BMS 450 Lecture Notes - Cytochrome C, Orthostatic Hypotension, Constipation
Document Summary
billion per year (direct and indirect costs) 3. 5 fold higher northeast and upper midwest > rest of nation. Changes in posture, movements, facial expression (noticed by family, friends) Progression: bilateral symptoms emerge (*nonspecific symptoms: diagnosis based on exclusion of other causes) *postural instability: poor balance, shorter steps shuffle feet. *loss of hand coordination harder to feed & dress self. Blank expression, appear to be staring (reduced eye blink) Imaging shows loss of 70% of dopamine in brain at onset of motor symptoms. Late stages: slow progression, typically over 20 years or more. Becomes an invalid, unable to walk or stand. Substantia nigra (primary affected area; melanin cells are dark pigmented) With loss of dopaminergic neurons, striatum fires excessively; becomes impossible to control movements. Sympathetic nervous system (noradrenergic) is damaged, causing orthostatic hypertension. Lesions are not restricted to dopaminergic cells, nor to brain. Lewy bodies (comprised of actin & alpha synuclein) found in 1/3 patients that develop dementia.
