6. Cognitive Disorders-Dementia Flashcards
Forms of Memory & Anatomical Sites of Brain
- Episodic memory –>
- Semantic/factual Memory –>
- Working memory –>
- Emotional Memory –>
- Procedural/muscle memory –>
- Medial temporal (hippocampus)
- Medial temporal (initial learning) & Lateral Temporal (long-term storage)
- Lateral pre-frontal cortex
- Amygdala
- Corticostriatal & cerebellum
Acute change in mental status (confusion, disrupted sleep/wake cycle, inattention) usually secondary to surgery, medications/polypharmacy, age, etc.
Delirium (섬망)
Type of Cognitive Disorder; an ACQUIRED, persistent and PROGRESSIVE impairment in intellectual function in multiple cognitive domains, usually MEMORY
Dementia
Examples of Reversible Dementia
- NPH
- Hypothyroidism
- B12 deficiency
- Neurosyphilis/HIV
- Benign Tumors
Type of Cognitive Disorder; REVERSIBLE Dementia due to increased CSF pressure W/O affecting subarachnoid space volume; Ventricle dilation on CT
Normal Pressure Hydrocephalus
Classic traid for the symptoms of Normal Pressure Hydrocephalus
Dementia
Gait instability
Urinary incontinence
(“Wacky, wobbly and wet”)
Treatment for Normal Pressure Hydrocephalus
LP
CSF shunt
Type of Neurodegenerative Dementia
Alzheimer’s
Lewy Body Dementia
Frontotemporal (“Pick Disease”)
Parkinson
Huntington
What is the central pathology for Neurodegenerative Diseases (Alzheimer’s, Parkinson’s, etc.)
Deposition of abnormal proteins leading to neuronal death
amyloid, tau, alpha synuclein
Which protein is associated with Alzheimer’s Dementia
B-amyloid
Tau
Which protein is associated with Frontotemporal Dementia (“Pick Disease”) and Chronic Traumatic Encephalopathy
Tau
Which protein is associated with Lewy Body Dementia and Parkinson’s disease?
Synuclein protein
Lewy Body
Type of Cognitive Disorder; Neurodegenerative Dementia; MOST COMMON; short term memory loss with many cortical deficits (language, praxis, etc.); atrophy of most lobes of the brain (Occipital usually spared); associated with deposition of “senile plaques” (B-amyloid) and “neurofibrillary tangles” (tau protein)
Alzheimer’s Disease
Alzheimer’s Disease usually involves atrophy of all cerebral lobes EXCEPT…
Occipital (usually spared)
Type of Cognitive Disorder; Neurodegenerative Dementia; SECOND most common cause of dementia; cognitive impairment, hallucinations, Parkinsonism (movement); brain is NOT as atrophic, but has Lewy bodies (synuclein protein) in cortex, limbic system, and brainstem
Lewy Body Dementia
How is LBD different than Parkinson’s disease?
IN LBD, cognitive symptoms appear first before motor symptoms.
Type of Cognitive Disorder; Neurodegenerative Dementia; more atrophy of Frontal and Temporal lobes with marked early PERSONALITY CHANGE more than memory; see Tau-positive bodies and ballooned neurons with dissolution of chromatin
Frontotemporal Dementia (aka “Pick Disease”)
Histological finding for Frontotemporal Dementia (aka “Pick Disease”)
Pick bodies with Tau protein and ballooned neurons with dissolution of chromatin
what cerebral lobe is spared in frontotemporal dementia?
Parietal lobe
Types of NON-degenerative Dementia
Vascular
Alcoholic
CJD
Type of Cognitive Disorder; NON-Degenerative Dementia; STEP-WISE DECLINE
caused by CVD such as numerous microinfarcts
Vascular Dementia
Type of Cognitive Disorder; NON-Degenerative Dementia; due to the direct toxicity of chronic alcohol exposures to neurons; associated with Wernicke-Korsakoff Syndrome (thiamine deficiency)
Alcoholic Dementia
Encephalopathy associated with chronic alcohol consumption resulting in thiamine deficiency; initially presents with Wernicke encephalopathy (confusion, ophthalmoplegia, and ataxia) and then may progress to Korsakoff syndrome (irreversible memory loss, confabulation, personality change); ALWAYS involves lesions in the mammillary bodies
Wernicke-Korsakoff Syndrome
Brain part that is associated with recolletive memory
mammillary bodies
