Glossary

Cabergoline:

An ergotamine-based dopamine-receptor agonist with a half-life of 65 hours. In the United States, it is marketed as Dostinex for the treatment of the rare disorder, hyperprolactinaemia, or high levels of the hormone prolactin.

Candida Albicans:

A normally harmless microscopic yeast that lives within the human gastrointestinal tract, it can overgrow and cause fatigue, depression, joint pain, headaches, and recurrent infections.

Capillaries:

Very small, hairline-thin vessels supplying blood to tissues.

Carbidopa:

Carbidopa is an ingredient in Sinemet which when combined with levodopa, slows the peripheral breakdown of the levodopa, thereby allowing more of the levodopa to enter the brain.

Carbohydrate:

A class of foods that serve as the body's main source of energy. They include starches, grains, vegetables, and sugars. Most carbohydrates are easily digested and quickly converted to glucose to provide energy for the cells.

Carbonic Anhydrase Inhibitors:

A class of medications that inhibits activity of the enzyme carbonic anhydrase. This zinc-containing enzyme is present in red blood cells and the renal tubules. These tubules form part of the filtering units of the kidneys. Carbonic anhydrase activity serves to accelerate the transfer of carbon dioxide from tissue to the blood and on to the lungs. By restricting carbonic anhydrase activity, these agents decrease hydrogen ion concentrations in the renal tubules, increasing excretion of sodium, potassium, bicarbonate, and water. Certain carbonic anhydrase inhibitors are prescribed to promote urinary production and excretion (i.e., as diuretics) or to lower fluid pressure within the eyes for those with glaucoma. They are also used to treat other conditions including epilepsy or certain neurologic movement disorders.

Cardiolipin:

One of the components of a cell membrane.

Carnitine:

A natural substance found in skeletal and cardiac muscle and the liver. Carnitine serves to transport fatty acids across mitochondrial membranes, thereby playing an important role in energy production and the metabolism of fatty acids.

Case Management:

Facilitating the access of a patient to appropriate medical, rehabilitation and support programs, and coordination of the delivery of services. This role may involve liason with various professionals and agencies, advocacy on behalf of the patient, and arranging for purchase of services where no appropriate programs are available.

Catabolic/Catabolism:

Breaking down of proteins and other chemical compounds in the body. Catabolism results in a weakening of bone and muscle tissue, a loss in skin resilience, as well as a general decline in other important body functions.

Cataplexy:

A sudden loss of voluntary muscle control, usually triggered by emotions such as laughter, surprise, fear or anger. Cataplexy occurs most often during times of stress or tiredness. The loss of muscle control may vary from a feeling of weakness to total body collapse. Although people having a cataplectic attack may appear to be asleep, they are actually awake, just unable to move.

Catecholamines:

(1) Any of a group of hormones that are catechol derivatives, e.g., adrenaline and noradrenaline. (2) eurotransmitters such as dopamine, norepinephrine, and epinephrine.

Catecholaminergic System:

Neurons that use catecholamines.

Catheter:

A flexible tube for withdrawing fluids from, or introducing fluids into, a cavity of the body. Frequently used to drain the uninary bladder.

Caudate:

One of the three major substructures that, together with the globus pallidus and putamen, form the basal ganglia. The caudate nuclei and putamen, which are relatively similar structurally and functionally, are collectively known as the striatum. Specialized clusters of nerve cells or nuclei within the caudate receive input from certain regions of the cerebral cortex. This information is processed and then relayed (by way of the thalamus) to areas of the brain responsible for controlling complex motor functions. The caudate nuclei are specifically thought to process and transmit cognitive information that influences the initiation of complex motor activities.

Caudate nuclei:

One of the 3 major substructures that, together with the globus pallidus and putamen, form the basal ganglia. The caudate nuclei and putamen, which are relatively similar structurally and functionally, are collectively known as the striatum. Specialized clusters of nerve cells or nuclei within the caudate receive input from certain regions of the cerebral cortex. This information is processed and then relayed (by way of the thalamus) to areas of the brain responsible for controlling complex motor functions. The caudate nuclei are specifically thought to process and transmit cognitive information that influences the initiation of complex motor activities.

