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Parkinson's disease is a progressive neurodegenerative condition that primarily affects the central nervous system, impacting both motor and non-motor systems.
Answer: True
Explanation: Parkinson's disease is defined as a progressive neurodegenerative condition affecting the central nervous system, which encompasses both motor and non-motor systems.
Parkinson's disease is known exclusively by the names idiopathic parkinsonism and paralysis agitans.
Answer: False
Explanation: While idiopathic parkinsonism and paralysis agitans are alternative names, Parkinson's disease is also known as hypokinetic rigid syndrome and shaking palsy.
Parkinson's disease is classified as a synucleinopathy due to the abnormal accumulation of the alpha-synuclein protein.
Answer: True
Explanation: The disease is categorized as a synucleinopathy because of the abnormal accumulation of the alpha-synuclein protein, which forms Lewy bodies.
Parkinson's disease is considered a movement disorder because it primarily affects the peripheral nervous system.
Answer: False
Explanation: Parkinson's is a movement disorder because it affects the central nervous system, specifically the dopamine-producing neurons in the substantia nigra, leading to movement abnormalities.
The motor symptoms of parkinsonism are exclusive to Parkinson's disease and do not appear in other conditions.
Answer: False
Explanation: The motor symptoms known as parkinsonism are not exclusive to PD and can appear in other conditions, such as HIV infection and as a result of recreational drug use.
Parkinson-plus syndromes are a group of neurodegenerative diseases that feature parkinsonism but have distinct differences from Parkinson's disease itself.
Answer: True
Explanation: Parkinson-plus syndromes, also known as atypical parkinsonian disorders, are neurodegenerative diseases that feature parkinsonism but have distinct characteristics that differentiate them from Parkinson's disease.
James Parkinson published the first comprehensive medical description of Parkinson's disease in 1817, calling it 'An Essay on the Shaking Palsy'.
Answer: True
Explanation: James Parkinson published the first comprehensive description in 1817 in his monograph titled 'An Essay on the Shaking Palsy'.
Jean-Martin Charcot was the first to describe bradykinesia as a cardinal symptom of Parkinson's disease.
Answer: True
Explanation: Jean-Martin Charcot expanded on Parkinson's description and is credited with including bradykinesia as a cardinal symptom.
Which of the following is NOT an alternative name for Parkinson's disease mentioned in the source material?
Answer: Progressive supranuclear palsy
Explanation: Progressive supranuclear palsy is a Parkinson-plus syndrome, a distinct neurodegenerative disease, not an alternative name for Parkinson's disease itself. The other options are listed as alternative names for PD.
Who is credited with renaming the condition 'Parkinson's disease' and expanding its description to include bradykinesia as a cardinal symptom?
Answer: Jean-Martin Charcot
Explanation: In 1877, French neurologist Jean-Martin Charcot renamed the condition 'Parkinson's disease' and was the first to include bradykinesia as a cardinal symptom.
Which of the following conditions can also present with parkinsonism, the collective term for PD's motor symptoms?
Answer: HIV infection
Explanation: Parkinsonism, the collection of cardinal motor symptoms, is not exclusive to Parkinson's disease and can appear in other conditions, including HIV infection.
Who described the microscopic particles, later named Lewy bodies, in 1912?
Answer: Frederic Lewy
Explanation: In 1912, Frederic Lewy was the first to describe the microscopic particles that are now named Lewy bodies in his honor.
The four cardinal motor symptoms of Parkinson's disease are tremors, bradykinesia, rigidity, and postural instability.
Answer: True
Explanation: The source material identifies tremors, bradykinesia (slowed movements), rigidity, and postural instability as the four cardinal motor symptoms of Parkinson's disease.
Non-motor symptoms of Parkinson's disease typically appear before motor symptoms and decrease in prevalence over time.
Answer: False
Explanation: Non-motor symptoms typically develop later in the disease's progression, and their prevalence increases, rather than decreases, over time.
Tremor is the most common motor symptom in Parkinson's disease, appearing in 70–75% of affected individuals.
Answer: True
Explanation: Tremor is identified as the predominant motor symptom, affecting 70-75% of individuals with Parkinson's disease.
Bradykinesia in Parkinson's disease primarily manifests as increased facial expressions and rapid, fluid movements.
