Assignment (1- to 2-page case study analysis)
In your Case Study Analysis related to the scenario provided, explain the following:

Both the neurological and musculoskeletal pathophysiologic processes that would account for the patient presenting these symptoms.
Any racial/ethnic variables that may impact physiological functioning.
How these processes interact to affect the patient.

Case Study Analysis

Name of the student

ANSWER

Case Study Analysis

Parkinson’s disease is a prevalent chronic gradual neurodegenerative disorders, considered an absolute movement disorder, meaning it affects a patient’s mobility ability and functions. The predominant motor symptomologies include postural distress, rigidity, tremors, and bradykinesia, as well as non-motor symptoms, including the freezing of gait, speech difficulties, sweating, and flushing as diagnosed in the patient. Parkinson’s disease is caused by the imperceptible degeneration or diminution of cells in the brain, especially the most involved part being the substantia nigra (Magrinelli, 2016). This means that the neurons in this part of the brain are impaired or dead. The substantia nigra is in charge of for generating dopamine, an essential messenger chemical or neurotransmitter responsible for transmitting signals linking various zones or regions of the brain to enable and harmonize activities.

An excellent instance of the dopamine’s function is to connect the substantia nigra with the corpus striatum to coordinate and regulate muscle activity. Hence, any deficiency in the production of dopamine, as in the case with Parkinson patients, results in movement control problems. As the disorder progresses, the brain and a patient’s nervous system equally degenerate, causing more deep-felt mobility problems such as tremors, stiffness, rigidity, and walking difficulties. Rigidity occurs due to the changes in latent mechanical properties in parts such as joints, muscles, and tendons (Mandal, 2019).  In addition to dopamine neurotransmitter, is the norepinephrine, another neurotransmitter affected due to nerve endings impairment and degeneration of brain neurons in the locus coeruleus and sympathetic ganglia. Its function is to regulate and coordinate automatic services, however, its deficiency in Parkinson’s disease results in organ abnormalities such as increased blood pressure, fatigue cases, and hypotension (Espay, LeWitt, & Kaufmann, 2014).

In a review article, Parkinson’s disease record was highest and prevalent among white populations compared to black and Asian populations. The reasons for these variations are biological, including genetic factors. Parkinson’s disease is caused by the mutation of LRRK2, DJ-1, SNCA, and PARK2 genes, which are associated with diverse phenotypes hence differing among ethnic groups. For instance, LRRK2 is the prevailing genetic cause of Parkinson’s disease globally; however, it is prevalent among North African PD patients accounting for 30%-39%, 26% among Jewish patients, and 0% among Nigerian patients (Ben-Joseph, 2020). Other factors and variables contributing to this variation include vascular disease, co-morbidities, and non-biological aspects such as healthcare disparities.

The above-identified processes explaining and accounting for the patient’s symptoms interact to affect a Parkinson’s disease patient in numerous ways, ranging from personal to social life. For instance, the most predetermined consequence is mobility limitations; that is, a PD patient’s movement ability is limited or constrained. Secondly, the neurological processes that explain deteriorating neurons may result in limited cognitive abilities meaning a patient’s thinking capacity will be affected; they may not think properly or make rational decisions and may forget quite often. The inability to move freely and reason may make a patient feel useless as their simple daily functionalities such as going to the bathroom, bowel control, eating, walking brushing their teeth, and memory loss are inhibited. This useless feeling can make Parkinson’s disease patients susceptible to depression, which is not healthy. Besides, with minimal or slight movements, you can find the patient complaining of low blood pressure, which can cause light-headedness, muscular fatigue, and general discomfort. When a Parkinson disease patient keeps witnessing and experiencing these discomforts, they are utterly discouraged to even move about, which can escalate their ‘useless’ feeling and depression levels.

References

Ben-Joseph, A. M. (2020). Ethnic Variation in the Manifestation of Parkinson’s Disease: A Narrative Review. Journal of Parkinson’s Disease, Vol 10(1), pp; 31-45.

Espay, A. J., LeWitt, P. A., & Kaufmann, H. (2014). Norepinephrine deficiency in Parkinson’s disease: the case for noradrenergic enhancement. Mov Disorder, Vol 29(140, pp; 1710-1719.

Magrinelli, F. A. (2016). Pathophysiology of Motor Dysfunction in Parkinson’s Disease as the Rationale for Drug Treatment and Rehabilitation. Parkinsons Disease.

Mandal, D. A. (2019, June 5). Parkinson’s Disease Pathophysiology. Retrieved from News Medical Life Science: https://www.news-medical.net/health/Parkinsons-Disease-Pathophysiology.aspx