MMSE

Question 1

What brain regions do the orientation questions test?

Answer 1

Frontal Lobe: can the patient pay attention in this question? Can they reason through the date/day
of the week if it is not readily in their mind? How many times do I ask the patient this question and
then frantically try to recall the date? Ok, let’s see…yesterday was the 11th, so today is the 12th.
Frontal lobe to the rescue! Medial prefrontal is associated with orientation to person
• Temporal Lobe: does the patient remember the date, as in are they storing memory on a day to day
basis? The frontal lobe’s ability to reason that yesterday was the 11th so today must be the 12th is
only doable if you remember what the date was yesterday. Does the patient remember how they got
to the room they are speaking to you now in? This tests spatial memory

Question 2

What brain regions do naming three objects and recall at 3 minutes test?

Answer 2

Immediate recall (seconds): you have just asked a patient to repeat words. First, they must have an
intact Wernicke’s in Tempo/Parietal area in order to comprehend what you’ve just asked (think:
parietal=understand words). Second, the patient must be able to connect word comprehension with
mechanical reproduction of words. The Arcuate Fasciculus connects Wernicke’s (comprehend) to
Broca’s (say the words) in order to repeat words. Finally, Broca’s in the frontal lobe helps to produce
words (think: motor strip in frontal=make words)
• Delayed recall (2-3 minutes): requires hippocampus to convert immediate memory to long term
memory and medial temporal lobe to actually store memory

Question 3

What brain regions does attention questions like spelling WORLD backwards test?

Answer 3

Prefrontal: can the patient concentrate while doing an unfamiliar task?
• Frontal Dorsolateral: working memory. Can the patient recall what letters were already used, and
which one comes next?
• Inferior Parietal: spelling, language, syntax
• Temporal: storage of how to spell anything

Question 4

What brain regions does attention questions like Serial 7s test?

Answer 4

• Prefrontal: can the patient concentrate on a difficult task, filtering out distractions?
• Frontal Dorsolateral: working memory. Can the patient recall what numbers have been used and
which ones come next?
• Left Parietal: understanding of numbers, math, and calculation
• Temporal: storage of what numbers are and how they relate to each other

Question 5

What brain regions does naming three objects test?

Answer 5

Naming: Show the patient 3 objects “Can you name this object?”
• Left Parietal: language, grammar
• Left Temporal: storage of learned names

Question 6

What brain regions does repetition (Repeat “No ifs, ands, or buts”) test?

Answer 6

Repetition: “Repeat no ifs, ands, or buts”

• Immediate Recall, involves Wernicke -> Arcuate -> Broca

Question 7

What brain regions does reading comprehension (“Close your eyes”) test?

Answer 7

Reading Comprehension: “Close your eyes”
• Occipital: ability to read/see the words
• Left parietal: word recognition, grammar so that the words make sense and are a command
• Temporal: storage of words learned previously

Question 8

What brain regions does writing test?

Answer 8

Writing: “Write a sentence”
• Occipital: ability to read/see what is written
• Frontal: attention, motor cortex coordinates movement
• Left parietal: words, grammar, syntax
• Basal ganglia: fine motor coordination. Is there a tremor?

Question 9

What brain regions does copying a figure test?

Answer 9

Design Copy: “Copy this design”
• Frontal: attention, planning. Motor coordination
• Right parietal: construct, gestalt. Damage leads to hemineglect