Neurocognitive Disorders (Tut 503 & PB)

Question 1

Define neurocognitive disorders NCD

Answer 1

A disorder that occurs when brain dysfunction affects thinking processes memory consciousness or perception.

Question 2

Define brain pathology

Answer 2

A dysfunction or disease of the brain

Question 3

What is major NCD

Answer 3

Condition involving significant decline in independent living skills and one or more areas of cognitive functioning

Decline occurs in
+One or more areas of cognitive functioning involving attention and focus, decision making and judgement, language,learning and memory, visual perception or social understanding.
+ The ability to independently meet the demands of daily living

Dementia: condition with symptoms involving deterioration in cognition and independent functioning.

Question 4

What is mild NCD

Answer 4

Condition involving a modest decline in at least one major cognitive area.

Question 5

What is delirium

Answer 5

Is an acute state of confusion involving diminished awareness disorientation and impaired attentional skills.

Question 6

What is neurodegeneration

Answer 6

Declining brain functioning due to progressive loss of brain structure neurochemical abnormalities or death of neurons.

Question 7

What is a medically induced coma

Answer 7

A deliberate induced state of deep sedation that allows the brain to rest and heal

Question 8

Define traumatic brain injury

Answer 8

A physiological wound or internal injury of the brain

Question 9

Discuss concussion

Answer 9

Trauma induced changes in brain functioning commonly caused by a blow to the head which affects functioning of neurons and cause disorientation or loss of consciousness.

Symptoms include

• Headache
• Dizziness
• Nausea
• Impaired co ordination
• Sensitivity to light

Question 10

What is a cerebral contusion

Answer 10

Bruising of the brain resulting from a blow that causes the brain to forcefully strike the skull

Question 11

What is a cerebral laceration

Answer 11

Open head injury in which brain tissue is torn pierced or ruptured

Question 12

What is chronic traumatic encephalopathy CTE

Answer 12

A progressive degenerative condition involving brain damage resulting from multiple episodes of head trauma.

Stage 1 headache and loss of attention and concentration

Stage 2 depression explosive outburst and short term memory loss

Stage 3 cognitive impairment including difficulties with planning and impulse control

Stage 4 dementia word finding difficulties and aggression

Question 13

Discuss vascular NCD

Answer 13

A condition involving decline in cognitive skills due to reduced blood flow to brain.

Symptoms include

• Complex attention
• Info processing
• Planning
• Problem solving
• Change in motivation
• Personality and mood changes

Can be caused by cardiovascular which pertains to heart and blood vessels. events

Atherosclerosis which is the clogging of arteries resulting from build up of plaque which is a sticky material that builds up on the walls of veins or arteries.

Question 14

Discuss the risk and types of strokes

Answer 14

A stroke is a sudden stop of blood flow to a portion of the brain leading to brain damage.

Hemorrhagic stroke: a stroke involving leakage of blood into brain

Ischemic stroke: a stroke due to reduced blood supply caused by a clot or severe narrowing of the arteries supplying blood to brain

Transient ischemic stroke: a minor stroke resulting from temporary blockage of arteries.

Symptoms include
#numbness or weakness and drooping of  facial features
#confusion or difficulty understanding questions
#slurred or incoherent speech
#vision difficulty in one or both eyes 
#sudden dizziness loss of balance difficult coordination
#severe headache

Question 15

What is Alzheimer’s disease

Answer 15

Dementia involving memory loss and other decline in cognitive and adaptive functioning.

Early symptoms include
$memory dysfunction
$irritability 
$cognitive impairment
$social withdrawal
$depression 
$apathy
$delusions 
$impulsivity

Neurofibrillary tangles: twisted fibres of tau protein found inside the nerve cells of individuals with Alzheimer’s disease.

Beta amyloid plaques: clumps of beta amyloid protein found in the space between neurons in individuals with Alzheimer’s disease.

Question 16

Discuss NCD due to dementia with Lewy bodies

Answer 16

DLB is dementia involving visual hallucinations cognitive fluctuations and atypical movement.

Characteristics are
A. Significant fluctuations in attention and alertness
B. Recurrent detailed visual hallucinations
C. Impaired mobility that occurs after onset of cognitive decline
D. Sleep disturbance including acting out dreams

Depression

Question 17

Explain NCD due to Frontotemporal lobar degeneration

Answer 17

FTLD is dementia involving degeneration in the frontal and temporal lobe of brain causing declines in language and behaviour.

Symptoms include
&Significant changes in behaviour, personality and Social skills
& Progressive difficulty with fluent speech or word meaning. Muscle weakness or other motoric abnormalities are present

Question 18

NCD due to Parkinson disease is

Answer 18

A progressive disorder characterized by poorly controlled motor movement sometimes following cognitive decline

Symptoms include
\+Tremors of hands arms legs jaw or face.
\+Rigidity of limbs and trunk 
\+ Slowness in initiating movements
\+Drooping posture or impaired balance and coordination.
- personality and mood changes
- apathy 
- depression or anxiety
- hallucinations and delusions

Question 19

Comment on NCD due to Huntington disease

Answer 19

HD is a genetic disease characterized by involuntary twitching movement and eventual dementia.

