Week 3: Chapter 27 - Psychiatric and Related Disorders Flashcards
What are the two major clinical categories of motor disorders?
Hypokinetic-Rigid Syndrome and Hyperkinetic-Dystonic Syndrome.
What characterizes hypokinetic-rigid syndromes like Parkinson’s disease?
Loss of movement due to basal ganglia dysfunction.
What defines hyperkinetic-dystonic syndromes such as Huntington’s and Tourette’s?
Excessive or involuntary movements due to basal ganglia dysfunction.
Who first described Huntington’s disease and in what year?
George Huntington in 1872.
What are the typical age of onset and average duration of Huntington’s disease?
Typically begins between ages 30 and 50; average survival is about 12 years.
What are choreas in the context of Huntington’s disease?
Dance-like, irregular involuntary movements.
What types of emotional and cognitive symptoms are seen in Huntington’s disease?
Memory issues, slowed processing, depression, mania, and psychotic episodes.
What is the inheritance pattern of Huntington’s disease?
Autosomal dominant with complete penetrance.
Which brain structures show degeneration in Huntington’s disease?
Cortical thinning and atrophy of the basal ganglia.
Which neurotransmitter imbalance is associated with Huntington’s disease?
Dopaminergic overactivity due to GABAergic and cholinergic neuron degeneration.
Who described Tourette’s syndrome and when?
Georges Gilles de la Tourette in 1885.
What are the three stages of symptom development in Tourette’s syndrome?
- Motor tics 2. Inarticulate vocalizations 3. Vocal tics like echolalia and coprolalia.
What is coprolalia and how is it related to Tourette’s syndrome?
Involuntary use of obscene language seen in some Tourette’s patients.
What percentage of Tourette’s patients exhibit motor tics in the face?
97% show facial tics.
What treatments are commonly used for Tourette’s syndrome?
Antidopaminergic drugs (e.g., haloperidol) and clonidine.
What cognitive deficits are commonly found in Tourette’s patients?
Impairments in visuospatial tasks like the Rey Complex-Figure Test.
Who first described Parkinson’s disease?
James Parkinson in 1817.
What is the ‘pill-rolling’ tremor in Parkinson’s disease?
A resting tremor resembling rolling a pill between fingers.
What is cogwheel rigidity?
A ratcheting resistance during passive limb movement.
What are examples of negative symptoms in Parkinson’s disease?
Postural disorders, akinesia, and speech disturbances.
What is festination in Parkinson’s patients?
Uncontrolled quickening of gait steps.
What are the three major types of Parkinson’s disease?
Idiopathic, postencephalitic, and drug-induced.
What toxin in synthetic heroin can cause Parkinson-like symptoms?
MPTP.
What is the role of the substantia nigra in Parkinson’s disease?
Produces dopamine and sends projections to the cortex and basal ganglia.
What are common pharmacological treatments for Parkinson’s disease?
l-dopa, MAO inhibitors, anticholinergics, amantadine.
What is deep brain stimulation (DBS)?
Surgical implantation of electrodes to reduce tremor and akinesia.
What are the goals of pharmacological treatment in Parkinson’s?
Increase dopamine and suppress overactive brain regions.
What are examples of supportive therapies for Parkinson’s?
Physical therapy, exercise, and psychological support.
How does Parkinson’s disease affect cognition?
Slowed processing, reduced motivation, and emotional flattening.
What are some neuropsychological test results seen in Parkinson’s patients?
Poor performance on working memory, verbal memory, and visuospatial tasks.
What is the projected percentage of the population over 65 in North America and Europe by 2030?
0.2
What percentage of people over 80 are affected by dementia?
25–50%
What is the estimated number of Americans with cognitive impairment projected for the coming decades?
Up to 20 million
According to DSM-5, what distinguishes Major Neurocognitive Disorder from Mild NCD?
Major NCD interferes with independence; Mild NCD shows modest decline with maintained independence
How is dementia diagnosed using standardized cognitive testing?
Performance 2+ SD below norms for Major NCD; 1–2 SD for Mild NCD
What are the common causes of dementia?
Protein accumulations, vascular disorders, and other conditions like CTE
What percentage of dementia cases in those over 65 is due to Alzheimer’s?
~65%
Who first described Alzheimer’s disease and when?
Alois Alzheimer in 1906
What are neuritic plaques made of?
Amyloid protein and degenerative neuronal fragments
Where are paired helical filaments typically found?
Cortex and hippocampus
What protein abnormality is associated with neurofibrillary tangles?
Tau protein
Which cortical regions are most affected by Alzheimer’s disease?
Posterior parietal, inferior temporal, and entorhinal cortex
What areas are relatively spared in Alzheimer’s disease?
Primary sensory and motor cortices
What type of neuronal change is common in Alzheimer’s?
Neuronal shrinkage and dendritic loss
Which neurotransmitters are reduced in Alzheimer’s?
ACh, noradrenaline, dopamine, serotonin, glutamate
What distinguishes Alzheimer’s neurotransmitter profile from normal aging?
Pattern of multiple reductions, not just individual level
What chromosome is the β-amyloid precursor protein gene located on?
Chromosome 21
Which genes are linked to early-onset Alzheimer’s?
Presenilin 1 and 2
Which gene is linked to tau protein dysfunction?
MAPT gene on chromosome 16
What environmental factor has been found in higher levels in Alzheimer’s brains?
Aluminum
How might the immune system contribute to Alzheimer’s?
Autoimmune destruction due to immune decline
What are early symptoms of Alzheimer’s?
Recent memory loss and impaired attention
How does Alzheimer’s typically progress?
From recent memory to remote memory and functional independence
Which Wechsler subtests reveal Alzheimer’s impairments?
Digit symbol, block design, object assembly, verbal memory
What does anomia in Alzheimer’s patients reflect?
Loss of semantic knowledge
What kind of language deficits appear in Alzheimer’s?
Deficits in complex tasks despite simple conversation ability
What pattern of hemisphere impairment does Alzheimer’s show?
Bilateral impairment
What distinguishes Alzheimer’s from vascular dementia?
No sudden onset, bilateral and progressive symptoms
What differs between early-onset and late-onset Alzheimer’s in the brain?
Early-onset: widespread atrophy; Late-onset: hippocampal atrophy
Why is physical activity and social engagement important for aging individuals?
They help reduce dementia risk
