Why does Parkinson’s dopamine depletion affect movement and not so much or so visibly learning and reward mechanisms?
Deep and beautiful. The reward prediction error hypothesis of dopamine – ScienceDirect
Twenty-Five Lessons from Computational Neuromodulation – ScienceDirect
Access options for healthcare and patients
https://en.m.wikipedia.org/wiki/Dopamine
The substantia nigra is a small midbrain area that forms a component of the basal ganglia. This has two parts—an input area called the pars compacta and an output area the pars reticulata. The dopaminergic neurons are found mainly in the pars compacta (cell group A8) and nearby (group A9).[42] In humans, the projection of dopaminergic neurons from the substantia nigra pars compacta to the dorsal striatum, termed the nigrostriatal pathway, plays a significant role in the control of motor function and in learning new motor skills.[44] These neurons are especially vulnerable to damage, and when a large number of them die, the result is a parkinsonian syndrome.[45] < wiki
https://en.m.wikipedia.org/wiki/Hypophonia
Levodopa is the mainstay of pharmacologic therapy for PD, although other agents are indicated for monotherapy or in combination with levodopa. These include traditional and newer dopamine agonists, amantadine, anticholinergics, selegiline, and an emerging class of agents called COMT inhibitors. < https://pubmed.ncbi.nlm.nih.gov/9597979/
The main problem for most patients after prolonged treatment with L-dopa is the longterm L-dopa syndrome. Fluctuations and dyskinesias are usually the principal complaint in younger, and neuropsychiatric symptoms in older, patients < https://pubmed.ncbi.nlm.nih.gov/9426870/
Benign tremulous parkinsonism (BTP) is a tremor dominant syndrome characterized by mild, levodopa-resistant parkinsonism with limited disability or progression.< https://pubmed.ncbi.nlm.nih.gov/24019787/
Recent genetic discoveries support this idea because mutations in a few genes (α-synuclein, LRRK2, tau) can cause partially overlapping pathologies < https://pubmed.ncbi.nlm.nih.gov/29151060/
For most of human history, Parkinson has been a rare disorder. However, demography and the by-products of industrialization have now created a Parkinson pandemic that will require heightened activism, focused planning, and novel approaches. < https://pubmed.ncbi.nlm.nih.gov/30584159/
Camptocormia https://en.wikipedia.org/wiki/Camptocormia#Neurological_origin
Chocolate : Clinical observations amongst in-patients with PD in Dresden suggested an increased chocolate consumption. We speculated that due to its high content of biogenic amines chocolate may partially substitute the dopaminergic system and may improve PD symptoms < https://link.springer.com/article/10.1007/s00702-022-02509-1
Thinking like a neurologist
Hickam’s dictum, the idea that a patient’s symptoms might be due to multiple lesions or diseases, becomes more likely with advancing age.
Pace + Localization = Syndrome
Syndrome + Context = Differential Diagnosis