Parkinson's Disease
Name two etiologies of Parkinson's.
Idiopathic, genetic
Name one type of hypokinetic dysarthria.
Parkinson's
T/F: The extrapyramidal system is direct.
False! It is indirect.
Name two symptoms of Parkinsons-Plus.
Not responding well to medication
Rapid progression of symptoms
Name changes you would notice in a motor assessment of an individual with hypokinetic dysarthria for the following areas: Chest, larynx, lips/tonuge/jaw
Chest: Rapid, shallow breathing
Larynx: Bowed vocal folds
Lips/tongue/jaw: Resting tremor, decreased ROM, variable speaking rate
Is Parkinson's high or low tone?
High tone! (But is HYPOkinetic)
The basal ganglia is made up of five clusters of neurons. What are they?
caudate nucleus
putamen
globus pallidus
claustrum
amygdaloid nucleus
Extrapyramidal level is made up of three clusters of neurons. What are they?
Basal ganglia
Substantia nigra
Subthalamic nucleus
Name two forms of Parkinson-Plus syndromes.
Multiple System Atrophy
Progressive Supranuclear Palsy
Where is noradrenaline produced?
The pons
Where is dopamine produced?
In the substantia nigra!
A short rush of speech and/or gait. A hallmark of hypokinetic dysarthria
What is the function of the extrapyramidal level?
Maintains posture and tone
Facilitates and coordinates all movement - either excitatory or inhibitory
T/F: Progressive supranuclear palsy and multiple system atrophy respond well to velodopa and deep brain stimulation.
False! They respond poorly.
Dysprosody or overshooting of target is a salient symptom of which dysarthria?
Ataxic
Describe the cogwheel phenomenon.
Rhythmic resistance to passive movement
T/F: Individuals must experience a loss of 50-70% of dopamine in their substantia nigra before they will have changes in movement.
True!
Describe the difference in roles of the cerebellar and extrapyramidal levels.
While the extrapyramidal level sends out indirect signals, the cerebellum modifies and refines those signals.
One symptom of progressive supranuclear palsy has a unique name describing looking into the distance. What is it?
Doll's eyes
The caudate nucleus and putamen (two parts of the basal ganglia) make up what?
The striatum!
What is masked facies?
Decreased facial expression and blinking
Name two late-stage hypokinetic symptoms.
PaUcItY oF sPeEcH
Social isolation
One of the extrapyramidal chemicals is noradrenaline. A decreased amount of this chemical is associated with what?
Tremors
Strained-strangled voice quality is a symptom of:
A) Progressive supranuclear palsy
B) Multiple system atrophy
B) Multiple system atrophy
Name three global symptoms of hypokinetic dysarthria.
Bowed vocal folds - reduced strength
Reduced ROM
Rigidity