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ECU Cognitive/Linguistic Impairment in Brain-Injured Adults > 6.2 - Subcortical Dementias > Flashcards

6.2 - Subcortical Dementias Flashcards

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1
Q

What are the 7 Hallmarks of Subcortical Dementias?

A

Bradyphrenia

Memory and learning disturbances

Frontal executive syndromes

Motor disturbances in gait and speech

Psychiatric disturbances

More rapid progression than cognitive dysfunction in PPA

Uncommon to see isolated aphasia, apraxia and agnosia

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2
Q

Where are Lesions seen in Subcortical Dementias?

3

A

Basal ganglia

Brainstem

Cerebellum

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3
Q

What is Bradyphrenia?

A

Slowing of cognition

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4
Q

What Psychiatric Disturbances may be seen in Subcortical Dementias?

(6)

A

Apathy

Irritability

Depression

Psychosis

Mania

Hallucinations

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5
Q

What is the Clinical Profiles of Subcortical Dementia?

A

There is not one specific clinical profile

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6
Q

What do Clinical Profiles of Subcortical Dementias depend on?

A

Underlying disease

Disease severity

Stage of disease

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7
Q

What is Corticobasal Degeneration characterized by?

A

Cell loss and atrophy primarily in the cerebral cortex and the basal ganglia.

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8
Q

There are an estimated ____-____ people in United States with Corticobasal Degeneration, but only ___-___ are diagnosed.

A

2000-3000

500-750

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9
Q

Is there a known cause of Corticobasal Degeneration?

A

No

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10
Q

Is there a cure for Corticobasal Degeneration?

A

No

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11
Q

When do the Initial

symptoms of Corticobasal Degeneration begin?

A

Around 60

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12
Q

What are the Initial Symptoms of Corticobasal Degeneration?

3

A

Sudden problems controlling certain limbs

Loss of balance and co-ordination

Slowness and reduced mobility

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13
Q

What 5 symptoms are seen as Corticobasal Degeneration progresses?

A

Symptoms become more wide-ranging

Muscle spasms and stiffness

Dementia

Dysphagia

Expressive language + comprehension issues

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14
Q

What 3 Language Issues are seen in Corticobasal Degeneration?

A

Phonologic + spelling impairments even in
nonaphasic patients

Visuospatial + constructional impairment

Frontal impairments

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15
Q

___% of individuals with Parkinson’s Disease develop signs of dementia.

A

50%

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16
Q

Average dementia prevalence approximately ___%.

A

35%

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17
Q

In those with Parkinson’s Disease, Cognitive Deficits emerge with ___________.

A

Disease progression

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18
Q

What Cognitive Deficits may be seen as Parkinson’s Disease progresses?

(3)

A

Memory

Problem solving

Abstract reasoning

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19
Q

Can Parkinson’s Disease co-occur with Alzheimer’s Disease?

A

Yes

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20
Q

What causes Parkinson’s Disease?

A

Disruption of Basal Ganglia-Frontal Circuits

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21
Q

What happens when the Basal Ganglia-Frontal Circuits are disrupted?

(4)

A

Executive function deficits

Bradyphrenia

Visuospatial disturbances

Depression

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22
Q

What Symptoms may be seen in Parkinson’s Disease?

3

A

Speech deficits

Linguistic deficits

Depression

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23
Q

What kinds of Speech Deficitsmay be seen in Parkinson’s Disease?

A

Hypokinetic dysarthria

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24
Q

What kinds of Linguistic Deficits may be seen in Parkinson’s Disease?

(4)

A

Language processing (due to subcortical damage)

Complex language processing

Verbal fluency

Both spoken + written language

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25
Q

How often does Depression affect those with Parkinson’s Disease?

(2)

A

Incidence up to 50%

May or may not be abnormal reaction to the disease process

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26
Q

How do those with Parkinson’s Disease respond to Drug Therapy in the EARLY Stage?

A

Some improvement in executive function and memory

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27
Q

How do those with ESTABLISHED Parkinson’s Disease respond to Drug Therapy?

A

Therapy improves speed of response but not other cognitive areas

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28
Q

What may be caused by increased medications for motor difficulties in Parkinson’s Patients?

A

Cognitive deterioration

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29
Q

How do the EARLY STAGES of Alzheimer’s Disease and Parkinson’s Disease differ?

A

AD = insidious cognitive decline, but no motor impairment

PD = Motor impairment, but no cognitive decline

30
Q

How do the LATE STAGES of Alzheimer’s Disease and Parkinson’s Disease differ?

A

AD = Bradykinetic Gait + Tremor

PD = Bradyphrenia + Memory Disfunction

31
Q

How does the CLASSIFICATION of Alzheimer’s Disease and Parkinson’s Disease differ

A

AD = Cortical

PD = Subcortical

32
Q

How does the NEUROPATHOLOGY of Alzheimer’s Disease and Parkinson’s Disease differ?

(2)

A

Both =

Depletion of cholinergic neurons in nucleus basalis of Mynert

Hypoperfusion (frontal, temporal, parietal)

33
Q

What is Huntington’s Disease associated with?

2

A

Cortical degeneration

Basal Ganglia degeneration

34
Q

What kind of decline is seen in Huntington’s Disease?

A

Progressive cognitive and behavioral

35
Q

What kinds of deficits are seen early in Huntington’s Disease?