Cell:

(1) The primary unit of physical life, whose integral structure and optimal status is crucial for the healthy functioning of the human body. (2) The smallest organized unit of living structure in the body. There are trillions of cells in humans. The brain alone has close to one trillion.

Cell Membrane:

(1) A thin layer consisting mostly of fatty acids that surrounds each cell. (2) The surrounding border of the cell, formed of proteins and lipids, that encloses the cell and controls the movement of substances inside and outside of the cell.

Central Nervous System (CNS):

Consists of the brain and spinal cord. The CNS, which receives sensory impulses from and sends motor impulses to the peripheral nervous system, plays an essential role in the coordination and control of the entire body. The peripheral nervous system refers to the nerves in the body outside of the central nervous system.

Central oscillators:

Nerve cells that discharge signals that result in alternating fluctuations of electrical impulses along certain tracts of the central nervous system.

Cerebellum:

A two-lobed region of the brain located behind the brainstem. The cerebellum receives messages concerning balance, posture, muscle tone, and muscle contraction or extension. Working in coordination with the basal ganglia and thalamus, the cerebellum integrates, adjusts, and refines messages transmitted to muscle groups from the cerebral cortex (i.e., motor cortex). Thus, the cerebellum plays an essential role in producing smooth, coordinated voluntary movements; maintaining proper posture; and sustaining balance.

Cerebral Cortex:

The outer region of the brain's cerebral hemispheres. Comprised of gray matter, the cerebral cortex contains several deep folds (gyri) and grooves (sulci or fissures). Two sulci divide the surfaces of both cerebral hemispheres into four distinct lobes that are named for overlying bones of the skull. These include the frontal, temporal, occipital, and parietal lobes. The cerebral hemispheres are joined by a thick band of nerve fibers known as the corpus callosum. The cerebral cortex is responsible for integrating higher mental functioning and conscious thought, sensations, and general movements.

Cerebral Embolism:

A brain attack that occurs when a wandering clot (embolus) or some other particle forms in a blood vessel away from the brain - usually in the heart.

Cerebral Hemorrhage:

A type of stroke occurs when a defective artery in the brain bursts, flooding the surrounding tissue with blood.

Cerebral Spinal Fluid Analysis (Also called spinal tap or lumbar puncture):

A procedure used to make an evaluation or diagnosis by examining the fluid withdrawn from the spinal column.

Cerebral Thrombosis:

The most common type of brain attack; occurs when a blood clot (thrombus) forms and blocks blood flow in an artery bringing blood to part of the brain.

Cerebrospinal fluid (CSF):

The fluid that flows through and protects the 4 cavities (ventricles) of the brain, the spinal cord's central canal, and the space (known as the subarachnoid space) between the middle and inner layers of the membrane (meninges) enclosing the brain and spinal cord. Laboratory analysis of CSF, usually obtained via lumbar puncture, may help to diagnose central nervous system infections, certain tumors, or particular neurologic disorders. During lumbar puncture, CSF is removed from the spinal canal via a hollow needle inserted between certain bones of the spinal column within the lower back (i.e., usually the third and fourth lumbar vertebrae).

Cerebrum:

The upper, main part of the brain, consisting of two parts (lobes), left and right, which form the largest and most developed part of the brain; initiation and coordination of all voluntary thought and movement take place within the cerebrum. The basal ganglia are located immediately below the cerebrum.

Chemodenervation:

Interruption of a nerve impulse pathway via administration of a chemical substance, such as botulinum toxin (BTX). For example, intramuscular injections of BTX produce local relaxation of treated muscles by inhibiting the release of acetylcholine, a neurotransmitter that is present at the junctions of nerve and muscle cells and that regulates the delivery of messages from neurons to muscle fibers.

Cholesterol:

(1) A complex fatty substance that performs a variety of tasks within the body. Cholesterol cannot move through the bloodstream by itself, but must be packaged into either high-density lipoprotein or low-density lipoprotein before it can circulate throughout the body. (2) The most abundant steroid in animal tissues. It is present in some of the animal foods we eat. Our liver can also make some if there's not enough in our diet. Cholesterol is used to make steroid hormones.

Choline:

A naturally occurring substance which is a precursor of acetylcholine.

