Parkinson's Disease Notes

The dopaminergic neurons start to die in the substantia nigra, located in the basal ganglia (part of the brain stem).
The basal ganglia controls our movement.
Dopaminergic neurons release the neurotransmitter dopamine.
If dopaminergic neurons die, there is less dopamine released.
Dopamine is nessecary for accuracy of movement.
Differences of Acetylcholine and Dopamine:
- Acetylcholine: Excitatory neurotransmitter (causes cholinergic activity – the sympathetic vs. parasympathetic activity).
- Dopamine: Has an inhibitory property.
Less dopamine affects the balance of the body’s movement.
In Parkinson's, there is overstimulation of the neurons, causing tremors and rigidity.

Age-related: 65 and above, but can also affect younger people.
Genetic issues: Not clearly defined.
No cure, but medications like cholinergic drugs are prescribed to decrease signs and symptoms.

Subtle and vary from patient to patient.
Symptoms worsen over time.
May start on one side of the body and in one extremity, progressing over time.
Tremors that occur at rest:
- Can occur in the hands, arms, legs, lips, tongue.
- Tremors of fingers and hands are called pill-rolling (like rolling a pill with the finger).
- Tremors tend to improve with purposeful movement and are worse when resting.
Stiffness of extremities:
- When walking, the arms do not sway but stay at the sides.
Akinesia:
- Loss of the ability to do muscle movement voluntarily.
- Patients can be walking and suddenly freeze up; feels like their feet are stuck on the ground, and they cannot move.
Stiffness of extremities causes shuffling of gait:
- Patients do not pick up their feet well as they walk.
- As they walk, they bend a little bit forward.
Cogwheel rigidity:
- Moving arms passively toward the body.
Bradykinesia: Slow movement.
- Swallowing issues: Drooling.
- Expressionless face: “Mask-like”.
- Chewing issues.
- Speech: Soft/slurred.
Coordination problems: They stoop to compensate.
Non-motor symptoms:
- Loss of smell.
- Constipation.
- Depression.

Safety: Because of balance and movement issues.
Psychosocial: Challenges include disrupted relationships, stigma, loneliness, and mental health sequelae such as anxiety, depression, and demoralization.
Digestion/Nutrition.
Medication side effects and education.

Research suggests that people with PD lack CoQ10, glutathione, and vitamins C and D.
Coenzyme Q10 at dosages of $300-1,200$ mg daily may have a positive impact on motor neuron symptoms, finger dexterity, visual color acuity, and inflammation.
Coenzyme Q10 (CoQ10) is an antioxidant that your body produces naturally.
Your cells use CoQ10 for growth and maintenance.
Levels of CoQ10 in your body decrease as you age.