95b - Alzheimer's and other Neurodegenerative Diseases Flashcards
Which areas of the brain are usually spared in AD?
Sensory areas
At the cellular level, which protein is mutated in Alzheimer’s Disease?
What is the result?
- Beta and/or gamma secretase don’t function properly
- Instead of making normal cleavages, they cut at the wrong spot and produce amyloid beta40 and amyloid beta 42
- These toxic structures result in microglial activation
- -> Inflammation/glutamatergic toxicity
- -> Phosphorylation of Tau proteins
- -> Neurofibrillary tangles
Which two classes of medications can be used to treat Alzheimer’s disease?
- NMDA Receptor Inhibitors (memantine)
- Blocks cytotoxicity caused by amyloid
- Cholinesterase inhibitors
- Increase ACh inthe brain
- Slow progression; best if started early
Which area/network of the brain is damaged in Alzheimer’s disease?
Limbic system
Involved in retentive memory
How do cholinesterase inhibitors affect patients with Dementia with Lewy Bodies vs. Alzheimer’s disease differently?
In Demetia with Lewy Bodies, cholinesterase inhibitors will make patients better
Vs. Alzheimer’s disease, they will slow progression
What is Benson’s syndrome?
How does it differ from typical Alzheimer’s disease?
Visual variant of Alzheimer’s Disease
- Delcine in visual processing
- Earlier onset than typical AD
- Memory and language remain intact
What are the non-pharmocological interventions for frontotemporla dementia?
PT, OT, speech therapy, reward-based therapy
(Main pharmacoogical is SSRI)
Before cognitive impairment, what symptoms of Lewy Body Dementia might be present?
- Constipation
- Violent dream eneactment
- Occasional dizziness
- Followed by slowing of movements, impaired balance
Describe the “typical” presenting symptoms/complaints associated with Alzheimer’s Disease
- Older patient
- Frequent forgetfulness
- Conversations, events sometimes
- Repetitive in conversations
- Trouble with word finding
- Results in difficulty with some functions
- Finances
What preventative measures can be taken if a person is at risk of Alzheimer’s Disease?
- Weight control
- Exercise
- Mental and social engagement
- Control:
- Blood pressure
- Blood sugar
- Cholestoral
- Vitamin B12
- Normalize sleep
- Mediterranean diet
Which genes are associated with Alzheimer’s Disease?
- Deterministic genes
- APP
- Presenilin 1
- Presenilin 2
- Risk genes
- APO E4
But <1% of AD is thought to be genetic
What is the main pharmacological intervention for frontotemporal dementia?
SSRIs
(Non-pharmacological include PT, OT, speech therapy, reward-based therapy)
Frontotemporal lobar degeneration is an umbrella term that encompasses 3 types of dementias
What are they?
- Language type: primary progressive aphasia
- Behavioral type: Behavioral type frontotemporal dementia(akaPick’s Disease)
- Motor type: Corticobasal syndrome, Progressive supranuclear palsy, or FTD-MND (Associated with ALS)
What CSF findings will be present in a patient with Alzheimer’s?
Decreased amyloid in the CSF
- It’s busy messing with the brain :(
- Amyloid:Tau index <1
- P-tau >60
What are the three motor types of frontotemporal dementia?
How do you differentiate them?
PSP and CBD will both have problems with balance, vision, speech, swallowing, and memory
-
Progressive supranuclear palsy (PSP)
- Cannot look down voluntarily
-
Corticobasal degeneration (CBD)
- Asymmetric (compared with PSP)
- Behavior deficits
-
FTD-Motor Neuron Disease (FTD-MND)
- Frontotemporal dementia + ALS
- Muscle weakness, shrinkage, jerking
- Fewer memory deficits, more language deficits compared with PSP, CBD
- Behavior deficits (like CBD)