Cholinergic System:

Braln cells that use the neurotransmitter acetylcholine.

Chorea:

An abnormal voluntary movement disorder, one of a group of neurological disorders called dyskinesias, which are caused by overactivity of the neurotransmitter dopamine in the areas of the brain that control movement. Chorea is characterized by brief, irregular contractions that are not repetitive or rhythmic, but appear to flow from one muscle to the next. Chorea often occurs with athetosis, which adds twisting and writhing movements. Chorea is a primary feature of Huntington's disease, a progressive, hereditary movement disorder that appears in adults, but it may also occur in a variety of other conditions. Syndenham's chorea occurs in a small percentage (20 percent) of children and adolescents as a complication of rheumatic fever. Chorea can also be induced by drugs (levodopa, anti-convulsants, and anti-psychotics) metabolic and endocrine disorders, and vascular incidents.

Choreoathetosis:

A dyskinesia characterised by choreic and athetoid movements.

Chorionic Villus Sampling (CVS):

A screening and diagnostic procedure performed during which tissue samples are obtained from a portion of the placenta using a specially guided needle via ultrasound. The placenta is the organ attached to the lining of the uterus that links the blood supplies of the developing fetus and the mother. The tissue sample is obtained from the layer from which the chorionic villi develop. Blood from the fetus flows through the umbilical cord to the placenta and enters minute blood vessels arranged in multiple "thread-like" projections or chorionic villi surrounded by maternal blood. Tissue samples obtained during chorionic villus sampling are analyzed to detect certain genetic or chromosomal abnormalities.

Chromosomes:

The thread-like structures within the nuclei of cells comprised of DNA. Deoxyribonucleic acid or DNA carries genetic information involved in directing cellular activities, thus controlling bodily growth and functioning and determining the expression of inherited traits. The chromosomes contain thousands of hereditary units known as genes or segments of DNA molecules. The nuclei of all human cells--except the reproductive (i.e., egg and sperm) cells--normally contain 46 chromosomes, with one of each pair from the father and one from the mother. The chromosomal pairs are numbered from 1 through 22, as well as a 23rd pair that includes one X chromosome from the mother and an X or a Y chromosome from the father. In females, the 23rd pair consists of two X chromosomes, whereas males have one X and one Y chromosome. All chromosomes have a short arm known as "p" and a long arm known as "q." Both chromosomal arms are subdivided into numbered bands.

Chronic:

Marked by long duration or frequent recurrence.

Circadian:

A rhythm of biological functions occurring in a 24-hour periodic cycle (e.g., sleeping, eating, etc.).

Clinical Global Impression (CGI):

The CGI is a scale to assess s patient’s response to treatment. At baseline, the doctor rates how much the disease or illness impacts a patient’s life. The patient receives the treatment, or, in some cases, a certain amount of time passes, and the doctor again rates the impact of the disease or illness, this time as very much improved, much improved, minimally improved, no change, minimally worse, much worse, or very much worse.

Clinical trial:

An organized test put together to show if a treatment works. It usually is made up of patients who are divided into 2 groups: a test group and a control group. At the end of the trial, the groups are compared to see if there was any difference in their outcomes. A randomized clinical trial is when patients are randomly selected to be included in the trial. This is done so that as broad a group of patients as possible can participate.

Clonus:

Movements characterized by alternate contractions and relaxations of a muscle, occurring in rapid succession. Clonus is frequently observed in conditions such as spasticity and certain seizure disorders.

Co-contraction:

The simultaneous contraction of agonist and antagonist muscles.

Coenzyme:

A substance that is necessary or enhances the activity of an enzyme. Several vitamins act as coenzymes.

Cognition:

Cognition involves thinking skills such as perception, memory, awareness, reasoning, judgment, intellect, and imagination.

Cognitive:

Involving cognition.

Cognitive Function:

The process a person uses to think. Good cognitive function allows a person to transform a thought into an action. Examples of cognitive function are identifying situations, coordinating actions, making decisions, and planning. Sometimes people with MS experience a loss in cognitive function, either occasionally or on an ongoing basis.

Cognitive impairment:

The decrease in the ability to process, learn, and remember information.

