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Summary clinical neuropsych.: NEUROPSYCHOLOGICAL ASPECTS OF PD

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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...

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  • December 11, 2023
  • 15
  • 2023/2024
  • Summary
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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

2. NON-MOTOR DISORDERS
Neuropsychiatric symptoms: Gastrointestinal symptoms:
- Depression, apathy - Dribbling of saliva
- Anxiety - Dysphagia (difficulty swallowing)
- Cognitive impairment - Reflux
- Executive dysfunction - Constipation
- Attention deficits - Fecal incontinence
- Hallucinations, delusions Autonomic symptoms:
- Dementia - Bladder disturbances (urgency, nocturia,
- Impulsive & compulsive behavior frequency)
 Sleep disorders: - Excessive sweating
- Restless legs - Orthostatic hypotension
- Excessive daytime somnolence - Erectile impotence

 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
gangliathalamusterug 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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