Parkinsonism and Treatment of Parkinson's Disease

by Georgina Cornwall, PhD

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    Let’s look at Parkinsonism versus Parkinson’s disease. Parkinsonism is a syndrome of Parkinson-like symptoms. That’s something that you need to keep straight. Parkinson’s disease is not the only cause of these types of symptoms. So, we consider Parkinsonism separate from Parkinson’s disease. There is primary Parkinsonism which is a result of Parkinson’s disease and the classic Lewy body and neural degeneration. Then other versions of Parkinsonism, we consider as secondary Parkinsonism, so things that develop from non-Parkinson’s disease syndromes. When we treat Parkinson’s disease, there are a number of different options. First of all, L-DOPA. Historically, L-DOPA has been around for much longer than it was actually used for treatment of Parkinson’s. It was initially used in the treatment of heroin withdrawal symptoms. It turns out heroin withdrawal symptoms have some of the same characteristics and difficulty of initiating movements and tremors that we see in Parkinson’s disease. So, someone thought let’s try this out on Parkinson’s patients. It worked. So, that was great progress. However, it didn’t work forever, right? The effect of treatment with L-DOPA even with increasing doses didn’t resolve the symptoms. But initially, L-Dopa on its own would relieve some of the early symptoms of Parkinson’s disease. Now, how does L-DOPA work? It turns out L-Dopa or levodopa is a precursor to dopamine. So, it also crosses the blood brain barrier. So, it can be taken orally, crosses the blood brain barrier at which point it is converted into dopamine. Now, it can also be converted into epinephrine and norepinephrine which can have its own issues. But the dopamine here is essentially adding extra dopamine so that the lower number of neurons have more signal being thrown at them and can make some signals. This works. Dopamine functions return and things look good for a while....

    About the Lecture

    The lecture Parkinsonism and Treatment of Parkinson's Disease by Georgina Cornwall, PhD is from the course Aging.

    Included Quiz Questions

    1. It blocks the peripheral conversion of Levodopa to dopamine, norepinephrine, and epinephrine, thus decreasing adverse side effects of Levodopa.
    2. It acts as a direct dopamine agonist, at the cost of increasing side effects of Levodopa.
    3. It is required for the transport of Levodopa across the blood-brain barrier.
    4. It acts as a direct dopamine antagonist peripherally, thus decreasing adverse side effects of Levodopa.
    5. It is a catalyst for the conversion of levodopa to dopamine once it crosses the blood-brain barrier.
    1. Neither DBS nor dopaminergic/dopa-decarboxylase inhibitor therapies are definitive, but both provided limited symptomatic relief of the disease.
    2. Both DBS and dopaminergic/dopa-decarboxylase inhibitor therapies are definitive treatments for the disease.
    3. DBS is a definitive treatment for Parkinson's disease, while dopaminergic/dopa-decarboxylase inhibitor medication is simply for symptomatic relief.
    4. Both DBS and dopaminergic/dopa-decarboxylase inhibitor stimulate the release of dopamine from neurons in the substantia nigra.
    5. DBS has far more peripheral side effects than dopaminergic/dopa-decarboxylase inhibitor medical therapy.
    1. Parkinson's disease
    2. Brain injury
    3. MTPT contiminant in heroin
    4. Wilson's disease
    5. Progressive supranuclear palsy

    Author of lecture Parkinsonism and Treatment of Parkinson's Disease

     Georgina Cornwall, PhD

    Georgina Cornwall, PhD

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