Glossary

 

Acetylcholine

a neurotransmitter in the striatum area of the brain. It is involved in many brain functions, such as memory and control of motor activity. There appears to be a interplay between the actions of acetylcholine and

dopamine.

 

Acetylcholinesterase inhibitor

A medication that increases the level of acetylcholine in the brain and is commonly used to treat cognitive disorders.

 

Acupuncture

a form of complementary or alternative medicine that consists of inserting small needles into the skin in order to relieve pain and other symptoms.

 

Adjunctive

supplemental or secondary (but not essential) to the primary agent. Sometimes used to describe medications used to enhance levodopa therapy.

 

Advanced directive

These often come in two parts. The first, sometimes called a living will, advises your doctor and healthcare team of your wishes for end-of-life care, such as whether you want to be resuscitated or placed on a respirator if your heart or breathing stop. Some states refer to this decision as 'DNR' (Do Not Resuscitate); some label it more gently, 'AND' (Allow Natural Death). The second, often called a medical power of attorney, designates who you want to make your healthcare or end-of-life decisions should you become unable to do so for yourself.

 

Agonist

a chemical or drug that enhances the activity of a neurotransmitter such as dopamine.

 

Akinesia

delay in initiating movement; inability to move; 'freezing'.

 

Alzheimer's Disease

the most common form of dementia. Dementia is a term that is used to describe a group of brain disorders. These brain disorders cause memory loss and make it harder to carry out daily tasks.

 

Anticholinergic

A substance that blocks the neurotransmitter acetylcholine in the central and the peripheral nervous system.

 

Antidepressant

A medication used to treat depression.

 

Anxiety

a feeling of nervousness, worried thoughts and physical distress.

 

Anxiety attack

A very sudden, discrete period of intense anxiety, mounting physiological arousal, fear, stomach problems and discomfort that is associated with a variety of somatic and cognitive symptoms. The onset of this episode is typically abrupt, and may have no obvious triggers.

 

Anxiolytic

an agent or a class of medications that reduce anxiety.

 

Apraxia

a neurological disorder characterized by loss of the ability to execute or carry out learned purposeful movements, despite having the desire and the physical ability to perform the movements.

 

Aromatherapy

the use of selected fragrances in lotions and inhalants in an effort to affect mood and promote health.

 

Ataxia

loss of balance.

Attention deficit disorder

a syndrome, usually diagnosed in childhood, characterized by a persistent pattern of impulsiveness, a short attention span, and often hyperactivity, and interfering especially with academic, occupational, and social performance.

 

Atypical parkinsonism

a group of brain disorders that initially look like Parkinson's disease, but differ in the course of the disease and response to antiparkinson medications. The term is used interchangeably with Parkinson-plus syndromes.

 

Auditory hallucination

A perceived voice or sound that is not real.

 

Basal ganglia

clusters of nuclei deep within the cerebrum, and the upper parts of the brain stem that play an important part in producing smooth, continuous muscular actions in starting and stopping movements.

 

Benzodiazepine

A class of anti-anxiety medication.

 

Blepharospasm

Spasmodic winking caused by the involuntary contraction of an eyelid muscle.

 

Botox

a neurotoxin that is injected into a particular muscle. The muscle becomes paralyzed for a temporary period—usually two to six months. It is used to treat a variety of conditions eyelid or eye muscle spasms, facial muscle imbalance, and/or facial wrinkles. It is also used to treat muscle spasms caused by neurological disorders.

 

Botulinim toxin

a neurotoxin that is injected into a particular muscle. The muscle becomes paralyzed for a temporary period—usually two to six months. It is used to treat a variety of conditions eyelid or eye muscle spasms, facial muscle imbalance, and/or facial wrinkles. It is also used to treat muscle spasms caused by neurological disorders.

 

Bowel impaction

stools (feces) that are firmly wedged in the bowel, and have become so hard and dry that they cannot be removed from the body naturally. Additional measures must be taken to allow them to be passed.

 

Bradykinesia

slowness of movement.

 

Bradyphrenia

slowness in thought processing.

 

Caregiver fatigue

Exhaustion and depression associated with taking care of a loved one with a chronic health condition.

 

Clinical trial

Depending on the type of product and the stage of its development, investigators enroll healthy volunteers and/or patients into small pilot studies initially, followed by larger scale studies in patients that often compare the new product with the currently prescribed treatment.

 

Cognitive remediation therapy

a therapeutic strategy that seeks to improve or restore a person's skills in the areas of paying attention, remembering, organizing, reasoning and understanding, problem-solving, decision making, and higher level cognitive abilities.

COMT

COMT is the second enzyme involved in the metabolism of levodopa to produce 3-O-methyldopa (3-OMD).

