Chapter 10

Question 1

Name a strategy that might influence the degeneration of the superior longitudinal fasciculus. For which patients is this strategy of particular importance? Why?

Answer 1

Enhance physical activity. Especially important in FTD and VaD, because gait-related areas are particularly vulnerable during early stage.

Question 2

Name a strategy that might influence the degeneration of the uncinate fasciculus. For which patients is this strategy of particular importance? Why?

Answer 2

Mental practice and imagination of foot movement. Most important in mild VaD, because the orbitofrontal cortex is not (yet) severely affected.

Question 3

Name strategies that might influence the degeneration of the frontocerebellar circuit.

Answer 3

(1) Passively move ankles (when there is no initiative)

2) Train gait speed (related to ADL and EFs

Question 4

Name a general strategy that might influence the degeneration of the frontostriatal circuit.

Answer 4

In AD: implicit, automatic motor learning. Constant training is essential!

Question 5

Name a strategy that might influence the degeneration of the cingulum in (1) mild AD patients and (2) FTD patients.

Answer 5

(1) Route learning tasks for FTD patients (PCC still intact, necessary for topographic orientation)
(2) Explicitly practice overlearned motor activities in AD patients (ACC still relatively intact!)

Question 6

Name and describe the two different types of gait seen in AD patients.

Answer 6

(1) Cautious gait: static instability, slow speed, hesitation and freezing at onset of walking.
(2) Frontal gait: start and turn difficulties, shuffling

Question 7

In which way can Diabetes type II lead to an higher risk of dementia?

Answer 7

Insuline resistance can lead to an impairment in nitric oxide mediated vasodilatation, causing vasoconstriction and hypertension. Hypertension, in turn, coincides with an increase in neurofibrillary tangles and amyloid plaques increasing the risk for dementia.

Question 8

Describe the gait of patients with vascular cognitive impairment - no dementia (VCIND).

Answer 8

Parkinsonian gait: decrease in speed, decline in static and dynamic balance, rigidity, bradykinesia.

Question 9

Describe the gait of patients with subcortical ischemic VaD.

Answer 9

Wide base, gait apraxia, decreased step length, bradykinesia, rigidity, disturbance in gait initiation, static and dynamic instability, freezing, decrease in gait velocity.

Question 10

Describe the vasodilatative mechanism of physical exercise.

Answer 10

Exercise leads to pressure on the endothelium in the vessel wall, which stimulates the release of nitric oxide. Nitric oxide increase, in turn, the dilatation of the blood vessels.