Parkinson's Knowledge 5 — Questions and Answers
Question 1: Which complication of Parkinson's disease describes a sudden inability to move, as if the feet are 'glued to the floor'?
- Festination
- Freezing of gait (Correct answer)
- Akinesia
- Camptocormia
Correct answer: Freezing of gait
Freezing of gait is an episodic inability to initiate or continue walking, often triggered by doorways, turns, or stress.
Question 2: Which protein misfolds and aggregates to form Lewy bodies in Parkinson's disease?
- Tau
- Beta-amyloid
- Alpha-synuclein (Correct answer)
- TDP-43
Correct answer: Alpha-synuclein
Alpha-synuclein misfolds and accumulates in Lewy bodies, the pathological hallmark of Parkinson's disease.
Question 3: What is Parkinson's disease dementia (PDD), and when does it typically develop?
- Dementia that precedes motor symptoms by 5 or more years
- Cognitive decline that emerges at least 1 year after the onset of motor symptoms (Correct answer)
- A separate disease unrelated to Parkinson's pathology
- Dementia caused exclusively by levodopa toxicity
Correct answer: Cognitive decline that emerges at least 1 year after the onset of motor symptoms
PDD is diagnosed when significant cognitive decline develops more than one year after the onset of established Parkinson's motor symptoms.
Question 4: Which dietary interaction is a concern for patients taking levodopa?
- High sodium intake reducing absorption
- High-protein meals competing with levodopa absorption in the gut (Correct answer)
- Vitamin C interfering with dopamine synthesis
- Caffeine accelerating levodopa breakdown
Correct answer: High-protein meals competing with levodopa absorption in the gut
Large neutral amino acids from dietary protein compete with levodopa for intestinal absorption and blood-brain barrier transport, reducing its effectiveness.
Question 5: What is orthostatic hypotension, and why is it a concern in Parkinson's disease?
- High blood pressure that triggers falls during exercise
- A drop in blood pressure upon standing that can cause dizziness and falls (Correct answer)
- Irregular heart rhythm associated with dopaminergic drugs
- Persistent low blood pressure unrelated to posture
Correct answer: A drop in blood pressure upon standing that can cause dizziness and falls
Orthostatic hypotension, a sudden drop in blood pressure when standing, is a common autonomic dysfunction in Parkinson's and increases fall risk.
Question 6: Which surgical brain target is most commonly used for deep brain stimulation in Parkinson's disease?
- Globus pallidus internus (GPi) only
- Subthalamic nucleus (STN) (Correct answer)
- Thalamus (Vim nucleus)
- Caudate nucleus
Correct answer: Subthalamic nucleus (STN)
The subthalamic nucleus (STN) is the most common DBS target because stimulation there effectively controls tremor, rigidity, and bradykinesia.
Question 7: Which speech therapy technique uses intensive voice exercises to address the soft, monotone speech (hypophonia) of Parkinson's disease?
- PROMPT therapy
- Lee Silverman Voice Treatment (LSVT LOUD) (Correct answer)
- Melodic intonation therapy
- Augmentative and alternative communication (AAC)
Correct answer: Lee Silverman Voice Treatment (LSVT LOUD)
LSVT LOUD is a research-supported speech treatment focusing on high-effort, loud phonation to improve voice loudness and clarity in Parkinson's patients.
Parkinson's Knowledge 5
Which complication of Parkinson's disease describes a sudden inability to move, as if the feet are 'glued to the floor'?