 

Continuous positive airway pressure

a method of respiratory ventilation used by people with sleep apnea. The CPAP machine was initially used mainly by patients for the treatment of sleep apnea at home, delivering a stream of compressed air via a hose to a nasal pillow, nose mask or full-face mask, splinting the airway (keeping it open under air pressure) so that unobstructed breathing becomes possible.

 

CT scan

a medical test that uses a computer linked to an x-ray machine to take pictures of the inside of the body.

 

D2 receptor

a subtype of dopamine receptor.

 

Deep brain stimulation

a surgical treatment for Parkinson's disease that involves putting electrical stimulators deep within the brain.

 

Delirium

a state of altered awareness with agitation, hallucinations and confusion.

 

Delusion

a false, fixed, idiosyncratic belief, not substantiated by sensory or objective evidence

 

Dementia

a broad complex of symptoms such as disorientation, confusion, memory loss, impaired judgment, and alterations in mood and personality--symptoms can arise from a variety of causes.

 

Depression

a feeling of sadness and/or loss of interest or pleasure, usually with negative thinking.

 

Dopamine

a neurotransmitter that regulates movement and emotions.

 

Dopamine agonist

a class of medications used to treat Parkinson's disease and includes ropinirole (Requip®), and pramipexole (Mirapex®).

 

Dopamine transporter

a membrane-spanning protein that pumps the neurotransmitter dopamine out of the synapse and into its vesicles for storage until later use.

Dopaminergic medication

A medication that increases the level of dopamine in the brain and is typically used to treat Parkinson's disease (i.e. carbidopa/levodopa and dopamine agonists).

 

Double-Blind

Which means that neither patient nor investigator knows which drug a patient is taking. This is another way to prevent observer bias in evaluating the effect of the drug.

Drug-induced psychosis

psychosis induced by certain drugs leading to hallucinations and/or thought distortions.

 

Durable power of attorney

legal authorization for someone to act as your 'agent' in financial and business matters should you become physically or mentally unable to represent yourself. All adults should complete this simple form to designate who will hold your POA. Many forms allow you to name an alternate if your primary agent is unable or unwilling to serve. Once completed and notarized, the document should be registered in your county of residence. It is a simple matter to revoke or change a POA if necessary.

 

Dysarthria

Slurred speech due to inability to control articulation.

 

Dyskinesia

abnormal, involuntary body movements that can appear as jerking, fidgeting, twisting, and turning movements; frequently induced by medications taken by Parkinson patients. Dystonia, athetosis, and chorea are forms of dyskinesias.

 

Dysphagia

difficulty in swallowing.

 

Dystonia

involuntary spasms of muscle contraction, which cause abnormal movements and postures.

 

Electroconvulsive therapy

a treatment for severe depression that is usually used only when people do not respond to medications and psychotherapy. ECT involves passing a low-voltage electric current through the brain. The person is under anesthesia at the time of treatment.

 

Endogenous

originating internally; developing from within, rather than caused by external factors; the opposite of

exogenous.

 

Essential tremor

a condition more common than Parkinson's disease, which often includes shaking of the hands or head, and an unsteady quality of the voice.

 

Freezing

temporary involuntary inability to take a step or initiate movement.

 

GABA

a neurotransmitter in the brain, which is considered to be involved in muscle relaxation, sleep, diminished emotional reaction and sedation.

 

Generalized anxiety disorder

an anxiety disorder that is characterized by excessive, uncontrollable and often irrational worry about everyday things that is disproportionate to the actual source of worry.

 

Globus pallidus

a sub-cortical structure of the brain. It is a major element of the basal ganglia system.

 

Hallucination

A deceptive sensory experience (involving seeing, hearing, tasting, feeling and smelling) that is not really happening.

 

Hallucinosis

a state of experiencing hallucinations.

 

Homocysteine

an amino acid used normally by the body in cellular metabolism and the manufacture of proteins.

 

Hyperhidrosis

excessive sweating.

 

Hypomimia

decreased facial expression due to rigidity of facial muscles.

 

Hypophonia

low voice volume or muffled speech

 

Idiopathic

of unknown origin.

 

Incontinence

involuntary urination or defecation.

 

Intercourse-Outercourse approach

a sexual therapy approach, which emphasizes both the importance of intercourse as well as outercourse activities defined as any erotic activity that does not involve the insertion of a penis into a vagina or anus.

 

Lewy body

a pink-staining sphere found in nerve cells, considered to be a pathological marker for Parkinson disease.

 

Limb dystonia

abnormal tone of muscle, characterized by prolonged, repetitive muscle contractions that may cause twisting or jerking movements of the body or a body part.

 

Livido reticularis

purplish or bluish mottling of the skin caused by certain medications taken by Parkinson's patients.