Answer: False
Explanation: Bradykinesia is characterized by slowed movements and can lead to hypomimia, which is reduced, not increased, facial expression.
Rigidity in Parkinson's disease is characterized by a feeling of stiffness and resistance when muscles are passively stretched.
Answer: True
Explanation: Rigidity, also called rigor, is defined as a motor symptom characterized by stiffness and resistance to passive muscle stretching.
Postural instability typically appears in the early stages of Parkinson's disease, leading to improved balance.
Answer: False
Explanation: Postural instability appears in the later stages of the disease and leads to impaired balance and an increased risk of falls.
Micrographia, or diminished, jagged handwriting, is a secondary motor symptom observed in Parkinson's disease.
Answer: True
Explanation: Micrographia, which is described as diminutive, jagged, and sharply fluctuating handwriting, is listed as a secondary motor deficit in Parkinson's disease.
Neuropsychiatric symptoms like anxiety and depression affect less than 10% of individuals with Parkinson's disease.
Answer: False
Explanation: Neuropsychiatric symptoms such as anxiety and depression are highly prevalent, affecting up to 60% of individuals with Parkinson's disease.
Dysautonomia symptoms, such as orthostatic hypotension and gastrointestinal problems, are highly debilitating and can appear at any stage of Parkinson's disease.
Answer: True
Explanation: Dysautonomia, which includes symptoms like orthostatic hypotension, can appear at any stage of Parkinson's disease and is described as highly debilitating.
Sensory deficits are rare in Parkinson's disease, affecting less than 10% of patients.
Answer: False
Explanation: Sensory deficits are common, affecting up to 90% of people with Parkinson's disease.
REM sleep behavior disorder (RBD) may begin years before the initial motor symptoms appear in Parkinson's disease.
Answer: True
Explanation: The source states that REM sleep behavior disorder (RBD) can begin years before the onset of motor symptoms.
Seborrheic dermatitis is recognized as a premotor feature of Parkinson's disease, indicating dysautonomia.
Answer: True
Explanation: Seborrheic dermatitis is identified as a premotor feature of Parkinson's disease and is an indicator of dysautonomia, suggesting that PD can be detected through tissue abnormalities outside the nervous system.
Which of the following is NOT one of the four cardinal motor symptoms of Parkinson's disease?
Answer: Hypomimia
Explanation: Hypomimia (reduced facial expression) is a manifestation of bradykinesia, but it is not one of the four cardinal motor symptoms. The four cardinal symptoms are tremors, bradykinesia, rigidity, and postural instability.
What is the characteristic frequency of a classic parkinsonian 'pill-rolling' tremor?
Answer: 4-6 Hz
Explanation: A classic parkinsonian tremor, often described as 'pill-rolling,' has a characteristic frequency of 4–6 Hz.
Which of the following is a common neuropsychiatric symptom that can precede motor symptoms in Parkinson's disease?
Answer: Anxiety
Explanation: Neuropsychiatric symptoms, including anxiety, can precede the onset of motor symptoms in individuals with Parkinson's disease. The other options are motor symptoms or complications.
What percentage of individuals with Parkinson's disease experience sensory deficits?
Answer: Up to 90%
Explanation: Sensory deficits are highly prevalent in Parkinson's disease, affecting up to 90% of individuals.
Which sleep disorder is mentioned as potentially beginning years before the initial motor symptoms of Parkinson's disease appear?
Answer: REM sleep behavior disorder (RBD)
Explanation: REM sleep behavior disorder (RBD) is noted as a sleep disorder that may begin years before the initial motor symptoms of Parkinson's disease manifest.
What is the term for the reduced facial expressions seen in Parkinson's disease patients, resulting from slowed movements?
Answer: Hypomimia
Explanation: Hypomimia is the term for reduced facial expressions, which is a manifestation of bradykinesia (slowed movements) in Parkinson's disease.
Which of the following is a type of pain commonly experienced by people with Parkinson's disease?
Answer: Nociceptive and neuropathic pain
Explanation: Sensory deficits in Parkinson's disease are common and include both nociceptive and neuropathic pain.
The primary cause of Parkinson's disease involves the abnormal aggregation of the alpha-synuclein protein into Lewy bodies within neurons.
