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DBS for Parkinson's disease.

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Amin Mohammadzadeh
Amin Mohammadzadeh

A brief overview of Parkinson's disease. Dr. Amin Mohammadzadeh https://www.linkedin.com/in/amin-mohammadzadeh-26283660?lipi=urn%3Ali%3Apage%3Ad_flagship3_profile_view_base_contact_details%3BBBeVf3VNSO61bsqvs1fLkw%3D%3D amin60m@gmail.com

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Parkinsons Disease MOVEMENT DISORDERS Dr.Amin Mohammadzadeh
Content: 1. Parkinsons Disease 2. Epidemiology 3. Classification 4. Cardinal Symptoms 5. EssentialTremor 6. EssentialTremorVS Parkinsons Disease 7. Neuroanatomy 8. Neuromodulation 9. Boston Scientific Portfolio
Parkinsons Disease First described in 1817 by James Parkinson Parkinsonism is a clinical syndrome of Rigidity, Bradykinesia, RestingTremor, and Postural Instability (loss of postural reflexes). Parkinson disease is a progressive brain disorder characterized by the loss of neurons in an area of the midbrain known as the substantia nigra.
Parkinsons Disease These neurons use dopamine as a neurotransmitter and project their axons to the thalamus and the caudate and putamen areas of the basal ganglia. Parkinsonism refers to any disease that alters dopaminergic pathways connecting the substantia nigra to the basal ganglia.
Famous Parkinson's Disease Patients Alan Alda MuhammadAli George H.W. Bush RobinWilliams Neil Diamond Michael J. Fox Pope John Paul II Brian Grant
Epidimiology Estimated prevalence: 500,0001 million patients in United States Incidence: 40,00060,000 new cases per year in USA. Affects up to 0.3% of general population, but 13% of those >65 y/o. PD is largely a disease of older adults: only 510% of patients have symptoms before 40 y/o (young-onset PD).
Epidemiology Occurs between 45 and 65 years of age: Distribution is equal in men and women. Most cases are sporadic, but some cases are familial.
Classification o Idiopathic Parkinsons Disease (~75% all patients) o Familial Parkinsons Disease Genetic inheritable forms are rare, named after respectve mutated locus (e.g. PARK1) o Secondary Parkinsonism Drug inducsed (e.g. neuroleptics) Post-traumatic (e.g. Boxers Encephalopathy) o Atypical Parkinsonism (they have a different neurodegenerative disease) Multiple System Atrophy (MSA) Progressive Supernuclear Palsy (PSP)
Cardinal Symptoms o RestingTremor (Frequency ~ 4-6 Hz) o Bradykinesia = Slowness of movement o Rigidity = Increased muscle tone, resistance to passive movements o Postural Instability = Loss of balance
DBS for Parkinson's disease.
Basal Ganglia Disruption
DBS for Parkinson's disease.
Dopamine Replacement Therapy L-Dopa Preperations L-Dopa in comboniation with Decarboxylase inibitor (Carbidopa, Benserazid) Dopamine Agonist Ergot alkaloids = Dopamine agonists (Bromocriptin, Caberoglin, Dihydroergocryptin,) Selective D2-Receptr agonists = Non-Ergoline Dopamine agonists (Apomorphin, Piribedil, Parmipexol, Ropinirol, Rotigotin)
Essential Tremor EssentialTremor is
Essential Tremor One of the most common movement disorders Prevalence of 3-4 per 1000 2-4% among over 40 3-6% among over 60 20% among over 95* Annual incidence of 23.7 per 100,000 Slightly higher prevalence among men (1.08 : 1) Genetic Component
ET Tremor VS PD Tremor ET IntentionTremor Faster (4-12 Hz) Variable Amplitude Primary Symptom Often Familial Alcohol Improves Onset anytime PD RestingTremor Slower (4-6 Hz) Moderate Amplitude Constellation of Symptoms Infrequently Familial Alcohol has no effect Late onset
DBS for Parkinson's disease.
Neuroanatomy - Gross Functions Frontal lobe: Thinking, behavior and movement Occipital lobe: Sight Temporal lobe: Hearing, learning, memory Parietal lobe: Language, touch Cerebellum: Balance, movement coordination Brainstem: Breathing, heart rate, temperature
DBS for Parkinson's disease.
DBS for Parkinson's disease.
Ventral intermediate nucleus (VIM): EssentialTremor, ParkinsonsTremor Subthalamic nucleus (STN): Parkinsons disease Globus pallidus internus (GPi): Dystonia, (Parkinsons disease)
DBS for Parkinson's disease.
Neuromodulation
Neuromodulation The International Neuromodulation Society defines therapeutic neuromodulation as the alteration of nerve activity through targeted delivery of a stimulus, such as electrical stimulation or chemical agents, to specific neurological sites in the body.
10 Things to Know About Neuromodulation 1. Neuromodulation improves the quality of life for patients in pain. 2. Neuromodulation can be applied through different techniques. 3. Neuromodulation is FDA approved and has been used in practice for more than a quarter century. 4. Potential neuromodulation patients can test drive the modality. 5. Neuromodulation implants can be removed.
10 Things to Know About Neuromodulation 6. Neuromodulation alleviates or lessens pain without putting patients into a drug fog. 7. There are neuromodulation specialists in your area. 8. Neuromodulation procedures are covered by most medical insurance and Medicare programs. 9. Patient care is of the utmost importance to neuromodulation specialists. 10.Neuromodulation is NOT SCIENCE FICTION.
DBS for Parkinson's disease.
DBS for Parkinson's disease.
DBS for Parkinson's disease.
DBS for Parkinson's disease.
DBS for Parkinson's disease.
DBS for Parkinson's disease.
DBS for Parkinson's disease.
DBS for Parkinson's disease.
Dr.Amin Mohammadzadeh

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DBS for Parkinson's disease.

