June 23, 2015

Concerning Parkinson's Disease and Its Causes


An elderly man with Parkinson's disease presents with his daughter who is very worried about him. She noticed a deterioration in his movement whilst away in the UK for a family reunion. He also had a fall during the night and banged his head.

On examination, his dopamine concentration was found to have decreased to 20% of the normal level since his last check up. You also observe severe symptoms of bradykinesia.

What is the least probable reason leading to the premature death of dopaminergic neurons?

Please choose one:
a). Brain damage
b). Genetic predisposition
c). Accelerated aging
d). Toxic factors
e). Proteolytic stress


The correct answer is A


Progressive loss of 6-8% of dopamine concentration every 10 years is a physiological finding attributed to age.
However, when it decreases to 20% of the normal level, symptoms as bradykinesia, cogwheel rigidity, resting tremor and postural reflex impairment appear.

The severity of these symptoms can be measured according to the Hoehn and Yahr Scale.

Probable reasons leading to the premature death of dopaminergic neurons are genetic predisposition, accelerated aging, toxic factors, specific and non-specific central nervous system inflammations, chronic inflammatory reaction of the neuroglia, oxidative stress and protein metabolism disturbances leading to so called proteolytic stress.

Although some studies have shown dopamine transporter loss, it is still the least probable cause as most of these studies have not been conducted on humans.

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