Basal Ganglia Diseases

Which neuron pool is responsible for

• Adjusting muscle tone in the postural/girdle muscles

• Stepping movement patterns of LE

• Contraction of neck muscles and extensor muscles

• Contraction of neck, shoulder and trunk muscles

Which neuron pool is responsible for

• Fractionated movement

• UE limb extension

Basal ganglia is composed of 5 nuclei, which are?

What is the medical diagnosis of a disease that damages the indirect pathway of the BG, is autosomal dominant, & onset is seen within the 3rd/4th decade? (No brakes)

What is the medical diagnosis of a disease that damages the direct pathway of the basal ganglia and symptoms begin to develop after the age of 50? (No accelerator)

The cortical motor areas produce which neurotransmitter that excites the striatum?

The substantia nigra is correlated to the production of which neurotransmitter?

Which disease is due to the death of dopamine producing cells in the substantia nigra → loss of dopamine to the putamen (reducing voluntary movement) & death of ACh producing cells in the PPN → disinhibition of the reticulospinal tract (excessive contraction of postural muscles) ?

What are the disease producing secondary PD? ( usually there’s a correlation to older meds that we don’t see often)

What is the term for increased resistance to movement ( in both flexor & extensor muscles) in all directions? Seen even in their sleep, the reflex never turns off

What is the term for when passive movement has repeated catches and releases?

What is the term for decrease in step length and heel strike resulting in small steps/shuffling →increased step cadence?

What is the term for involuntary, rhythmic shaking? Tend to see pill-rolling behavior and tremor decreases during active movement

In terms of resting tremor what type of hold/contraction do we see elicit the tremor

What is the term for slow movement especially with initiation?

What the term for less movement often seen in facial expressions?

What is the for term absence of movement?

What are the 2 clinical subgroups of Parkinson’s Disease?

What are the 2 main symptoms of PIGD phenotype?

What are the 3 differences seen with TD phenotype?

Diagnosis of PD peaks at ages 60-69, but by the time of detection individuals have lost about how much function of their substantia nigra?

What are the 4 cardinal features of PD? ( diagnosis requires 2/4 features to be present)

What are the 4 Basal Ganglia Loops?

What is Stage 1 PD & what do we see as the signs of it?

What is Stage 2 PD & what do we see as the signs of it?

What is Stage 3 PD & what do we see as the signs of it?

What is Stage 4 PD & what do we see as the signs of it?

What is Stage 5 PD & what do we see as the signs of it?

What is Stage 6 PD & what do we see as the signs of it?

In terms of clinical manifestation of PD, which category do the following fall under as effecting

• decreased torque production

• fatigue

• contractures/deformity

• micrographia

• resting tremor (70% of patients)

In terms of clinical manifestation of PD, which category do the following fall under as effecting

• starting hesitation

• freezing

• “poverty” of movement

• visuomotor difficulties

In terms of clinical manifestation of PD, which category do the following fall under as effecting

• slower, reduced efficiency

• increased context specificity ( cannot translates movements to new settings)

• Procedural learning deficits for complex tasks

In terms of clinical manifestation of PD, which category do the following fall under as effecting

• Kyphosis with forward head, scapular protraction

• Leaning to one side

• Increased fall risk

In terms of clinical manifestation, which category do the following fall under as effecting

• Paresthesia

• Pain

• Akinesia

• Proprioceptive and kinesthetic deficits

In terms of clinical manifestation, which category do the following fall under as effecting

• hypokinetic dysarthria

• dysphagia

• reduced vital capacity

In terms of clinical manifestation, which category do the following fall under as effecting

• Reduced step length

• Reduced step width and BOS

• Reduced speed

• Freezing of gait

• Difficulty side stepping, dual tasking

In terms of clinical manifestation, which category do the following fall under as effecting

• Dementia

• Bradyphrenia

• Visuospatial deficits

• Depression

• Dysphoric Mood

• Apathy

• Anxiety

In terms of clinical manifestation, which category do the following fall under as effecting

• Excessive sweating

• Constipation

• Urinary bladder dysfunction

• Orthostatic Hypotension

In terms of clinical manifestation, which category do the following fall under as effecting

• Low resting blood pressure

• Compromised cardiovascular response to exercise

• Impaired respiratory function

What are the common and severe side effects of medication affecting dopamine to treat PD?

What is the ability to achieve, maintain and regain balance?

• Abnormal response to controlling COM w/in BOS

• Smaller function LOS

• Narrowing BOS

• Competing attentional demands

• Difficulty during dynamic and self-initiated movements

• Abnormal coactivation response…inability to access postural synergies

• Difficulty regulating feed-forward or anticipatory responses (slowed responses)

• Impaired sensorimotor integration (muscle force is not proportional to demand)

These are all causes of what in terms of PD….

What disease is hereditary, progressive neurodegenerative disorder characterized by emotional, behavioral, psychiatric abnormalities, and movement abnormalities? ( no breaks)

HD is the degeneration of striatum and cerebral cortex, decreased signals from BG, disinhibition of motor thalamus and PPN →

What are the 4 characteristics associated with HD?

Balance and Training exercise improve ______ __but does not ___ ___________

What is the cognitive screen done on our patients with HD or PD (any neurological condition)?

What are the barriers care that we face when it comes to HD and PD?