Multiple choice questions: ANSWERS

Size: px
Start display at page:

Download "Multiple choice questions: ANSWERS"

Transcription

1 Multiple choice questions: ANSWERS Chapter 1. Redefining Parkinson s disease 1. Common non-motor features that precede the motor findings in Parkinson s disease (PD) include all of the following except? d. Dementia 2. Is the following statement correct? Hyposmia usually occurs after tremor begins in PD: b. False 3. Genetic mutations in PD may be considered prephysiologic biomarkers: a. True 4. Which sleep disorder appears to be a synucleinopathy? b. REM sleep behavior disorder 5. Disease-modifying treatment probably needs to be started before motor symptoms of PD occur because? c. Once motor symptoms are present degeneration is probably too far along for disease-modifying treatment to be effective Chapter 2. Motor features of Parkinson s disease 1. Which of the following is a cardinal motor feature of PD? b. Postural instability 2. Which of the following is true regarding the re-emergent tremor in PD? a. It occurs after a variable latency when the arms are outstretched or in posture For reprint orders, please contact: reprints@futuremedicine.com 2013 Future Medicine Ltd 141

2 3. Motor decrement may manifest as: c. Reduction in amplitude of a finger tap 4. Which of the following is not considered a risk factor for motor fluctuations and dyskinesias? d. History of stroke 5. Diphasic dyskinesias: b. May be associated with a prominent dystonic component Chapter 3. Olfaction, pain and other sensory abnormalities in Parkinson s disease 1. In Parkinson s disease (PD) restlessness during nocturnal sleep is likely to be due to: 2. In PD pain: e. Can be a prodromal symptom and can lead to misdiagnosis 3. The following symptoms may present as common features of non-motor fluctuation: 4. Olfactory dysfunction in PD: 5. Similar to PD olfactory impairment can be found in: d. Alzheimer disease and DLB Chapter 4. Cognitive and behavioral abnormalities in Parkinson s disease 1. Overlapping signs of Parkinson s disease (PD) and psychiatric disturbances do not include: c. Delusions 2. Depressive disorders: e. Are all of the above 3. Which of the the following class of medications is associated with delirium in PD? b. Anticholinergic 142

3 Multiple choice questions: answers 4. Across multiple studies, the cross-sectional prevalence of depressive disturbances has been found to be approximately: c. 40% 5. Treatment of impulse control disorder (ICDs) includes all of the following except: e. Pramipexole and ropinirole 6. Which of the following is not true of depressive disorders in PD: c. They are associated with need for lower doses of antiparkinsonian medications 7. Which of these are not classified as an anxiety disorder: c. Schizophrenia 8. Which of the following pairs of medications are recommended to treat psychosis in PD: d. Clozapine and quetiapine 9. A cognitive behavior therapy program for treatment of depression in PD might include all of the following modules except: d. Joke-telling 10. Randomized, placebo-controlled trials of antidepressant medications to treat depression in PD have demonstrated the efficacy of all of the following except: d. Fluoxetine Chapter 5. Autonomic dysfunction in Parkinson disease 1. The blood pressure (BP) and heart rate (HR) responses to the Valsalva maneuver reflect changes in autonomic nervous system activity. The normal hemodynamic response to the Valsalva maneuver does not include: d. Fall in BP during Phase IV 2. In patients with Parkinson s disease (PD) and neurogenic orthostatic hypotension the Valsalva maneuver shows: c. No overshoot in BP during Phase IV 3. Midodrine is a pressor agent approved by the US FDA for the treatment of neurogenic orthostatic hypotension. Mididorine is: a. A peripheral a1 agonist 143

4 4. Protein aggregates forming Lewy bodies are seen in neuropathologic studies of peripheral autonomic nerves and autonomic ganglia of patients with PD, dementia with Lewy bodies and pure autonomic failure. What is the main protein found in Lewy bodies? b. a-synuclein 5. Several medications can trigger or worsen orthostatic hypotension in susceptible patients. The most common are: 6. Ambulatory monitoring involves intermittent recordings of BP (and HR) during 24 h both while the patient is awake and asleep. Normally, there is a fall in both BP and HR at night during sleep. In patients with PD and impaired autonomic reflexes this night-time dipping is frequently: b. Absent 7. Diagnostic criteria for orthostatic hypotension are: a. A fall in systolic BP of at least 20 mmhg and/or diastolic BP of at least 10 mmhg within 3 min of standing 8. Symptoms of orthostatic hypotension are often worse at specific times of the day or after particular activities. These include: 9. A 75-year-old male recently diagnosed with PD complained of urinary frequency and weak stream as well as influenza-like symptoms. He visited three doctors the day before and was prescribed three new medications. He was taken to the ER owing to a brief episode of loss of consciousness when he got up at night to urinate. On questioning, he previously had occasional episodes of lightheadedness when standing for prolonged periods at church or when gardening on a hot day. Which new medications are the probable cause of his episode of loss of consciousness a. Tamsulosin by his urologist Chapter 6. Biomarkers for Parkinson s disease 1. According to the NIH Biomarker Working Group, in order for a biomarker to be considered a surrogate end point, it must: c. Predict the clinical benefit or harm that would be observed on a valid clinical end point 144

5 Multiple choice questions: answers 2. A trait biomarker measures a characteristic that: a. Does not change over time, such as a genetic variation 3. Single-photon emission computed tomography imaging of the dopamine transporter is useful for: b. Identifying conditions that produce dopamine deficiency including Parkinson s disease and multiple system atrophy 4. One type of MRI that may be useful in the diagnosis of Parkinson s disease is: d. Diffusion tensor imaging 5. Measurement of a-synuclein is possible in all of the following tissues except: b. Hair Chapter 7. Animal models of Parkinson s disease 1. Parkinson s disease (PD) animal models are used to: 2. Animal models of PD are evaluated by: d. Combination of behavioral, biochemical and pathologic assessments 3. 1-methyl-4-phenyl 1,2,5,6-tetra-hydro-pyridine is a neurotoxin that: a. Can cause parkinsonism in humans and primates 4. 6-hydroxydopamine lesions animal models of PD are mostly produced: b. By unilateral injection of 6-OHDA in the medial forebrain bundle of a rat 5. Currently developed genetic models: 145

