Neurodegeneration 2 Flashcards
giggles
Glial produce inflammatory cytokines that activate…
astrocytes and death receptors on neurons
Mitochondrial uncoupling causes
increased MNDA sensitivity
Central Integrative State (CIS) increases because
sitting in a pool of glutamate
neurologic failure as a result of this?
stoke essentially with no imaging
serotonin issue
triptins work great and help stimulate serotonin receptors
why shouldn’t you piss off astrocytes?
they make and uptake glutamate
and regulate extracellular potassium
Increased extracellular potassium can _____ and_____ activity
depolarize cells
epileptform
increases ____ can activate microglial cells and lead to degeneration due to firing greater than metabolic rate
K
glycosylated end products
what does it mean if they are elevated for a prolonged period of time
homocysteine
A1C
they need to be reduced because the process of TND has already started
increased A1c=
bbb dysfunctions and microglial activity
increased homocysteine means
bbb dysfunctions and excitotoxicity
apigenin
luteolin
curcumin
modulate cytokines, NO, prostaglandin, lipopolysaccharide, mitosen protein degeneration
decreases activation of death receptors
rutin
good for brain
catechin
good for brain
alzheimers factors to consider
optimize methylation modulate stress control diabetes/blood glucose levels prostaglandin balance antioxidants for inflammation control associated lymphoid tissue optimize control TB cell activity Control/optimize NT levels
methylation
BBB
small vessel damage
energy landed excitotoxins
homocysteine
patient comes in with depression
1.energy
2.bbb
3.inflammation
4. activate
5. decrease excitotoxins
allergens/immune
NT pprecursors
drugs
Challenges
exotic
mito
inflammatory
allergens
Tau diseases
fronto temporal dementia
progressive super nuclear palsy
cortico bacilar degeneration
Trinuclear disorders
huntington
spinocerebellar ataxia
alpha synuclein disorders
Dementia
Parkinsons
protein folding
multisystem
amyloid and tau pathology
alzheimers
ALS is a ____ _____ disease
ventral horn
how do you manage ALS?
high doses of antioxidants and neuroprotective stuff B/C ALS is massive, unregulated free radical damage
ALS in upper extremity
characteristics of upper motor neuron lesion
- fasiculations
- atrophy, hands and move proximal
- decreases reflexes un upper extremities
ALS in lower extremity
characteristics of lower motor neuron lesion
- hyperreflexia
- pathological reflexes
- clonus
ALS has no ____ or ____ changes
visual or sensory
How is MS typical managed?
down regulate immune system that doesn’t like myelin anymore
first sign of MS
optic findings “pain behind eye, hurts when moved”
lose central vision in MS
scotomas
typical neurologic patter of MS
none since multiple areas can be demylinating
Causes of Big pupils
oculomotor lesion
lesion to sympathetic chain
internuclear ophthalmoplegia
Internuclear opthalmoplegia
double vision (side by side, not stacked or vertical)
MS every single time
aDduction bad
can still converge
lesion to sympathetic chain
smaller on opposite side
Occulomotor lesion
deviation and pupillary change
lid change
will increase by 4x before 2050
alzheimers
first signs of alzheimers
memory deficit
aphasia: loss in purposeful speaking
apraxia slow performance: speaking/moving
Agnosia: can’t recognize things
Aphasia receptive vs expressive
spot localization ok=expressive
first sign of dementia
loss of smell because deposits occur in olfactory nerve first
extra pyramidal signs:tremors
first signs of front temporal demise
hyperoral
disinhibition
no tremor
common triggers of neurodegeneration (DX is final condition but not cause)
Neuro inflammation of bowel
HPA axis
Mesencephalon firing in inflammatory situation
Neuroinflammation in bowel
damages enteric NS and decreases function
GALT activation increase inflammatory cytokines and causes energy linked excitotoxicity
Altered GI functions will up regulate HPA axis and oxidative stress from this decreases pituitary function and immune system weakening
decreases serotonin and dopamine
_____ ganglia in the gut degenerate prior to dopaminergic ones in enteric NS in ______
autonomic
Parkinsons
HPA axis
cortisol destroys hippocampus
decreases enzymes to make T3 from T4
unregulates IML
increases catecholamines
destruction of hippocampus=
short term memory bad and depression
increases in catecholamine due to HPA axis does what?
depolarizes C fibers and increases substance P (inflames nerves)
what can cause the mesencephalon to spontaneously fire?
pro inflammatory situation
RAS does what?
fires up to the cortes and doesn’t let it shut down. Increases anxiety. (happens when mesencephalon spontaneously fires)
signs of dementia
saccadic abnormality optic abnormality memory loss loss in speech and affect executive function loss mood swings difficulty learning loss in smell
eye symptoms of dementia
lose vertical saccades and eye movements
horizontal eye movements
pons
vertical eye movements
frontal
