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CM Clinical Symposia > The Neuropathology of Dementia (14) > Flashcards

The Neuropathology of Dementia (14) Flashcards

1
Q

Limbic system

A

Arousal, emotion, motivation, attention and memory

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2
Q

Hippocampus

A

New info is stored, helps concentrate on specific things

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3
Q

Amygdala

A

Emotions and fiction

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4
Q

Cognition

A

Sum of brain functions which allows us to integrate in the environment

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5
Q

Intellectual skills

A

Learning and memory, language, visuospatial skills, emotion, personality

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6
Q

Microcircuits in brain

A

Neuron > synapse > neurotransmitter > AP

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7
Q

Classification of neurodegenerative disorders

A

Functional - cognitive (AD)/movement (PD)

Anatomical - frontotemporal dementia (FTB), corticobasal degeneration (CBD)

Etiological - vascular dementia (VaD), prion disease

Proteinopathy - taupathy (AD), a-Synucleionpathy (DLB)

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8
Q

Cognitive disorders

A
  • AD (temporal, parietal and front degeneration)
  • Frontal temporal degeneration
  • Multifocal degeneration (Cortiocobasal degeneration)
  • Cognitive and movement (DLB)
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9
Q

Proteins involved

A

B-amyloid, Tau, a-synclein, Ubiquitin

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10
Q

B-amyloid

A

Insoluble fibrous protein aggregates (fibrils), >18 > amyloidosis/degenerative disorders

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11
Q

Tau proteins

A

Intra-cellular, stabilise microtubules in neurons, 6 isoforms

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12
Q

A-synuclein

A

Start to globulise > Lewy body, intra-cellular, interferes with RER, mitochondria, ribosomes, seen in PD and DLB

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13
Q

Ubiquitin

A

Small regulatory proteins found in almost all cells, direct proteins to compartment in cell - proteasome (destroy and recycle proteins, can be attached to and label them), mutation > build up of abnormal proteins and chemicals

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14
Q

Pathogenesis of proteins

A
  • Oxidative stress - free radicals
  • Glutamine stimulation
  • Apoptosis
  • Cytokines - inflammatory response
  • Genetic - single gene mutations/multiple
  • Age-related decline in efficiency of some metabolic pathways
  • Unknown
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15
Q

Accumulation of abnormal proteins (intracellular)

A

Tau (AD), a-synuclein (DLB), Polyglutamine (HD), Ubiqutin (Pi D)

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16
Q

Accumulation of abnormal proteins (extracellular)

A

Amyloid (AD)

17
Q

Macroscopical examination

A
  • Brain weight 900-1100 grams (1200-1400 normal)
  • Atrophy in cerebral gyri (hippocampus, temporal, parietal, frontal lobe, cingulate gyrus)
  • Atrophy in white matter - thin corpus callous
  • Atrophy in deep white matter
  • Ventricular dilatation
  • Atrophy in brain stem and cerebellum
  • Pale substantia nigra and locus ceruleus
18
Q

Microscopical examination

A
  • Neuron loss from hippocampus, cerebral cortex, SN and LC
  • Microvacuolation in cerebral neocortex
  • Attenuation in white matter
  • Wide perivascular spaces in white matter
  • Accumulation of abnormal proteins (amyloid-plaques, tau-neurofibiliary tangles, a-synuclein - Lewy bodies, ubiquitin - pick’s bodies)
19
Q

Where do plaques start?

A

In hippocampus and spread out

20
Q

CERAD plaque densities

A

Links plaque density with age and clinical symptoms, useful for research (normal, definite AD, probable AD, possible AD)

21
Q

Macroscopical findings in AD

A
  • Brain weight 900-1200
  • Atrophy of gyro, widening of sulci (frontal, temporal, parietal and hippocampus)
  • Ventricular dilatation
22
Q

Microscopical findings in AD

A

Neuronal loss, NP, NFT and neuropil threads

23
Q

Macroscopical findings in Dementia with Lewy body (DLB)

A
  • Pale SN and LC

- Atrophy in amygdala, cingulate gyrus, tempora, parietal and frontal lobes

24
Q

Microscopical findings in Dementia with Lewy body (DLB)

A
  • Neuronal loss from SN and LC

- Accumulation of a-synuclein +ve bodies in neurons of SN, amygdala and later cerebral cortex

25
Q

Lewy bodies appearance

A

Bright red bodies inside neurons

26
Q

Vascular dementia

A
  • Multi-infarct dementia
  • Binswanger’s disease
  • Arteriolosclerosis
27
Q

Binswanger’s disease

A

Infarct in white matter

28
Q

Arteriolosclerosis

A

High arterial blood pressure, smooth muscle walls > collagen > infarction

29
Q

Frontotemporal dementia/Pick’s disease

A
  • Neurons look like balloons

- Picks bodies - Ubiquitin and tau +ve

CM Clinical Symposia (24 decks)

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