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ECU Cognitive/Linguistic Impairment in Brain-Injured Adults > 6.1 - Cortical Dementias > Flashcards

6.1 - Cortical Dementias Flashcards

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1
Q

What are the 2 Dementia Taxonomies?

A

Cortical Dementias

Subcortical Dementias

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2
Q

What are the 4 Cortical Dementias?

A

Alzheimer’s Disease

Lewy Body Dementia

Frontotemporal Lobar Dementia

Vascular Dementia

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3
Q

What are the 4 Subcortical Dementias?

A

Corticobasal Degeneration

Parkinson’s Dementia

Huntington’s Dementia

Progressive Supranuclear Palsy

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4
Q

What is the most common form of dementia?

A

Alzheimer’s Disease

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5
Q

How many Americans are affected by Alzheimer’s Disease?

A

More that 5 million

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6
Q

What causes a significant prevalence and incidence of Alzheimer’s Disease?

A

Age

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7
Q

What are 11 risk factors for Alzheimer’s Disease?

A

Aging

Genetics/Family History

Gender

Education

Down syndrome

Head trauma

Depression

Vascular risk

Sedentary lifestyle

High fat diets

Low vitamin intake

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8
Q

Who is more at risk for developing Alzheimer’s Disease: men or women?

A

Women

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9
Q

Who is more at risk for developing Alzheimer’s Disease: those with more or less education?

A

Less

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10
Q

What are three Characteristics of Alzheimer’s Disease?

A

Insidious onset

Progressive course

Heterogeneous

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11
Q

What are three Pathological Changes in Alzheimer’s Disease?

A

The cortex shrivels up

Shrinkage in the hippocampus is especially severe

Ventricles increase in size

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12
Q

The brain has _______ of neurons, each with an axon and many dendrites.

To stay healthy, neurons must communicate with ___________, carry out metabolism, and ___________.

AD disrupts all three of these essential jobs

A

Billions

Each other

Repair themselves

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13
Q

What two abnormal structures are seen abundantly in individuals with Alzheimer’s Disease?

A

Beta-Amyloid Plaques

Neurofibrillary Tangles

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14
Q

What are Beta-Amyloid Plaques?

2

A

Dense deposits of protein and cellular material

They accumulate outside and around nerve cells

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15
Q

What are Neurofibrillary Tangles?

A

Twisted fibers that build up inside the nerve cell

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16
Q

Neurons have an internal support structure partly made up of _______.

A

Microtubules

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17
Q

A protein called ______ helps stabilize microtubules.

A

Tau

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18
Q

In Alzheimer’s Disease, tau changes, causing microtubules to ______, and tau proteins __________ to form __________

A

Collapse

Clump together

Neurofibrillary tangles

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19
Q

What 4 Common Neuropathology are seen in Alzheimer’s Disease?

A

Neurofibrillary tangles

Amyloid plaques

Granuvacuolar degeneration

Accumulation of large, double membrane-bound bodies within certain neurons

Ventricular enlargement

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20
Q

Is there a single test to diagnosis Alzheimer’s Disease?

A

No

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21
Q

What 3 health arenas are used to diagnosis Alzheimer’s Disease?

A

Physical examinations

Psychiatric examinations

Neurologic examinations

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22
Q

How can examinations be definitively diagnosed?

A

Pathology examination of brain tissue during autopsy

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23
Q

What 2 symptoms are seen in the Early Stage of Alzheimer’s Disease?

A

Mild word retrieval

Mild decrease in
comprehension

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24
Q

What 3 symptoms are seen in the Middle Stage of Alzheimer’s Disease?

