Pa Tho Physiology of Parkinson

PATHOPHYSIOLOGY OF PARKINSON¶S DISEASE

Non-Modifiable Risk Factors

Genetics

Age

Extra

Mutation

Wear and

copy of 

in a gene

Tear theory

gene-

called

synuclei

the

n (SNCA)

Degenerative

gene

changes in the

Protein

sible for

build-

early

up in

onset

the

PD)

brain

High doses of 

Environmental

Viral encephalitis

Structural brain

Endogenous

antipsychotic

exposures to toxin

(Von Economos

disorders (Brain

toxins produced

disease; type A

tumor, stroke,

after toxicities

encepha-litis)

and head injury)

such as carbon

drugs (e.g., phenothiazines, butyrophenones) side-effect

Parkin

(respon-

Modifiable Risk Factors

substantia nigra of the brain

Endotoxins called

monoxide,

lipopolysaccharides

pesticide,

(LPSs) are in the air in

methyl-phenyl-

agricultural and other

tetrahydropyri-

industries; Living in

dine, or welding

dopamine

rural areas or near

fumes toxicity

receptors and

wood pulp mills and

Blockage of 

dopamine output

well water

by the cells of the

consumption

substantia nigra

Alteration of  neurotransmitter regulation

Brain damage

Destruction or death of dopamineproducing neurons

Interference with or blockage of the action of  neurotransmitters particularly dopamine and acetylcholine (acetylcholine > dopamine)

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Imbalance between excitation and inhibitory neuronal activity

Musculoskeletal system

Stage I: INITIAL

Resting tremor with mild weakness, possibly unilateral and increased with emotional stress or fatigue; pill-rolling

Stage II: MILD

Bilateral symptoms with mask-like facies (blunt affect), and a slow shuffling gait

Stage III: MODERATE

Previous symptoms with significant progression of  gait disturbance (shuffling gait) and postural instability (stooped posture, arms flexed at elbows and wrist, hips amd knees slightly flexed) GIT system

Stage IV: SEVERE DISABILITY

Akinesia (inability to

Interference of  pharyngeal muscles

Inability to chew and/or swallow

Malnutrition