Summary clinical neuropsych.: NEUROPSYCHOLOGICAL ASPECTS OF PD
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Vrije Universiteit Brussel (VUB)
summary of the NEUROPSYCHOLOGICAL ASPECTS OF PD given by prof. M.Firouzi from the clinical neuropsychology course. It is a summary of the powerpoint slides and additional items noted during the lesson. The slides were in English and my own notes are always in Dutch as much as possible. It is theref...
Neurospych. SWINNEN: NEUROPSYCHOLOGICAL
ASPECTS OF PD
INTRODUCTION
PARKINSON’S DISEASE IN A NUTSHELL
James Parkinson (1755 – 1824)
- First to describe PD in his Essay on the Shaking Palsy (1817)
focus on motor symptoms
“intellect = unafflicted”
- 1980’s: non-motor symptoms addressed in research
- today: cognitive changes in PD acknowledged in clinical practice … but still underrecognized and
undertreated
Chronic Progressive Degenerative Brain Disorder
- Fastest growing neurological disorder
- Second-most common neurodegenerative disorder
First-most common = alzheimer
- Cause: degeneration dopamine-producing cells in substantia nigra of basal ganglia
- Effect: typical motor symptoms, non-motor features & neuropsychological
abnormalities
- Sinds 1990 incidentie x2
Meest voorkomende neurodegeneratieve aandoening
- alzheimer
1. SYMPTOMS
Rigidity
Tremor
Postural instability & balance disorders
Bradykinesia
Freezing of gait
Shuffling and propulsive gait, …
Recognisable motor symptoms of PD = Tip of the iceberg...
Nala Melis Pagina 1
, Neurospych. SWINNEN: NEUROPSYCHOLOGICAL
ASPECTS OF PD
niet allemaal even duidelijk voor het blote oog
Sommige symptomen doen zich ook ivoor bij verouderen
- Niet perse gezien als gevolg PD
THE FRONTOSTRIATAL NETWORK
1. EVOLUTIONARY INTERPRETATION
Organisms are in need of two systems for behavioral control:
- 1. Routine responses to known environmental stimuli: pre-programmed behavior, stimulus- based,
procedural, automatic
BASAL GANGLIA
Vb:wandelen
- 2. Reflective, problem-solving behavior in new situations
FRONTAL CORTEX
Vb:leren autorijden
these two systems are integrated in the FRONTOSTRIATAL NETWORK
- striataal= basale ganglia
Learning how to drive a car recuirs a lot of attention in the beginning (frontal)
2. LOOPS BETWEEN CORTEX – BASAL GANGLIA – THALAMUS – CORTEX
Loop starts at the cortex goes to the BG (upper and
lower nuclei), to the thalamus and then back to the
cortex
Eerste 5(van links te beginnen)
- Frontale cortex input nuclei basale
gangliathalamusterug naar frontale cortex
3. 3 LOOP SYSTEMS
1 manier van onderverdelen
Deficits in these circuits will cause problems in motor,
cognition and emotions
Manier om het fronto-striataal network te
onderscheiden
Basale ganglia spelt in alle 3 een cruciale rol
- Motor symptoms
- Cognitieve problemen
- Emotionele problemen
Nala Melis Pagina 2
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