Recent advances in Parkinson’s disease treatment MCQs With Answer

Introduction: This quiz collection on recent advances in Parkinson’s disease treatment is tailored for M.Pharm students preparing for Advanced Pharmacology-II. It reviews contemporary therapeutic strategies, from refined levodopa delivery systems and infusion/device-based therapies to novel pharmacologic agents, gene and cell therapies, immunotherapies targeting alpha‑synuclein, and emerging molecular targets such as LRRK2 and GBA. Each question emphasizes mechanisms, clinical applications, and translational progress reported in recent trials. The set is designed to deepen conceptual understanding, connect pharmacology with clinical practice, and reinforce knowledge of both symptomatic and potential disease‑modifying interventions in Parkinson’s disease.

Q1. What is Inbrija?

• Oral extended‑release levodopa capsule for sustained motor control
• Inhaled levodopa powder (Inbrija) for rapid rescue of OFF episodes
• Subcutaneous levodopa depot for once‑weekly dosing
• Levodopa patch delivering continuous transdermal drug to the brain

Correct Answer: Inhaled levodopa powder (Inbrija) for rapid rescue of OFF episodes

Q2. What does LCIG (levodopa‑carbidopa intestinal gel) primarily provide in advanced PD?

• Intermittent oral bolus to reduce peak‑dose dyskinesia
• Continuous intestinal infusion via PEG‑J to reduce motor fluctuations
• Transdermal sustained release to treat nonmotor symptoms
• Intramuscular injections for long‑term dopamine replacement

Correct Answer: Continuous intestinal infusion via PEG‑J to reduce motor fluctuations

Q3. Which statement best describes continuous subcutaneous apomorphine infusion?

• It is an oral MAO‑B inhibitor used for early PD
• A dopamine agonist delivered subcutaneously for continuous dopaminergic stimulation in advanced PD
• A COMT inhibitor used to enhance levodopa half‑life
• A gene therapy vector delivering AADC to the putamen

Correct Answer: A dopamine agonist delivered subcutaneously for continuous dopaminergic stimulation in advanced PD

Q4. Which recently approved adjunct reduces OFF time by antagonizing adenosine A2A receptors?

• Safinamide
• Istradefylline (adenosine A2A receptor antagonist)
• Opicapone
• Amantadine ER

Correct Answer: Istradefylline (adenosine A2A receptor antagonist)

Q5. Safinamide’s primary pharmacologic actions include:

• COMT inhibition and peripheral dopa decarboxylase inhibition
• Irreversible MAO‑B inhibition only
• Reversible MAO‑B inhibition and modulation of glutamate release
• NMDA receptor blockade without monoamine effects

Correct Answer: Reversible MAO‑B inhibition and modulation of glutamate release

Q6. Which GLP‑1 receptor agonist has shown potential disease‑modifying effects in clinical trials for PD?

• Metformin
• Exenatide (GLP‑1 receptor agonist) showing potential disease‑modifying effects in trials
• Insulin glargine
• Pioglitazone

Correct Answer: Exenatide (GLP‑1 receptor agonist) showing potential disease‑modifying effects in trials

Q7. Prasinezumab is best described as:

• A small molecule LRRK2 inhibitor
• A gene therapy delivering AADC to the striatum
• Prasinezumab is a monoclonal antibody targeting aggregated alpha‑synuclein
• A GCase enzyme replacement product administered intravenously

Correct Answer: Prasinezumab is a monoclonal antibody targeting aggregated alpha‑synuclein

Q8. AAV‑AADC gene therapy aims to:

• Deliver alpha‑synuclein to immune cells to provoke tolerance
• Increase aromatic L‑amino acid decarboxylase expression in the putamen to enhance local levodopa conversion
• Replace GBA enzymatic activity in lysosomes systemically
• Inhibit LRRK2 kinase activity via RNA interference

Correct Answer: Increase aromatic L‑amino acid decarboxylase expression in the putamen to enhance local levodopa conversion

Q9. LRRK2 inhibitors under development target which pathogenic mechanism?

• Excessive LRRK2 kinase activity associated with familial and sporadic PD
• Reduced MAO‑B activity in glia
• Peripheral COMT activity causing rapid levodopa metabolism
• Alpha‑synuclein transcription in the substantia nigra

Correct Answer: Excessive LRRK2 kinase activity associated with familial and sporadic PD

Q10. What defines closed‑loop (adaptive) deep brain stimulation (DBS)?