Cogwheel Phenomenon:

Rhythmic brief increase in resistance during passive movement about a joint.

Cogwheel Rigidity:

Stiffness in the muscles, with a jerky quality when arm and leg joints are repeatedly moved.

Collagen:

Collagen is the major protein found in the connective tissue of cartilage and bone.

Complementary and Alternative Medicine:

Complementary and alternative medicine, as defined by National Institutes of Health, is a group of diverse medical and health-care systems, practices, and products that are not presently considered to be part of conventional medicine.

Composite Autonomic Scoring Scale:

The Composite Autonomic Scoring Scale is a battery of validated, sensitive, and specific tests for the assessment of autonomic nervous systems, resulting in a 10-point composite score.

Computerized Tomography scan (Also called CT or CAT scan):

An advanced diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays. In some cases, a contrast medium, which is opaque on x-rays, may be injected intravenously to produce enhanced images of certain tissues, organs, or blood vessels.

COMT Inhibitors:

Drugs that block catechol-O-methyltransferase, an enzyme that breaks down dopamine. COMT inhibitors include entacapone (Comtan®) and tolcapone (Tasmar®).

Concussions

Concussions occur when your brain crashes into your skull, usually from a sudden knock or unexpected blow.

Condom Catheter:

A soft latex, self-adhesive male external (non-invasive) catheter that is connected to a urinary leg or overnight drainage bag.

Congenital:

Existing at birth.

Constipation:

Diminished ability of intestinal muscles to move feces (stool), often resulting in very hard stool. A common problem in Parkinson's.

Contracture:

(1) Shortening of a muscle due to chronic lack of stretching. (2) Fixed resistance to passive stretching of certain muscles due to shortening or wasting (atrophy) of muscle fibers or the development of scar tissue (fibrosis) over joints.

Contralateral:

The opposite side. For example, during brain surgery for essential tremor, if the surgery is performed on the right side of the brain, the left side of the body will be affected.

Control:

In any study, whenever a group of animals or humans are given a certain medicine, they are compared to a second group of animals or humans who are in similar circumstances regarding everything except the medicine. This second group is known as the control. This way, researchers can find out the role of the medicine independent of any other factors.

Controlled-release Formulation:

A form of a drug (e.g., L-dopa) that is absorbed slowly by the digestive system, prolonging the duration of effect of each dose.

Cortex:

The outer layer of the cerebrum, densely packed with nerve cells.

Corticobasal Degeneration (CBD):

A slowly progressive disorder characterized by neurodegenerative changes of certain brain regions, including the cerebral cortex (particularly the frontal and parietal lobes) and parts of the basal ganglia. Most patients initially develop symptoms in their 60s or 70s. Primary findings may include stiffness (rigidity); slowness of movement (bradykinesia); loss of the ability to coordinate and execute certain purposeful movements of the arms or legs (limb apraxia); the sensation that a limb is not one's own ("alien limb phenomenon"); and other sensory abnormalities. Affected individuals may also develop slurred, labored speech (dysarthria); dystonia; and irregular, involuntary, "shock-like" contractions of certain muscle groups, particularly of the hands and forearms, that may be provoked or aggravated by voluntary movement and certain external stimuli (action and reflex myoclonus).

Corticospinal:

Referring to or connecting the outer region of the brain (cerebral cortex) and the spinal cord.

Corticosteroids:

Drugs that can reduce inflammation. They work by blocking a chemical in the body called prostaglandin that causes inflammation.

Corticosteroid agents:

Synthetic medications similar to corticosteroid hormones, which are naturally produced by the outer regions of the adrenal glands (adrenal cortex). Corticosteroid agents may be prescribed to treat inflammatory conditions; as long-term therapy to suppress the immune system (immunosuppressive therapy) in order to prevent rejection of a transplanted organ; as hormone replacement therapy for those with insufficient levels of natural corticosteroid hormones; or as therapy for other conditions. High dose, long-term corticosteroid therapy may result in various adverse effects, including an increased susceptibility to infection; osteoporosis, a bone disorder characterized by a progressive loss of bone mass; high blood pressure (hypertension); tissue swelling (edema); or retarded bone growth in children.

