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T2 - Phase 3 - Brain, Mind, and Behavior > BMB 2 - Dementia; Movement Disorders > Flashcards

BMB 2 - Dementia; Movement Disorders Flashcards

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1
Q

The left hippocampus is more responsible for which aspects of memory?

A

Language / verbal memory

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2
Q

The right hippocampus is more responsible for which aspects of memory?

A

Visuospatial memory

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3
Q

Which brain structure is largely responsible for linguistic and verbal memory?

A

The left hippocampus

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4
Q

Which brain structure is largely responsible for visuospatial memory?

A

The right hippocampus

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5
Q

Which brain structure is largely responsible for emotional memory?

A

The amygdala

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6
Q

Which brain structure is largely responsible for procedural memory?

A

The basal ganglia and cerebellum

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7
Q

Name two memory-processing structures connected by the fornix.

A

The hippocampus and the mamillary bodies

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8
Q

Which neural loop involves the hippocampus and is largely responsible for episodic, declarative memory?

A

The Papez circuit

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9
Q

Which neural loop involves the amygdala and is largely responsible for emotional memory?

A

The Yakolev circuit

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10
Q

What are the major structures of one hemisphere of the Papez neural loop?

A

The cingulate gyrus, parahippocampal gyrus, hippocampus, fornix, and mamillary body

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11
Q

What are the major structures of one hemisphere of the Yakolev neural loop?

A

Tha amygdala, thalamus, and prefrontal/temporal cortices

(the hypothalamus and brainstem also have input)

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12
Q

What is the most important risk factor for Parkinson’s disease?

A

Age

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13
Q

You tap on a patient’s forhead between their eyes (on their glabella); they blink slowly and late.

What is this called?

A

The Myerson (or glabella) sign

(indicates Parkinson’s)

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14
Q

What percentage of Parkinson’s disease patients have depression?

A

50%

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15
Q

Name some of the S/Sy of Parkinson’s disease.

A

Gait disturbance;

resting tremor;

depression;

Myerson (glabella) sign;

bradykinesia;

cogwheel rigidity;

cognitive impairment;

pin-wheel tremor;

postural instability;

ANS dysfunction

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16
Q

What is the major etiology of Parkinson’s disease?

A

Degeneration of the substantia nigra pars compacta

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17
Q

What is the classic triad of Parkinson’s disease?

A

Resting tremor

Bradykinesia

Rigidity

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18
Q

Parkinson’s disease has close associations with which form of neuropathology and dementia?

A

Lewy body

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19
Q

Are Lewy bodies present in Parkinson’s disease?

A

Yes, in the substantia nigra pars compacta

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20
Q

Where within the cell are Parkinsonian Lewy bodies found?

A

As intranuclear deposits

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21
Q

Parkinsonian symptoms with early-onset dementia is likely _______________.

Parkinsonian symptoms with late-onset dementia is likely _______________.

A

Parkinsonian symptoms with early-onset dementia is likely Lewy body dementia.

Parkinsonian symptoms with late-onset dementia is likely Parkinson’s disease.

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22
Q

What are some of the general pharmacological treatment options for Parkinson’s disease?

A

Levodopa

Dopamine agonists

Amantadine

MAO inhibitors (monoamine oxidase)

CMOT inhibitors (catechol-o-methyl transferase)

(also therapy and deep-brain stimulation)

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23
Q

What is the general pharmacological treatment for Lewy body dementia?

A

Cholinesterase inhibitors

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24
Q

Alzheimer’s disease most severely damages which portions of the brain?

A

The hippocampus;

the posterior cortical areas

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25
Q

Alzheimer’s disease is associated with a loss of which neurotransmitter from which nucleus?

A

Acetylcholine;

the basal nucleus of Meynert

26
Q

Alzheimer’s disease is associated with what neuropathology?

A

Tau neurofibrillary tangles and beta-amyloid plaques

27
Q

What is the most important risk factor for Alzheimer’s disease?

A

Age

28
Q

What are the genetics of Alzheimer’s disease?

A

APoE4 on chromosome 19 increases risk

(APoE2 is protective)

29
Q

Early-onset Alzheimer’s disease has an onset before what age?

A

65 years

(usually in one’s 40s or 50s)

30
Q

What are the genetics of early-onset, familial Alzheimer’s disease?

A

APP, PSEN1, PSEN2

31
Q

What is the mode of inheritance of familial (early-onset) Alzheimer’s disease?

A

Autosomal dominant

32
Q

Most cases of Alzheimer’s disease are ____________ (sporadic/familial).

A

Most cases of Alzheimer’s disease are sporadic (>95%).

33
Q

True/False.

Most cases of both Parkinson’s disease and also Alzheimer’s disease are sporadic and not likely to be inherited.

A

True.

34
Q

What is the most common form of dementia?

And second?

A

Alzheimer’s disease (40%)

Vascular dementia (20%)

35
Q

True/False.

Vascular dementias can result due to both large-vessel multiinfarcts or chronic small-vessel disease.

A

True.

36
Q

Describe some of the features of vascular dementia.

A

Symptoms of Alzheimer’s disease

+

chronic microvascular white matter changes

37
Q

Describe some of the features of frontotemporal dementia (Pick’s disease).

A

Associated with chromosome 17 abnormalities

Pick bodies in frontal and temporal lobes

Loss of inhibition

Progressive aphasia

38
Q

Describe some of the features of Lewy body dementia.