A

Memory

36
Q

What kinds of Speech Deficits are seen in Huntington’s Disease?

A

Hyperkinetic dysarthria

37
Q

What kinds of Linguistic Deficits are seen in Huntington’s Disease?

(5)

A

Impairment in comprehension of prosody

Simplified syntax

Press of speech

Word finding difficulties

Reduced verbal fluency

38
Q

What is the Pathology of Progressive Supranuclear Palsy?

3

A

Reticular formation

Thalamus

Hypothalamus

39
Q

When is Death expected in patients with Progressive Supranuclear Palsy?

A

Within 6 years

40
Q

When does Dementia appear in Progressive Supranuclear Palsy?

A

In middle-late stages of the disease

41
Q

Progressive Supranuclear Palsy occurs in ___-___ per 100,00.

A

1.0 - 3.1

42
Q

What are the 8 Characteristics of Progressive Supranuclear Palsy?

A

Gaze palsy

Pseudobulbar palsy

Dysarthria

Dysphagia

Dystonic rigidity of the neck and upper trunk

Slowed movements

Frequent falling

Poor visual function

43
Q

What kinds of difficulty can be caused by Poor Visual Function in Progressive Supranuclear Palsy?

A

Reading

Feeding

Performing other eye-hand tasks

44
Q

What difficulty can be caused by the Impaired or Inability to maintain Eye Contact in Progressive Supranuclear Palsy?

A

It gives the impression patient is uninterested

45
Q

What is the Cognitive-Behavioral Profile of Progressive Supranuclear Palsy?

(4)

A

Forgetfulness

Slow mental abilities

Emotional and personality changes

Impaired ability to manipulate knowledge

46
Q

What kinds of Speech Deficits are seen in Progressive Supranuclear Palsy?

(2)

A

Palilalia

Mutism common in late stages

47
Q

What kinds of Linguistic Deficits are seen in Progressive Supranuclear Palsy?

(3)

A

Mild word finding difficulties

Reading and writing deficits (due to gaze palsy)

Well formed sentences with simple syntax

48
Q

What is the onset of Corticobasal Degeneration?

What is the course?

A

Gradual onset

Slow progression

49
Q

What is the onset of Parkinson’s Disease?

What is the course?

A

Sporadic

Gradual

50
Q

What is the onset of Huntington’s Disease?

What is the course?

A

Gradual onset

Progressive

51
Q

What is the onset of Progressive Supranuclear Palsy?

What is the course?

A

Gradual onset

Rapid progression if untreated

52
Q

What are 4 Other Dementias?

A

Mixed Dementias (Multi-Infarct)

HIV-associated cognitive impairment

Dementia associated with alcoholism

Dementia occurring from Normal Pressure Hydrocephalus

53
Q

What are 3 types of Mixed/Multi-Infarct Dementias?

A

Lacunar state

Multiple cortical Infarcts

Binswanger’s disease

54
Q

What causes Lacunar State dementia?

1+4

A

Multiple infarcts in the…

- Basal Ganglia
- Thalamus
- Midbrain
- Brainstem
55
Q

What causes Multiple Cortical Infarcts?

A

Occlusion of cortical arteries

56
Q

What causes Binswanger’s disease?

2

A

Rare disease

Multiple infarcts in white matter; severe HTN

57
Q

What is seen in HIV-Associated Cognitive Impairment?

3

A

Abnormality of one cognitive domain

Underperformance on 2 or more domains

Minor cognitive/motor disorder which affects everyday functioning to at least a mild degree

58
Q

What is seen in HIV Dementia?

A

Marked cognitive impairment

59
Q

What are 2 types of Dementia associated with Alcoholism?

A

Wernicke-Korsakoff Syndrome

Wernicke’s encephalopathy

60
Q

What is seen in Wernicke-Korsakoff Syndrome?

A

Amnesia vs dementia due to chronic alcoholism

61
Q

What is seen in Wernicke’s Encephalopathy?

A

Thaimine deficiency due to chronic alcholism

62
Q

Chronic alcohol abuse and associated head trauma can lead to ______.

A

Dementia

63
Q

Why are there Communication Issues in Dementia associated with Alcoholism?

A

Due to reductions in memory

64
Q

Why is there Dysarthria in Dementia associated with Alcoholism?

A

Due to damage to neurotransmitter and subcortical systems

65
Q

What 2 conditions are often seen in Normal Pressure Hydrocephalus?

A

Dementia

Urinary incontinence

66
Q

What Dementia symptoms are seen in Normal Pressure Hydrocephalus?

(5)

A

Slowing of mental functions

Impaired memory

Attentional deficits

Aphasia?

Gait disturbance

67
Q

What Other Disorders are associated with Dementia?

A

Pseudodementia

Delirium

68
Q

What are 4 symptoms of Pseudodementia?

A

Clinical depression

Identifiable onset w/rapid symptom development

Minimal effort to perform tests

Highly variable test performance

69
Q

What can be caused by the Clinical Depression in Pseudodementia?

(4)

A

Cognitive impairment

Loss of appetite

Difficulty sleeping

Social withdrawal

70
Q

What is Delirium?

A

A transient, confusional state

71
Q

What can cause Delirium?

4

A

Medications

Infections

Metabolic disorders

Surgery; anesthesia

ECU Cognitive/Linguistic Impairment in Brain-Injured Adults (23 decks)

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