w7 - Clinical Neuroscience #2a

Question 1

What is a primary dementing illness ?

Answer 1

One where the disease process operates directly on neural tissue

Question 2

Why is Alzheimer’s disease a major focal point for contemporay societies

Answer 2

• aging population (more cases)
• dependence
• high level care
• expensive

Question 3

How to we diagnose alzheimer’s ?

Answer 3

While the individual is alive one can only diagnose Demntia of the Alzheimer type (DAT)
- Alzheimer disease can only be confirmed via autopsy

Question 4

Name one gene linked to the late onset of AD.

Answer 4

A prevalence of the epsilion 4 allele gene are of higher risk

Question 5

What do genes linked to both early and late onset AD have in common ?

Answer 5

All alter production of amyloid peptide principal component of senile plagques

Question 6

How to senile plaques broadly relate to AD ?

Answer 6

They are one of the primary pathologies you see at the cellular level in AD

Question 7

What is McKhann et al.’s criteria for making an AD diagnosis ?

Answer 7

• Probable AD
• Possible AD
• Definite AD

Question 8

AD causes the brain to atrophy (shrink), what areas of the brain does this effect?

Answer 8

Frontal and temporal lobes > parieto-occipital regions

Question 9

Neurologically what do we see in people with AD

Answer 9

• Extensive amount of senile plaques
• Extensive amount of neurofibrillary tanges (NFT; abnormal tau protein)
• Extent of NFT’s coreelates with severity of dementia

Question 10

Where do the neurofibrillary tangles (NFT) first occur in the brain?

Answer 10

Start im hippocampal formation / mesial temporal lobes
- Spread outward to parietal cortex
- then to frontal cortex

Question 11

As Tau protines effect the hippocampal / MTL, what kinds of memory are effected ?

Answer 11

**Anterograde memory **
- Impaired new learning, delayed recall
- Poor recognition memory
Retrograde memory
- Intact for remote memories
- Reduced recent retrograde memories

Question 12

What occurs as DAT spreads the parietal and posterior temporal lobes ?

Answer 12

Wernicke-type aphasia (posterior)
- Word finding difficulty, absense of nouns
- Sounds gramatically correct

Dyspraxia, visual agnosia, acalculia
- Visopatial deficits and topograpghical disorientation

Question 13

What occurs as DAT spreads into frontal lobes ?

Answer 13

*Behaviour change *
- Apathy
- Agititation

Question 14

What has to be present to receive a DAT diagnosis ?

Answer 14

• Cognitive impairment (involving two cognitive domains)
• Impact on day to day function
• Signs the pathology is progressive

Question 15

In DAT which side of the hippocampus is effected ?

Answer 15

DAT occurs bilaterally. Both sides would be effected