Parkinson Disease. Lorraine Kalia, MD, PhD, FRCPC. Presented by: Ontario s Geriatric Steering Committee

Parkinson Disease. Lorraine Kalia, MD, PhD, FRCPC. Presented by: Ontario s Geriatric Steering Committee Parkinson Disease Lorraine Kalia, MD, PhD, FRCPC Key Learnings Parkinson Disease (L. Kalia) Key Learnings Parkinson disease is the most common but not the only cause of parkinsonism Parkinson disease is

More information

10th Medicine Review Course st July Prakash Kumar

10th Medicine Review Course st July Prakash Kumar 10th Medicine Review Course 2018 21 st July 2018 Drug Therapy for Parkinson's disease Prakash Kumar National Neuroscience Institute Singapore General Hospital Sengkang General Hospital Singhealth Duke-NUS

More information

Parkinson s Disease WHERE HAVE WE BEEN, WHERE ARE WE HEADING? CHARLECE HUGHES D.O.

Parkinson s Disease WHERE HAVE WE BEEN, WHERE ARE WE HEADING? CHARLECE HUGHES D.O. Parkinson s Disease WHERE HAVE WE BEEN, WHERE ARE WE HEADING? CHARLECE HUGHES D.O. Parkinson s Epidemiology AFFECTS 1% OF POPULATION OVER 65 MEAN AGE OF ONSET 65 MEN:WOMEN 1.5:1 IDIOPATHIC:HEREDITARY 90:10

More information

III./3.1. Movement disorders with akinetic rigid symptoms

III./3.1. Movement disorders with akinetic rigid symptoms III./3.1. Movement disorders with akinetic rigid symptoms III./3.1.1. Parkinson s disease Parkinson s disease (PD) is the second most common neurodegenerative disorder worldwide after Alzheimer s disease.

More information

Pharmacologic Treatment of Parkinson s Disease. Nicholas J. Silvestri, M.D. Associate Professor of Neurology

Pharmacologic Treatment of Parkinson s Disease. Nicholas J. Silvestri, M.D. Associate Professor of Neurology + Pharmacologic Treatment of Parkinson s Disease Nicholas J. Silvestri, M.D. Associate Professor of Neurology + Disclosures n NO SIGNIFICANT FINANCIAL, GENERAL, OR OBLIGATION INTERESTS TO REPORT + Learning

More information

DIFFERENTIAL DIAGNOSIS SARAH MARRINAN

DIFFERENTIAL DIAGNOSIS SARAH MARRINAN Parkinson s Academy Registrar Masterclass Sheffield DIFFERENTIAL DIAGNOSIS SARAH MARRINAN 17 th September 2014 Objectives Importance of age in diagnosis Diagnostic challenges Brain Bank criteria Differential

More information

Pharmacologic Treatment of Parkinson s Disease. Nicholas J. Silvestri, M.D. Assistant Professor of Neurology

Pharmacologic Treatment of Parkinson s Disease. Nicholas J. Silvestri, M.D. Assistant Professor of Neurology + Pharmacologic Treatment of Parkinson s Disease Nicholas J. Silvestri, M.D. Assistant Professor of Neurology + Overview n Brief review of Parkinson s disease (PD) n Clinical manifestations n Pathophysiology

More information

Parkinson s Disease in the Elderly A Physicians perspective. Dr John Coyle

Parkinson s Disease in the Elderly A Physicians perspective. Dr John Coyle Parkinson s Disease in the Elderly A Physicians perspective Dr John Coyle Overview Introduction Epidemiology and aetiology Pathogenesis Diagnosis and clinical features Treatment Psychological issues/ non

More information

Appendix N: Research recommendations

Appendix N: Research recommendations Appendix N: recommendations N.1 First-line treatment of motor symptoms recommendation 1 Interventions What is the effectiveness of initial levodopa monotherapy versus initial levodopa-dopamine agonist

More information

Evaluation of Parkinson s Patients and Primary Care Providers

Evaluation of Parkinson s Patients and Primary Care Providers Evaluation of Parkinson s Patients and Primary Care Providers 2018 Movement Disorders Half Day Symposium Elise Anderson MD Medical Co-Director, PBSI Movement Disorders 6/28/2018 1 Disclosures GE Speaker,

More information

Motor symptoms: Tremor: Score (total of four limbs) Absent 0 Symptom not present

Motor symptoms: Tremor: Score (total of four limbs) Absent 0 Symptom not present Motor symptoms: Bradykinesia: (total of finger tapping, alternating hand, movements, legs agility, total impression of body bradykinesia) Mild 1 Minimal slowness, giving movement a deliberate character;

More information

The Parkinson s Disease Composite Scale

The Parkinson s Disease Composite Scale The Parkinson s Disease Composite Scale Motor symptoms Bradykinesia: (Total of finger tapping, alternating hand movements, legs agility, total impression of body bradykinesia) Mild 1 Minimal slowness,

More information

PARKINS ON CENTER. Parkinson s Disease: Diagnosis and Management. Learning Objectives: Recognition of PD OHSU. Disclosure Information

PARKINS ON CENTER. Parkinson s Disease: Diagnosis and Management. Learning Objectives: Recognition of PD OHSU. Disclosure Information OHSU PARKINS ON CENTER Parkinson s Disease: Diagnosis and Management for Every MD Disclosure Information Grants/Research Support: National Parkinson Foundation, NIH, Michael J. Fox Foundation Consultant:

More information

Overview. Overview. Parkinson s disease. Secondary Parkinsonism. Parkinsonism: Motor symptoms associated with impairment in basal ganglia circuits

Overview. Overview. Parkinson s disease. Secondary Parkinsonism. Parkinsonism: Motor symptoms associated with impairment in basal ganglia circuits Overview Overview Parkinsonism: Motor symptoms associated with impairment in basal ganglia circuits The differential diagnosis of Parkinson s disease Primary vs. Secondary Parkinsonism Proteinopathies:

More information

Behavioral Aspects of Parkinson s Disease

Behavioral Aspects of Parkinson s Disease Behavioral Aspects of Parkinson s Disease Joseph H. Friedman, MD Director, Movement Disorders Program Butler Hospital Dept of Neurology Alpert Medical School of Brown University 1 Disclosures Drugs will

More information

Parkinson s Disease Update. Presented by Joanna O Leary, MD Movement disorder neurologist Providence St. Vincent s

Parkinson s Disease Update. Presented by Joanna O Leary, MD Movement disorder neurologist Providence St. Vincent s Parkinson s Disease Update Presented by Joanna O Leary, MD Movement disorder neurologist Providence St. Vincent s What is a movement disorder? Neurological disorders that affect ability to move by causing

More information

Parkinson s Disease: initial diagnosis, initial treatment & non-motor features. J. Timothy Greenamyre, MD, PhD

Parkinson s Disease: initial diagnosis, initial treatment & non-motor features. J. Timothy Greenamyre, MD, PhD Parkinson s Disease: initial diagnosis, initial treatment & non-motor features J. Timothy Greenamyre, MD, PhD Involuntary tremulous motion, with lessened muscular power, in parts not in action and even

More information

Treatment of Parkinson s Disease: Present and Future

Treatment of Parkinson s Disease: Present and Future Treatment of Parkinson s Disease: Present and Future Karen Blindauer, MD Professor of Neurology Director of Movement Disorders Program Medical College of Wisconsin Neuropathology: Loss of Dopamine- Producing

More information

Parkinson s Disease Initial Clinical and Diagnostic Evaluation. J. Timothy Greenamyre, MD, PhD

Parkinson s Disease Initial Clinical and Diagnostic Evaluation. J. Timothy Greenamyre, MD, PhD Parkinson s Disease Initial Clinical and Diagnostic Evaluation J. Timothy Greenamyre, MD, PhD Involuntary tremulous motion, with lessened muscular power, in parts not in action and even when supported

More information

PARKINSON S PRIMER. Dr. Kathryn Giles MD, MSc, FRCPC Cambridge, Ontario, Canada

PARKINSON S PRIMER. Dr. Kathryn Giles MD, MSc, FRCPC Cambridge, Ontario, Canada PARKINSON S PRIMER Dr. Kathryn Giles MD, MSc, FRCPC Cambridge, Ontario, Canada COPYRIGHT 2017 BY SEA COURSES INC. All rights reserved. No part of this document may be reproduced, copied, stored, or transmitted

More information

How to Diagnose Early (Prodromal) Lewy Body Dementia. Ian McKeith MD, FRCPsych, F Med Sci.

How to Diagnose Early (Prodromal) Lewy Body Dementia. Ian McKeith MD, FRCPsych, F Med Sci. How to Diagnose Early (Prodromal) Lewy Body Dementia Ian McKeith MD, FRCPsych, F Med Sci. Parkinson s Disease Lewy Body Disease Time PD Dementia Lewy Body Dementias Dementia with Lewy Bodies (DLB) Diagnostic

More information

WHAT DEFINES YOPD? HANDLING UNIQUE CONCERNS REBECCA GILBERT, MD, PHD VICE PRESIDENT, CHIEF SCIENTIFIC OFFICER, APDA MARCH 14, 2019

WHAT DEFINES YOPD? HANDLING UNIQUE CONCERNS REBECCA GILBERT, MD, PHD VICE PRESIDENT, CHIEF SCIENTIFIC OFFICER, APDA MARCH 14, 2019 WHAT DEFINES YOPD? HANDLING UNIQUE CONCERNS REBECCA GILBERT, MD, PHD VICE PRESIDENT, CHIEF SCIENTIFIC OFFICER, APDA MARCH 14, 2019 YOUNG ONSET PARKINSON S DISEASE Definition: Parkinson s disease diagnosed

More information

Optimizing Clinical Communication in Parkinson s Disease:

Optimizing Clinical Communication in Parkinson s Disease: Optimizing Clinical Communication in Parkinson s Disease:,Strategies for improving communication between you and your neurologist PFNCA Symposium March 25, 2017 Pritha Ghosh, MD Assistant Professor of

More information

United Council for Neurologic Subspecialties Geriatric Neurology Written Examination Content Outline

United Council for Neurologic Subspecialties Geriatric Neurology Written Examination Content Outline United Council for Neurologic Subspecialties Geriatric Neurology Written Examination Content Outline REV 3/24/09 The UCNS Geriatric Neurology examination was established to determine the level of competence

More information

Contempo GIMSI Cosa cambia alla luce della letteratura in tema di terapia farmacologica

Contempo GIMSI Cosa cambia alla luce della letteratura in tema di terapia farmacologica Contempo GIMSI 2015-2017 Cosa cambia alla luce della letteratura in tema di terapia farmacologica Dott.ssa Diana Solari Centro Aritmologico e Sincope Unit, Lavagna www.gimsi.it POST 2 (Prevention of Syncope

More information

Atypical parkinsonism

Atypical parkinsonism Atypical parkinsonism Wassilios Meissner Service de neurologie et CMR atrophie multisystématisée, CHU de Bordeaux Institut des Maladies Neurodégénératives, Université Bordeaux 2, CNRS UMR 5293 Parkinsonism?