 

Living trust

Many financial planners feel like these alternatives to simple wills are the most over-sold and unnecessary document being marketed to senior adults. The goal of a living trust is to protect the heirs (called 'trustees') from certain estate taxes, and avoid lengthy and expensive probate procedures. Many states have streamlined probate procedures to be completed within 60 days of a death, and many Certified Financial Planners (CFP) advise clients to avoid them if all property owned is in the state of residence.

 

LRRK-2 Gene

There are genes that have now been implicated in the cause of a subtype of Young-Onset Parkinson's disease known as the LRRK-2 gene or Parkin 9 gene.

 

Lumbar puncture

a procedure in which a needle is put into the lower part of the spinal column to collect cerebrospinal fluid or to give drugs. Also called spinal tap.

 

MAO-B

an enzyme in our body that naturally breaks down several chemicals in our brain including dopamine.

 

Meditation

a mental discipline by which one attempts to get beyond the reflexive, 'thinking' mind into a deeper state of relaxation or awareness.

 

Micrographia

small, cramped handwriting.

 

Mini-Mental State Examination

the mini-mental state examination which is also known as the MMSE, standardized MMSE, SMMSE, or the Folstein, is a brief examination consisting of eleven questions intended to evaluate an adult patient's level of cognitive functioning.

 

Minor depression

refers to a less extreme form of clinical depression and does not meet the criterion of major depression.

 

Monotherapy

treatment that involves only one drug.

Montreal Cognitive Assessment

 

MOCA, a brief examination consisting of eleven questions intended to evaluate the level of cognitive functioning, tailored specifically for patients with Parkinson's disease.

 

MRI

a medical imaging technique that uses magnetic forces to obtain detailed images of the body. MRI is non-invasive and does not use radiation.

 

Multi-task

to handle multiple tasks at once.

 

Muscle wasting

also known as muscle atrophy, is a decrease in the mass of the muscle; it can be a partial or complete wasting away of muscle. When a muscle atrophies, it becomes weaker, since the ability to exert force is related to mass.

 

Myoclonus

abrupt, jerking movements of the arms or legs, commonly occurring during sleep and benign, but could be a separate movement disorder.

 

Neurodegenerative

a disease in which there is a progressive loss of structure or function of neurons, including death of neurons.

 

Neuroleptics

drugs that block dopamine receptors, usually prescribed to treat psychiatric symptoms.

 

Neuron

a cell that generates or conducts electrical impulses to carry information from one part of the brain to another.

 

Neuroplasticity

the changing of neurons, the organization of their networks, and their function via new experiences.

According to the theory of neuroplasticity, thinking, learning, and acting actually change both the brain's physical structure anatomy and functional organization (physiology) from top to bottom. (also referred to as brain plasticity, cortical plasticity or cortical re-mapping)

 

Neuroprotective

mechanisms within the nervous system which protect neurons from apoptosis or degeneration, for example following a brain injury or as a result of chronic neurodegenerative diseases.

 

Neuropsychologist

a licensed psychologist with expertise in how behavior and skills are related to brain structures and systems. In clinical neuropsychology, brain function is evaluated by objectively testing memory and thinking skills.

 

Neurostimulator

a battery-powered device designed to deliver electrical stimulation to the brain.

 

Neurotransmitter

a biochemical substance (such as dopamine, acetylcholine, or norepinephrine) that carries impulses from one nerve cell to another.

 

Norepinephrine

a chemical transmitter involved in regulating the involuntary nervous system.

Obsessive-Compulsive Disorder

an anxiety disorder in which a person has an unreasonable thought, fear, or worry that he or she tries to manage through a ritualized activity to reduce the anxiety.

 

Obstructive Sleep Apnea

the more common form of sleep apnea in which throat muscles collapse preventing patient from breathing and culminating in the short episode of breathing interruption (apnea).

 

Off-On phenomena

changes in motor performance by patients on levodopa therapy.

 

Orthostatic hypotension

a drop in blood pressure upon standing; can cause fainting.

 

Palsy

paralysis of a muscle group.

 

Paranoia

extreme distrust or suspicion.

 

Parkin-9 Gene

There are genes that have now been implicated in the cause of a subtype of Young-Onset Parkinson's disease known as the Parkin-9 gene or LRRK-2 gene.

 

Parkinson's Disease

Parkinson’s disease is a neurodegenerative brain disorder that progresses slowly in most people. When approximately 60 to 80% of the dopamine-producing cells in the brain are damaged, and do not produce enough dopamine, the motor symptoms of Parkinson’s disease appear.

 

Perimenopausal

the years leading up to menopause, during which levels of female hormones fluctuate more widely than normal from month to month as hormone production gradually decreases and periods become irregular. Perimenopause usually lasts 2 to 8 years, with an average of 5 years.

 

Positron emission tomography

(also called PET imaging or a PET scan)a type of nuclear medicine imaging that uses small amounts of radioactive material to diagnose or treat a variety of diseases.

