Week 5H20,21,22,25 Flashcards
Which disorder, schizophrenia or bipolar disorder, has a stronger negative impact due to cognitive dysfunction?
The negative impact is stronger in people with schizophrenia than bipolar disorder.
True or False: The risk of psychotic disorder is higher in people whose relatives exhibit only physical symptoms.
False. The risk is higher in people whose relatives exhibit psychotic/cognitive symptoms.
True or False: People with schizophrenia and bipolar disorder have thicker cortices in their brain than healthy controls.
False. People with schizophrenia and bipolar disorder have thinner cortices.
How do first generation antipsychotics work and what were their limitations?
First generation antipsychotics work by blocking dopamine receptor D2, but they didn’t improve negative symptoms and cognitive functioning and had serious motor side effects.
What is the advantage of third-generation antipsychotics over the first generation?
Third-generation antipsychotics target more receptors and have the potential to improve negative and cognitive symptoms without causing the severe motor side effects of first-generation drugs.
What is the transdiagnostic domain associated with cognitive impairments in psychotic disorders called?
The transdiagnostic domain associated with cognitive impairments in psychotic disorders is called the ‘C-factor’.
What is the RDOC and what was its purpose?
The Research Domain Criteria (RDOC) is a cross-diagnostic framework established in the past decade for investigating psychiatric disorders.
What does Frontotemporal dementia (FTD) encompass?
Frontotemporal dementia (FTD) encompasses a group of neurodegenerative disorders that primarily affect the frontal and temporal lobes of the brain. These areas of the brain are generally associated with personality, behavior, and language. most prevalent early onset form of dementia.
Which types of dementia are considered part of the spectrum of FTD?
Some examples in the spectrum of FTD are:
- the behavioral variant (bvFTD), language variants (primary progressive aphasia or PPA), myotropic lateral sclerosis (ALS), corticobasal syndrome (CBS), and progressive supranuclear palsy (PSP).
In diagnosing Primary Progressive Aphasia (PPA), what is the most prominent clinical feature?
difficulty with language.
What is the second step in the diagnosis of Primary Progressive Aphasia (PPA)?
The second step is classifying into one of the three subtypes of PPA: Semantic variant (svPPA), Non-fluent variant (nfvPPA), and Logopenic variant (lvPPA).
How is Semantic variant (svPPA) characterized?
svPPA is characterized by difficulty in word understanding and finding, with patients often replacing words with ones that have a similar meaning or are easier to remember.
Describe the Non-fluent variant (nfvPPA) of PPA.
nfvPPA is characterized by speech apraxia (slow, effortful, flat speech), errors in speech sounds, and difficulty forming and understanding complex sentences.
What characterizes the Logopenic variant (lvPPA)?
lvPPA is characterized by non-fluent speech. It is mostly caused by underlying Alzheimer pathology and not FTD. For diagnosis, both core features (impaired single-word retrieval and impaired repetition) and at least three of the supporting features need to be present.
what is the typical neuroradiological characteristic of FTD compared to Alzheimer’s?
FTD often shows an asymmetric pattern of atrophy of the frontal and temporal lobes, whereas Alzheimer’s commonly has symmetrical atrophy.
Match the FTD subtypes with their most common locations of atrophy:
1svPPA
2nfvPPA
3lvPPA
4bvFTD
5PPA
a. Cortex, prefrontal and orbitofrontal cortex
b. Left hemisphere (associated with language functions)
c. Left anterior and inferior temporal lobe
d. Left inferior frontal gyrus, insular cortex, and premotor and supplementary motor areas
e. Posterior temporal and parietal areas
1c 2d 3e 4a 5b
What is the main focus of pharmacological treatments for FTD?
Pharmacological treatments primarily focus on alleviating behavioral and motor problems.
True or False?
In bvFTD, episodic memory is heavily affected and is a primary criterion for diagnosis.
False (Episodic memory is relatively spared in bvFTD, so it should be considered an exclusion criterion.)
True or False?
PPA patients with underlying Alzheimer pathology usually experience impairments in repetition and working memory.
true
1Parkinson’s disease
2MSA (multiple system atrophy)
3PSP (progressive supranuclear palsy)
4CBD (corticobasal degeneration)
a. A form of parkinsonism where disturbances increase in severity and new symptoms may occur. Has chronic progressive nature.
b. Parkinsonism with faster cerebrovascular damage.
c. Characterized by both cerebellar and parkinsonian symptoms.
d. Atypical parkinsonism with slow progression, generally free from tremors.
1-a, 2-c, 3-b, 4-d
What are the four cardinal motor symptoms of Parkinson’s disease?
Bradykinesia: Slow movement and akinesia.
Rigidity: Stiffness, especially during movement.
Resting tremor: Shaking or trembling of a limb at rest.
Postural instability: Issues with balance due to loss of postural reflexes.
True/false?
In Parkinson’s disease, micrographia is characterized by difficulty in starting movement.
Answer: False. (Micrographia refers to the occurrence of small handwriting.)
In the context of Parkinson’s disease, what is meant by hypophonia?
Hypophonia refers to a low voice volume.
What are the two subtypes of Parkinson’s disease based on motor symptoms?
The two subtypes are tremor-dominant subtype and postural instability and gait difficulty subtype (PIGD).
True or False?
Non-motor symptoms of Parkinson’s disease are always seen in the late stages of the disease.
Answer: False. (Non-motor symptoms often present even in early stages.)
TRUE/FALSE?
In Parkinson’s disease neuropathology, the main affected area is the dopamine-producing neurons in the pars compacta of the substantia nigra.
true
In the context of Parkinson’s disease neuropathology, what differentiates Lewy bodies from Lewy neurites?
