Parkinson's Knowledge 3 — Questions and Answers
Question 1: Which brain region is most severely affected in the early stages of Parkinson's disease?
- Cerebellum
- Hippocampus
- Substantia nigra pars compacta (Correct answer)
- Prefrontal cortex
Correct answer: Substantia nigra pars compacta
The substantia nigra pars compacta, which produces dopamine, is the region most affected early in Parkinson's disease.
Question 2: What is the 'on-off' phenomenon in Parkinson's disease?
- Fluctuations between periods of good motor control and poor motor control (Correct answer)
- Alternating tremor that switches between hands
- The effect of turning DBS therapy on and off
- Daily variation in non-motor symptoms only
Correct answer: Fluctuations between periods of good motor control and poor motor control
The 'on-off' phenomenon describes unpredictable motor fluctuations where medication effectiveness varies, causing periods of good control ('on') and poor control ('off').
Question 3: Which of the following genes is associated with autosomal dominant Parkinson's disease?
- PARKIN (PARK2)
- DJ-1 (PARK7)
- LRRK2 (PARK8) (Correct answer)
- PINK1 (PARK6)
Correct answer: LRRK2 (PARK8)
Mutations in LRRK2 are the most common known genetic cause of autosomal dominant Parkinson's disease.
Question 4: What does the term 'wearing off' describe in the context of Parkinson's medication?
- Tolerance developing to dopamine agonists
- Return of symptoms before the next scheduled dose (Correct answer)
- Gradual reduction in DBS effectiveness
- Skin irritation from transdermal patches
Correct answer: Return of symptoms before the next scheduled dose
'Wearing off' occurs when levodopa's benefit diminishes before the next dose is due, causing symptoms to return.
Question 5: Which occupational therapy goal is most relevant for a patient with Parkinson's disease experiencing freezing of gait?
- Improving fine motor skills for writing
- Using visual cues or rhythmic auditory signals to initiate movement (Correct answer)
- Increasing upper limb strength
- Managing cognitive fatigue
Correct answer: Using visual cues or rhythmic auditory signals to initiate movement
Visual floor cues (e.g., tape lines) and auditory rhythms help patients with freezing of gait overcome motor blocks.
Question 6: Approximately what percentage of Parkinson's disease cases are considered genetic in origin?
- Less than 5%
- 10–15% (Correct answer)
- 30–40%
- Over 50%
Correct answer: 10–15%
About 10–15% of Parkinson's cases have an identified genetic cause; the majority are idiopathic.
Question 7: Which medication class acts as a MAO-B inhibitor to slow dopamine breakdown in Parkinson's treatment?
- Anticholinergics
- COMT inhibitors
- Dopamine agonists
- Selegiline/Rasagiline (Correct answer)
Correct answer: Selegiline/Rasagiline
Selegiline and rasagiline inhibit monoamine oxidase B (MAO-B), an enzyme that breaks down dopamine, thereby prolonging its effect.
Parkinson's Knowledge 3
Which brain region is most severely affected in the early stages of Parkinson's disease?