Dementia Pathology

Question 1

25% Brain Loss

Answer 1

Loss of 25% of brain, anywhere, will result in dementia

Question 2

4 Gross Features w/ AD

Answer 2

Gyri are shrunken/sulci larger, tissue is granular
Enlarged ventricles/hydrocephalus ex vacuo
Hippocampus, amygdala, basal forebrain (nucleus basalis), entorhinal cortex very affected
Primary sensory and motor areas relatively preserved

Question 3

Nucleus Basalis

Answer 3

Cholinergic neurons that get hit hard by AD so not making it anymore. AchEis can help symptoms somewhat

Question 4

Synaptophysin

Answer 4

Presynaptic protein that you can stain for and see noticeable decrease in synapses in AD

Question 5

Neurofibrillary Tangle

Answer 5

Classic sign of AD, do a Nissl stain and it looks flame shaped

Question 6

Paired Helical Filaments

Answer 6

Hyperphospho’d tau that accumulate IC in tangles

Question 7

Glycogen Synthase Kinase 3 (GSK3)

Answer 7

Suspected kinase responsible for hyperphos of tau

Question 8

Neuritic Plaques

Answer 8

Another hallmark of AD. Can see w/ H&E or silver stain (see nerve fibers in them). Also see w/ congo red stain that visualizes ABeta in center. They are EC accumulations

Question 9

Congophilic Angiopathy

Answer 9

ABeta invasion of blood vessels

Question 10

2 Cellular Components of Plaques

Answer 10

Inside: reactive microglia. Outside: reactive astrocytes

Question 11

3 AD NT Abnormalities

Answer 11

Everything decrease, except glu increases and GABA usually unaffected

Question 12

Familial AD (FAD)

Answer 12

Less than 10%, early onset and usually by Presenilin-1 gene mut

Question 13

5 Factors of Toxicity of ABeta

Answer 13

Stimulates free radical formation
Disturbed Ca homeostasis
Some evidence of apoptosis
Trigger inflammation/complement
mt dysfunction

Question 14

Pick’s Disease

Answer 14

Lobar atrophy of frontal lobe

Question 15

Pick Bodies

Answer 15

Tau inclusions in neurons

Question 16

Lewy Bodies Dementia

Answer 16

See Lewy bodies w/ alpha-synuclein in cerebral cortex (also in Parkinson’s)

Question 17

Diff b/w LBD and PD

Answer 17

LBD changes are generalized w/ involvement of cerebral cortex

Question 18

Normal Pressure Hydrocephalus

Answer 18

Fibrosis of arachnoid granulations causing hydrocephalus and AD like symptoms. Cure 100% w/ shunt

Question 19

Clinical Triad of NPH (& which diff from AD)

Answer 19

Dementia

Gait Apraxia and Urinary Incontinence diff