Alzheimer's and Normal Aging

Question 1

Synapse elimination explanation

Answer 1

more synapses are originally made between neurons than will be retained; “synapses that fire together wire together”; “pruning”

Question 2

Failure of what is always associated with intellectual impairment?

Answer 2

(Dendritic) Spine Maturation

Question 3

When is the 2nd critical period, during which brain growth spurt occurs?

Answer 3

third trimester through the first two years of life

Question 4

Brain Growth Spurt occurs not by increase in neurons but by what?

Answer 4

a. An increase in the size of neurons
b. An elaboration of dendritic processes
c. Myelination of axons
d. An increase in the number and size of glial cells

Question 5

What is the most common primary dementia and the most common neurodegenerative disease in the U.S?

Answer 5

Alzheimer’s Disease

Question 6

Common causes of death in Alzheimer’s patients?

Answer 6

infection or aspiration subsequent to pneumonia (primarily from being bedridden), and cerebral hemorrhage (due to the build up of amyloid in vessels)

Question 7

Gross pathological change in alzheimer’s seen at autopsy?

Answer 7

Global cortical atrophy: narrowing of gyri and widening of sulci; internally, there is compensatory dilatation of the lateral and third ventricles

Question 8

Loss of neurons in Alzheimer’s is localized to what regions?

Answer 8

neo-cortex, hippocampus, amygdala, nucleus basalis of Meynert, nuclues locus coeruleus, raphe nuclei

Question 9

First area to show neuron loss in AD

Answer 9

Area 28 (entorhinal cortex)

Question 10

What area supplies majority of cholinergic input to the cortex and important for normal cognitive functioning?

Answer 10

nucleus basalis of Meynert

Question 11

Function of and neurotransmitter used in Nucleus Locus Coeruleus?

Answer 11

Norepinephrine

regulation of blood flow, selective attention, arousal, sleep/wake cycle, and REM sleep

Question 12

Raphe Nuclei have ascending and descending axons. What are their roles and NT used?

Answer 12

5-HT
Ascending - regulation of mood
Descending - regulation of pain transmission to brain

Question 13

Chromatolysis definition

Answer 13

a change in neuron cell bodies that occurs when axons are damaged

Question 14

Decreased Nissl staining of cell bodies in AD is due to what?

Answer 14

reduction in RNA within the brain

Question 15

What happens to tau protein in AD? What are insoluble polymers of tau called?

Answer 15

hyperphosphorylated; paired helical filaments

Question 16

Neurofibrillary Tangles (NFTs) are extra or intra-cellular?

Answer 16

intracellular

Question 17

Plaques are extra or intra-cellular?

Answer 17

extracellular

Question 18

Pathologically, diagnosis of Alzheimer’s disease at autopsy is based primarily on…?

Answer 18

plaques/per view/age

Question 19

Neuritic plaques are circumscribed areas consisting of…

Answer 19

congophilic amyloid core surrounded by ApoE and increased glial cells due to chronic inflammation

Question 20

AD changes in dendritic shafts and spines how?

Answer 20

decrease in the number of main dendritic branches and in the total numbers of spines

Question 21

explain congophilic angiopathy in AD

Answer 21

amyloid can “replace” the blood vessel wall and lead to leakage and hemorrhage; this contributes to decreased blood flow, and to why cerebrovascular hemorrhage is common late in Alzheimer’s disease

Question 22

Describe the various biochemical (NT) changes in AD

Answer 22

decrease in ACh, NE, and 5-HT

glutamate dumping after neuron death leads to excitotoxicity

Question 23

What is the problem with prescribing tri-cyclic anti-depressants to AD patients?

Answer 23

depression may worsen; this is because the tricyclics have some anti-cholinergic activity

Question 24

Sundowning explanation

Answer 24

presence of severe anxiety/fear/agitation/hallucinations, particularly in the evening - may occur in some patients

Question 25

Cachexia definition

Answer 25

severe weight loss and muscle mass depletion due to disease

Question 26

What are the two classes of drugs for AD

Answer 26

drugs which increase ACh

drugs which target Glutamatergic neurotransmission

Question 27

DBS of what part of the brain resulted in increased glucose metabolism and activation of the Papez Circuit?

Answer 27

Fornix

Question 28

B-Amyloid protein plaque may be due to what changes in AD?

Answer 28

augmented release and/or a failure of removal of the β amyloid protein

Question 29

What chromosome and disorder are related to increased risk for AD?

Answer 29

Trisomy 21

Question 30

Mutations in what three genes all appear to have in common that they alter amyloid protein processing, supporting the amyloid cascade hypothesis?

Answer 30

chromosomes 21, 14 (presenilin 1), and 1 (presenilin 2)

Question 31

Co-morbidity of Alzheimer’s Disease and what chronic disease is a new theory in the etiology of AD?

Answer 31

Cardiovascular Disease leading to cerebrovascular dysregulation

Question 32

Inheritance of what alleles coding for ApoE increase risk of AD?

Answer 32

E4 alleles

Question 33

High fat diet etc result in what changes in clearance of amyloid?

Answer 33

decreased clearance

Question 34

What hormones in hormone replacement therapy for women are associated with increased risk for AD?

Answer 34

progesterone and estrogen

Question 35

Define mild cognitive impairment

Answer 35

short-term memory loss without other cognitive deficits

Question 36

Inheritance of E2/E2 alleles for ApoE result in decreased risk for AD because?

Answer 36

tau stability

Question 37

Continuing mental challenge decreases risk for AD because?

Answer 37

increased neurogenesis in aging/adult brain