Cortisol:

(1) A hormone produced by the adrenal glands in response to stress, affecting the body's metabolism of glucose, proteins, and fats. Cortisol is normally released by the body in a regular daily pattern of highs and lows. Imbalances are associated with fatigue, depression, obesity, and immune dysfunction. (2) Same as hydrocortisone, a sterol (related to a steroid) secreted by the human adrenal glands. It is often released in hugh amounts during stress. High doses lead to interference with the proper functioning of the immune system.

Coumadin:

A drug that has blood-thinning abilities, often prescribed for patients who clot easily.

Cranial:

Of or from the cranium or skull.

Cranial nerve nuclei:

Specialized groups of nerve cells (nuclei) that give rise to and convey or receive impulses from sensory and motor constituents of the cranial nerves, which are the 12 pairs of nerves that emerge from the brain. These nerve pairs convey sensory impulses for various functions including taste, smell, hearing, and vision; motor impulses involved in controlling eye movements, chewing, swallowing, facial expressions, etc.; and impulses for transmission to certain organs and glands for regulation of various involuntary or autonomic activities.

Cranial neuropathy:

Disease or damage of a cranial nerve or nerves. The cranial nerves are the 12 nerve pairs that arise directly from the brain and are involved in conveying impulses for various functions including smell, hearing, vision, and taste; pupil contraction; eye movements; facial expressions; movements of the tongue, head, and shoulders; etc. Cranial neuropathy may result in associated muscle weakness; abnormal sensations, such as numbness, tingling, or pain; or other findings. Specific symptoms depend upon the specific nerve(s) affected.

Creatine:

Creatine is produced naturally in both humans and animals form the amino acids L-Arginine, Glycine and L-Methionine. Creatine is converted into Creatine Phosphate in muscle tissue where it, in turn, converts ADP to ATP to replace ATP consumed during exercise. Muscle fatigue occurs when the supply of Creatine Phosphate is exhausted and ADP can no longer be converted.

Creutzfeldt-Jakob disease (CJD):

A rare, degenerative, life-threatening brain disorder characterized by severe, progressive dementia; visual disturbances; muscle weakness; and abnormal involuntary movements, such as sudden, brief, "shock-like" muscle spasms (myoclonus), tremor, and relatively slow writhing motions that appear to flow into one another (athetosis). Although CJD usually appears to occur sporadically, about 10 percent of cases are familial, potentially suggesting a hereditary predisposition to the disease. In rare cases, CJD may also result from exposure to contaminated surgical instruments during brain surgery and was reported in the past due to therapy with pituitary-derived human growth hormone. In addition, a variant form of CJD (V-CJD) has been reported primarily in the United Kingdom; V-CJD has been potentially linked to consumption of beef from cows with bovine spongiform encephalopathy or BSE (so-called "mad cow disease"). Evidence suggests that CJD may be caused by mutations in the human prion* protein gene or contamination with abnormal prion protein. (*The term "prion" was named for "protein infectious agent.") Changes in the prion protein appear to lead to distinctive neurodegenerative abnormalities, i.e., relatively small, round, "sponge-like" (spongiform) cavities or gaps in certain brain regions. CJD and BSE belong to a group of related neurodegenerative disorders categorized as "transmissible spongiform encephalopathies."

Crossover:

In a research study, the placebo and medicine groups are switched (crossed over) to determine a more accurate effect of the medicine. The group that initially got the medicine now gets the placebo, and the group that initially got the placebo now gets the medicine.

Crossreact:

Refers to the interaction of an antibody with an antigen that did not specifically or originally trigger its production. For example, in an abnormal autoimmune reaction, an antibody that was initially formed in response to an invading bacterium may inappropriately react against certain of the body's own tissues that contain some of the same amino acid sequences as within the microorganism.

Cytokines:

Cytokines are small hormonelike proteins secreted by the immune system that regulate the body’s immunity, inflammation, blood-cell production responses in the body and aid healing.

Cryothalamotomy:

A surgical procedure in which a super-cooled probe is inserted into a part of the brain called the thalamus in order to stop tremors.

Cytoplasm:

The fluid gel substance inside a cell, enclosed by the cell membrane. It does not include the nucleus.

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