Parkinson's

This is a curated page. Report corrections to Microbewiki.

Introduction

Parkinson’s Disease (PD) is a neurogenic disorder associated primarily with expressed motor dysfunctions. From bradykinesia and awkward gait, to postural instability and hypomimia, PD is conceptualized so classically as an illness affecting body movement that the abnormal psychological or neuropsychological states that often accompany it, remain inconspicuous and, in some cases, vastly underreported. Major Depressive Disorder commonly presents as a comorbidity with PD, and cognitive dysfunctions, particularly in cortical areas pertaining to executive functions such as judgement and planning, are also frequent, and in need of further research. Additionally, investigations into the prevalence of acquiring Impulse Control Disorders, or associated conditions such as punding, is now underway, and reports are demonstrating these conditions to be common, despite the public’s lack of knowledge regarding them. Fortunately, recent scientific investigations into these and other detrimental effects of PD have resulted in several discoveries that could set the foundations for novel treatments to increase quality of life for individuals afflicted by PD, and, with increasing treatment options will come increasing public awareness of the vast scope of issues related to this incurable, progressive, degenerative illness.

This image, part of an article on Parkinson's Disease published by the Siberian Times in 2012, depicts several of the major, noticeable, motor-related deficits frequent in patients diagnosed with the disease. http://siberiantimes.com/science/casestudy/news/a-major-breakthrough-in-treating-parkinsons-disease-cannot-reach-patients/.

By [Name]

At right is a sample image insertion. It works for any image uploaded anywhere to MicrobeWiki. The insertion code consists of:
Double brackets: [[
Filename: Ebola_virus2.jpg
Thumbnail status: |thumb|
Pixel size: |300px|
Placement on page: |right|
Legend/credit: Electron micrograph of the Ebola Zaire virus. This was the first photo ever taken of the virus, on 10/13/1976. By Dr. F.A. Murphy, now at U.C. Davis, then at the CDC.
Closed double brackets: ]]

Other examples:
Bold
Italic
Subscript: H₂O
Superscript: Fe³⁺

Introduce the topic of your paper. State your health service question, and explain the biomedical issues.

Section 1

By far the most common generalized treatment for PD is administration of the drug levodopa (L-DOPA.) L-DOPA is a precursor molecule to DA (as well as any neurotransmitter in the catecholamine class) and is necessary for synthesis of the chemical. Unlike DA, L-DOPA is small enough to permeate the blood-brain barrier. Once through the membrane, the molecule is catalyzed by the enzyme Aromatic-L-amino-acid decarboxylase into DA (3) where an increase in the neurotransmitter may help to mitigate the hypokinesic symptoms characteristic of PD. Since the 1960’s, treatment with the L-DOPA drug has been the standard Parkinson’s treatment, however recent investigations have implicated several other treatment methods as potentially beneficial. Whereas L-DOPA remains an effective treatment, it frequently leads to development of hyperkinesic side effects such as tremors. Additionally, though rare, there are instances in which L-DOPA does not prove to be effective. For these reasons, additional or alternative preventative measures must be investigated.

Section 2

Punding, a seemingly rare though perhaps merely underreported side effect of long-term L-DOPA intake, refers to the incidence of (a) severe, irrepressible, repetitive behavior(s), usually detrimental to the individual’s physical and social well-being. One case report described a 68 year-old PD patient who, after medications, developed a compulsive obsession with drumming, playing for hours every day, purchasing a recording studio for his home, and shunning social interactions, food, and sleep, in order to avoid feelings of depression and anxiety. (After six months, his medication was changed and the patient no longer felt controlled by the need to drum to achieve “wellbeing and a feeling of calmness.”) (4) A study published in 2013 analyzed the effects of low-frequency repetitive transcranial magnetic stimulation (rTMS) on incidence of such a strange side effect of PD medication in Parkinson’s patients. Researchers focused their efforts specifically on the brain’s dorsolateral prefrontal cortex (DLPFC), comparing effects of left- versus right-hemisphere stimulation. (5) After delivering a series of low-frequency electrical pulses over a period of 32 minutes, to a sample of patients who had demonstrated punding behaviors, it was found that score on a Punding Scale decreased after stimulation over the right of left DLPFC. After right-sided stimulation, the score remained lower after a second measurement. At third measurement, however, regardless of hemisphere, scores were not significantly different from initially Punding Scale scores. This demonstrates rTMS over the DLPFC, especially when directed at the right hemisphere, has the potential of minimizing punding behaviors. The authors conclude by suggesting a patient undergoing repeated rTMS for several consecutive days may experience a longer-duration of benefits from the treatment. (5)

Section 3

Include some current research, with at least one figure showing data.

References

[1] Hodgkin, J. and Partridge, F.A. "Caenorhabditis elegans meets microsporidia: the nematode killers from Paris." 2008. PLoS Biology 6:2634-2637.

Authored for BIOL 291.00 Health Service and Biomedical Analysis, taught by Joan Slonczewski, 2016, Kenyon College.