More information

Program Highlights. Michael Pourfar, MD Co-Director, Center for Neuromodulation New York University Langone Medical Center New York, New York

Program Highlights. Michael Pourfar, MD Co-Director, Center for Neuromodulation New York University Langone Medical Center New York, New York Program Highlights David Swope, MD Associate Professor of Neurology Mount Sinai Health System New York, New York Michael Pourfar, MD Co-Director, Center for Neuromodulation New York University Langone

More information

Parkinson s Disease. Sirilak yimcharoen

Parkinson s Disease. Sirilak yimcharoen Parkinson s Disease Sirilak yimcharoen EPIDEMIOLOGY ~1% of people over 55 years Age range 35 85 years peak age of onset is in the early 60s ~5% of cases characterized by an earlier age of onset (typically

More information

Dementia: It s Not Always Alzheimer s

Dementia: It s Not Always Alzheimer s Dementia: It s Not Always Alzheimer s A Caregiver s Perspective Diane E. Vance, Ph.D. Mid-America Institute on Aging and Wellness 2017 My Background Caregiver for my husband who had Lewy Body Dementia

More information

Parkinson s Disease. Gillian Sare

Parkinson s Disease. Gillian Sare Parkinson s Disease Gillian Sare Outline Reminder about PD Parkinson s disease in the inpatient Surgical patients with PD Patients who cannot swallow End of life care Parkinson s disease PD is the second

More information

Parkinson s Disease Psychosis Treatment in Long-Term Care: Clinical and Operational Considerations

Parkinson s Disease Psychosis Treatment in Long-Term Care: Clinical and Operational Considerations Parkinson s Disease Psychosis Treatment in Long-Term Care: Clinical and Operational Considerations Pari Deshmukh MD Triple board-certified psychiatrist (Boards of psychiatry, addiction medicine, integrative

More information

Parkinson s Disease and other related movement disorders a video guide to diagnosis

Parkinson s Disease and other related movement disorders a video guide to diagnosis Parkinson s Disease and other related movement disorders a video guide to diagnosis Parkinson s Disease Masterclass November 2017 Dr Frank Phelan MidYorkshire Hospitals NHS Trust Ideopathic Parkinson s

More information

Alison Charleston 1 st September 2016

Alison Charleston 1 st September 2016 Alison Charleston 1 st September 2016 Clinical features of Parkinson s disease Differential diagnosis Management of the motor features Non-motor and neuropsychiatric aspects 100-200 per 100,000 prevalence

More information

Središnja medicinska knjižnica

Središnja medicinska knjižnica Središnja medicinska knjižnica Adamec I., Klepac N., Milivojević I., Radić B., Habek M. (2012) Sick sinus syndrome and orthostatic hypotension in Parkinson's disease. Acta Neurologica Belgica, 112 (3).

More information

Depression & Anxiety. What can I do? What are other possible treatments? What is this? Why does this happen? KEY POINTS

Depression & Anxiety. What can I do? What are other possible treatments? What is this? Why does this happen? KEY POINTS Depression & Anxiety One set of important protectors from depression is friends and family as much as you can, keep yourself active and engaged with others. Exercise, particularly while outside, may help.

More information

The PD You Don t See: Cognitive and Non-motor Symptoms

The PD You Don t See: Cognitive and Non-motor Symptoms The PD You Don t See: Cognitive and Non-motor Symptoms Benzi M. Kluger, M.D., M.S. Associate Professor of Neurology and Psychiatry Director Movement Disorders Center University of Colorado Denver Goals

More information

Scott J Sherman MD, PhD The University of Arizona PARKINSON DISEASE

Scott J Sherman MD, PhD The University of Arizona PARKINSON DISEASE Scott J Sherman MD, PhD The University of Arizona PARKINSON DISEASE LEARNING OBJECTIVES The Course Participant will: 1. Be familiar with the pathogenesis of Parkinson s Disease (PD) 2. Understand clinical

More information

Faculty. Joseph Friedman, MD

Faculty. Joseph Friedman, MD Faculty Claire Henchcliffe, MD, DPhil Associate Professor of Neurology Weill Cornell Medical College Associate Attending Neurologist New York-Presbyterian Hospital Director of the Parkinson s Institute

More information

Parkinson s Disease Current Treatment Options

Parkinson s Disease Current Treatment Options Parkinson s Disease Current Treatment Options Daniel Kassicieh, D.O., FAAN Sarasota Neurology, P.A. PD: A Chronic Neurodegenerative Ds. 1 Million in USA Epidemiology 50,000 New Cases per Year Majority

More information

Chapter 161 Antipsychotics

Chapter 161 Antipsychotics Chapter 161 Antipsychotics Episode Overview Extrapyramidal syndromes are a common complication of antipsychotic medications. First line treatment is benztropine or diphenhydramine. Lorazepam is used in

More information

Parkinson s Disease Update

Parkinson s Disease Update Parkinson s Disease Update Elise Anderson MD Providence Center for Parkinson s Disease October 26, 2017 11/6/2017 1 Disclosures GE Speaker, DaTSCAN 11/6/2017 2 Outline PD diagnosis Motor and nonmotor symptoms

More information

DEMENTIA and BPSD in PARKINSON'S DISEASE. DR. T. JOHNSON. NOVEMBER 2017.

