Biochemistry 460Case Study

By: Ashley Rude

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Consider the Following Patient• Nick is a 55 year old man who came into

the hospital over unusual sleep problems. He says that he has difficulty moving and has been very stiff lately. While he sits there talking, you can see his hands shaking uncontrollably. Upon some simple testing, you notice that he also has very poor balance.

What diagnosis would your initial diagnosis be for Nick?

What tests would you perform to confirm your diagnosis for Nick?

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Diagnosis: Parkinson’s Disease

• Diagnosis is based on a person's medical history and a neurological examination.

• Can request brain scans or laboratory tests to rule out other diseases.– CT and MRI scans usually appear normal

• Preform a DaTscan, which is an imaging technique which detects signals related to dopamine function

What is Parkinson’s Disease?• Parkinson’s Disease is a degenerative, progressive

disorder that affects nerve cells in deep parts of the brain called the basal ganglia and substantia nigra.

• Nerve cells in the substantia nigra produce the neurotransmitter dopamine and are responsible for relaying messages that plan and control body movement.

• When 80 percent of dopamine is lost, symptoms such as tremor, slowness of movement, stiffness, and balance problems occur.

Dopamine (C8H11NO2)• Dopamine is a chemical messenger, or neurotransmitter,

responsible for transmitting signals between the substantia nigra and multiple brain regions.

• It is a monoamine (a compound containing nitrogen formed from ammonia by replacement of one or more of the hydrogen atoms by hydrocarbon radicals).

• Dopamine is formed by the decarboxylation (removal of a carboxyl group) from dopa.

Dopamine and Parkinson’s• Body movement is controlled by a complex chain involving

nerve cells called ganglia. Information comes to a central area of the brain, which works with the substantia nigra to send impulses back and forth from the spinal cord to the brain. When dopamine receptors are not adequately stimulated, parts of the basal ganglia are either under- or over-stimulated. When overstimulation occurs, it has an over-inhibitory effect on the thalamus, which in turn decreases thalamus

output and causes

tremor.

Treatment• There is no cure for Parkinson’s, but it can be managed with self-care,

medication, and surgery.• Exercise helps maintain flexibility and improves balance and range of

motion. • There are three groups of medications for Parkinson's:

– drugs that increase the level of dopamine in the brain– drugs that affect other neurotransmitters in the body in order to ease some of

the symptoms of the disease– medications that help control non-motor symptoms (those that do not affect

movement) of Parkinson's• People cannot simply take dopamine pills because dopamine does not

easily pass through the blood-brain barrier.– Carbidopa-Levodopa is the main medication used.

• Deep brain stimulation, or DBS, is a surgical procedure that can be used to treat the symptoms of Parkinson’s disease.

References

• https://nihseniorhealth.gov/parkinsonsdisease/symptomsanddiagnosis/01.html

• http://www.mayfieldclinic.com/PE-PD.htm

• http://www.medicinenet.com/script/main/art.asp?articlekey=14345

• https://s3.amazonaws.com/user-media.venngage.com/298415-45bcc1356607508e6ec1224fbee6eee5.jpg