Neurocognitive Disorders & White Matter Disease Flashcards
Are neurocognitive disorders (NCDs) developmental or acquired?
Acquired
- Significant cognitive decline
- Interfere with independence
- Not due to delirium
- Not due to other mental disorder
Major NCD
- Moderate cognitive decline
- Does not interfere with the independence
- Not due to deliurium
- Not due to other mental disorders
Minor NCD
What cognitive domains are specified by DSM-5 to be affected in NCD. (6)
- Complex attenuation
- Executive function
- Learning and memory
- Language
- Perceptual-motor
- Social cognition
How does delirium differ from other NCDs?
- Rapid onset (hours to days)
- Linked to medical condition, substance use, withdrawal, medications, etc
- May be acute (hours to days) or persistent (weeks to months)
What are the criteria for a diagnosis of delirium? (6)
- Rapid onset of impaired attention
- Rapid onset of lack of awareness of environment
- Change in at least one cognitive domain (memory, orientation, language, perception)
- Changes in sleep/wake cycle
- Changes in emotional state
- Worsening of behavioral problems in the evening
What are the symptoms of NCD due to Lewy Body Disease (LBD).
- Fluctuating cognition/attention/alertness
- Visual hallucinations (well-formed and detailed)
- Parkinsonian movement ~1 year after cognitive impairment
Is onset of NCD due to LBD prolonged or rapid?
Prolonged
Is onset of NCD due to AD prolonged or rapid?
Prolonged onset and gradual progression
What are the criteria for probable AD?
- Evidence of AD genetic mutation, or…
- All of the following:
- Impairment in memory +1 other domain
- Progressive gradual decline
- No other possible etiology
What is dysmyelination?
- Inability to complete the myelination or formation of abnormal dysfunctional white matter
- Early manifestation in developmental window
What is demyelination?
- Destruction of an already formed myelin sheath
- Caused by complex etiological agents that are toxic to microenvironment
Is myelination a prenatal or postnatal process?
Postnatal
Over what time period is the most intensive myelination in humans?
0-2 years
What are leukodystrophies?
- Group of genetic disorders affecting enzymes of lipid metabolism, which leads to white matter diseases
- Typically affect peroxisomes, lysosomes, and mitochondria