L43. Memory Defects Flashcards

1
Q

What is the difference between subjective memory loss and objective assesment?

A
  • Subjective memory loss is a personal assessment of one’s one memory and it is often a very critical one (majory of people feel they don’t have good or have a fleeting memory
  • Objective memory loss is often due to memory deficits.

It is important to distinguish between two but also to remember that subject complaint may pre-date formal deficits in some cases of dementia

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2
Q

Describe the famous case of HM

A

HM was a sufferer of severe epilepsy that was resistant to treatments and had severe negative impacts on his life.

He had a biltaral medial temporal lobe resection to fix the problem. The surgery was successful in reducing seizure frequency but he suffered from severe amnesia problems

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3
Q

Describe the difference between retrograde and anterograde amnesia

A
  • Retrograde amnesia is the inability to rember things that have happened in the past
  • Anteriograde amnesia is the inability to form new memories from the time of the procedure/trauma forwards
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4
Q

Is it possible to loss all memory at once?

A

Memories are all over the cortex and subcortex thus you can’t really lose all of your memory in one go

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5
Q

Define Short term memory

A

It holds a small amount of information (typically around 7 items or even less) in mind in an active, readily-available state for a short period of time (typically from 10 to 15 seconds, or sometimes up to a minute).

(it is dinguished from working memory as it does not entail the manipulation or organization of material held)

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6
Q

Define working memory

A

Working memory is the system that is responsible for the transient holding and processing of new and already stored information, an important process for reasoning, comprehension, learning and memory updating

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7
Q

Describe long term memory?

A

Long term memory is the storage of information over minutes, hours, years for later retrieval

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8
Q

What is non-declarative memory?

A

A type of long-term memory that doesn’t require conscious thought. It allows you to do things by rote.

It includes

  • Skills and habits
  • Priming
  • Classical conditioning
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9
Q

What is procedural memory?

A

Another type of long term memory

Also called implicit memory

  • It is skill acquisition, it is the type of implicit memory that enables us to carry out commonly learned tasks without consciously thinking about them
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10
Q

What is declarative memory?

A

Also called explicit memory (conscious). The ability to put memories you learn from day to day into context and to process them. It is the common form of memory

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11
Q

Episodic memory/autobiographical memory

A
  • Events in the personal context
  • It is a unique and personal episode
  • It is the association between a personal event and a specific temporal, spatial and emotional context
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12
Q

What is semantic memory?

A

Remembering general facts and general knowledge.

It is shared knowledge and is not contextual

Includes the general meaning of words

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13
Q

What system is the most crucial to memory? Where does it sit?

A

The hippocampal system which sits in the medial temporal region of the brain

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14
Q

What other structures are heavily involved in memory?

A

The limbic system (entorhinal cortex)

Most memory is subcortical

  • Thalamus
  • Mammilary Bodies
  • Basal ganglia
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15
Q

Describe the lateralisation of function in terms of memory

A

The left hippocampus has a dominant role of verbal memory:

  • List learning
  • Paired associate learning
  • Story recall

The right hippocampus has a dominant role in non-verbal memory

  • Visuo-spatial associations
  • Face recall
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16
Q

What are some degenerative disorder causes of memory impairment?

A
  • Alzheimer’s (primary dementia)
  • Chronic alcoholism (secondary dementia)
17
Q

What are some cerebovascular disorder causes of memory impairment?

A
  • Bilateral thalamic infarction (thalamus is very important to memory)
  • Cardiogenic cerebral anoxia (the hippocampus is very susceptible to lack of oxygen)
18
Q

What are some paroxysmal/transient disorder causes of memory impairment?

A
  • Transient global amnesia
  • Temporal lobe epilepsy
  • Post-traumatic amnesia
19
Q

Describe the neuropathology of temporal lobe epilepsy

A
  • The hippocampus (in the temporal lobe) is quite epileptogenic
  • Hippocampa sclerosis is a leading cause of complex seizures (gliosis and scar tissue)
  • Hippocampal resection is a very successful treatment for seizures with little to no cognitive and memory defects, this is because the sclerosed hippocampus is unlikely to be functionally properly)
20
Q

Describe transient global amnesia

A
  • These are transient, but striking anterograde amnesia
  • Precipitating events include: sexual intercourse, immersion in cold water, emotional stress
  • No disruption to ‘self-identity’
  • Underlying cause remains unknown – possibilities include vascular, migraine, epileptic event, drug effects.
21
Q

Describe post-traumatic amnesia

A
  • Often occurs after a major non-penetrating head trauma as a result of acceleration/deceleration forces.
  • It is a profound inability to remember new events and is linked to a range of behacioural side effects like aggregion, agitation and sleep disturbances
  • Concussions are small movements
  • Can last up to several months
22
Q

Describe Alzheimer’s Disease

A
  • The most common cause of dementia
  • Age is a major risk factor
  • Slow insidious onset
  • Memory is not the only thing to be impacted
  • No treatments
23
Q

What is a mild cognitive impairment (MCI)?

A

It is a subclinical impairment that involves a number of criteria:

  • Self reported (subjective) memory complaint lasting 6-12 months
  • Mild objective memory impairment
  • Unaffected general cognitive function
  • Normal capacity to perform ADLs
24
Q

How is mild cognitive impairment related to Alzheimer’s Disease?

A

It may be a transitional phase between normal aging and dementia

People with questionable dementia (MCI) may have higher risks of developing Alzheimer’s

25
Q

What is the risk of developing Alzheimer’s Disease for patients who are diagnosed with MCI?

A

10-15% of those people will develop Alzheimer’s disease per year

26
Q

What is the Braak and Braak staging of Alzheimer’s Disease?

A

Stage

Neurofibrillary change in:

Symptoms

I-II

transentorhinal

“asymptomatic”

III-IV

limbic system (entorhinal cortex)

“incipient”

V-VI

neocortical association cortex

“fully developed AD”

27
Q

Describe the impact of Alzheimer’s disease on language

A

People with AD often get associated deficits as it moves out of the limbic system to surronding areas.

They get prominant dysnomia (inability to name things)

  • Fluent, empty language
  • Paraphasic errors
  • Missing key information and words

A Wernike’s Area like aphasia