DEMENTIA and BPSD in PARKINSON'S DISEASE. DR. T. JOHNSON. NOVEMBER 2017. DEMENTIA and BPSD in PARKINSON'S DISEASE. DR. T. JOHNSON. NOVEMBER 2017. Introduction. Parkinson's disease (PD) has been considered largely as a motor disorder. It has been increasingly recognized that

More information

Prior Authorization with Quantity Limit Program Summary

Prior Authorization with Quantity Limit Program Summary Gocovri (amantadine) Prior Authorization with Quantity Limit Program Summary This prior authorization applies to Commercial, NetResults A series, SourceRx and Health Insurance Marketplace formularies.

More information

Presented by Meagan Koepnick, Josh McDonald, Abby Narayan, Jared Szabo Mentored by Dr. Doorn

Presented by Meagan Koepnick, Josh McDonald, Abby Narayan, Jared Szabo Mentored by Dr. Doorn Presented by Meagan Koepnick, Josh McDonald, Abby Narayan, Jared Szabo Mentored by Dr. Doorn Objectives What agents do we currently have available and what do we ideally need? What biomarkers exist for

More information

Let s Look at Parkinson s (PD) Sheena Morgan Parkinson s Disease Nurse Specialist Isle of Wight NHS Trust November 2016

Let s Look at Parkinson s (PD) Sheena Morgan Parkinson s Disease Nurse Specialist Isle of Wight NHS Trust November 2016 Let s Look at Parkinson s (PD) Sheena Morgan Parkinson s Disease Nurse Specialist Isle of Wight NHS Trust November 2016 What is Parkinson s? Parkinson's is a progressive neurological condition. People

More information

Revised criteria for the clinical diagnosis of dementia with Lewy. Dementia with Lewy bodies. (Dementia with Lewy Bodies)

Revised criteria for the clinical diagnosis of dementia with Lewy. Dementia with Lewy bodies. (Dementia with Lewy Bodies) Dementia with Lewy bodies First described: Okazaki H, 1961, Diffuse intracytoplasmic ganglionic inclusions (Lewy type) associated with progressive dementia and quadriparesis in flexion. J Neuropathol Exp

More information

Dizziness, postural hypotension and postural blackouts: Two cases suggesting multiple system atrophy

Dizziness, postural hypotension and postural blackouts: Two cases suggesting multiple system atrophy Dizziness, postural hypotension and postural blackouts: Two cases suggesting multiple system atrophy Dr Rahul Chakor, Associate Prof and Head Dept of Neurology, Dr Anand Soni, Senior Resident, T N Medical

More information

Dementia ALI ABBAS ASGHAR-ALI, MD STAFF PSYCHIATRIST MICHAEL E. DEBAKEY VA MEDICAL CENTER ASSOCIATE PROFESSOR BAYLOR COLLEGE OF MEDICINE

Dementia ALI ABBAS ASGHAR-ALI, MD STAFF PSYCHIATRIST MICHAEL E. DEBAKEY VA MEDICAL CENTER ASSOCIATE PROFESSOR BAYLOR COLLEGE OF MEDICINE Dementia ALI ABBAS ASGHAR-ALI, MD STAFF PSYCHIATRIST MICHAEL E. DEBAKEY VA MEDICAL CENTER ASSOCIATE PROFESSOR BAYLOR COLLEGE OF MEDICINE Objectives At the conclusion of the session, participants will be

More information

Psychiatric aspects of Parkinson s disease an update

Psychiatric aspects of Parkinson s disease an update Psychiatric aspects of Parkinson s disease an update Dr Chris Collins 027 2787593 chris.collins@cdhb.health.nz Disclosures: none Non-motor aspects physical Sensory anosmia, visual symptoms Speech and

More information

Parkinson s Disease. Prevalence. Mark S. Baron, M.D. Cardinal Features. Clinical Characteristics. Not Just a Movement Disorder

Parkinson s Disease. Prevalence. Mark S. Baron, M.D. Cardinal Features. Clinical Characteristics. Not Just a Movement Disorder Prevalence Parkinson s Disease Mark S. Baron, M.D. Associate Professor of Neurology Movement Disorders Section VCU School of Medicine Common disorder Approaching 1% by 65 yrs of age, 2% by 80 yrs of age

More information

Drugs used in Parkinsonism

Drugs used in Parkinsonism Drugs used in Parkinsonism قادة فريق علم األدوية : لي التميمي & عبدالرحمن ذكري الشكر موصول ألعضاء الفريق املتميزين : جومانة القحطاني ندى الصومالي روان سعد القحطاني pharma436@outlook.com @pharma436 Your

More information

Movement Disorders. Eric Kraus, MD! Neurology!

Movement Disorders. Eric Kraus, MD! Neurology! Movement Disorders Eric Kraus, MD! Neurology! Classify Bradykinesia! Tic! Myoclonus! Tremor! Dystonia! Athetosis! Chorea! Ballismus! Case 1 This 64 year-old female has had progression of a tremor over

More information

MOVEMENT DISORDERS AND DEMENTIA

MOVEMENT DISORDERS AND DEMENTIA MOVEMENT DISORDERS AND DEMENTIA FOCUS ON DEMENTIA WITH LEWY BODIES MADHAVI THOMAS MD NORTH TEXAS MOVEMENT DISORDERS INSTITUTE, INC DEMENTIA de men tia dəˈmen(t)sh(ē)ə/ nounmedicine noun: dementia a chronic

More information

droxidopa (Northera )

droxidopa (Northera ) Applies to all products administered or underwritten by Blue Cross and Blue Shield of Louisiana and its subsidiary, HMO Louisiana, Inc.(collectively referred to as the Company ), unless otherwise provided

More information

Coordinating Care Between Neurology and Psychiatry to Improve the Diagnosis and Treatment of Parkinson s Disease Psychosis

Coordinating Care Between Neurology and Psychiatry to Improve the Diagnosis and Treatment of Parkinson s Disease Psychosis Coordinating Care Between Neurology and Psychiatry to Improve the Diagnosis and Treatment of Parkinson s Disease Psychosis Jeff Gelblum, MD Senior Attending Neurologist Mt. Sinai Medical Center Miami,

