Neurodegenerative Diseases (Neuropath CPC2)

Question 1

lesions and components of Alzheimer’s disease

Answer 1

senile plaques and neurofibrillary tangles

amyloid b and tau

Question 2

ALS lesions and components

Answer 2

cytoplasmic inclusions and spheroids

ubiquitin/TDP-43 and neurofilaments

Question 3

lesions and components of Parkinson’s Dz Dementia with Lewy Bodies

Answer 3

Lewy bodies

alpha-synuclein

Question 4

lesions and components of tauopathies

Answer 4

neuronal and glial tangles

tau

Question 5

frontotemporal dementia lesions and components

Answer 5

cytoplasmic and nuclear inclusions

ubiquitin/TDP-43

Question 6

multiple systems atrophy lesions and components

Answer 6

glial cytoplasmic inclusions

alpha-synclein

Question 7

prion disease lesions and components

Answer 7

spongiform degeneration & prion plaques

prion protein

Question 8

short term memory

Answer 8

1. Ability to retain and manipulate information for short periods of time (seconds to minutes)
2. Dependent on attentional processes, processing speed
3. Impaired with lesions of the frontal lobes, but also with diffuse brain disease
4. Impairments lead to inefficient initial acquisition of information

Question 9

long term memory

Answer 9

1. Ability to retain information after delay or distraction (days to months)
2. Benefits from rehearsal (e.g. studying for a test)

Question 10

what does LT memory rely on? what happens if impaired?

Answer 10

3. Depends on mesial temporal lobe function
4. Impairments lead to anterograde amnesia
   a. Failure to recall newly learned information, starting at the time of brain injury
   b. Preservation of previously learned information
   c. Most common form of memory impairment

Question 11

what kind of lesion impairs ST memory?

Answer 11

frontal lobes and diffuse brain disease

Question 12

remote memory

Answer 12

1. Ability to retain well-learned information from the remote past (years)
2. Information thought to be represented more diffusely in the cortex
   a. Therefore relatively preserved after mesial temporal lobe injury
   b. Patients with dementia often remember earlier life reasonably well
3. Well preserved in most clinical settings

Question 13

when do you see impairment of remote memory?

Answer 13

Deficits in recollection of well-learned information comprise retrograde amnesia and can be seen in more severe stages of dementia

Question 14

what part of brain is responsible for explicit memory?

Answer 14

medial temporal lobe

Question 15

what part of brain is responsible for implicit memory?

Answer 15

neural structures outside of medial temporal lobe

Question 16

what are hemispheric differences?

Answer 16

i. Left hemisphere: Tends to have larger role in verbal memory
ii. Right hemisphere: Tends to have larger role in visuospatial memory

Question 17

what is diagnostic criteria for dementia?

Answer 17

Diagnostic criteria (DSM-IV) entail impairment of memory and at least one of the following:

i. Disturbances of language (word-finding difficulties)
ii. Disturbances of praxis (inability to execute skilled motor activities in the absence of weakness)
iii. Disturbances of visual processing (visual agnosia and constructional disturbances)
iv. Disturbances of executive function (including abstract reasoning and concentration)

Question 18

what is dementia?

Answer 18

The gradual onset and continuing decline of cognitive function from a previously higher level, resulting in impairment in social or occupational function

Question 19

what are early symptoms of AD?

Answer 19

i. Deficits in delayed recall
ii. Language difficulties
iii. Visuospatial deficits
iv. Deficits in reasoning and related functional impairments
v. Alterations in Mood or Behavior

Question 20

what are treatable dementia syndromes?

Answer 20

a. Vitamin B12 deficiency
b. Neurosyphilis
c. Normal pressure hydrocephalus
d. Chronic subdural hematomas
e. Chronic meningitis
f. Paraneoplastic limbic encephalitis (can improve with identification and treatment of neoplasm)
g. “Pseudodementia” of depression

Question 21

what are features that make AD unlikely?

Answer 21

a. Sudden, apoplectic onset
b. Focal neurologic findings such as hemiparesis, sensory loss, visual field deficits, and incoordination early in the course of the illness
c. Seizures or gait disturbances at the onset or very early in the course of the illness