Answer: True
Explanation: The pathophysiology of Parkinson's disease involves the death of nerve cells, which is linked to the abnormal aggregation of the alpha-synuclein protein into Lewy bodies.
The exact cause of neurodegeneration in Parkinson's disease is fully understood and is primarily genetic.
Answer: False
Explanation: The exact cause of neurodegeneration remains unclear but is thought to involve a complex interplay of genetic and environmental factors, with most cases being idiopathic (without a clear cause).
The prion hypothesis suggests that alpha-synuclein aggregates can spread from affected neurons to healthy ones, seeding new aggregates.
Answer: True
Explanation: The prion hypothesis posits that pathogenic alpha-synuclein aggregates can spread from affected to healthy neurons, thereby seeding new aggregates.
Heiko Braak's hypothesis suggests Parkinson's disease begins in the brain and spreads outwards to the gut.
Answer: False
Explanation: Braak's hypothesis suggests the opposite: that the pathology begins outside the brain, potentially in the gut or nasal cavity, and travels to the central nervous system.
Tobacco use and smoking are associated with an increased risk of Parkinson's disease.
Answer: False
Explanation: Tobacco use and smoking are associated with a decreased risk of Parkinson's disease, reducing it by up to 70%.
By the time motor symptoms appear in Parkinson's disease, approximately 10-20% of dopaminergic neurons in the substantia nigra have degenerated.
Answer: False
Explanation: By the time motor symptoms become apparent, a much higher percentage, approximately 50–80%, of dopaminergic neurons have degenerated.
Mitochondrial dysfunction is a well-established factor in Parkinson's disease, with faulty gene variants like PINK1 and Parkin preventing the removal of dysfunctional mitochondria.
Answer: True
Explanation: Mitochondrial dysfunction is a well-established factor, and faulty gene variants such as PINK1 and Parkin are linked to familial PD by preventing mitophagy, the process of removing dysfunctional mitochondria.
What is the primary pathophysiological process underlying Parkinson's disease?
Answer: Progressive degeneration of nerve cells in the substantia nigra
Explanation: The primary pathophysiological process is the progressive degeneration and death of nerve cells in the substantia nigra, which reduces the supply of dopamine to the basal ganglia.
What protein is considered a key contributor to the pathogenesis of Parkinson's disease due to its misfolding and aggregation?
Answer: Alpha-synuclein
Explanation: The abnormal aggregation of the alpha-synuclein protein is considered a key contributor to the pathogenesis of Parkinson's disease, leading to the formation of Lewy bodies.
According to Braak's hypothesis, where is an unknown pathogen believed to initially enter the body, triggering Parkinson's disease pathology?
Answer: Through the nasal cavity and swallowed into the digestive tract
Explanation: Braak's hypothesis proposes that a pathogen enters through the nasal cavity and is swallowed, initiating Lewy pathology in the gut, which then travels to the central nervous system.
Which of the following is identified as the most significant risk factor for developing Parkinson's disease?
Answer: Age
Explanation: Age is identified as the most significant risk factor for developing Parkinson's disease, with prevalence increasing substantially in older populations.
Which of the following factors is associated with a DECREASED risk of Parkinson's disease?
Answer: Caffeine consumption
Explanation: Caffeine consumption from sources like coffee or tea is associated with a decreased risk of developing Parkinson's disease. The other options are associated with an increased risk.
What percentage of dopaminergic neurons in the substantia nigra have typically degenerated by the time motor symptoms become apparent in Parkinson's disease?
Answer: Approximately 50–80%
Explanation: By the time motor symptoms of Parkinson's disease become apparent, a significant loss of approximately 50–80% of dopaminergic neurons in the substantia nigra has already occurred.
Which of the following is NOT one of the three major cellular pathways known to be affected in Parkinson's disease pathogenesis?
Answer: Ribosomal synthesis
Explanation: The three major cellular pathways identified as being affected in Parkinson's disease pathogenesis are vesicular trafficking, lysosomal degradation, and mitochondrial maintenance.
Diagnosis of Parkinson's disease relies solely on medical imaging techniques like positron emission tomography.
Answer: False
Explanation: The diagnosis is primarily based on a neurological examination of signs and symptoms, although medical imaging can be used to support the diagnosis.
Given there is no known cure, levodopa is a common initial pharmacological treatment for managing the symptoms of Parkinson's disease.
