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PSY325 - Neuropsychology & Clinical Neuroscience > Week Five - Multiple Sclerosis > Flashcards

Week Five - Multiple Sclerosis Flashcards

1
Q

What is MS?

A

An auto-immune disorder with both inflammatory and neurodegenerative pathologies

  • affects the neurons and is heterogenous
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2
Q

What are the 2 major processes that affect MS?

A

demyelination - occurs due to inflammation

axonal disruption

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3
Q

What are the 2 white blood cells that help immune functioning?

A

B cells

T cells

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4
Q

Where do B cells develop and what do they do?

A

Develop in bone marrow and produce antibodies that ambush foreign antigens in the bloodstream.

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5
Q

Where do T cells develop and what do they do?

A

Develop in the thymus gland and direct attacks on foreign substances (eg bacteria, viruses)

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6
Q

What do T cells produce?

A

Substances called cytokines that direct responses and activities in other immune cells

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7
Q

What is MRI success at looking at MS lesions?

A

Cannot always detect small fine grain changes

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8
Q

When do MS lesions occur?

A

When there is a lot of inflammation in the brain

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9
Q

Main symptoms of MS

A 
Central (unvisible) eg fatigue - most common, impairments
Visual
Speech (dysarthria), Throat (dysphagia)
Musculoskeletal
Sensation
Bowel
Urinary
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10
Q

Why do so many individuals with MS live away from the equator?

A

Because they typically have temperature intolerance - move to colder climates

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11
Q

Onset age of MS?

A

Late 20s, early 30s

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12
Q

Gender differences in MS?

A

x2 more females

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13
Q

Common misdiagnosis of MS?

A

Depression

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14
Q

What are the 4 different types of MS?

A

Progressive-relapsing
Secondary progressive
Primary progressive
Relapsing-remitting

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15
Q

What is PROGRESSIVE-RELAPSING MS associated with?

A

A steady decline since onset with superimposed attacks

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16
Q

What is SECONDARY PROGRESSIVE MS associated with?

A

Initial relapsing-remitting MS that suddenly begins to have decline without period of remission

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17
Q

What is PRIMARY PROGRESSIVE MS associated with?

A

Steady increase in disability without attacks

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18
Q

What is RELAPSING-REMITTING MS associated with?

A

Unpredictable attacks which may or may not leave permanent deficits followed by periods of remission.

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19
Q

What do we need to diagnose MS?

A

At least 2 occurrences of flare ups in the brain (space) and evidence that there are 2 distinct lesions in the brain from MRI (time)

20
Q

Why is the EDSS scale not always appropriate?

A

Too much focus on physical functioning and not enough of cognitive and invisible symptoms

21
Q

What causes MS/risk factors?

A

Interaction of

  • immunological and environmental factors (vitamin D deficiency - white collar workers)
  • personal factors (age, gender)
  • infectious factors (epstein-barr)
  • smoking
  • genetics (ethnic background - vikings disease, siblings/relative)
22
Q

Cognitive impairments occur largerly independent of what?

A

Disease duration

23
Q

Most people report what type of cognitive impairments?

A

Mild to moderate

24
Q

Do cognitive impairments occur in a uniform pattern?

A

No, they are heterogenous across people

25
Q

Cognitive areas most affected by MS?

A 
processing speed
complex attention
learning and memory of new things
prospective memory
working memory
EF
social cognition
26
Q

What is the hallmark feature of cognitive impairments in people with MS? why?

A

Processing speed because it is directly related to myelin loss and irreversible damage to neurons

27
Q

What aspects of attention are most affected?

A

The most complex ones

  • working memory
  • divided attention
  • sustained attention (directly related to fatigue
28
Q

What is one of the most reported symptoms in MS?

A

Long-term memory - but more related to learning than retrieval

29
Q

What aspects of memory are most affected?

A

long term

prospective

30
Q

What are memory deficits in MS undermined by?

A

Slow processing speed, susceptibility to interferences, executive difficulties, and visual difficulties

31
Q

Why do people with MS have visuospatial difficulties?

A

Visual disturbances due to optic nerve (optic neuritis)

32
Q

Difficulties in visuospatial abilities can result in what? (3)

A

Difficulties:
Organising visual information
Seeing relationships between objects
Proprioception

33
Q

What characteristics are related to having more cognitive difficulties?

A 
disease course
gender - males
temperature
cannabis users
smoking

grey matter atrophy!

34
Q

What are some social cognition effects of MS? (5)

A

Pseudobular affect: uncontrollable laughing/crying out of context

Emotion recognition

Theory of mind: ability to see another’s perspective

Emotional lability

Inappropriate behaviour

35
Q

How is MS Dementia different to other dementia?

A

Basic language is intact
Complex attention is less impaired early in the disease course
Memory problems are due to retrieval and initial acquisition
Orientation to place/person rarely affected

36
Q

What are some drugs used for MS relapses?

A

Corticosteroids

Plasma exchange

37
Q

What are the three types of drugs that modify progression of MS?

A
  • immunosuppressants
  • immunomodulators
  • immune constitution therapies
38
Q

How do immunosuppressants and immunomodulators work?

A

By being continuously administered and only active in suppressing relapse when they are being taken

39
Q

How do immune constitution therapies work?

A

By being administered short periods of time but effectiveness lasts as it allows immune system to repair itself (closest thing to a cure)

40
Q

What is the process of stem cell treatment/therapy?

A

Cells moved from bone marrow to blood stream

machine collects and separates out stem cells

Then frozen

Chemo to fully wipe out bone marrow/immune system

new cells returned via a drip

recovery

41
Q

Are there treatments for those with progressive MS?

A

No
They need to focus on:
physical therapy
muscle relaxants and medications to reduce cog an phys difficulties

42
Q

Strategies to improve memory in MS?

A

Techniques to increase chances of encoding/restoring

  • repetition/rehearsal
  • increased exposure
  • writing down
  • self-learning
43
Q

Strategies to improve processing speed in MS?

A

Take time to repeat and learn

Have information repeated

44
Q

Strategies to improve EF in MS?

A

Plan ahead
Ask for help
Break things down
List alternatives

45
Q

Can improved sleep quality help cognition in MS patients?

A

May only improve their own perception of cognitive function

46
Q

Can high intensity training improve cognition in MS patients?

A

Can improve verbal memory and lowers inhibition errors

47
Q

Concept of self in MS?

A

There are changes in how people describe themselves (over the disease progression)

PSY325 - Neuropsychology & Clinical Neuroscience (12 decks)

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