Question 20

Comment on NCD associated with HIV

Answer 20

Symptoms include
. slower mental processing
. difficulty with complex mental tasks
. difficulty concentrating or learning new info

AIDS dementia complex ADC is made for serious cases.

Question 21

What are the treatment options for NCD

Answer 21

Rehabilitation services

Biological intervention

Cognitive and behavioural treatment

Lifestyle changes

Environmental support

Question 22

Define the following definitions

Answer 22

Abulia: loss or impairment of the ability to make decisions or act independently..

Agnosia: an impairment of ability to recognise or identify familiar objects entities or people usually as a result of a neurological deficit or disorder despite an intact sensory system

Angiopathy: any of several diseases of the blood or lymph vessels

Anticholinergic: an agent that is antagonistic to the action of parasympathetic or other cholinergic nerve fibres.

Aphasia: an impairment of Expression or comprehension of language caused by injury or disease in the language Centre for the brain

Apraxia: a loss or diminution in ability caused by neurological impairment to perform purposeful movement or gesture on request despite an intact motor system

Corticobasal degeneration: a rare progressive disease involving both cerebral cortex and extra pyramidal structures clinically manifest as disturbance of voluntary movement and rigidity pathologic characteristic include degeneration of cerebral cortex with balloon neurons and degeneration of substantia nigra apraxia cortical sensory loss myoclonus and Phantom limb syndrome have been reported.

Delirium: a state of excitement and mental confusion accompanied by hallucinations caused by high fever poisoning brain injury.

Dysphagia: difficulty in swallowing caused by an obstruction or spasm of the eosophagus.

Executive functioning: higher order brain functions such as planning towards a goal sequences intellectual flexibility abstract thinking and making inferences.

Question 23

Give the meaning of the following

Answer 23

Gnosis: ability of the brain to recognise previously learnt information collected from our senses

Hyperorality: a condition characterized by insertion of inappropriate objects in the mouth

Hyperphagia: pathologically insatiable hunger

Homocysteine: an amino acid used by the body in cellular metabolism and the manufacturing of proteins. High concentrations in blood are thought to increase risk for heart disease by damaging the lining of blood vessels and enhance blood clotting

Incontinence: inability or failure to restrain sexual appetite and inability of body to control evacuative functions

Ischemic: a decrease in the blood supply to a bodily organ tissue or part caused by constriction or obstruction of blood vessels.

Lewy bodies: abnormal proteins that occurs on the nerve cells of the cerebral cortex and basal ganglia causing PD and dementia

Myoclonus: irregular involuntary contraction of muscle usually resulting from functional disorder of controlling motor neurons

Perseveration: uncontrollable repetition of a certain response like word phrase or gesture despite the absence or cessation of a stimulus caused by brain injury or other organic disorder.n

Polymorphism: the occurance of something in different forms

Praxis: neurological process by which cognition directs Motor action

Supranuclear palsy: progressive supranuclear palsy is a rare disease that gradually destroys nerve cells in the parts of the brain that control eye movements breathing and muscle coordination. The loss of nerve cells causes palsy or paralysis that slowly gets worse as the disease progresses.

Theory of mind: ability to interpret one’s own and others mental and emotional states understand that each person has unique motives perception.

Question 24

What are the 6 cognitive domains used to diagnose NCD

Answer 24

Complex attention: sustained selective and divided attention and processing speed.

major NCD is difficulty in environment with multiple stimuli easily distracted. Unable to attend unless input is restricted. Difficulty holding and recalling new info unable to perform mental calculation where thinking takes longer than usual and components need to be simplified

Mild NCD is normal tasks take longer errors are found in routine tasks and work needs supervision.

Executive functioning: planning decision making working memory response to feedback or error correction overriding habits or inhibition mental flexibility

major-abandons complex projects needs to focus on one task at a time relies on others to plan important activities of daily living

Mild-increased effort required to complete multitasking project extra effort required therefore is increased fatigue due to extra effort.

Learning and memory: immediate memory span and recent and long term memory

major-constant repetition needs reminding and is unable to keep tract of daily things

Mild- difficulty recalling recent events relies on notes and calendar needs reminding to keep track of visual entertainment constant repetition and track of paying bills.

Language: expressive language grammar and syntax and receptive language

Major- difficulty with expressive or receptive language. Uses general phrase and pronouns rather than names grammatical errors and spontaneity of output

Mild- word finding difficulties

Perceptual motor: visual perception visuo constructional perceptual motor Praxis and gnosis

Major- difficulty with previous familiar activity

Mild- relies on maps for directions more followers others and uses notes.

Social cognition: recognition of emotions and theory of the mind

Major- behaviour is our of acceptable social range insensitivity to social standard of modesty

Mild- subtle changes in behaviour or attitude