Answer: True
Explanation: As there is no cure, treatment focuses on alleviating symptoms, and initial pharmacological treatment often includes levodopa.
A Parkinson's disease diagnosis is typically confirmed by meeting any two of these criteria: responsiveness to levodopa, the presence of a resting tremor, levodopa-induced dyskinesia, or confirmation through a DaT scan.
Answer: True
Explanation: The source confirms that a diagnosis is typically confirmed by meeting any two of the listed criteria, which support a clinical diagnosis based on signs and symptoms.
Levodopa is considered the 'gold standard' for Parkinson's disease treatment because it directly cures the disease.
Answer: False
Explanation: Levodopa is the 'gold standard' for its effectiveness in alleviating symptoms, but it does not cure the disease. There is currently no known cure for Parkinson's.
Deep brain stimulation (DBS) is typically recommended for Parkinson's disease patients who are intolerant to or do not respond effectively to medication.
Answer: True
Explanation: DBS is typically recommended for patients who do not respond effectively to medication or are intolerant to it, primarily to target motor symptoms like rigidity and tremor.
A Mediterranean diet is advised for Parkinson's disease patients and may help slow disease progression.
Answer: True
Explanation: A Mediterranean diet is advised for patients to manage digestive issues and is noted to potentially slow the progression of the disease.
Palliative care for Parkinson's disease is only recommended in the very late stages of the illness.
Answer: False
Explanation: Early integration of palliative care is recommended to improve quality of life for both the patient and their family throughout the course of the illness.
What is the 'gold standard' pharmacological treatment for Parkinson's disease?
Answer: Levodopa
Explanation: Levodopa is the most widely used and effective therapy for Parkinson's disease and is often referred to as the 'gold standard' treatment.
Why are inhibitors like carbidopa and entacapone often taken with levodopa?
Answer: To prevent its metabolism outside the brain and reduce side effects
Explanation: Inhibitors like carbidopa are co-administered with levodopa to prevent its metabolism in the periphery, which helps reduce side effects like nausea and ensures more of the drug reaches the brain.
What are the primary motor symptoms targeted by Deep Brain Stimulation (DBS) in Parkinson's disease patients?
Answer: Rigidity and tremor
Explanation: Deep Brain Stimulation (DBS) is a surgical procedure that primarily targets motor symptoms such as rigidity and tremor in Parkinson's disease patients.
What type of diet is advised for Parkinson's disease patients to manage digestive problems and potentially slow disease progression?
Answer: Mediterranean diet
Explanation: A Mediterranean diet is advised for Parkinson's disease patients as it may help manage digestive issues and potentially slow the progression of the disease.
Parkinson's disease typically manifests in individuals younger than 50, affecting about one percent of this population.
Answer: False
Explanation: Parkinson's disease typically manifests in individuals over the age of 60, affecting about one percent of that population, not those younger than 50.
Parkinson's disease dementia (PDD) is a cognitive decline that affects all Parkinson's disease cases as the disease progresses.
Answer: False
Explanation: Parkinson's disease dementia (PDD) is a form of cognitive decline that occurs in 30% of Parkinson's disease cases, not all of them.
The 2017 Parkinson's Progression Markers Initiative study identified three broad subtypes of PD, with the diffuse malignant subtype having the longest mean survival.
Answer: False
Explanation: The diffuse malignant subtype has the most rapid progression and the shortest mean survival (8.1 years), not the longest.
Hypokinetic dysarthria and dysphagia are common complications in advanced Parkinson's disease, posing a risk of aspiration pneumonia.
Answer: True
Explanation: Hypokinetic dysarthria (speech problems) and dysphagia (swallowing difficulty) are noted as significant complications in advanced PD, with dysphagia increasing the risk of aspiration pneumonia.
Parkinson's disease is the third-most common neurodegenerative disease globally, with cases projected to decrease by 2040.
Answer: False
Explanation: Parkinson's is the second-most common neurodegenerative disease, and the number of cases is projected to increase to over 12 million by 2040.
The diagnosis of Parkinson's disease in notable figures like Michael J. Fox has had little impact on public understanding of the disorder.
Answer: False
Explanation: The diagnosis in notable figures like Michael J. Fox has significantly increased public understanding and awareness of the disorder.