A

Corticobasilar degeneration

Cognitive and motor symptoms

Mild memory loss, executive functioning problems, magnetic apraxia

39
Q

What part of the brain routes input from the cerebellum and basal ganglia to the cortex for control of motor movement?

A

The ventral lateral thalamus

40
Q

What part of the brain is targeted by deep-brain stimulation (e.g. for Parkinson’s disease or essential tremor)?

A

The ventral lateral thalamus

41
Q

Describe the typical etiology and presentation of Huntington’s disease.

A

CAG repeats on chromosome 4 –>

Accumulation of abnormal huntingtin protein –>

Degeneration of the caudate –>

Loss of motor inhibition by basal ganglia –>

Chorea / Hemiballismus / Depression / Dementia

42
Q

The motor S/Sy of Huntington’s disease largely result due to deposition of the ___________ protein in the medium _________ neurons of the caudate nucleus.

A

The motor S/Sy of Huntington’s disease largely result due to deposition of the huntingtin protein in the medium spiny neurons of the caudate nucleus.

43
Q

What is the mode of inheritance of Huntington’s disease?

A

Autosomal dominant

44
Q

Name the relevant, respective symptomatic treatment(s) for each of the following aspects of Huntington’s disease:

Chorea —

Depression​ —

Psychosis​ —

Cognition​ —

A

Name the relevant, respective symptomatic treatment(s) for each of the following aspects of Huntington’s disease:

Chorea — VMAT2 inhibitors (e.g. tetrabenazine) (decreasing dopamine)

Depression​ — SSRIs

Psychosis​ — Antipsychotics

Cognition​ — No known treatment

45
Q

What are some of the general symptomatic treatments for dementia?

A

Acetylcholinesterase inhibitors: donepezil, galantamine, and rivastigmine

N-methyl-D-aspartate antagonists: memantine

Diet, exercise, sleep

46
Q

Alzheimer’s disease alone is responsible for _____% of cases of dementia.

Vascular dementia alone is responsible for _____% of cases of dementia.

Frontal and mixed dementias (e.g. Pick’s, Lewy body, progessive aphasia, etc.) are responsible for _____% of cases of dementia.

Other types (e.g. Parkinson’s, TBIs, toxins, infections, metabolic issues, etc.) are responsible for _____% of cases of dementia.

A

Alzheimer’s disease alone is responsible for 40 % of cases of dementia.

Vascular dementia alone is responsible for 20 % of cases of dementia.

Frontal and mixed dementias (e.g. Pick’s, Lewy body, progessive aphasia, etc.) are responsible for 25 % of cases of dementia.

Other types (e.g. Parkinson’s, TBIs, toxins, infections, metabolic issues, etc.) are responsible for 15 % of cases of dementia.

47
Q

What is a tic?

A

A premonitory urge to move

48
Q

What is the definition of chronic tic disorder?

A

Either ≥ 1 motor or ≥ 1 verbal tics that began before age 18 and are present for ≥ 1 year

49
Q

Define Tourette’s syndrome.

A

A tic disorder with onset of symptoms before 18 years of age;

≥ 2 motors tics and ≥ 1 vocal/phonetic tics throughout the overall course of the disease

50
Q

What are the major comorbidities associated with Tourette’s syndrome?

A

OCD and ADHD

51
Q

What are the phonetic tics often seen in Tourette’s syndrome?

A

Throat clearing, coughing, grunting, anything that makes sounds

Coprolalia: shouting of obscenities (only 5-15% of patients)

52
Q

What are the motor tics often seen in Tourette’s syndrome?

A

Copropraxia: obscene movements

53
Q

Name some of the treatments available for reducing the burden of tic disorders generally (and Tourette’s syndrome specifically).

A

Agents which deplete or block dopamine

Clonazepam

Botulinum toxin injections

54
Q

Describe essential tremor.

A

A familial, bilateral movement disorder

55
Q

Does alcohol help or exacerbate the involuntary motor movement of essential tremor?

A

Help

56
Q

Name some of the treatments used for managing essential tremor.

A

Topiramate (first-line)

Propranolol (not for the elderly)

Primidone

Deep brain stimulation

57
Q

How does cerebellar ataxia typically present?

A

Slow, progressive worsening of symptoms over the years involving speech, swallowing, coordination, gait, or ataxia

58
Q

How is cerebellar ataxia managed?

A

Only by treating underlying causes

(e.g. repleting vitamin deficiency, giving steroids for inflammatory conditions, treating underlying cancers, etc.)

59
Q

What is generically meant by the term ‘dystonia?’

A

Sustained, abnormal muscle contractions

(e.g. as an adverse reaction of antipsychotic use)

60
Q

Name some of the adverse motor effects of antipsychotic use.

A

Dystonia

Akathisia

Tardive dyskinesia

61
Q

How is generalized dystonia treated?

How about acute focal dystonia?

How about dystonia due to antipsychotic use?

A

Baclofen

Botulinum toxin

IV anticholinergics

62
Q

How are tardive syndromes (i.e. dystonia, akathisia, dyskinesia) treated?

A

Removal of the offending agent (usually an antipsychotic);

tetrabenazine;

symptomatic management

T2 - Phase 3 - Brain, Mind, and Behavior (43 decks)

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