• Fixed constant stimulation parameters set at implantation
• Patient‑activated on/off stimulation via handheld remote only
• DBS that adjusts stimulation in real time based on sensed neural signals
• DBS that targets peripheral nerves instead of basal ganglia

Correct Answer: DBS that adjusts stimulation in real time based on sensed neural signals

Q11. Which approach describes current restorative cell therapy research for PD?

• Human embryonic stem cell (ESC)‑derived dopaminergic neuron grafts for restorative cell therapy
• Peripheral blood infusion to stimulate endogenous neurogenesis
• Oral stem cell tablets that cross the blood–brain barrier
• Intranasal microglial cell transplantation to reduce inflammation

Correct Answer: Human embryonic stem cell (ESC)‑derived dopaminergic neuron grafts for restorative cell therapy

Q12. The primary advantage of levodopa inhalation as a rescue therapy is:

• It provides continuous 24‑hour plasma levodopa levels
• It achieves rapid pulmonary absorption to reverse OFF episodes
• It prevents levodopa‑induced dyskinesia by slow release
• It is used prophylactically to prevent nonmotor symptoms

Correct Answer: It achieves rapid pulmonary absorption to reverse OFF episodes

Q13. Which target is central to many disease‑modifying strategies in PD?

• Alpha‑synuclein aggregation and propagation
• Peripheral acetylcholine receptor upregulation
• Excessive serotonin synthesis in striatum
• COMT overexpression in skeletal muscle

Correct Answer: Alpha‑synuclein aggregation and propagation

Q14. Which COMT inhibitor is approved as a once‑daily adjunct to levodopa?

• Entacapone
• Tolcapone
• Opicapone is a once‑daily COMT inhibitor used to reduce OFF time
• Carbidopa

Correct Answer: Opicapone is a once‑daily COMT inhibitor used to reduce OFF time

Q15. Ambroxol in PD trials is being repurposed because it:

• Acts as a dopamine receptor agonist in the striatum
• Serves as a pharmacological chaperone to increase glucocerebrosidase (GCase) activity
• Directly inhibits alpha‑synuclein aggregation through covalent binding
• Blocks LRRK2 kinase activity irreversibly

Correct Answer: Serves as a pharmacological chaperone to increase glucocerebrosidase (GCase) activity

Q16. Which drug is specifically approved for levodopa‑induced dyskinesia?

• Istradefylline
• Amantadine extended‑release (Gocovri) is approved for levodopa‑induced dyskinesia
• Safinamide for dyskinesia only
• Opicapone as an antidyskinetic agent

Correct Answer: Amantadine extended‑release (Gocovri) is approved for levodopa‑induced dyskinesia

Q17. The rationale for alpha‑synuclein monoclonal antibody therapy is to:

• Enhance intracellular synthesis of alpha‑synuclein to protect neurons
• Promote clearance of extracellular aggregated alpha‑synuclein to reduce propagation
• Deliver dopamine across the blood–brain barrier by antibody transport
• Block MAO‑B in the basal ganglia via antibody‑mediated inhibition

Correct Answer: Promote clearance of extracellular aggregated alpha‑synuclein to reduce propagation

Q18. Which repurposed tyrosine kinase inhibitor was investigated in PD but yielded conflicting clinical results?

• Imatinib
• Nilotinib, a c‑Abl tyrosine kinase inhibitor, was repurposed for PD but produced conflicting clinical results
• Dasatinib
• Sorafenib

Correct Answer: Nilotinib, a c‑Abl tyrosine kinase inhibitor, was repurposed for PD but produced conflicting clinical results

Q19. MRI‑guided focused ultrasound thalamotomy is primarily used to treat which PD symptom?

• Dopamine‑resistant orthostatic hypotension
• Medication‑refractory tremor via non‑invasive thalamic lesioning
• Levodopa‑induced dyskinesia through subthalamic ablation
• Cognitive decline by hippocampal stimulation

Correct Answer: Medication‑refractory tremor via non‑invasive thalamic lesioning

Q20. Which imaging biomarker is commonly used in PD clinical trials to assess dopaminergic terminal integrity?

• FDG‑PET for glucose metabolism only
• DAT‑SPECT (dopamine transporter imaging) is used as an imaging biomarker in PD trials
• MRI T2* for iron deposition exclusively
• CT perfusion imaging of basal ganglia

Correct Answer: DAT‑SPECT (dopamine transporter imaging) is used as an imaging biomarker in PD trials

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