The total economic burden of Parkinson's disease in the United States was estimated at $51.9 billion in 2017 and is projected to decrease by 2037.
Answer: False
Explanation: The economic burden was $51.9 billion in 2017 and is projected to increase, exceeding $79 billion by 2037.
At what age does Parkinson's disease typically manifest, affecting about one percent of that population?
Answer: Over the age of 60
Explanation: Parkinson's disease typically manifests in individuals over the age of 60, and it affects approximately one percent of this demographic.
According to the 2017 Parkinson's Progression Markers Initiative study, which subtype of Parkinson's disease has the most rapid progression and shortest mean survival?
Answer: Diffuse malignant
Explanation: The 'diffuse malignant' subtype was identified as having the most rapid progression and the shortest mean survival of 8.1 years after diagnosis.
What percentage of Parkinson's disease patients are affected by dysphagia (difficulty swallowing), posing a risk of aspiration pneumonia?
Answer: Over 80%
Explanation: Dysphagia, or difficulty swallowing, is a significant complication affecting over 80% of patients with Parkinson's disease, which increases the risk of aspiration pneumonia.
What is the term for the cognitive decline that occurs in 30% of Parkinson's disease cases as the disease progresses?
Answer: Parkinson's disease dementia (PDD)
Explanation: Parkinson's disease dementia (PDD) is the term for the cognitive decline that occurs in 30% of Parkinson's disease cases as the disease progresses.
What is the estimated total economic burden of Parkinson's disease in the United States projected to exceed by 2037?
Answer: $79 billion
Explanation: The total economic burden of Parkinson's disease in the United States, which was $51.9 billion in 2017, is projected to exceed $79 billion by 2037.
What was the estimated global prevalence of Parkinson's disease as of 2023?
Answer: 1.51 per 1000
Explanation: As of 2023, the estimated global prevalence of Parkinson's disease was 1.51 per 1000 people.
The first gene identified for Parkinson's disease, *SNCA*, was discovered in 1997 and encodes the protein alpha-synuclein.
Answer: True
Explanation: The *SNCA* gene, which encodes alpha-synuclein, was the first gene identified for PD and was discovered in 1997.
Current clinical research for Parkinson's disease is focused on developing disease-modifying therapies to reverse or slow progression, as none currently exist.
Answer: True
Explanation: As no disease-modifying therapies currently exist, a primary focus of clinical research is to develop agents that can reverse or slow the progression of the disease.
Cell-based therapies for Parkinson's disease primarily focus on replacing lost glial cells in the substantia nigra.
Answer: False
Explanation: Cell-based therapies focus on replacing lost dopaminergic neurons, not glial cells, as the loss of this single cell type is responsible for many symptoms.
In what year was the first gene identified for Parkinson's disease, *SNCA*, discovered?
Answer: 1997
Explanation: The first gene identified for Parkinson's disease, *SNCA*, which encodes for alpha-synuclein, was discovered in 1997.
What is the primary goal of current clinical research for Parkinson's disease, given that no disease-modifying therapies exist?
Answer: To develop therapies that reverse or slow disease progression
Explanation: As no disease-modifying therapies currently exist, a primary goal of clinical research is to develop neuroprotective agents and other therapies that can reverse or slow the progression of the disease.
Which of the following is an emerging neuroprotective treatment strategy being investigated for Parkinson's disease?
Answer: Drugs that prevent alpha-synuclein oligomerization
Explanation: Emerging neuroprotective strategies include the development of drugs, such as small molecules and immunotherapies, that can prevent the aggregation of alpha-synuclein or promote its clearance.
What is the main reason cell-based therapies hold promise for Parkinson's disease?
Answer: Many symptoms are attributed to the loss of a single cell type, making regeneration promising.
Explanation: Cell-based therapies are a promising approach because many of the motor symptoms of Parkinson's disease are attributed to the loss of a single cell type—dopaminergic neurons—making their regeneration a targeted therapeutic goal.
How does gene therapy for Parkinson's disease typically aim to restore function to dopaminergic neurons?
Answer: By delivering genetic material via a viral vector to diseased cells.
Explanation: Gene therapy aims to restore function by delivering genetic material, typically using a viral vector, to the diseased dopaminergic neurons to either provide a functional gene or knock down a pathological one.