Neurocognitive Disorders 2

Question 1

What is amnesia?

Answer 1

A significant memory impairment

• is an acquired deficit
• does not occur in the context of a decline in other cognitive areas as in a dementia
• Is caused by a medical condition or effect of a substance

Question 2

What are the memory systems?

Answer 2

1. Short term memory (STM)
   on-line working memory
   Brief duration (approx. 30 sec)
   Small capacity( 7 and 2 times more or less)
2. Long-term memory (LTM)
   Memory beyond STM
   -duvided into “recent” vs “remote’ LTMz
3. Encoding amid consolidation: the process of turning STM into LTM (I.e., learning new info)

Question 3

Where is memory stored?

Answer 3

Memory is stored in multiple brain regions

• recalling pictures= right pre-frontal cortex
• recalling words - left prefrontal cortex
• LTM - storage occurs in the cortex

-Consolidation of memory (STM converted you LTM-occurs in the hippocampus BUT the hippocampus does not store LTM)

Question 4

What are the types of amnesia?

Answer 4

Retrograde

Anterograde

Question 5

What is retrograde amnesia?

Answer 5

Loss of memories for events prior to damage

• refers to difficulty remembering events (declarative memory ) that occurred prior to injury
• The duration of amnesia varies but can extend back for several years
• information is forgotten in a temporal gradient

Question 6

What is aryerograde memory?

Answer 6

Loss of ability to store new memories of events after damage

- refers to problems learning new facts
    - specific to episodic memories
    - procedural memories intact
    - implicit memory performance normal

Famous case: H.M.

Question 7

What is the typical profile of amnestics?

Answer 7

-intact(working) STM

• Some impairment in retrieval of LTM
  
  • refferred to as a retrograde amnesia
  -A temporal gradient is often seen with recent LTMs impaired relative to remote LTMs
• Prominent impairment in encoding and consolidation
  
  • Reffered to as an anterograde amnesia

Question 8

Describe the course of amnesia

Answer 8

Depending on the cause of the amnesia, onset can be sudden of gradual with short of long duration

The patient often fills in memory gaps by unconsciously making up information (c”confabulation “)

Question 9

What are the ma8n causes of amnesia?

Answer 9

1. Direct damage to hippocampus- H.M.

2. Indirect damage to hippocampus -kersakoff’s syndrome

Question 10

What caused amnesia to the famous patient H.M.?

Answer 10

Direct damage to hippocampus

H.M. had a bilateral temporal lobectomy(removing most of both hippocampi) for seizure control

-A profound anterograde amnesia resulted with other functions (e.g., language) largely intact. He did show some ability to learn procedural tasks without conscious recollection

Question 11

How can indirect damage to the hippocampus cause amnesia? How can this be treated?

Answer 11

Korsakoof’s syndrome

Results from chronic alcoholism and consequent thiamine deficiency

Due to thiamine (vitamin B1) deficiency, brain damage occurs to inputs to the hippocampus, leading to an amnesia

Treatment: thiamine (doesn’t reverse damage but helps stop progression).

Question 12

What is the best treatment of amnesia?

Answer 12

1. Treat underlying cause
2. Cognitive rehabilitation
   a) restoration of function: memory exercises to strengthen memory systems through repeated practice

b) training in the use of mnemonic strategies as compensation:

 External strategies (non-mental strategies)
  Internal strategies (mental activities)

Question 13

What are the internal and external treatments of amnesia? Mnemonics pt. 1

Answer 13

External- lists, calendars, electronic schedulers

Internal
Rhyme: a saying that directly contains the information to be remembered without the need to decode.
-example: “I before E except after C” for spelling assistance

-Acrostjc: A phrase in which the first letter of each word is a cue to the information to be recalled . The phrase must be decoded to obtain the information

Example: “On old Olympus towering tips...” where each underlined letter stands for the first letter of as cranial nerve (e.g. O= olfactory, O= optic, O= Oculomotor, T = trochlear)

Question 14

Give an example of Mnemonics (pt. 2)

Answer 14

Acronym: a single word formed from the first letter of each of a series of words to be recalled
-example: “SIGECAPS” to remember symptoms of depression (S=sleep, I= interest loss, G= guilt, E= energy, C= concentration, A= apetite, P= psychomotor activity, S=suicide ideation)

Clustering= grouping of similar information
-example: to remember a shopping list, group the items according to category (fruits, tools, spices)

Imagery: visually picturing information in a meaningful way

Question 15

What is a lexeme?

Answer 15

A design of language

• a lexicon consists of lexemes
• run, runs, ran, running… Are forms of the same extreme

Question 16

What is morpheme ?

Answer 16

a design of language

• smallest language unit
• Un-believe -able …3 morphemes

Question 17

How fast do children learn new words?

Answer 17

Children learn a new word every 90 minutes

6 years- 13,000 words, end of high school - 60,000 words

Question 18

How do children learn words?

Answer 18

Don’t have to learn words, they only have to hear them

Question 19

What is grammar?

Answer 19

• System how vocabulary units can be combined into words, phrases and sentences
• How the meaning of a combination can be determined by the meaning of the units and by the way they are arranged
• number of meaningful sentences that can be produced is vast

Question 20

What is morphology?

Answer 20

The study of words

Combining word and affixes to larger words
(Adore-able…)

-nouns: person/event/place
(Lover)

-verbs: used to describe action, state, occurrence
(Loving)

Question 21

What is syntax?

Answer 21

Rules for continuing words into phrases and sentences that make sense and determining relations among words

Question 22

What is phonology?

Answer 22

Combining sounds into a consistent pattern in the language

-prosody pattern of intonation, grammatical role, indicating sarcasm, expressing emotion (right hemisphere)

Question 23

What is the process of sentence production?

Answer 23

Choose words —> grammatical rules to encode ideas and intentions (the message) —> generate a set of articulatory commands to the motor system

Question 24

How are sentences comprehended?

Answer 24

Coordination of the sensory information that comes the auditory system (or visual system) with grammar and lexicon and send information about the interpretation (the message) to the systems underlying memory and reasoning

Using language requires complex patterns of information flow, involving many parts of the brain

Question 25

How to examine Aphasia?

Answer 25

Comprehension

• spoken language
• written language

Naming

• visual confrontation naming
• auditory naming
• tactile naming

Repetition

Expressive speech
  -fluent/nom-fluent 
  -rhythm, prosody
  - content (paraphasias?)
  - articulation (dysarthria?)
Writing

Question 26

What to do to classify aphasia?

Answer 26

To classify aphasia, it is necessary to determine whether a patient is able to

• Understand spoken language, as evidence by accurate responses to spoken language and ability to follow spoken commands
• read aloud accurately and with comprehension
• consistently name common objects, presented visually, auditorily, or tactilely
• Accurately repeat spoken words, words and phrases
• Speak fluently with normal articulation and rhythm, without paraphrasic syntactical or grammatical errors or usage of curcumlocutory phrases
• write legibly and grammatically

Question 27

Contrast Broca’s aphasia and Wernicke’s aphasia

Answer 27

Broca’s aphasia- damage to inferior frontal cortex (frontal lobe)

Wernicke’s- damage to posterior sector of left auditory association cortex(temporal lobe)