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Psychology 479 > Chapter 26 - Neurological Disorders > Flashcards

Chapter 26 - Neurological Disorders Flashcards

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1
Q

What is a neurological disorder?

A
  • Disorder associated with an abnormality or injury to the CNS and/or PNS
  • They are the leading cause of health and disability worldwide
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2
Q

Are men or women more affected by neurological disorders?

A
  • Men more affected
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3
Q

What are some risk factors for neurological disorders?

A
  • High blood pressure (can lead to stroke)
  • Air pollution
  • High plasma glucose levels
  • Smoking
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4
Q

What’s a traumatic brain injury (TBI)?

A
  • Wound to brain following blow to the head
  • Minor TBI = concussion
  • Most common form of brain damage in people under 40
  • Sports accounts for around 20% of cases; more common in males
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5
Q

How is the brain affected by TBI?

A
  • Direct damage
  • Disrupted blood supply
  • Bleeding
  • Increased intracranial pressure/swelling
  • Infection
  • Tissue scarring
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6
Q

What’s a coup, and contrecoup?

A
  • Coup - the spot that signifies damage at the site of impact
  • Contrecoup - the pressure resulting from a coup may push the brain to the opposite end or side of the skull
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7
Q

What’s chronic traumatic encephalopathy (CTE)?

A
  • Can be caused by cumulative effects of mTBI
  • It’s a progressive degenerative disorder
  • Dementia pugilistica (DP) or “punch-drunk syndrome” or “boxer’s dementia”
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8
Q

What’s the pathology of chronic traumatic encephalopathy?

A
  • Continuous microhemorrhages caused by mTBI contribute to a loss of blood-brain barrier integrity
  • Leads to an accumulation of tau protein (neurofibrillary tangles)
  • Would develop PD-like symptoms
  • Leads to cerebral atrophy and expanded ventricles (due to shrinking brain volume)
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9
Q

What are the common areas affected in CTE?

A
  • Substantia nigra
  • Frontal lobes
  • Temporal lobes
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10
Q

What are the behavioural effects of CTE?

A
  • Aggression
  • Explosivity
  • Impulsivity
  • Mood - anxiety, apathy, depression, mania
  • Poor attention and concentration
  • Dementia
  • Motor
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11
Q

What’s ataxia?

A
  • Uncoordinated movements
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12
Q

What is epilepsy?

A
  • A chronic neurological disorder characterized by recurrent seizures
  • Abnormal, spontaneous, neuronal discharges as a result of scarring from injury, infections, or tumors
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13
Q

Symptomatic vs. Idiopathic epilepsy?

A
  • Symptomatic - specific cause
  • Idiopathic - appears to arise spontaneously in the absence of other CNS disease
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14
Q

What are some of the precipitating factors for epilepsy?

A
  • Drugs
  • Emotional stress
  • Fever
  • Hormonal changes
  • Hyperventilation
  • Sensory stimuli
  • Sleep
  • Sleep deprivation
  • Trauma
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15
Q

What are three particular symptoms that can occur in many types of epilepsy?

A

1) Aura - precedes onset of seizure, lasting 1-2 minutes. A subjective sensation, perception, or motor phenomenon
2) Loss of consciousness (wakefulness or awareness)
3) Movement - convulsions, automatic movements (rubbing, chewing, lip-smacking)

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16
Q

How is epilepsy usually diagnosed?

A
  • Typically confirmed by an EEG (small changes in electrical activity (graded potentials) measured by electrodes on scalp
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17
Q

What are focal seizures?

A
  • Begins in one brain location and then spreads
  • Focal aware seizure: person is aware
  • Focal impaired seizure: loss of awareness commonly originates in temporal lobe
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18
Q

What are generalized seizures?

A
  • Bilaterally symmetrical
  • Around 50% preceded by aura
  • AKA grand mal seizures; tonic-clonic seizures
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19
Q

What are the stages of generalized seizures?

A

1) Tonic stage - body stiffens, breathing stops
2) Clonic stage - rhythmic shaking (convulsions)
3) Postseizure - depressive symptoms (confusion, ,oss of affect)
*Tonic +clonic phase = ictal period (during seizure)

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20
Q

What are akinetic seizures?

A
  • Sudden and complete loss of muscle tone
  • Generally in children only, often short
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21
Q

Myoclonic spasms?

A
  • Massive seizures consisting of sudden flexion or extension of the body; often begin with a cry
  • Starts around 3-10 months of age
  • Don’t last long
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22
Q

What are dissociative seizures?

