Parkinson's Disease -Symptoms 1. Resting tremor(静止震颤 R 2 Bradykinesia(运动迟缓) 3 Rigidity(肌肉强直 Cogwheel phenomenon(Lead pipe phenomenon) 4. Ataxia(共济失调) 颤,慢,硬,共济失调 16
16 Parkinson’s Disease - Symptoms 1. Resting tremor (静止震颤) 2. Bradykinesia (运动迟缓) 3. Rigidity (肌肉强直) Cogwheel phenomenon (Lead pipe phenomenon) 4. Ataxia (共济失调) 颤，慢，硬，共济失调
5. Others p Abnormality of posture and gait > Handwriting Memory impairment, confusion(精神混乱), disorientation > Cognitive deficits Depression 17
17 ▪ 5. Others ➢Abnormality of posture and gait ➢Handwriting ➢Memory impairment, confusion (精神混乱), disorientation ➢Cognitive deficits ➢Depression
Rhythmic tremor often Leaning forward occurs at first in one hand or backward when where it resembles the motion upright reflects of rolling a pill between the Impairment of thumb and forefinger balance and coordination Difficulty rising from a sitting position is a Muscle rigidity shows itself in the common sign of disordered cogwheel phenomenon: pushing on an arm control over movement causes it to move in jerky increments Some patients report instead of smoothly feelings of weakness and of being constrained by Parkinson’ s disease ropes or other forces
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PD symptoms Onset Diagnosis Dopaminergic neuron loss in PD 0S0=0z9 Nonmotor ① Sleep Olfactory Mood Autonomic system Presymptomatic phase Early nonmotor symptoms Specific symptoms Time(years Olfactory dysfunction may predate clinical PD by at least 4 years Halperin et al. Neurotherapeutics. 2009: 6: 128-140 Lang. Neurology. 2007: 68: 948-952 Ross et al. Ann Neuro 2008: 63: 167-173 Adapted image reprinted from Neurotherapeutics, Vol 6, Halperin 1, Morelli M, Korczyn AD, Youdim MB, Mandel SA Biomarkers for evaluation of clinical efficacy of multipotential neuroprotective drugs for Alzheimer's and Parkinsons diseases pages 128-140, Copyright 2009, with permission from Elsevier
Presymptomatic phase Onset Sleep Olfactory* Mood Autonomic system Diagnosis Early nonmotor symptoms Specific symptoms Motor PD symptoms Dopaminergic neuron loss in PD % Remaining Dopaminergic Neurons Time (years) Nonmotor Adapted image reprinted from Neurotherapeutics, Vol. 6, Halperin I, Morelli M, Korczyn AD, Youdim MB, Mandel SA. Biomarkers for evaluation of clinical efficacy of multipotential neuroprotective drugs for Alzheimer's and Parkinson's diseas es, pages 128-140, Copyright 2009, with permission from Elsevier. *Olfactory dysfunction may predate clinical PD by at least 4 years. Halperin et al. Neurotherapeutics. 2009;6:128-140. Lang. Neurology. 2007;68:948-952. Ross et al. Ann Neurol. 2008;63:167-173
PD- Epidemiology The second most common neurodegenerative disorder after ad Increase with age population >65 years old: 1% >mean age at onset: 60 years old >85% of patients are over 65 years old
20 PD - Epidemiology ▪ The second most common neurodegenerative disorder after AD. ▪ Increase with age ➢population >65 years old: 1% ➢mean age at onset: 60 years old ➢85% of patients are over 65 years old