Affect: One’s mood conveyed through facial expression, voice, body language and appearance. PD patients may seem depressed or down to others because they lose facial expressions and can speak with a muted voice.
Akathesia: Restlessness somewhat relieved by standing and moving about.
Akineisa: Literally, not-moving. In general, reduced or absent movement. People with PD blink, swallow and move less than others.
Anhedonia: The inability to enjoy or experience pleasure.
Anticholinergic: Medications that block the action of acetylcholine, an important neurotransmitter; benztropine (Cogentin), trihexyphenidyl (Attane) procyclidine (Kemadrine) and Akineton.
Apathy: Indifference, or not caring, having reduced emotions and dulled interest.
Ataxia: Loss of balance.
Bradykinesia: Gradual loss of spontaneous movement; slowness of movement. This is often the most disabling of symptoms.
Carbidopa(Lodosyn): A drug that is usually given in combination with a Parkinson’s drug called levodopa; the combination drug’s brand name is Sinemet. Carbidopa improves the effectiveness of levodopa and can be used to reduce the side effects of levodopa.
Cholinestrerase Inhibitors: These medications increase acetylchoine in the brain by preventing the enzyme from breaking it down. These work in the opposite way of anti-cholinergic drugs. These are used a lot in Alzheimers’ disease and other dementing illnesses including PD, and may help memory, concentration and modd; donepezil (Aricept), glantamine (Reminyl) and rivastigmine (Exelon).
Cognition: Ability to think, understand and solve problems.
COMT Inhibitors: catechol-O-Methyltransferase inhibitors increase the bioavailability of levodopa in the brain and subsequent conversion into dopamine by reducing the peripheral metabolism of levodopa used to extend benefits of levodopa, lessen fluctuations particularly “wearing off”. Side effects include difficulty performing voluntary muscle functions, excessive muscle activity, nausea, diarrhea and discolored urine.
Corpus Straitum: a part of the brain that helps regulate motor activities.
Deep Brain Stimulation (DBS):A surgical procedure that is very effective in treating Parkinson’s disease. The surgery includes the implantation of permanent electrodes in various parts of the brain through which continuous pulses of electricity are given to control the symptoms of Parkinson’s.
Dopamine: A chemical messenger, or neurotransmitter, deficient in the brains of Parkinson’s disease patients that transmits impulse from one nerve cell to another.
Dopamine Agonist: Stimulates dopaminergic terminals within the striatum: benefits include a longer half-life that results in less pulsatile stimulation of dopaminergic receptors. Usually given in combination with levodopa containing medications. Side effects include nausea, vomiting, anorexia, malaise, positional low blood pressure-orthostatic hypotension and psychiatric reactions.
Dyskinesias: Abnormal involuntary movement that can result from long-term use of high doses of levodopa.
Festination: A symptom characterized by small, quick forward steps.
Levodopa:A drug, containing a form of the important brain chemical dopamine, commonly used to treat symptoms of Parkinson’s disease. In combination with carbidopa, it is called Sinemet.
Lewy Body: A ball of proteins lodged within cells, visible microscopically and usually present in PD.
MAO Inhibitors: Monoamine oxidase inhibitors. Dopamine is a component of MAO. Non-specific MAO inhibitors are known for provoking hypertensive crises when combined with tyramine-rich foods, typically cheese or red wine. Selegiline, developed in the late 1960s has MAO-B class of enzymatic activity inhibitor, in the brain MAO-B preferentially metabolizes dopamine. The inhibitor slows reuptake of dopamine and increases its production. Side effects may be caused by its metabolites, yielding excitement, irritability and anxiety. Most side effects are not brought on by the drug itself, but by increasing the effects of levodopa yielding nausea, vomiting and dizziness.
Micrographia:The tendency to have very small handwriting due to difficulty with fine motor movements in Parkinson’s disease.
On-off Effect: A change in the patient’s condition with sometimes rapid fluctuations between uncontrolled movements and normal movement, usually occurring after long-term use of levodopa and probably caused by changes in the ability to respond to this drug.
Postural Instability: Impaired balance and coordination, often causing patients to lean forward or backward and to fall easily.
Propulsive Gait:Disturbance of gait typical of people with symptoms of Parkinson’s in which, during walking, steps become faster and faster with progressively shorter steps that passes from a walking to a running pace and may precipitate falling forward.
Resting Tremor:Shaking that occurs in a relaxed and supported limb.
Retropulsion: The tendency to step backwards if bumped from the front or upon initiating walking, usually seen in patients who tend to lean backwards because of problems with balance.
Rigidity: A symptom of the disease in which muscles feel stiff and display resistance to movement even when another person tries to move the affected part of the body, such as the arm.
Substantia Nigra: Movement control center in the brain where loss of dopamine producing nerve cells triggers symptoms of Parkinson’s disease, substantia nigra means “black substance: so called because the cells in this area are dark.
Tremor: Shakiness or trembling, often in a hand which in Parkinson’s disease is usually most apparent when the affected part is at rest.
Unilateral: Occurring on one side of the body. Parkinson’s disease symptoms usually begin unilaterally.
Wearing-off Effect: The tendency, following long-term levodopa treatment, for each dose of the drug to be effective for shorter periods of time.