A
  • AKA functional seizures/psychogenic non-epileptic seizures
  • May share features with focal and generalized seizures, but no change in EEG
  • Can retain or lose awareness
  • With or without motor symptoms
  • Person usually feels cut-off from themselves and their surroundings
  • Can be an unconscious reaction to stress/traumatic experiences
  • Can’t be treated with regular medication
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23
Q

T/F: Dissociative seizures are more common in women.

A
  • TRUE, onset in late teens-early 20s
  • May be comorbid with anxiety and depression
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24
Q

WHat’s another word for a brain tumor?

A
  • Neoplasm
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25
Q

What categories can brain tumors be divided into?

A
  • Glial and non-glias (gliomas account for around 45% of brain tumors)
  • Benign (confined to one region) or malignant (cancerous)
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26
Q

Encapsulating vs. Infiltrating tumors?

A
  • Encapsulating - well-defined borders; often benign; pressure on the brain
  • Infiltrating - no distinct borders (invasive)
27
Q

What are general symptoms of tumors?

A
  • Headache
  • Vomiting
  • Swelling of optic disk (papilledema)
  • Slowing of heart rate (bradycardia)
  • Mental dullness
  • Double vision (diplopia)
  • Convulsions
  • Functional impairments
28
Q

What’s Myasthenia Gravis (MG)?

A
  • Translates to “severe muscle weakness”
  • It’s an autoimmune disorder affecting the neuromuscular junction
  • Impaired ACh neurotransmission
  • nAChRs targeted by autoantibodies, which are important for muscle contraction
29
Q

What are some characteristics of myasthenia gravis (MG)?

A
  • Usually involves muscles of eyes, throat, and extremities
  • Fluctuating weakness, often more prominent in afternoon
  • More common in women, onset usually in 30s
30
Q

What are common symptoms of MG?

A
  • Diplopia (double vision)
  • Ptosis (eyelid drooping)
  • Weakness of voice
  • Difficulty chewing/swallowing/holding up head
31
Q

What are common treatments for MG?

A
  • AChE inhibitors (leave more ACh at receptors)
  • Immunosuppressive drugs
32
Q

What’s poliomyelitis?

A
  • Disease of motor neuron cell bodies in spinal cord (most often) and brainstem
  • It’s a neurotropic enterovirus; infection may result in muscle weakness and paralysis
33
Q

What was the iron lung used for?

A
  • Used for polio patients to help simulate breathing
  • Would have to live in the machines
34
Q

Amyotrophic Lateral Sclerosis (ALS)?

A
  • Means “hardening of lateral spinal cord”
  • Affects motor neurons (progressive degeneration; usually fatal within 5 years of diagnosis)
  • Onset usually 55-75, can occur as early as teens
  • Slightly more likely to develop in men and white people
35
Q

What are some early symptoms of ALS?

A
  • General weakness in throat/upper chest, arms, and legs
36
Q

Hyperkinetic-dystonic syndromes vs. hypokinetic-rigid syndromes?

A
  • hyperkinetic-dystonia - involuntary muscle contractions
  • Hypokinetic-rigidity - hypertonic state (excessive muscle tone) characterized by constant resistance throughout range of motion (independent of velocity of movement)
37
Q

Huntington Disease?

A
  • Progressive degeneration of the basal ganglia
  • Leads to cognitive impairments, movement disorders, and psychiatric disorders (i.e., depression)
  • Affects 2.7/100 000
  • Symptoms usually appear between 30-50, usually fatal 12 years post-onset
37
Q

What makes up the striatum?

A
  • The caudate nucleus (outer arm part)
  • Putamen (inner circular part)
38
Q

What’s the cause of Huntington disease?

A
  • Caused by a trinucleotide repeat expansion (CAG) in the huntingtin (HTT) gene on chromosome 4
  • 10-35 repeats normal; 39+ causes HD
  • Autosomal dominant gene
  • Mutant Huntingtin protein accumulates and destroys the medium spiny neurons of the striatum
39
Q

What’s the cortico-striatal-thalamo-cortical (CSTC) circuit?

A
  • Describes the direct and indirect pathways to the basal ganglia, cycles through the thalamus and cortex.
40
Q

How does HD impact the CSTC circuit?

A
  • HD may feature a decrease in the activity of the indirect inhibitory pathway due to cell loss in putamen and globus pallidus, making it difficult for the Globus Pallidus internal to inhibit movement via the thalamus since the putamen, which contains medium spiny neurons, is compromised
  • Indirect pathway - antagonizes movement
41
Q

What’s chorea?