A

Frequent word retrieval deficits

Ungrammatical sentences

Reduced conversation

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25
What 4 symptoms are seen in the Late Stages of Alzheimer’s Disease?
Non-functional reading/writing Limited comprehension Speech limited to single words Bizarre and devoid of meaning
26
What are the 7 stages of Alzheimer’s Disease?
Stage 1: No Cognitive Decline Stage 2: Very Mild Cognitive Decline Stage 3: Mild Cognitive Decline Stage 4: Moderate Cognitive Decline Stage 5: Moderate-to-Severe Cognitive Decline Stage 6: Severe Cognitive Decline Stage 7: Very Severe Cognitive Decline
27
What are the 6 levels of Language Progression in Alzheimer’s Disease?
Reduced verbal fluency Anomic aphasia Transcortical sensory aphasia Semantic aphasia Wernicke’s aphasia Unrecognizable output, mutism
28
With what other disorder does Lewy Body Dementia share common neuropathologic and neurogenetic features?
Parkinson's disease
29
What 3 features distinguish Lewy Body Dementia from other neurodegenerative diseases?
Fluctuating attention Visual hallucinations Parkinsonism
30
Lewy Body Dementia presents in ___-___% of all autopsy confirmed dementias.
15-20%
31
Lewy Body Dementia is characterized by _______ and ______ disease.
Cortical Subcortical
32
Lewy Body Dementia has less __________ involvement than Alzheimer's Disease.
Medial temporal
33
Where are Lewy Bodies found in Lewy Body Dementia? | 6
Substantia nigra Temporal lobe Frontal lobe Parietal lobe Limbic cortex Brainstem
34
Lewy bodies can occur in ______ and ______ areas
Cortical Subcortical
35
What are the 3 Common Presentations of Lewy Body Dementia?
Type 1 Type 2 Type 3
36
What is seen in Type 1 Lewy Body Dementia? | 2
Memory impairment or cognitive disorder similar to Alzheimer's Disease Over time two or more distinctive Lewy Body Dementia features appear
37
What 9 symptoms can be used to distinguish Lewy Body Dementia from Alzheimer's Disease?
Unpredictable levels of cognitive ability Attention or alertness Changes in walking or movement Visual hallucinations Sleep disorders Hallucinations Impaired in all areas of cognition and with higher variability compared to healthy controls. Less severe memory impairment More visuo-perceptual, visuospatial, and constructional disabilities
38
What is seen in Type 2 Lewy Body Dementia? | 2
Movement disorder that leads to Parkinson's Disease This then develop symptoms of dementia common in Lewy Body Dementia
39
What is seen in Type 3 Lewy Body Dementia? | 2
Neuropsychiatric symptoms These then develop DLB
40
What 3 Neuropsychiatric Symptoms are seen in Type 3 Lewy Body Dementia?
Allucinations Behavioral problems Difficulty with complex mental activities
41
What are the 4 Core Clinical Features seen in Lewy Body Dementia?
Fluctuating Cognition Neuropsychiatric Symptoms Motor Features of Parkinsonism Supportive Features
42
How is Fluctuating Cognition seen in Lewy Body Dementia? | 3
Fluctuating attention Daytime drowsiness Transient confusion
43
What Neuropsychiatric Symptoms are seen in Lewy Body Dementia?
Recurrent, detailed and persistent hallucinations of animate + inanimate figures and scenes
44
What Motor Features of Parkinsonism are seen in Lewy Body Dementia? (6)
Rigidity Bradykinesia Hypophonic speech Masked facies Stooped posture Shuffling gait
45
What Supportive Features are seen in Lewy Body Dementia? | 8
Repeated falls Syncope Transient loss of consciousness Neuroleptic sensitivity Systematized delusions Hallucinations of other modalities Depression REM sleep behavior disorder
46
What is the Course of Lewy Body Dementia? | 2
Course is variable and patient dependent Mean disease duration is 5-6 years (range 2-20)
47
What are the Early Motor Signs in Lewy Body Dementia related to?
Nigrostriatal changes
48
What are early Hallucinations related to?
Cortical and limbic involvement
49
How frequent is Frontotemporal Dementia?
Very rare
50
At what age does Frontotemporal Dementia tend to develop?
Between 35-75
51
How long do patients usually live after a diagnosis of Frontotemporal Dementia?
2-10 years
52
What is Frontotemporal Dementia linked to?
Chromosome 17 (FTDP-17)
53
What is a common characteristic among Frontotemporal Dementia types?
“Cortical atrophy”
54
What neuro structures are primarily affected in Frontotemporal Dementia? (2)
Frontal lobes Temporal lobes
55
What symptoms are seen in Frontotemporal Dementia? | 6
