neurocognitive disorders

Question 1

what are NCDs?

Answer 1

insult to neural sites from disease, physical trauma, genetic predisposition that give rise to loss of cognition/funtion

Question 2

what are some of the common causes of NCDs?

Answer 2

Alzheimer’s, Parkinson’s, stroke, closed brain injury

Question 3

NCDs include disorders in which the primary deficit is in _________

Answer 3

cognitive function

Question 4

are NCDs acquired or developed?

Answer 4

acquired

Question 5

NCDs represent a _____ from previous level of function

Answer 5

decline

Question 6

why has the name in the DSM-5 changed for NCDs?

Answer 6

to allow the intro of mild neurocognitive disorders into diagnostic criteria, moving towards NCDs being on a spectrum

Question 7

what are the changes of the DSM for major NCDs?

Answer 7

memory impairment no longer essential for diagnosis, impairment in only 1 cognitive domain is sufficient for diagnosis

Question 8

why is it important that cognitive impairments that don’t reach the threshold for dementia are now classified as mild NCDs?

Answer 8

patients still have symptoms that interfere with everyday life and experience a problem they need help with. new criteria allows them to receive appropriate support to function > relieves stress

Question 9

why with an increasing pop is it important the DSM criteria has changed?

Answer 9

increasing ageing population means increased demand for expertise in dementia, clear need for early diagnosis, mild NCDs provides earlier treatment

Question 10

_______ is the leading cause of death in the UK

Answer 10

dementia

Question 11

what are the benefits of an early diagnosis of NCDs?

Answer 11

people with mild NCDs often progress to display major NCDs, early intervention and close symptom monitoring, neuropathology emerges before onset of symptoms

Question 12

why are NCDs on the rise in young and old people?

Answer 12

increasing brain injuries from more extreme sports/wars, more sophisticated medical treatments so more people surviving brain trauma resulting in developing NCDs later on, increasing cumulative effects from repeated brain injuries

Question 13

what are NCDs typically a result of?

Answer 13

neural insult or CNS dysfunction

Question 14

inability to learn new info and recall past and recent events =

Answer 14

amnesia

Question 15

specific traumatic head injuries often result in _________ amnesia

Answer 15

anterograde

Question 16

what parts of the brain result in anterograde amnesia?

Answer 16

hippocampus or temporal lobe injury

Question 17

what type of deficits provide the earliest indication of onset of degenerative NCDs?

Answer 17

attention and arousal deficits

Question 18

what are the symptoms of attention and arousal deficits?

Answer 18

lack of attention, increased distractibility, performance of well learnt activity slowed, difficulty focusing on conversation

Question 19

what brain regions are implicated with attention and arousal deficits?

Answer 19

frontal and parietal

Question 20

aphasia =

Answer 20

language deficits (difficult producing/comprehending speech)

Question 21

difficulty initiating speech or producing complex words, not coherent, poor word retrieval, non-fluent speech = what type of aphasia?

Answer 21

Broca’s

Question 22

production of incoherent jumbled speech, rate and fluency maintained but meaningless speech, unaware of impairment = what type of aphasia?

Answer 22

Wernicke’s

Question 23

difficulty repeating speech = what type of aphasia?

Answer 23

conduction

Question 24

anomia =

Answer 24

poor word retrieval

Question 25

inability to process sensory info due to neural insult e.g. may be unable to recognise objects/people =

Answer 25

visa-pereptual functioning > agnosia

Question 26

prosopagnosia =

Answer 26

face agnosia

Question 27

amusia =

Answer 27

music agnosia

Question 28

akinetopsia =

Answer 28

movement agnosia

Question 29

loss of familiarity of known faces, struggle to identify family/friends, face processing problems = what type of agnosia?

Answer 29

prospopagnosia

Question 30

what will patients with prosopagnosia still show an understanding of?

Answer 30

face components (can name facial features)

Question 31

is pure prosopagnosia rare or common?

Answer 31

rare

Question 32

loss of fluid motion perception, stroboscopic vision, very debilitating, static objects visual acquity is preserved = what type of agnosia?

Answer 32

akinetopsia

Question 33

what is an example of a motor deficit?

Answer 33

apraxia

Question 34

loss of ability to carry out learnt movements despite the desire and physical ability to do so =

Answer 34

apraxia

Question 35

what is apraxia typically caused by?

Answer 35

lesion or degeneration of posterior or parietal lobe

Question 36

inability to perform gestures or interact with objects using limbs = what type of apraxia?

Answer 36

limb apraxia

Question 37

deficit in planning and sequencing the required movements to produce sounds in speech =

Answer 37

speech apraxia

Question 38

executive function deficits include...

Answer 38

WM, problem solving, goal directed behaviour, attentional control, inhibitory control, planning and monitor complex behaviour

Question 39

how are executive function deficits often expressed?

Answer 39

poor judgement, inappropriate behaviour, erratic mood swings

Question 40

why is it necessary to identify specific causes of NCDs?

Answer 40

determine nature and location of neural insult, provide details about symptoms and progression, discriminate between neurological and psychiatric symptoms, identify focus for rehab programmes

Question 41

what are the different methods of diagnosis

Answer 41

brain scans (EEG, PET, fMRI), biomarker assessments (CSF, blood), behavioural info, historical context

Question 42

what does the WAIS-IV assessment provide info on?

Answer 42

source deficits, info on developmental stage that deficits emerge

Question 43

describe the Trail Making task used to assess NCDs

Answer 43

quicker and more specific than WAIS-IV, patients have to connect circles by alternating between letters and number (A>1>B>2>C>3 etc)

Question 44

how long does the trail making task take?

Answer 44

5-10 mins

Question 45

what does the trail making task allow the evaluation of?

Answer 45

processing speed, visual scanning, integration of vasomotor functions, letter-number sequencing

Question 46

what are the difficulties associated with diagnosing NCDs?

Answer 46

overlap in symptoms of different neurological disorders, emergence of psychological problems when decline affects everyday life

Question 47

what is a common risk factor for NCDs?

Answer 47

age

Question 48

reflect substantial cognitive impairment, correspond to disorders previously categorised as dementias = major or mild?

Answer 48

major

Question 49

reflect more moderate impairments = major or mild?

Answer 49

mild

Question 50

distinction between mild and major NCD =

Answer 50

extent of deterioration, interference with everyday activities

Question 51

what is the role of a psychologist in rehabilitation?

Answer 51

restoring previously affective cognitive and behavioural functions, develop new skills, provide therapy for comorbid disorders, skills to help structure living environment

Question 52

what are some of the problems with cognitive interventions?

Answer 52

limited long term efficacy, adverse side effects, surgical = risky and invasive, tractable causes often needed

Question 53

with visuo-perceptual deficit interventions, they often rely on compensatory strategies as recovery is rare. what would these include?

Answer 53

if can't focus on face recognition then focus on voice, body shape, gait to assist recognition

Question 54

what do patients with aphasia often develop for their lack of coherent speech?

Answer 54

compensatory behaviours e.g. increased gesturing/pointing

Question 55

what does CIMT intervention aim to do?

Answer 55

improve speech by mass practice of verbal responses only > unable to gesture or point (effective but difficult and frustrating for some patients)

Question 56

why is group communication treatment different from CIMT?

Answer 56

allows communication and info exchange through any possible route e.g. miming, pointing, gestures, noise > not limited to speech