 

Postural hypotension

a drop in blood pressure (hypotension) due to a change in body position (posture) when a person moves to a more vertical position from sitting to standing or from lying down to sitting or standing. Postural hypotension is more common in older people.

 

Postural instability

the tendency to fall without explanation, usually when pivoting.

 

Psychosis

a broad medical term used to describe a loss of contact with reality that involves hallucinations and/or delusions.

 

Psychotherapy

the treatment of people diagnosed with mental and emotional disorders using dialogue and a variety of communication techniques.

 

Randomization

a method used in clinical trials whereby study participants are assigned to a treatment group based on chance.

 

Rapid-Eye Movement

a normal stage of sleep characterized by the rapid movement of the eyes. REM sleep in adult humans typically occupies 20–25% of total sleep, about 90–120 minutes of a night's sleep. During a normal night of sleep, humans usually experience about four or five periods of REM sleep; they are quite short at the beginning of the night and longer toward the end.

 

Rapid-Eye Movement Behavior Disorder

a disorder in which people act out dramatic and/or violent dreams during rapid-eye movement (REM) stage sleep. Another feature of RBD is shouting and grunting. RBD is a type of parasomnia, which is a condition that occurs during sleep and creates a disruptive event.

 

Restless legs syndrome

a sleep disorder in which an uncomfortable or creepy-crawly feeling occurs in the legs while at rest, primarily at night, and causes an irresistible urge to move the legs.

 

Retropulsion

the tendency to fall backwards.

 

Rigidity

changes of the muscle tone associated with increased resistance noted to the passive movement of a limb.

 

Schizophrenia

a psychiatric illness that can involve hallucinations and delusions.

 

Seborrhea

oily skin.

 

Selective Serotonin Reuptake Inhibitors

also known as an SSRI, is an antidepressant drug that acts by blocking the reuptake of serotonin so that more serotonin is available to act on receptors in the brain.

 

Sensate Focus

a term usually associated with a set of specific sexual exercises for couples or for individuals. The term was introduced by Masters and Johnson, and was aimed at increasing personal and interpersonal awareness of self and the other's needs.

 

Serotonin

a neurotransmitter that regulates mood, emotion, sleep and appetite.

 

Shunt

a shunt is a hole or passage that moves, or allows movement of fluid from one part of the body to another.

 

Sialorrhea

drooling; increased salivation.

 

Sleep apnea

is a sleep disorder characterized by pauses in breathing during sleep. Snoring and daytime sleepiness are signs a person might have sleep apnea.

 

Sleep study

a test used in the study of sleep and as a diagnostic tool in sleep medicine.

 

Social avoidance

avoiding social situations due to feelings of anxiety, fear and/or embarrassment around others.

 

Speech-language pathologist

a specialist in the diagnosis and non-medical treatment of speech and language disorders.

 

SSRI

Selective Serotonin Reuptake Inhibitor. Is an antidepressant drug that acts by blocking the reuptake of serotonin so that more serotonin is available to act on receptors in the brain.

 

Striatum

the area of the brain that controls movement, balance, and walking.

 

Stroke

the sudden death of some brain cells due to a lack of oxygen when the blood flow to the brain is impaired by blockage or rupture of an artery to the brain.

 

Substantia nigra

an area of the brain where cells produce dopamine.

 

Subthalamic nucleus

a small lens-shaped nucleus in the brain where it is a part of the basal ganglia system

.

Subthalmus

a region of the brain that sits below the thalamus and It receives input connections from the substantia nigra and striatum.

 

Synapse

the junction between a terminal of a neuron and either another neuron or a muscle or gland cell, over which nerve impulses pass.

 

Tai-Chi

Chinese system of slow meditative physical exercise designed for relaxation and balance and health.

 

Thalamus

a structure consisting of two egg-shaped masses of nerve tissue, each about the size of a walnut, deep within the brain. The thalamus is a key relay station for sensory information flowing into the brain and filters out information of particular importance from the mass of signals entering the brain.

 

Tremor

involuntary shaking of the hands, arms, legs, jaw, or tongue.

 

Trunk

the body of a human or animal excluding the head and limbs

.

Urinary retention

a lack of ability to urinate.

 

Visual-perceptual skills

the capacity of the mind and the eye to 'see' something as it objectively exists.

 

Visuospacial function

pertaining to perception of the spatial relationships among objects within the field of vision.

 

Vivid dreaming

a dream state in which the dreams are vivid, lifelike and disturbing at times.

 

Wearing-off phenomena

waning of the effects of a dose of levodopa prior to the scheduled time for the next dose, resulting in decreased motor performance.

 

Yoga

a system of exercises practiced as part of the Hindu discipline to promote control of the body and mind.

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