Cognitive/Behavioral Flashcards
cant navigate familiar places, draw maps
topographagnosia
localizes to nondominant posterior parahippocampal region, nondominant parietal lobe
optic ataxia + oculomotor apraxia + simultanagnosia
Balint’s syndrome
bilateral parieto-occipital region
“where” pathway
dorsal visual pathways
parieto-occipital regions
“what” pathway
ventral visual pathways
temporo-occipital
cortical blindness + confabulation
Anton’s syndrome
bilateral medial occipital lobes
blind person with vivid hallucinations, but they know it’s a hallucination
Charles Bonnet syndrome
alexia without agraphia (AKA pure word blindness)
disconnection syndrome
lesion in dominant PCA territory, often involving splenium (so words cant get transmitted to Broca’s area)
will have contralateral homonymous hemianopia
patient can’t understand when people talk to them, but they can speak normally and reading comprehension is fine
verbal auditory agnosia (pure word deafness)
hearing is fine, but can’t comprehend auditory language
bilateral middle superior temporal gyri (spares Wernicke’s area)
disrupted connections between primary auditory cortex (Heschl’s gyrus) and temporal lobe association cortices
can’t comprehend, can’t read, can’t repeat
fluent, nonsensical speech
Wernicke’s aphasia
agnosia to sounds, like animal sounds or environmental sounds
nonverbal auditory agnosia
bilateral anterior temporal lobe lesions
patient can write fine, but speech is fragmented and effortful. brief phrases, paraphasic errors. can’t repeat. can comprehend fine.
aphemia - pure word mutism
verbal apraxia
different from Broca’s because retained ability to to write and comprehend written language
lesion to dominant frontal operculum
can’t speak, write, name, or repeat. can comprehend fine
pure Broca’s expressive aphasia
posterior inferior frontal gyrus
severe dysarthria + bilateral VOLUNTARY paralysis of lower cranial nerves, preserved involuntary and emotional innervation (will laugh at joke, yawn fine but can’t voluntarily smile on command)
Foix-Chavany-Marie syndrome
aka ANTERIOR OPERCULAR SYNDROME (insula)
patient speaking fluently, nonsensically, comprehension impaired. but can repeat and has echolalia. recent hypotension
transcortical sensory aphasia
watershed infarct MCA-PCA territory or thalamic lesion (thalamic aphasia), Alzheimer’s
basically Wernicke’s but with intact repetition
patient can’t verbalize besides few 1-2 word phrases, can’t write. can comprehend and can REPEAT
transcortical motor aphasia (like Broca’s but with intact repetition)
watershed infarcts in ACA/MCA sparing connections between Wernicke’s and Broca’s, but messing up connections between Broca’s and supplementary motor area
normal speech, normal language comprehension, normal naming. CAN’T REPEAT
conduction aphasia
lesion in internal arcuate fasciculus (connects Wernicke’s to Broca’s)
patient can’t vary speech based on their emotions, so they sound super monotonous
amelodia or affective motor aprosodia
nondominant posteriro inferior frontal gyrus (basically the ‘nondominant broca’s area’)
can’t understand emotional variation of other people’s speech
sensory/receptive aprosodia
nondominant Wernicke’s area (posterior superior temporal gyrus)
pseudobulbar affect - where is the injury
bilateral lesions that disconnect corticobulbar tracts from brainstem cranial nerve nuclei
seen in ALS, MS, TBI, stroke, mass
tx detromethorphan-quinidine
ideomotor apraxia
using a body part to pantomime - weird postures and errors, use their tooth as a toothbrush rather than pretending to hold a toothbrush.
localizes to dominant parietal cortex
dressing apraxia localizes where
right parietal lobe
often seen with neglect
part of brain responsible for judgment, inhibition of socially inappropriate behaviors, emotional/visceral functions. lesions –> change in personality
orbitofrontal cortex
part of brain responsible for motivation, lesion –> apathy, indifference, loss of initiative, abulia, reduced movement/communication
dorsoMedial prefrontal cortex (M for motivation)
also bilateral anterior cingulate
often due to ACA strokes/tumors
most severe form when bilateral dorsomedial prefrontal cortex affected is akinetic mutism
part of brain responsible for planning motor activity, executive functioning, problem solving –> lesion causes lack of interest in prior interests, can’t plan/multitask/problem solve
dorsoLateral prefrontal cortex (L for Likes, Logic puzzles)
Wisconsin Card Sorting Test
measures prefrontal cortex function
have to arrange cards based on a concept
Grooved Pegboard Test
tests finger dexterity - fine motor function
Trail Making Test
part A: processing speed, visual search, attention
part B: set shifting, working memory
Clock Drawing Test
tests visuospatial function
also auditory comprehension, attention, executive function
Capgras delusion
people in your life are imposters
Fregoli’s syndrome
same person, different disguises
Cotard’s delusion
patient believes they are dead or dying
right-left confusion and finger agnosia localizes where
Gerstmann’s syndrome
localizes to dominant inferior parietal lobe (dominant angular gyrus) - can be seen in inferior division MCA stroke
4 things: finger agnosia, left/right disorientation, acalculia, agraphia
hemispatial neglect localizes where
nondominant parietal cortex involving primary somatosensory cortex
thalamus can also do it
left hemiparesis and left gaze deviation could localize where?
right pons
unopposed action of left PPRF leads to ipsilateral conjugate gaze towards left
not overcome by oculocephalic maneuver
hyper orality, hypersexuality, blunted emotional affect, hypokinesia - localizes where?
Kluver Bucy syndrome
bilateral medial temporal lobe lesions involving amygdala
can happen after HSV encephalitis, neurodegen disorders, anoxic brain injury
alien limb syndrome associated with what
corticobasal syndrome
descriptive term for many etiologies - can be seen in PSP, CBD
consciousness localizes to
reticular activating system in brainstem
thalamus
medial frontal lobes
biomarkers for Alzheimer’s
hippocampal atrophy on MRI
CSF findings: reduced CSF beta-amyloid, increased CSF tau
FDG-PET hypometabolism in temporoparietal regions
amyloid PET imaging
14-3-3
CJD
phases of Alzheimer’s
- preclinical (no clinical sx but can see amyloid imaging changes, predates AD by years)
- prodromal (+biomarkers and early sx)
- Alzheimer’s dementias (+biomarkers + functional deficits)
apoE2 vs apoE4 allele
2 - two phew! lower risk of Alzheimer’s
4 - four is more risk of late-onset Alzheimer’s
