etiologic clue? Neurology 1995;45(6):1041-1051. 12. Morens DM, Grandinetti A, Reed D, White LR, Ross GW.[samj.org.za]
  • Both genetic and environmental etiologies share a common pathogenic pathway. Pharmacological Intervention The main motor features that are characteristic of PD are mainly due to the loss of the nigrostriatal dopaminergic pathway.[tocris.com]

Epidemiology

  • Topics covered include: Differential diagnosis and epidemiology Drug-induced parkinsonism and gait apraxia The drug treatment of elderly patients Cognitive impairment in elderly patients with Parkinson's disease The multidisciplinary rehabilitation team[books.google.com]
  • Epidemiological, clinical and genetic characteristics of early-onset parkinsonism. Lancet Neurol 2006;5(4):355-363. [(06)70411-2] 6. Schrag A, Schott JM. Epidemiological, clinical and genetic characteristics of early-onset parkinsonism.[samj.org.za]
  • Kurth is an adjunct associate professor of epidemiology at Harvard School of Public Health. “This is important research that adds to our understanding of the impact of specific features of Parkinson’s disease on outcomes,” he tells WebMD.[webmd.com]
  • Schrag A, Schott JM (2006) Epidemiological, clinical, and genetic characteristics of early onset parkinsonism. Lancet Neurol 5:355–363 CrossRef PubMed Google Scholar 39.[link.springer.com]
  • View Article PubMed Google Scholar Tandberg E, Larsen JP, Nessler EG, Riise T, Aarli JA: The epidemiology of Parkinson's disease in the county of Rogaland, Norway. Movement Disorders. 1995, 10: 541-549. 10.1002/mds.870100503.[jnrbm.biomedcentral.com]
Sex distribution
Age distribution

Pathophysiology

  • It has long been argued that many rare diseases are the best way to study the pathophysiology of more common disease since they can be a purer form of the condition.[raredr.com]
  • Pathophysiologic and clinical implications. N Engl J Med 318:876–880 CrossRef PubMed Google Scholar 23.[link.springer.com]

Prevention

  • Treatment for young onset Parkinson’s To date, there is no known cure or way to prevent Parkinson’s disease. However, research is ongoing and remarkable progress is being made.[apdaparkinson.org]
  • […] the metabolism of dopamine and hence increase the synaptic half-life of dopamine and the amount of dopamine taken back up into the presynaptic terminal Catechol O-methyltransferase (COMT) inhibitors prevent the metabolism of levodopa to 3-O-methydopa[tocris.com]
  • “Our findings suggest that early prevention of motor progression, psychotic symptoms, and dementia might be the most promising strategies to increase life expectancy in Parkinson’s disease.”[webmd.com]
  • As patients were included in each group, efforts were made to maintain equal gender proportions (both groups had seven females and six males) to prevent any confounding bias.[ruralneuropractice.com]

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