A
  • Involuntary, dance-like movements, seen in those with HD
42
Q

What’s Tourette Syndrome?

A
  • A hyperkinetic motor disorder
  • Usually starts with motor tics, moves to simple vocal tics (i.e., inarticulate cries) then complex vocal tics
  • First symptoms usually appear between 2-15 years
  • More common in boys
43
Q

What are the different types of complex vocal tics?

A
  • Articulate words
  • Echolalia - repeating the actions/words of others
  • Coprolalia - involuntary swearing (rare)
44
Q

Why does Tourette Syndrome occur?

A
  • Due to a dysfunction in the CSTC circuit, likely due to aberrant neuronal development
  • Excess striatal DA, leading to a disinhibition of thalamic output via the direct pathway
45
Q

Which dopaminergic pathway is impacted by PD?

A
  • The nigrostriatal pathway
  • This one is active in maintaining normal motor behaviour
  • Originates in the ventral tegmentum
46
Q

What are the 4 major symptoms in PD?

A
  • Tremor, muscular rigidity, bradykinesia, and postural disturbance
47
Q

How does PD impact the CSTC circuit?

A
  • There’s hyperactivity of indirect pathway, leading to reduced movement and rigidity
48
Q

Positive vs. Negative symptoms in PD?

A
  • Positive - tremor at rest, muscular rigidity, involuntary movements (akathisia = constantly restless, oculogyric crisis = turn head and eyes in one direction)
  • Negative - postural disorders, righting disorders, locomotive disorders, speech disturbances, akinesia
49
Q

T/F: Most of PD cases are idiopathic.

A
  • TRUE
50
Q

What are the three major types of PD?

A

1) Idiopathic
2) Post-encephalitic
3) Drug-induced (ex. “frozen addicts”, MPP+ killed DA neurons

51
Q

What altered protein may contribute to classic PD?

A
  • Alpha-synuclein
  • When improperly folded, they can aggregate and form Lewy bodies
  • These have been implicated in several sporadic neurodegenerative diseases termed alpha-synucleinopathies
52
Q

What are cerebral vascular accidents/disorders?

A
  • Sudden appearance of neurological symptoms resulting from interrupted blood flow
  • Often produces an infarct - an area of dead or dying tissue
  • Most common cause of death worldwide (i.e., stroke)
53
Q

What’s the FAST approach to spot a stroke?

A
  • Face - ask for a smile to check both understanding and motor control
  • Arms - check whether one arm is weak by asking the person to raise both arms
  • Speech - listen for slurred speech
  • Time - call 911 right away
54
Q

What’s a cerebral ischemia?

A
  • A vessel blockage resulting in insufficient blood supply to the brain
  • Most often affects left, middle cerebral artery
  • i.e., stroke
55
Q

Thrombosis vs. Embolism?

A
  • Thrombosis - a blood clot that stays in place
  • Embolism - Pieces of the clot break away and clog other smaller blood vessels
56
Q

What’s a cerebral hemorrhage?

A
  • A brain bleed
  • Can be caused by high blood pressure
  • Life-threatening and required immediate treatment
  • Poor prognosis, especially if patient unconscious for more than 48 hours
57
Q

What are angiomas?

A
  • Abnormal collections/tangles of blood vessels that divert the normal flow of blood
  • Often inherently weak and can lead to stroke
58
Q

What are arteriovenous aneurysms?

A
  • Abnormal bulge/ballooning in the wall of a blood vessel
  • Usually weak and prone to rupture
  • Often congenital, but may also be caused by hypertension, arteriosclerosis, embolisms, or infections
59
Q

What’s the characteristic symptoms of arteriovenous aneurysms?

A
  • Severe, chronic headaches
  • The aneurysms put pressure on the dura mater
60
Q

What’s first to be affected in cerebral vascular disorders/accidents?

A
  • Ionic changes
  • Next is second messengers, then mRNA, proteins, inflammation
61
Q

What are the three major treatments for cerebral vascular disorders?

A
  • Anti-coagulant therapy to dissolve clot (must be delivered within 3-5 hours of ischemic stroke onset)
  • Neuroprotectant drugs to limit changes leading to cell death (block calcium channels, reduce edema, reduce BP)
  • Hemorrhage - surgery to relieve pressure that pooling blood exerts on brain
62
Q

What’s the most effective treatment for treating cerebral vascular disorders?

A
  • Prevention (diet, exercise, stress management, weight control, no smoking etc.,)

Psychology 479 (13 decks)

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