Diseases of the Brain Flashcards
Define neurological
Physical signs and symptoms
Define psychiatric
Mental disorders
- research shows that brain is functionally abnormal
Neurological assessment
- State of consciousness
- Gait
- Mental state
- Coordination
- Cognitive function
Psychiatric assessment
- General behaviour
- Mood
- Abnormal beliefs
- Cognitive state
Symptoms of Parkinson’s disease
- Spontaneous movement
- Gait difficulty
- Postural instability
- Rigidity
- Tremor
What is the pathology of Parkinson’s disease?
Degeneration of the pigmented neurones in the substantial nigra of the brain —> decreased DA availability
What is used as a treatment for Parkinson’s disease?
Deep brain stimulation
Deep brain stimulation
- sub thalamic nucleus most effective
Frequencies > 60Hz alleviate symptoms
Frequencies <30Hz exacerbate symptoms
What causes Parkinson’s disease?
Mutations in α-synuclein, Parkin, PINK1, DJ-1, LRRK2, ATP13A2, PLA2G6 but even identical mutations can have different effects
Lack of dopamine
What does a mutation in α-synuclein cause?
Aberrant proteostasis
What do mutation in Parkin, PINK1, DJ-1 affect?
Mitochondrial function
Substantia nigra dopamine neurons - Ca2+ burden
Energy burden for Ca2+ homeostasis is high meaning less energy for other things such as proteostasis –> misfolding proteins
Why do substantia nigra dopamine neurones have an energy burden?
Ca2+ homeostasis
21st century treatments for Parkinson’s disease
PROTECTION - Ca2+ channels blockers
REGENERATION - transplantation, stem cells
STIMULATION - smart stimulators, optogenetics
Symptoms of Huntington’s disease
- Progressive hyperkinesis/dyskinesis
- Dystonia
- Dementia
What is the pathology of Huntington’s disease?
Striato-GPe neurons die first, followed by striato-GPi neurones –> widespread neurodegeneration
Generally put, neuronal loss in the basal ganglia and dilation of the lateral ventricles
Cause of Huntington’s disease
Autosomal dominant hereditary disease
CAG repeats in Huntingtin gene relates to disease expression
How does the number of CAG repeats in Huntingtin relate to disease expression?
- <35 no disease
- 35-39 enhanced risk, onset 40-75 yrs
- 40-50 disease onset 30-40 yrs
- > 50 early onset
What is the Huntingtin gene involved in?
Synaptic vesicle dynamic and neurotransmitter release
Treatments of Huntington’s disease?
- Memantine
- Tetrabenazine
- Deep brain stimulation
- RNAi
- Stem cell transplantation
Positive symptoms of schizophrenia
- Delusions
- Hallucinations
- Disordered thought and speech
What are positive symptoms?
Things that may start to happen if you have the disease
What are negative symptoms?
Things that may stop happening if you have the disease
Negative symptoms of schizophrenia
- Alogia (lack of speech)
- Anhedonia
- Asociality
- Avolition
- Flat affect
Pathology of schizophrenia
Increased levels of dopamine in the mesolimbic pathway
What is the gene associated with schizophrenia?
DISC1
Causes of schizophrenia?
- Genetics - DISC1
- Environment
- Development
- Drug abuse
- Reduced NMDA receptor function
Treatment of schizophrenia
- Antipsychotics
- Psychotherapy
Pathology of depression
Reduced hippocampal volume
Causes of depression
- Serotonin transporter abnormalities
- Social
- Psychological
Treatment of depression
- SSRIs
- Light therapy, sleep deprivation
- Psychotherapy
- Exercise
What is a stroke?
Neurological deficit of cerebrovascular cause that persists more than 24 hours, interrupted by death
Types of stroke
Ischaemic or Haemorrhagic
Ischaemic strokes
- Embolus
- Thrombus
Haemorrhagic strokes
- Entry of blood into CNS via rupture of blood vessels
Classifications of haemotomas affecting the brain
Epidural
Subdural
Subarachnoid
Intracerebral
Epidural haemotoma
Traumatic damage to a meningeal artery or dural venous sinus
Subdural haemotoma
Rapid movement of head causes tearing of the cerebral vein as it enters a dural venous sinus
Subarachnoid haemotoma
Caused by damage to a cerebral after or vein and subsequent bleeding into the subarachnoid space
Intracerebral haemotoma
Caused by damage of a blood vessel within the brain
What is epilepsy?
Repeated seizures
Types of epilepsy
Partial/focal and generalised
What is the most common epilepsy of adult?
Temporal lobe epilepsy
Causes of epilepsy
- 2/3 idiopathic
- Genetic
- Drugs
etc.
Treatments for acute epilepsy
- Recovery position and give reassurance
- Benzodiazepines
Treatments for chronic epilepsy
- Surgical
- Deep brain stimulation
- Avoid trigger
- Pharmacological; Ethosuximide Ca2+ channel blocker, carbamazepine GABA receptor
Symptoms of Alzheimer’s disease
- Short-term memory loss
- Progressive apathy, confusion, irritability
- Long-term memory loss, loss of control of bodily function
Pathology of Alzheimer’s disease
- Loss of neurons
- ß-amyloid plaques
- Neurofibrillary tangles
Causes of Alzheimer’s disease
- Age is a factor
- Genetics: ApoE4
- Trauma
- High cholesterol
Which gene is associated with Alzheimer’s disease?
ApoE4
Treatment for Alzheimer’s disease
AChE inhibitors, NMDA receptor antagonists
Diet, exercise, intellectual stimulation, no caffeine, non-steroidal anti-inflammatory drugs