  • 2. Content: 1. Parkinsons Disease 2. Epidemiology 3. Classification 4. Cardinal Symptoms 5. EssentialTremor 6. EssentialTremorVS Parkinsons Disease 7. Neuroanatomy 8. Neuromodulation 9. Boston Scientific Portfolio
  • 3. Parkinsons Disease First described in 1817 by James Parkinson Parkinsonism is a clinical syndrome of Rigidity, Bradykinesia, RestingTremor, and Postural Instability (loss of postural reflexes). Parkinson disease is a progressive brain disorder characterized by the loss of neurons in an area of the midbrain known as the substantia nigra.
  • 4. Parkinsons Disease These neurons use dopamine as a neurotransmitter and project their axons to the thalamus and the caudate and putamen areas of the basal ganglia. Parkinsonism refers to any disease that alters dopaminergic pathways connecting the substantia nigra to the basal ganglia.
  • 5. Famous Parkinson's Disease Patients Alan Alda MuhammadAli George H.W. Bush RobinWilliams Neil Diamond Michael J. Fox Pope John Paul II Brian Grant
  • 6. Epidimiology Estimated prevalence: 500,0001 million patients in United States Incidence: 40,00060,000 new cases per year in USA. Affects up to 0.3% of general population, but 13% of those >65 y/o. PD is largely a disease of older adults: only 510% of patients have symptoms before 40 y/o (young-onset PD).
  • 7. Epidemiology Occurs between 45 and 65 years of age: Distribution is equal in men and women. Most cases are sporadic, but some cases are familial.
  • 8. Classification o Idiopathic Parkinsons Disease (~75% all patients) o Familial Parkinsons Disease Genetic inheritable forms are rare, named after respectve mutated locus (e.g. PARK1) o Secondary Parkinsonism Drug inducsed (e.g. neuroleptics) Post-traumatic (e.g. Boxers Encephalopathy) o Atypical Parkinsonism (they have a different neurodegenerative disease) Multiple System Atrophy (MSA) Progressive Supernuclear Palsy (PSP)
  • 9. Cardinal Symptoms o RestingTremor (Frequency ~ 4-6 Hz) o Bradykinesia = Slowness of movement o Rigidity = Increased muscle tone, resistance to passive movements o Postural Instability = Loss of balance
  • 13. Dopamine Replacement Therapy L-Dopa Preperations L-Dopa in comboniation with Decarboxylase inibitor (Carbidopa, Benserazid) Dopamine Agonist Ergot alkaloids = Dopamine agonists (Bromocriptin, Caberoglin, Dihydroergocryptin,) Selective D2-Receptr agonists = Non-Ergoline Dopamine agonists (Apomorphin, Piribedil, Parmipexol, Ropinirol, Rotigotin)
  • 15. Essential Tremor One of the most common movement disorders Prevalence of 3-4 per 1000 2-4% among over 40 3-6% among over 60 20% among over 95* Annual incidence of 23.7 per 100,000 Slightly higher prevalence among men (1.08 : 1) Genetic Component
  • 16. ET Tremor VS PD Tremor ET IntentionTremor Faster (4-12 Hz) Variable Amplitude Primary Symptom Often Familial Alcohol Improves Onset anytime PD RestingTremor Slower (4-6 Hz) Moderate Amplitude Constellation of Symptoms Infrequently Familial Alcohol has no effect Late onset
  • 18. Neuroanatomy - Gross Functions Frontal lobe: Thinking, behavior and movement Occipital lobe: Sight Temporal lobe: Hearing, learning, memory Parietal lobe: Language, touch Cerebellum: Balance, movement coordination Brainstem: Breathing, heart rate, temperature
  • 21. Ventral intermediate nucleus (VIM): EssentialTremor, ParkinsonsTremor Subthalamic nucleus (STN): Parkinsons disease Globus pallidus internus (GPi): Dystonia, (Parkinsons disease)
  • 24. Neuromodulation The International Neuromodulation Society defines therapeutic neuromodulation as the alteration of nerve activity through targeted delivery of a stimulus, such as electrical stimulation or chemical agents, to specific neurological sites in the body.
  • 25. 10 Things to Know About Neuromodulation 1. Neuromodulation improves the quality of life for patients in pain. 2. Neuromodulation can be applied through different techniques. 3. Neuromodulation is FDA approved and has been used in practice for more than a quarter century. 4. Potential neuromodulation patients can test drive the modality. 5. Neuromodulation implants can be removed.
  • 26. 10 Things to Know About Neuromodulation 6. Neuromodulation alleviates or lessens pain without putting patients into a drug fog. 7. There are neuromodulation specialists in your area. 8. Neuromodulation procedures are covered by most medical insurance and Medicare programs. 9. Patient care is of the utmost importance to neuromodulation specialists. 10.Neuromodulation is NOT SCIENCE FICTION.