Reasoning Social behavior Personality Speech/language Movement Memory
56
What do the Neurological Changes in Frontotemporal Dementia depend on?
Whether damage is primarily on the left or right front of the brain
57
What is the Neuropathology of Frontotemporal Dementia? | 4
Accumulation of abnormal “tau” protein in nerve cells (Tau proteins also present in AD) Gliosis Vacuolation Picks Bodies
58
In Frontotemporal Dementia “tau” becomes ______ and aggregates into ______; this disrupts normal nerve cell processes and ultimately leads to __________.
Abnormal Tangles Cell death
59
In Frontotemporal Dementia, where is the progressive loss of nerve cells seen?
In the frontal and temporal lobes
60
What is Gliosis?
A form of tissue scarring in the CNS
61
What is Vacuolation?
Process in which holes form in the outer layer of | the brain
62
What are Picks Bodies?
Abnormal cell inclusions begin to form in the brain
63
What are 8 Clinical Characteristics of Frontotemporal Dementia?
Uninhibited and socially inappropriate behaviors Inappropriate sexual behavior Loss of awareness of concern about changes in behavior Major increase in appetite Loss of speech/language Compulsive and repetitive behaviors Oral fixation Memory loss
64
What are 4 specific types of Frontotemporal Dementia?
Pick's Disease FIDP-17 Supranuclear Palsy Corticobasal Degeneration (May also be classified as subcortical dementias)
65
How does Frontotemporal Dementia differ from Alzheimer's Disease? (5)
Episodic memory loss = AD Semantic memory loss = FTD Early behavioral changes = FTD Early personality changes = FTD FTD tends to emerge one decade but the overall risk is not increased
66
What are 3 Historical Definitions of Vascular Dementia?
Multi-infarct dementia Vascular dementia Vascular cognitive impairment
67
How is Vascular Dementia clinically defined?
Memory decline Two more cognitive deficits
68
What can the "two more cognitive deficits" be that can be seen in Vascular Dementia? (6)
Orientation Attention Language Visuospatial functions Executive functions Motor control or praxis
69
Those with Vascular Dementia typically have history of what 3 things?
HTN Heart Disease HTN + Heart Disease
70
Those with Vascular Dementia have usually had multiple ______.
Strokes
71
What kind of onset is seen in Vascular Dementia?
An abrupt onset of focal neurological signs
72
What causes the Slow Stepwise Progression seen in Vascular Dementia?
Multiple strokes
73
How does Vascular Dementia affect Personality and Intellect?
Preserved until late stages
74
What are the 8 Pathology Locations in Vascular Dementia?
Bilateral large vessels (MCA, PCA) territories Multiple lacunes Thalamus Frontal white matter Basal forebrain Basal ganglia Internal capsule Hippocampus
75
What are the 4 Clinical Features in Vascular Dementia?
Sudden onset of neurological deficits Stepwise deterioration Fluctuating course 90% of cases have history of stroke
76
What is Primary Progressive Aphasia?
A decline in one or more language functions
77
At what age does Primary Progressive Aphasia tend to occur? | 2
Can occur in individuals under the age of 65 Sometimes occurs in individuals as young as 40
78
What causes Primary Progressive Aphasia?
Brain cell degeneration
79
What is the course of Primary Progressive Aphasia? | 4
Begins gradually and initially results in difficulty thinking of common words while speaking or writing Results in limited verbal communication and reduction in comprehension Memory, reasoning and visual perception are not affected by the disease in early stages Mental abilities decline during disease progression
80
In Primary Progressive Aphasia, isolated language deficits occur for typically for ___-___ years.
2-5
81
Is Primary Progressive Aphasia more prevalent in males than females?
Females
82
Many patients with Primary Progressive Aphasia progress to ___________.
Global deterioration
83
What are the 5 Language Deficits seen in Primary Progressive Aphasia?
Increased difficulty thinking of words Problems reading or writing Reduced ability to understand speech Decreased use of language Problems in arithmetic and calculations
84
What is the most common sign of Primary Progressive Aphasia?
Anomia
85
What do the Language Deficits seen in Primary Progressive Aphasia correlate with?
Anomalies in anatomical regions

ECU Cognitive/Linguistic Impairment in Brain-Injured Adults (23 decks)

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