Lecture 1

Question 1

The 6 neuro-cognitive domains (SAMPLE)

Answer 1

1. Social cognition
2. Attention (complex attention)
3. Memory and learning
4. Perceptual motor functions
5. Language
6. Executive functions

Question 2

Multiple Sclerosis (MS)

Answer 2

A chronic disorder of the CNS, which causes inflammation, demyelination and neurodegeneration in the brain. The different regions of demyelation in the brain cause many different symptoms (fatigue, eye sight loss, walking problems etc.).

Question 3

Relapse and remission phase in MS

Answer 3

In the relapse phase people start to show symptoms because of demyelization and in the remission phase myelin is build up again and symptoms mostly disappear.

Question 4

Prevalence and onset of MS

Answer 4

The age of onset is between 20 and 40 years old. MS mostly affects information processing speed and memory. A larger maximal lifetime brain volume protects against cognitive decline for a while. Having enriching experiences also protects for a while.

Question 5

Diagnosis of MS

Answer 5

1. Dissemination in time: at least 2 periods of relapses, seperated in time with clinical symptoms.
2. Dissemination in space: the relapse should have different types of symptoms and originate from different regions.

Question 6

Cognitive symptoms in MS (occurs in 43-65% of patients)

Answer 6

• Information processing speed and memory is most commonly affected.
• Heavy impact on daily life, work, social contacts etc.
• Related to atrophy of the cortex and damage to the thalamus and hippocampus (not so much to the white matter damage).

Question 7

Brain reserve hypothesis

Answer 7

The larger your maximal lifetime brain volume is, the better you are protected against cognitive decline.

! Doesn’t prevent the brain disease from happening, but it lowers the impact of the disease.

Question 8

Cognitive reserve hypothesis

Answer 8

Enriching experiences (education, exercise etc.) protect against cognitive decline.

! Doesn’t prevent the brain disease from happening, but it lowers the impact of the disease.

Question 9

Parkinson’s disease

Answer 9

Degeneration of dopaminergic cells (substantia nigra) and changes in noradrenergic, serotonergic and cholinergic systems. Symptoms are bradykinesia (slowness of movement) combined with one of the following:
- Rigidity
- Rest tremor
- Postural instability

Other symptoms can be:
- Fatigue
- Disturbed sense of smell
- Autonomic disorders
- Sleep disorders
- Neuropsychiatry
- Cognitive impairment

Onset: very subtle between 50 and 70

Question 10

Cognitive problems in Parkinsons disease

Answer 10

Around 24% of PD patients experience cognitive problems. Patients do have the information stored, but sometimes can’t get to it spontaneously. Most patients eventually develop major neurocognitive disorder (dementia). Often starts with executive impairments and later on problems wil memory and visual-spatial deficits.

Question 11

Treatment of Parkinson’s

Answer 11

There is only symptomatic treatment, this works for a while but then wears off. After this, deep brain stimulation can be administered to decrease the tremor. There is also a lot of paramedical and psychological help.

Question 12

Treatment of MS

Answer 12

There is no cure for MS, so treatment is only based on tempering the inflammation:
- Disease modifying treatment: to be able to live/work with the disease.
- Treatment for symptoms management: for pain, fatigue etc.
- Ocrelizumab, siponimod (medication) for progressive MS