Now what are the most common types of medications used to cure Parkinson’s Disease?
So you can just draw yourself a note, what medications do we use to cure Parkinson’s Disease?
Yeah, the sad news is there currently is no cure.
Medications just treat the symptoms.
We try to address the motor symptoms and the non-motor symptoms
to help give them quality of life because Parkinson's is imbalance, okay,
it’s an imbalance in movement and it’s an imbalance between dopamine and acetylcholine in the brain.
Okay, that’s a really helpful point for you to know,
Parkinson's is an imbalance that will give you a mental picture of how they walk,
they're stooped, they're rigid, they shuffle, they tend to be really at risk for falls
and they have an imbalance between their neurotransmitter’s dopamine and acetylcholine in the brain
and it’s this imbalance that gives them the problems with motor.
They don’t have enough dopamine.
So I put a picture there for you can see your brain lightly in the background
and you see how we've got more acetylcholine effective than we have dopamine
and that’s why we've got the scales there to help you remember that.
Okay, so if a Parkinson's patient’s problem is they don’t have enough dopamine,
why don’t we just give them dopamine? I know we have dopamine as a medication -
Well, here's the problem - it’s the blood-brain barrier. Now that’s a super cool thing.
If I'm a neonate it’s not very mature so things can get across into my brain that really shouldn't,
they're dangerous for me -- but as adults, we have mature blood-brain barriers.
See in other blood vessels they’ve got these pores and this openings
so things can just go right on in, but in the blood-brain barrier - look, there's tight junctions.
See the difference on the right-hand side? That’s the blood brain barrier.
There's no junctions that are open like that like you see in normal blood vessels,
now that is to protect my brain.
The body knows - hey, this is what's controlling everything in the rest of my body?
So we wanna be very picky about what gets to the brain.
That could be problematic if you have an infection in your brain
because we have a hard time getting antibiotics over that blood-brain barrier
and only certain ones will do it, but with Parkinson's Disease,
if we give you dopamine in your vein let’s say, which we do, it can't get across that blood-brain barrier.
We can have some sympathetic nervous system response down here
but it’s not gonna make it across that blood-brain barrier.
So that’s the answer why we just don’t give patients dopamine who have Parkinson's Disease.
Now we give drugs that help increase dopamine levels in the brain or act like dopamine in the brain
but we can't actually get dopamine itself over the blood-brain barrier.
So it’s all about balance in that striatum.
In order to control movement,
we have to have appropriate levels of the neurotransmitter’s acetylcholine and dopamine and in Parkinson's Disease
we have not enough dopamine so therefore it ends up being
theoretically too much acetylcholine for the amount of dopamine that is available.
So neurons in the subtantia nigra, they're the ones that supply dopamine.
See that tiny little organ right down there at the bottom is supplying it up to the striatum.
All of these is deep in your brain.
When these neurons are damaged, they can no longer supply dopamine to the striatum
so the big X that just appeared on your slide, that’s why there's an imbalance in the striatum.