More information

Clinical Features and Treatment of Parkinson s Disease

Clinical Features and Treatment of Parkinson s Disease Clinical Features and Treatment of Parkinson s Disease Richard Camicioli, MD, FRCPC Cognitive and Movement Disorders Department of Medicine University of Alberta 1 Objectives To review the diagnosis and

More information

Multiple System Atrophy

Multiple System Atrophy Multiple System Atrophy This document has been prepared to help you become more informed about Multiple System Atrophy. It is designed to answer questions about the condition and includes suggestions on

More information

Clinical Differences Among Four Common Dementia Syndromes. a program of Morningside Ministries

Clinical Differences Among Four Common Dementia Syndromes. a program of Morningside Ministries Clinical Differences Among Four Common Dementia Syndromes a program of Morningside Ministries Introduction Four clinical dementia syndromes account for 90% of all cases after excluding reversible causes

More information

2/20/18. History of Parkinson s. What is happening in the brain? DOPAMINE! Epidemiology. Parkinson s Disease. It s much more than tremor

2/20/18. History of Parkinson s. What is happening in the brain? DOPAMINE! Epidemiology. Parkinson s Disease. It s much more than tremor Parkinson s Disease History of Parkinson s It s much more than tremor Laura Dixon, DNP, MPA, APRN, FNP-BC University of Louisville Department of Neurology Movement Disorders Division Parkinson s Disease

More information

Joint Session with ACOFP and Mayo Clinic. Parkinson's Disease: 5 Pearls. Jay Van Gerpen, MD

Joint Session with ACOFP and Mayo Clinic. Parkinson's Disease: 5 Pearls. Jay Van Gerpen, MD Joint Session with ACOFP and Mayo Clinic Parkinson's Disease: 5 Pearls Jay Van Gerpen, MD Parkinson s Disease: 5 Pearls J.A. van Gerpen, MD Sections of Movement Disorders and Clinical Neurophysiology

More information

Diagnosis and Treatment of Alzhiemer s Disease

Diagnosis and Treatment of Alzhiemer s Disease Diagnosis and Treatment of Alzhiemer s Disease Roy Yaari, MD, MAS Director, Memory Disorders Clinic, Banner Alzheimer s Institute 602-839-6900 Outline Introduction Alzheimer s disease (AD)Guidelines -revised

More information

Nuplazid. Nuplazid (pimavanserin) Description

Nuplazid. Nuplazid (pimavanserin) Description Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.60.03 Subject: Nuplazid Page: 1 of 4 Last Review Date: June 22, 2018 Nuplazid Description Nuplazid (pimavanserin)

More information

PARKINSON S DISEASE. Nigrostriatal Dopaminergic Neurons 5/11/16 CARDINAL FEATURES OF PARKINSON S DISEASE. Parkinson s disease

PARKINSON S DISEASE. Nigrostriatal Dopaminergic Neurons 5/11/16 CARDINAL FEATURES OF PARKINSON S DISEASE. Parkinson s disease 5/11/16 PARKINSON S DISEASE Parkinson s disease Prevalence increases with age (starts 40s60s) Seen in all ethnic groups, M:F about 1.5:1 Second most common neurodegenerative disease Genetics role greater

More information

POSTURAL ORTHOSTATIC TACHYCARDIA SYNDROME (POTS) IT S NOT THAT SIMPLE

POSTURAL ORTHOSTATIC TACHYCARDIA SYNDROME (POTS) IT S NOT THAT SIMPLE POSTURAL ORTHOSTATIC TACHYCARDIA SYNDROME (POTS) IT S NOT THAT SIMPLE POTS Irritable heart syndrome. Soldier s heart. Effort syndrome. Vasoregulatory asthenia. Neurocirculatory asthenia. Anxiety neurosis.

More information

Psychiatric and Behavioral Symptoms in Alzheimer s and Other Dementias. Aaron H. Kaufman, MD

Psychiatric and Behavioral Symptoms in Alzheimer s and Other Dementias. Aaron H. Kaufman, MD Psychiatric and Behavioral Symptoms in Alzheimer s and Other Dementias Aaron H. Kaufman, MD Psychiatric and Behavioral Symptoms in Alzheimer s and Other Dementias Aaron H. Kaufman, M.D. Health Sciences

More information

Basics of Restless Legs Syndrome (Willis-Ekbom Disease)

Basics of Restless Legs Syndrome (Willis-Ekbom Disease) Basics of Restless Legs Syndrome (Willis-Ekbom Disease) Michael H. Silber, M.B.Ch.B. Professor of Neurology Mayo Clinic College of Medicine Objectives Understand how RLS is diagnosed Understand what we

More information

노인병원에서 Light Therapy 의 활용 박 기 형 진주삼성병원 송도병원 신경과

노인병원에서 Light Therapy 의 활용 박 기 형 진주삼성병원 송도병원 신경과 Light Therapy 1 : 15 / 63 (23.8%) 1 : 7 2 : 8 : 6 / 86 (7%) 1, : 48 / 205 (23.4%) 1 : 43 2 : 5 Sleep in Geriatrics Prevalence NIH survey of 9000 american senior above age 65 ; 88% had sleep disturbances

More information

Comprehensive Approach to DLB Management

Comprehensive Approach to DLB Management Comprehensive Approach to DLB Management Bradley F. Boeve, MD Division of Behavioral Neurology Department of Neurology Mayo Clinic Rochester, Minnesota Comprehensive Approach to DLB Management Disclosures

More information

Evaluation and Management of Parkinson s Disease in the Older Patient

Evaluation and Management of Parkinson s Disease in the Older Patient Evaluation and Management of Parkinson s Disease in the Older Patient David A. Hinkle, MD, PhD Comprehensive Movement Disorders Clinic Pittsburgh Institute for Neurodegenerative Diseases University of

