NRS 301 Exam 4 UPDATED QUESTIONS
AND CORRECT ANSWERS
Parkinson's disease - CORRECT ANSWER long-term neurodegenerative disease that
affects primarily the motor system
Parkinson's disease symptoms (early) - CORRECT ANSWER Classic triad:
1. Bradykinesia
2. Tremor
3. Rigidity
Bradykinesia - CORRECT ANSWER slow movement
Tremor - CORRECT ANSWER shaking that occurs at rest
Rigidity in the muscles - CORRECT ANSWER difficulty walking, autonomic function
compromised
Parkinsonism - CORRECT ANSWER can be caused by other types of disorders or a
side effect of certain medications - motor function symptoms
Substantia nigra (dark) - CORRECT ANSWER contains pigmented dopamine-
producing neurons that are lost due to parkinsons disease
Pathogenesis of PD - CORRECT ANSWER Dopamine activity is greatly reduced
Substantia nigra is lost and the dopmine-producing neurons in the SN project to the Striatum
(Motor movement)
Misfolded alpha-synuclein aggregates
Dopamine - CORRECT ANSWER main neurotransmitter in the striatum
,Medium spiny neurons (MSNs) - CORRECT ANSWER activated/inhibited by
dopamine
Dopamine in striatum - CORRECT ANSWER Activates direct pathway and inhibits
indirect pathway
PD: imbalance of pathways - CORRECT ANSWER Dopamine neurons die which
leads to less activated direct movements and less inhibited indirect movements which leads to
trouble in initiating movements
PD histological changes - CORRECT ANSWER substantial loss of SN dopamine cell
bodies
Remaining neurons have Lewy bodies
Lewy bodies - CORRECT ANSWER accumulation of alpha-synuclein
Alpha-synuclein misfolding - CORRECT ANSWER Lewy bodies spread throughout
the brain starting in the lower brain stem and olfactory bulb
The a-synuclein spread throughout the brain like a prion
Prion - CORRECT ANSWER a protein that has the ability to spread by inducing
normal proteins to misfold
PD starts in the gut - CORRECT ANSWER misfolded a-synuclein in the gut leads to a
cascading of misfolding of endogenous protein in the brain, travel through the vagus nerve
Levodopa - CORRECT ANSWER precursor to dopamine
DDC (dopa decarboxylase) converts it to dopamine
DDC inhibitors do not cross BBB and cause for increased levodopa to the brain
peripherak side effects - DDC inhibitors reduce them
, COMT - CORRECT ANSWER breaks down DA
COMT inhibitors can increase DA but have liver toxicity
DA agonists - CORRECT ANSWER replaces DA by acting post synaptically
not as effective as levodopa
less side effects
MAO-B inhibitors - CORRECT ANSWER MAO-B breaks down DA
inhibitors can increase DA
not as effectve and lots of side effects
Deep brain stimulation - CORRECT ANSWER electrical stimulation of the brain to
increase motor function
MRI is used to guide the insertion
DBS effectiveness - CORRECT ANSWER Prior to DBS, patient oscillates between
symptomatic periods (immobility), to effective mobility periods to periods where side effects
are present (dyskinesias)
DBS widens the "on" window allowing for medications to be effective longer
AADC gene therapy in PD - CORRECT ANSWER AADC converts l-dopa to DA,
however AADC declines in patients with PD
Virus is genetically engineered to deliver the AADC gene to the striatum
Neuronal patterning - CORRECT ANSWER the biological process by which cells in
the developing nervous system acquire distinct identities according to their specific spatial
positions
Basic stages of Neuronal development - CORRECT ANSWER Proliferation
AND CORRECT ANSWERS
Parkinson's disease - CORRECT ANSWER long-term neurodegenerative disease that
affects primarily the motor system
Parkinson's disease symptoms (early) - CORRECT ANSWER Classic triad:
1. Bradykinesia
2. Tremor
3. Rigidity
Bradykinesia - CORRECT ANSWER slow movement
Tremor - CORRECT ANSWER shaking that occurs at rest
Rigidity in the muscles - CORRECT ANSWER difficulty walking, autonomic function
compromised
Parkinsonism - CORRECT ANSWER can be caused by other types of disorders or a
side effect of certain medications - motor function symptoms
Substantia nigra (dark) - CORRECT ANSWER contains pigmented dopamine-
producing neurons that are lost due to parkinsons disease
Pathogenesis of PD - CORRECT ANSWER Dopamine activity is greatly reduced
Substantia nigra is lost and the dopmine-producing neurons in the SN project to the Striatum
(Motor movement)
Misfolded alpha-synuclein aggregates
Dopamine - CORRECT ANSWER main neurotransmitter in the striatum
,Medium spiny neurons (MSNs) - CORRECT ANSWER activated/inhibited by
dopamine
Dopamine in striatum - CORRECT ANSWER Activates direct pathway and inhibits
indirect pathway
PD: imbalance of pathways - CORRECT ANSWER Dopamine neurons die which
leads to less activated direct movements and less inhibited indirect movements which leads to
trouble in initiating movements
PD histological changes - CORRECT ANSWER substantial loss of SN dopamine cell
bodies
Remaining neurons have Lewy bodies
Lewy bodies - CORRECT ANSWER accumulation of alpha-synuclein
Alpha-synuclein misfolding - CORRECT ANSWER Lewy bodies spread throughout
the brain starting in the lower brain stem and olfactory bulb
The a-synuclein spread throughout the brain like a prion
Prion - CORRECT ANSWER a protein that has the ability to spread by inducing
normal proteins to misfold
PD starts in the gut - CORRECT ANSWER misfolded a-synuclein in the gut leads to a
cascading of misfolding of endogenous protein in the brain, travel through the vagus nerve
Levodopa - CORRECT ANSWER precursor to dopamine
DDC (dopa decarboxylase) converts it to dopamine
DDC inhibitors do not cross BBB and cause for increased levodopa to the brain
peripherak side effects - DDC inhibitors reduce them
, COMT - CORRECT ANSWER breaks down DA
COMT inhibitors can increase DA but have liver toxicity
DA agonists - CORRECT ANSWER replaces DA by acting post synaptically
not as effective as levodopa
less side effects
MAO-B inhibitors - CORRECT ANSWER MAO-B breaks down DA
inhibitors can increase DA
not as effectve and lots of side effects
Deep brain stimulation - CORRECT ANSWER electrical stimulation of the brain to
increase motor function
MRI is used to guide the insertion
DBS effectiveness - CORRECT ANSWER Prior to DBS, patient oscillates between
symptomatic periods (immobility), to effective mobility periods to periods where side effects
are present (dyskinesias)
DBS widens the "on" window allowing for medications to be effective longer
AADC gene therapy in PD - CORRECT ANSWER AADC converts l-dopa to DA,
however AADC declines in patients with PD
Virus is genetically engineered to deliver the AADC gene to the striatum
Neuronal patterning - CORRECT ANSWER the biological process by which cells in
the developing nervous system acquire distinct identities according to their specific spatial
positions
Basic stages of Neuronal development - CORRECT ANSWER Proliferation