Both Lewy bodies and Lewy neurites contribute to neuronal dysfunction and death in Parkinson’s disease, but
lewy bodies: found within the cell bodies (soma) of neurons, are especially common in the substantia nigra region of the brain.
lewy neurites: thread-like inclusions of misfolded alpha-synuclein protein found within the axons or dendrites of neuron
Why is it crucial to distinguish Parkinson’s from atypical parkinsonism?
It’s essential because the course of the disease and treatment can be vastly different, even though the symptoms might appear similar.
Match the following atypical types of parkinson’s with their descriptions:
1MSA
2PSP
3CBD
4DLB
a. Early autonomic disorders like incontinence; erectile dysfunction; hypotension, speech and swallowing disorders; cold blue hands and feet.
b. Upright (even stretched back) posture; disturbances in eye movement; disinhibition; emotional instability.
c. Cognitive impairment and neuropsychiatric symptoms are prominent; hallucinations are very similar to parkinsonian dementia, with the key difference being the timing of symptoms.
d. Very heterogeneous; asymmetrical symptoms; some symptoms may be dystonia; limb movement tension, difficulty controlling a limb.
1a 2b 3d 4c
What is the main objective of Deep brain stimulation (DBS) in Parkinson’s therapy?
DBS involves implanting a wire in brain areas with abnormal signals, primarily the subthalamic nucleus, STN, to provide high-frequency stimulation, thus improving both motor and non-motor symptoms.
Match the following treatments/therapies with their descriptions:
1Levodopa-carbidopa intestinal gel (LCIG)
2Subcutaneous administration of apomorphine
3Medications for non-motor symptoms
4Supportive care
a. Helps in physical and exercise therapy, occupational therapy, speech therapy, and CBT.
b. A gel directed to the first part of the small intestine to sustain dopaminergic stimulation.
c. Incorporates antidepressants, antipsychotic medications, and drugs to slow the breakdown of acetylcholine in the brain.
d. A method to introduce a dopamine agonist beneath the skin.
1-b, 2-d, 3-c, 4-a
How do cognitive changes present in most Parkinson’s patients?
Cognitive changes in Parkinson’s, termed Parkinson-MCI, show as impairments in executive functioning due to the degeneration of fronto-striatal tracts. This affects cognitive flexibility, working memory, planning, and task execution.
What characterizes Parkinson’s dementia in comparison to typical dementia symptoms?
Parkinson’s dementia is associated with visuospatial impairments that are more severe than in Alzheimer’s, and memory impairment is characterized by an impairment in the active retrieval of information, while retention and recognition of information are preserved.
Which type of parkinsonism is associated with cognitive impairment marked by slowness in information processing and related impairment in complex attention, memory, and word finding?
Atypical parkinsonism.
Match the following terms with their descriptions:
1PSP
2CBD
3nfvPPA
a. Shows symptoms associated with language disorders, including agrammatism and difficulties in naming.
b. A type of tauopathy related to language disorders, particularly with speech and comprehension.
c. Another tauopathy with language disorders focusing on distribution areas already present in the early stages.
1-c, 2-b, 3-a
Is this statement true or false?
Huntington’s disease is caused by the presence of a positive DNA test result.
False. (The disease is identified through a DNA test, but it is caused by a gene mutation.)
What is the connection between the CAG repeats and the age of disease manifestation?
CAG repeats <36 means the disease won’t manifest, but repeats >40 always lead to disease manifestation.
How does a PGT: pre-implantation genetic test help in the context of Huntington’s disease?
A PGT can ensure that Huntington’s disease is not passed on to a child through IVF.
How can the quality of life for Huntington’s disease patients be optimized?
Through non-pharmaceutical treatment for posture and balance, strength and mobility physiotherapy, speech therapy, and medication to treat behavioral and neuropsychiatric symptoms.
What deficits arise in Huntington’s disease due to cognitive impairments?
Neuropsychologists identify and treat deficits in information processing speed, attention, social cognition, memory, language, and perception.
1Problems in the early stages of Huntington’s disease
2Underestimating risks
3Impulsiveness and difficulty in correcting mistakes
4Not recognizing motor disorders as part of oneself
a. Linked with attention problems
b. Results from self-control issues
c. Called egosyntone
d. Changes in complex attention and executive function
1-d, 2-a, 3-b, 4-c
TRUE/FALSE?
In the final stages of Huntington’s disease, the patient might lose their ability to express themselves through language.
true
What affects perception and spatial cognition in Huntington’s disease?
Reduced structural and functional integration of the visual pathways, including retinal thinning and cell loss.
What type of motor deficits is most clearly marked in Huntington’s disease?
Movement deficits comprising an increase in involuntary movements (chorea).
Match the following motor deficits with their descriptions:
1Dyskinesias
2Hypokinesia
3Bradykinesia
4Dystonia
5Rigidity
a. Increase in involuntary movements
b. Slowness of movement
c. Decrease in spontaneous movements
d. Impaired muscle tone
e. Stiffness
1-a, 2-c, 3-b, 4-d, 5-e
Which somatic symptom increases the risk of choking in Huntington’s disease?
Dysphagia, which is progressive chewing and swallowing problems.
Which disorders can exhibit psychotic symptoms?
Schizophrenia spectrum disorders, depressive disorder, bipolar disorder, personality disorders, and neurogenerative disorders.
Which cognitive aspect is especially affected in bipolar disorder and schizophrenia?
Face recognition.
What effect does the dopamine increase at random times have on individuals with psychosis?
It enhances the perception of stimuli,
which four factors?
werkgroep
werkgroep
werkgroep
werkgroep
