Week 5 Flashcards
Does does MS literally mean?
many scars
What happens in MS according to Charcot?
demyelinations and astrogliosis also with come axonal destruction
What is astrogliosis?
Increased astrocytes in the brain
What are astroglia?
Perform many functions. Star shaped. Repair function.
What is myelin produced by?
Oliodendricyte
The node of ranvier help
neuron speed
What are the 2 main processes in MS?
- loss of myelin
2. axonal destruction
What happens after demylination?
remylination, however, it is never quite the same.
What is involved in the immune response of, in white blood cells?
- B cells
2. T cells
What do B cells do?
develop bone marrow
produce antibodies that ambush foreign antigens in bloodstream
What do T cells do (very important)?
develop in thymus gland
dirrect attacks on foreign substances.
What cause lesions?
inflammation in the brain
What happens in MS with lesions over a 12 months, which may or may not cause symptoms?
relapse and remission
What is cognitive reserve?
The ability for our brain to “bounce back” through relapse and remission. Eventually, this will catch up with people.
What are some symptoms of MS?
- vision
- speech
- throat
- muscular
- standing
- fatigue
- depression
What is age of onset in MS?
late 20s early 30s
MS occurs twice in what gender?
females
How many people are there worldwide and in AUS with MS?
2.5 million, 24,000 in Aus
The further you are away from the equator, are you more or less likely to get MS?
more
How many types of MS are there?
4
What are the different types of MS dictated by?
remission, relapse rates, ordered by increasing disability
What causes MS (risk factors)?
- environmental factors
- person factors (gender)
- immunological factors
- infectious factors
- smoking
- genetic factors
If someone is in a risky MS environment and they move locations before 15, what does this in turn do?
Decrease their chances of getting MS. Assumes the risk factor of that new place.
What percentage of people with MS will self report cognitive difficulties?
Approx. 58% of people with MS in Australia. This can be independent of physical symptoms.
What are the areas MOST affected in MS?
- processing speed
- complex attention and more
Which areas are LEAST affected in MS patients?
- general knowledge
- intelligence
- basic attention and orientation
- language
- implicit memory
What is a hallmark feature of MS?
thinking speed (speed of processing) due to myelin loss, slowed and irreversible damage to neuron conduction, affects higher-order cognition
___ attention is note usually affected in MS, but ___ attention is.
simple (remembering a phone number)
complex (working memory, divided between tasks, sustained attention)
What is working memory?
ability to maintain and manipulate information
Working memory is highly related to:
processing speed
What is one of the most reported symptoms in MS?
long-term memory. Due to learning difficulties rather than retrieval.
Learning of 12 words took on average how many trials from people with MS?
8 in comparison to 3 in healthy participants
Visual disturbances in MS is generally due to:
optic nerves
Visual disturbances can results in difficulties in:
- organising visual information
- proprioception
- seeing relationships between objects
What negatively affects the cognitive decline in MS patients?
- gender
- hotter temperatures
- disease course (progressive MS)
- smoking
- cannabis
grey matter atrophy is associated with:
cognitive decline
What is pseudobular affect, as sometime seen in MS patients?
- uncomfortable laughing/crying
- more intense/out of context
What is emotion recognition, as seen in MS patiens?
impaired on fear and anger
Theory of mind is ___ affected by MS/
negatively
Emotional lability and inappropriate behaviour is seen in __ patient
MS
What is MS dementia
severe cognitive impairment due to MS (10% of people with MS)
With MS, dementia has to do with issues with ___ while Alzheimer’s dementia is more related to ___
learning/encoding
forgetting already learned information.
What are two broad things to keep in mind with MS dementia patients?
- usually takes many years to develop
2. careful discrete use of term dementia recommended (can be shocking/offensive)
What are the aims for medication in relapses
to reduce inflammation
plasma exchange can be used if this doesn’t work
Drugs that modify MS progression:
- differ for each person
- immunosuppressants
- immunomodulators
What are immune constitution therapies in MS?
-Administered in frequently
drug in system for short time
-allows immune system to regenerate itself
What is stem cell therapy?
- A potential cure for MS?
- incredibly expensive
- aren’t available yet in Australia
- 6 stages
- takes stem cells out, wipe immune system, put back into body
- death rate
Which forms of MS are there no medication for?
progressive forms of MS. Drugs only help symptoms.
There are currently no medicinal treatments for the cognitive declines associated with MS. What are the most effective “treatments”?
- memory techniques
- processing speed techniques (taking time to learn, repeated information)
- executive ability techniques
- helping manage fatigue
What has been shown to be quite effective to manage fatigue in MS people?
CBT
Does sleep quality improve cognition in MS patients?
Improves PERCEIVED cognitive ability, but not actual ability
Can exercise improve cognition in MS?
conflicting views, however only due to lack of research
What did a HIIT exercise groups show in MS patients?
Improved cognition
Can gut health improve cognition in MS patients?
No evidence as of yet. However, may help healthy individuals improve some pathways associated with MS.