More information

Parkinson s Disease Associated Sleep Disturbance Ehsan M. Hadi, MD, MPH. Dignity Health Neurological Institute

Parkinson s Disease Associated Sleep Disturbance Ehsan M. Hadi, MD, MPH. Dignity Health Neurological Institute Parkinson s Disease Associated Sleep Disturbance Ehsan M. Hadi, MD, MPH. Dignity Health Neurological Institute Parkinson s Disease 2 nd most common neurodegenerative disorder Peak age at onset is 60 years

More information

The Parkinson s You Can t See

The Parkinson s You Can t See The Parkinson s You Can t See We principally see the motor phenomena of Parkinson's disease, but is there an early stage without visible features? Might this provide a window for disease-modifying therapy?

More information

Enhanced Primary Care Pathway: Parkinson s Disease

Enhanced Primary Care Pathway: Parkinson s Disease Enhanced Primary Care Pathway: Parkinson s Disease 1. Focused summary of PD relevant to primary care Parkinson s Disease (PD) and Essential tremor (ET) are two of the most common movement disorders encountered

More information

Improving diagnosis of Alzheimer s disease and lewy body dementia. Brain TLC October 2018

Improving diagnosis of Alzheimer s disease and lewy body dementia. Brain TLC October 2018 Improving diagnosis of Alzheimer s disease and lewy body dementia Brain TLC October 2018 Plan for this discussion: Introduction to AD and LBD Why do we need to improve diagnosis? What progress has been

More information

M. Carranza M. R. Snyder J. Davenport Shaw T. A. Zesiewicz. Parkinson s Disease. A Guide to Medical Treatment

M. Carranza M. R. Snyder J. Davenport Shaw T. A. Zesiewicz. Parkinson s Disease. A Guide to Medical Treatment M. Carranza M. R. Snyder J. Davenport Shaw T. A. Zesiewicz Parkinson s Disease A Guide to Medical Treatment SEEd srl. All rights reserved Piazza Carlo Emanuele II, 19 10123 Torino, Italy Tel. 011.566.02.58

More information

The PD You Don t See: Cognitive and Non-motor Symptoms

The PD You Don t See: Cognitive and Non-motor Symptoms The PD You Don t See: Cognitive and Non-motor Symptoms Benzi M. Kluger, M.D., M.S. Assistant Professor of Neurology and Psychiatry University of Colorado Denver Goals 1) What are the most common non-motor

More information

Non-motor symptoms as a marker of. Michael Samuel

Non-motor symptoms as a marker of. Michael Samuel Non-motor symptoms as a marker of progression in Parkinson s s disease Michael Samuel London, UK 1 Definitions and their problems Non-motor symptoms as a marker of progression Non-motor symptoms (NMS)

More information

Non-Motor Symptoms of Parkinson s Disease

Non-Motor Symptoms of Parkinson s Disease Non-Motor Symptoms of Parkinson s Disease Samantha Holden, MD University of Colorado Movement Disorders MOTOR SYMPTOMS Rigidity Bradykinesia Tremor Gait Imbalance NON-MOTOR SYMPTOMS Dementia Urinary frequency

More information

Movement Disorders- Parkinson s Disease. Fahed Saada, MD March 8 th, th Family Medicine Refresher Course St.

Movement Disorders- Parkinson s Disease. Fahed Saada, MD March 8 th, th Family Medicine Refresher Course St. Movement Disorders- Parkinson s Disease Fahed Saada, MD March 8 th, 2019 48 th Family Medicine Refresher Course St. Joseph s Health Disclosure ACADIA Pharmaceuticals Objectives Review the classification

More information

Making Every Little Bit Count: Parkinson s Disease. SHP Neurobiology of Development and Disease

Making Every Little Bit Count: Parkinson s Disease. SHP Neurobiology of Development and Disease Making Every Little Bit Count: Parkinson s Disease SHP Neurobiology of Development and Disease Parkinson s Disease Initially described symptomatically by Dr. James Parkinson in 1817 in An Essay on the

More information

Any interventions, where RCTs in PD are not available, are not included in the tables.

Any interventions, where RCTs in PD are not available, are not included in the tables. Tables Interventions where new studies have been published are indicated in bold italics. Changes in conclusions are indicated in italics and are highlighted in yellow. Any interventions, where RCTs in

More information

Best Medical Treatments for Parkinson s disease

Best Medical Treatments for Parkinson s disease Best Medical Treatments for Parkinson s disease Bernadette Schöneburg, M.D. June 20 th, 2015 What is Parkinson s Disease (PD)? Progressive neurologic disorder that results from the loss of specific cells

More information

Antidepressants. Dr Malek Zihlif

Antidepressants. Dr Malek Zihlif Antidepressants The optimal use of antidepressant required a clear understanding of their mechanism of action, pharmacokinetics, potential drug interaction and the deferential diagnosis of psychiatric

More information

Learnings from Parkinson s disease: Critical role of Biomarkers in successful drug development

Learnings from Parkinson s disease: Critical role of Biomarkers in successful drug development Learnings from Parkinson s disease: Critical role of Biomarkers in successful drug development Ken Marek Coalition Against Major Diseases and FDA 2014 Annual Scientific Workshop Oct 2014 Disclosure Co-founder

More information

MAXIMIZING FUNCTION IN PARKINSON S DISEASE

MAXIMIZING FUNCTION IN PARKINSON S DISEASE 1 MAXIMIZING FUNCTION IN PARKINSON S DISEASE September 13, 2016 End Falls This Falls Conference Jan Goldstein Elman One Step Ahead Mobility Toronto, Ontario Outline An overview of Parkinson s disease (PD):

