<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 59-year-old woman comes to the physician because of progressively worsening coordination and involuntary movements in her left hand for the past 6 months. Her husband also reports that she has been withdrawn and apathetic during this period. She is oriented to time, place, and person. Examination shows a bimanual, rhythmic, low-frequency tremor that is more prominent in the left hand. There is normal range of motion in the arms and legs; active movements are very slow. Muscle strength is normal, and there is increased resistance to passive flexion and extension in the limbs. She walks with a shuffling gait and takes small steps. Which of the following is the most likely underlying cause of this patients symptoms?? A: Accumulation of neurotoxic metabolites secondary to hepatocyte damage, B: Copper accumulation due to mutations in hepatocyte copper-transporting ATPase, C: Neuronal degeneration due to α-synuclein protein misfolding, D: Cerebellar ischemia due to chronic hypertension, E: Proliferation of beta-adrenergic receptors from excessive circulating T4,  <response>: This is a clinical vignette describing a 59-year-old woman with progressively worsening coordination issues and involuntary movements in her left hand over the past 6 months. She also has apathy and withdrawal. On exam, she has a low-frequency tremor more prominent on the left, slow movements, normal strength, increased tone to passive movement, and a shuffling gait. Based on the clinical presentation, the most likely diagnosis is Parkinsons disease. The key features are asymmetric resting tremor, bradykinesia, rigidity, and shuffling gait. Parkinsons is caused by neuronal degeneration due to alpha-synuclein protein misfolding and aggregation into Lewy bodies.Choice A describes hepatic encephalopathy, which is unlikely with the described extrapyramidal findings. Choice B describes Wilsons disease, which also presents differently. Choice D describes cerebellar issues, which do not match the extrapyramidal findings. Choice E describes hyperthyroidism, which does not match the presentation.C: Neuronal degeneration due to α-synuclein protein misfolding 