neurodegenerative disorders

Question 1

dementia

Answer 1

non acute cognitive decline that interferes with everyday functioning
- multidimensional disorder affecting multiple areas
progressive

Question 2

general definitions of dementia

Answer 2

clinical severity
cognitive problems in: memory, language, visuospatial, executive, affective/personality
abscence of delerium

Question 3

cortical vs subcortical dementias

Answer 3

cortical: alzheimers
subcortical: parkinsons, huntingtons

Question 4

differential diagnosis

Answer 4

aging: learning, working memory, concentration gets overwhelmed easier
mci, focal lesions, delirium, depression, visual and auditory deficits, psychosis, static encephalopathy

Question 5

neuropsychological syndromatic patterns within dementia

Answer 5

anterograde amnesic disorder
frontotemporal dementia (FTD)
semantic disorder: anomia, receptive language
primary progressive aphasia: expressive language
posterior cerebral cortical atrophy
dementia with psychomotor slowing

Question 6

neurophysiology: neuronal tau protein abnormalities

Answer 6

intra: neurofibrillary tangles or granulovacuolar
extra: neuritic plaques
- affect metabolism of cell
- abnormal protein disturbances

Question 7

where do neuronal tau protein abnormalities occur

Answer 7

associative cortex and in hippocampile area (entorhinal)

Question 8

tau protein abnormalities on NT

Answer 8

disturb acetylcholine, serotonin, catecholamines (dopamine and norepinepherine)

Question 9

imaging tau protein abnormalities

Answer 9

correlate with severity of disease and course
seen in non-demented elders but to lesser extent and not often outside of hippocampus
- can use to plot trajectory of illness

Question 10

neuropathology

Answer 10

impaired episodic memory: medial temporal, hippocampus (CA1), entorhinal cortex, amygdala, parahippocampal gyrus
impaired semantic and implicit association cortex
impaired organization, encoding and source memory
intact procedural memory, relatively intact basal ganglia

Question 11

alzheimers disease

Answer 11

most common dementia

risk factors: family history, APOE genotype, low education, brain reserve, early head injury, cardiovascular disease

Question 12

alzheimers neuropathology: memory and learning

Answer 12

semantic, new learning, interference, spared recognition at first, tangle formation in cholinergic projection. implicit memory

Question 13

alzheimers neuropathology: language

Answer 13

word finding difficulty, lexical access problems and semantic processing, writing compromised but reading spared

Question 14

alzheimers neuropathology: visuospatial function

Answer 14

agnosia in later stage
impaired performance on judgement of line orientation
impaired visuoconstructional ability ray complex figure
- FRONTAL LOBES

Question 15

alzheimers neuropathology: executive functions

Answer 15

high sensitivity to early AD
judgement, abstract reasoning, problem solving and complex decision making processes affected
working memory impaired
divided attention and other attentional control problems

Question 16

alzheimers neuropathology: other symptoms

Answer 16

disorientation, apraxia, motor and psychomotor dysfunciton, anosognosia, behavioral and affective changes

Question 17

dementia with lewy bodies

Answer 17

over 50, more males than females, apoE4
more rapid decline than AD but similar
multiple cognitive deficits, fluctuating
extrapyramidal signs usually develop (parkinsonism)
hallucinations/delusions can develop early

Question 18

lewy bodies

Answer 18

intracytoplasmic inclusions made of synuclein protein

Question 19

neuropathology profile of dementia with lewy bodies

Answer 19

slightly better memory but worse executive functions
lack of initiative and apathy
visuospatial and constructional impairments
psychomotor and motor slowing
delusional thinking
outrageous hallucinations

Question 20

frontotemporal dementia

Answer 20

executive functions severly affected
personality changes
loss of insight, disinhibition
some motor problems
genetic component: tau pathology, tbi?
younger onset (40-65)

Question 21

FTP neurophysiology

Answer 21

microvascular defects (ischemic) 
astrocytic gliosis
often with picks bodies: enlarged, ballon cells intracyotplasmic, fill entire cell until bursts, tau based