More information

Key Concepts and Issues in Parkinson s Disease in 2016

Key Concepts and Issues in Parkinson s Disease in 2016 Key Concepts and Issues in Parkinson s Disease in 2016 Michael Rezak, M.D., Ph.D. Section Chief, Neurosciences Institute Director, Movement Disorders and Neurodegenerative Diseases Center Northwestern

More information

Disorders of Movement M A R T I N H A R L E Y N E U R O L O G Y

Disorders of Movement M A R T I N H A R L E Y N E U R O L O G Y Disorders of Movement M A R T I N H A R L E Y N E U R O L O G Y Educational Objectives Improved history taking in patients with movement disorders. Develop a systematic approach to observing and describing

More information

7/3/2013 ABNORMAL PSYCHOLOGY SEVENTH EDITION CHAPTER FOURTEEN CHAPTER OUTLINE. Dementia, Delirium, and Amnestic Disorders. Oltmanns and Emery

7/3/2013 ABNORMAL PSYCHOLOGY SEVENTH EDITION CHAPTER FOURTEEN CHAPTER OUTLINE. Dementia, Delirium, and Amnestic Disorders. Oltmanns and Emery ABNORMAL PSYCHOLOGY SEVENTH EDITION Oltmanns and Emery PowerPoint Presentations Prepared by: Ashlea R. Smith, Ph.D. This multimedia and its contents are protected under copyright law. The following are

More information

Blood pressure fluctuation and hypertension in patients with Parkinson s disease

Blood pressure fluctuation and hypertension in patients with Parkinson s disease Blood pressure fluctuation and hypertension in patients with Parkinson s disease Tetsuro Tsukamoto 1, Yoshimi Kitano 2 & Sadako Kuno 3 1 Department of Neurology, Numazu Rehabilitation Hospital, 2510-22

More information

EMERGING TREATMENTS FOR PARKINSON S DISEASE

EMERGING TREATMENTS FOR PARKINSON S DISEASE EMERGING TREATMENTS FOR PARKINSON S DISEASE Katerina Markopoulou, MD, PhD Director Neurodegenerative Diseases Program Department of Neurology NorthShore University HealthSystem Clinical Assistant Professor

More information

Issues for Patient Discussion

Issues for Patient Discussion onmotor complications radykinesia Screening Tools asked PD micrographia eurodegeneration Designed for Use by Family Practitioners remor on-off opamine agonists tiffness depression ostural instability wearing

More information

Dr Barry Snow. Neurologist Auckland District Health Board

Dr Barry Snow. Neurologist Auckland District Health Board Dr Barry Snow Neurologist Auckland District Health Board Dystonia and Parkinson s disease Barry Snow Gowers 1888: Tetanoid chorea Dystonia a movement disorder characterized by sustained or intermittent

More information

PD: Key Treatment Considerations

PD: Key Treatment Considerations PD: Key Treatment Considerations 2018 Management of Neurologic and Neurosurgical Disorders in Daily Practice Elise Anderson MD Medical Co-Director, PBSI Movement Disorders 11/27/2018 1 Outline Treatment

More information

Motor Fluctuations Stephen Grill, MD, PHD Parkinson s and Movement Disorders Center of Maryland and Johns Hopkins University

Motor Fluctuations Stephen Grill, MD, PHD Parkinson s and Movement Disorders Center of Maryland and Johns Hopkins University Motor Fluctuations Stephen Grill, MD, PHD Parkinson s and Movement Disorders Center of Maryland and Johns Hopkins University I have no financial interest with any entity producing marketing, re-selling,

More information

8/28/2017. Behind the Scenes of Parkinson s Disease

8/28/2017. Behind the Scenes of Parkinson s Disease BEHIND THE SCENCES IN Parkinson s Disease Behind the Scenes of Parkinson s Disease Anna Marie Wellins DNP, ANP C Objectives Describe prevalence of Parkinson's disease (PD) Describe the hallmark pathologic

More information

Moving Treatment Earlier Disease Modification in Early PD

Moving Treatment Earlier Disease Modification in Early PD Moving Treatment Earlier Disease Modification in Early PD Ron Postuma Montreal General Hospital McGill University Disclosures: - Grants: Fonds de la Recherche en Sante Quebec, Canadian Institute of Health

More information

Motor Fluctuations in Parkinson s Disease

Motor Fluctuations in Parkinson s Disease Motor Fluctuations in Parkinson s Disease Saeed Bohlega, MD, FRCPC Senior Distinguished Consultant Department of Neurosciences King Faisal Specialist Hospital & Research Centre Outline Type of fluctuations

More information

Movement Disorders: A Brief Overview

Movement Disorders: A Brief Overview Movement Disorders: A Brief Overview Albert Hung, MD, PhD Massachusetts General Hospital Harvard Medical School August 17, 2006 Cardinal Features of Parkinsonism Tremor Rigidity Bradykinesia Postural imbalance

More information

Corporate Medical Policy

Corporate Medical Policy Corporate Medical Policy Dopamine Transporter Imaging with Single Photon Emission File Name: Origination: Last CAP Review: Next CAP Review: Last Review: dopamine_transporter_imaging_with_single_photon_emission_computed_tomography

More information

Psychosis in the Elderlyy

Psychosis in the Elderlyy Psychosis in the Elderly Handout Package PSYCHOSIS IN THE ELDERLY What is Psychosis? Impaired cognitive functioning, disorganized thinking and speech Presence of delusions or prominent hallucinations in

More information

Premotor PD: autonomic failure

Premotor PD: autonomic failure Premotor PD: autonomic failure Division of Neurobiology Department of Neurology Medical University of Innsbruck Non-motor symptoms in PD Autonomic OH, constipation, impotence, urinary incontinence or retention,

More information