Lecture 17+18+DLA

Question 1

role of the right hemisphere

Answer 1

communicative and emotional prosody
(stress, timing, intonation)

pragmatics of language

Question 2

right anterior damage (right hemi)

Answer 2

wrong intonation

Question 3

right posterior damage (right hemi)

Answer 3

difficulty in interpretation

Question 4

damage to the right hemi?

Answer 4

pragmatics of language:

difficulty in construction of sentences into a story

difficulty in understanding jokes, sarcasm

Question 5

Broca’s aphasia

Answer 5

damage to inferior frontal cortex

comprehension of language is normal (spoken and written)

speech content is telegraphic, agrammical
repetition of speech is abnormal
pronunciation of speech is effortful, stuttering, dysarthria

Question 6

Wernicke’s aphasia

Answer 6

Damage to posterior sector of left auditory association cortex (posterior superior temporal gyrus)

speech rhythm is normal
speech content is abnormal (use of wrong words)
repetition is speech is abnormal
comprehension is very abnormal

can speak fluently, but does not understand what is being said

Question 7

Gerstmann Syndrome

Answer 7

damage to the angular gyrus

will have left/right confusion, acalculia, finger agnosia, reading issues

Question 8

Conduction Aphasia

Answer 8

Damage to the arcuate fasciculus

pronunciation of speech is normal
comprehension is usually normal

repetition is speech is abnormal

Question 9

Transcortical Sensory Aphasia

Answer 9

Damage to occipito-temporal-parietal watershed
zone between posterior and middle cerebral artery territories

writing, naming, comprehension of written and spoke is abnormal

speech rhythm is normal

Question 10

Transcortical Motor Aphasia

Answer 10

Damage to frontal watershed zone between middle and anterior cerebral artery territories

pronunciation speech rhythm is non-fluent
writing and naming are abnormal
written speech is normal

Question 11

alexia

Answer 11

the inability to read

Alexia results from disruptions in transfer of visual
information to the areas of the left hemisphere

damage to the splenium (posterior part of CC)

Question 12

Vascular Dementia

Answer 12

dementia that is due to multiple infarcts caused by cerebral vascular disease

typical patient will have the risk factors for CVD such as hypertension

onset is sudden with a stepwise progression

treatment is preventing further infarcts by treating CVD

Question 13

Frontotemporal Dementia (FTD) or picks disease

Answer 13

earlier onset (40/50) 
will have emotional disinhibition and personality change 

hypometabolism and lobar atrophy of prefrontal and temporal cortices

will have pick bodies when looking at histology

Question 14

Lewy Body Dementia (LBD)

Answer 14

will have fluctuating cognition/alertness
visual hallucination
mild parkinsonism

will see Lewy bodies in histology

will have a REM sleep disorder eventually

Question 15

LBD treatments

Answer 15

will use cholinesterase inhibitors these drugs might improve symptoms

do not use antipsychotics or L-dopa.. make symptoms much worse

Question 16

Parkinson’s Disease Dementia (PDD)

Answer 16

up to 1/2 of those with PD will get dementia

1 year rule
motor first and then dementia = PDD
dementia first then motor = LBD

Question 17

Prion Disease (e.g., Creutzfeldt-Jakob)

Answer 17

dementia progresses rapidly
death within two years

brain will look spongy… spongiform degeneration

Question 18

Benign Senescent Forgetfulness

Answer 18

normal cognitive decline that occurs with aging

Question 19

Mild Cognitive Impairment (MCI)

Answer 19

Cognitive decline beyond the normal aging process but that does not cause impairment in activities of daily living

Patients with MCI are at increased risk for developing a dementia

Question 20

Pseudodementia

Answer 20

due to a psychiatric disorder like depression