Higher Cortical Function & Dementia Flashcards
Outline some behavioural clinical consequences of cortical damage
Frontal - personality and behavioural changes, inability to solve problems, withdrawn, apathetic, amoral, loss of empathy and social rules, motor, expression of speech
Parietal - self awareness, body image, orchestration of skilled movement, dyspraxia, attention deficits e.g. right hemisphere damage, contralateral neglect syndrome, sensory
Temporal - language, memory, recognition deficits e.g. agnosias, prosopagnosia, hearing, comprehension of speech, olfaction, emotion
Occipital - visual cortex, processing –> homonymous hemianopia, central vision defect, cortical blindness
Global e.g. Alzheimer’s, cerebrovascular disease
Describe the pathway for speaking a heard word
Primary auditory area –> Wernicke’s area -arcuate fasciculus-> Broca’s area –> motor cortex
Describe the pathway for speaking a written word
Primary visual cortex -angular gyrus-> Wernicke’s area -arcuate fasciculus-> Broca’s area –> motor cortex
Describe and differentiate between Wernicke’s and Broca’s aphasia
Wernicke’s - area in temporal lobe, disorder of comprehension, fluent but unintelligible speech (jargon aphasia), loss of maths skills
Broca’s - area in frontal lobe, poorly constructed sentences, disjointed speech, comprehension fine, expressive, non-fluent aphasia
Name some other aphasias
Nominal/amnesia
Global (–> dementia)
What is Wernicke’s and Broca’s area?
Wernicke’s - interpretation of written and spoken words
Broca’s - formation of language components, sends information to motor cortex
Outline ideas on the neuronal mechanisms of learning and memory
Declarative memory - hippocampus
Procedural memory - cerebellum, basal ganglia
Neuronal plasticity
Short term –> long term achieved by emotion, rehearsal, association, automatic
Memory formation - senses –> cortical sensory area –> amygdala, hippocampus –> diencephalon, basal forebrain, prefrontal cortex
Long term potentiation - glutamate, NMDA receptors, hippocampus
Define ‘declarative’ and ‘procedural’ memory
Long term memory
Declarative - memories that can be consciously recalled such as facts and verbal knowledge e.g. name, birthday
Procedural - stores information on how to perform certain procedures e.g. walking, talking, riding a bike
Name common memory dysfunctions and their causes
Retrograde amnesia
Anterograde amnesia
Transient global amnesia
Causes - Karsakoff’s syndrome, ECT
Describe lateralisation of the dominant and non-dominant hemispheres
Dominant - language, maths, logic, motor skills
Non-dominant - emotion of language, music/art, visiospatial, body awareness
Connected by anterior commissure of corpus callosum
Define dementia
Acquired loss of cognitive ability sufficiently severe to interfere with daily function and QoL
Delirium, drugs, depression
Name markers of dementia
Progressive deterioration of memory, intellect, behaviour, personality, speech
Outline the progression of dementia
Hippocampus –> temporal –> parietal –> frontal
Discuss different types of dementia
Alzheimer’s
Dementia with Lewi bodies
Fronto-temporal dementia
Outline the causes, imaging and management of dementia
Causes - infection, metabolic, nutritional, tumour, chronic inflammatory, trauma
Imaging - MRI/CT, functional
Management - manipulation of neurotransmitters, MDT
