Brain damage and neurodegenerative disease

Question 1

What is congenital brain injury

Answer 1

Genetic factors, pre-natal, or birth related trauma

Question 2

What is acquired brain trauma

Answer 2

Includes silly things we do to ourselves as a species

Question 3

What are example of non-traumatic brain injuries?

Answer 3

Stroke, infection, tumours, hypoxia, anoxia. Often occurs inside skull with very little control over

Question 4

What are the 2 causes of stroke?

Answer 4

Cerebral haemorrhage cerebral ischaemia

Question 5

What is cerebral haemorrhage?

Answer 5

Burst of a blood vessel

Question 6

What is cerebral ischaemia?

Answer 6

Caused by interruption of the blood supply to part of the brain due to blockage of blood vessel

Question 7

What is a closed injury?

Answer 7

No penetration of the skull

Question 8

What is dementia pugilistica?

Answer 8

Punch Drunk syndrome
Repeated powerful blows to the head are not conducive to long term brain health
Cumulative structural damage occurs resulting in dementia symptom

Question 9

What is an open headed injury

Answer 9

Where the skull doesn’t remain intact

Question 10

Describe the brain structure associated with Alzheimer’s disease

Answer 10

Diffuse changes in brain structure and volume associated with widespread neuronal loss

Question 11

What are the type of symptoms of AD?

Answer 11

Predominantly cognitive symptoms in early stages

Question 12

What neurotransmitter is associated with AD?

Answer 12

The loss of acetylcholine

Question 13

What is the brain structure of PD?

Answer 13

Mainly attributable to a loss of a single type of neuron in a specific brain region

Question 14

What type of symptoms associated with PD?

Answer 14

Predominantly but not entirely motor symptoms

Question 15

What neurotransmitter is PD associated with?

Answer 15

The loss of the neurotransmitter dopamine

Question 16

How much of the population is affected by PD?

Answer 16

Affects 0.5 percent of the population. 2.5X more common in men

Question 17

What type of disease is PD?

Answer 17

An idiopathic disease

Question 18

What are the symptoms of parkinsons?

Answer 18

Paucity of spontaneous movement (insufficiency of movement)
Bradykinesia (very slow movements)
Akinesia (no movements)
Resting tremor (@4.5Hz)
Shuffling gait and flexed posture, impaired balance

Question 19

What is PD caused by?

Answer 19

Lack of dopamine in the nigrostriatal dopamine pathway found in the basal ganglia. Cells that release dopamine die off

Question 20

Describe the heroin problem of the 80s

Answer 20

Development of new synthetic heroin led to spate of cases of individuals with pronounced parkinsonian symptoms
MTPT was an unwanted byproduct of the chemical process, that in the brain becomes converted to the highly neurotoxic MPP+
MTPT was found to be specifically targeting the dopamine producing cells of the substantia nigra

Question 21

Describe the link between dopamine and motor system

Answer 21

Burst of dopamine disinhibits the motor system - doesn’t happen in PD

Question 22

Talk about Levo Dopa

Answer 22

A dopamine precursor - replaces the lost dopamine - acts as treatment
Limitation - cells that release dopamine have died

Question 23

Talk about DBS

Answer 23

Deep brain stimulation
Electrical stimulation of the basal ganglia - targets same sites as lesions but with electrical current tuned to shut them down

Question 24

What is dementia

Answer 24

A chronic or persistent disorder of the mental processes caused by brain disease or injury and marked by memory disorders, personality changes and impaired reasoning

Question 25

What is AD?

Answer 25

A disease that causes dementia

Question 26

What are the symptoms of AD?

Answer 26

10% over 65 years old 45% of 85 years old Memory loss Selective decline in memory Deficits in attention and personality changes Intermediate stages; confusion, anxiety, irritability Final stages; swallowing and bladder control

Question 27

What is the assessment used for AD?

Answer 27

MMSE - mini mental state examination

Question 28

Describe the neurons of someone who has Alzheimers

Answer 28

Includes neurofibrillary tangles and amyloid plaques

Question 29

What are amyloid plaques

Answer 29

Aggregate lumps of amyloid proteins

Question 30

Talk about the genetic risk factor of amyloid precursor protein

Answer 30

Found on chromosome 21 Downs syndrome - trisomy chromosome (150% of normal APP levels)

Question 31

Describe genetic forms of AD

Answer 31

Appear to have an early onset They are usually mutations in the APP gene

Question 32

Talk about the genetic risk factor apoE

Answer 32

Apolipoprotein E 3 common alleles - E3, E4, E5 E4is bad and E2 is good In the periphery it is involved in the transport of cholesterol

Question 33

What are the sticks inside neurons called

Answer 33

Microtubules

Question 34

What do microtubules do?

Answer 34

Part of the cytoskeleton - keeps a cells shape

Question 34

What is tau?

Answer 34

A MAP - gets into a muddle and gets tangled up

Question 34

What are microtubules formed from?

Answer 34

MAPs - microtubule associated proteins

Question 35

What is acetylcholine important for?

Answer 35

Normal cognitive function, especially memory

Question 36

What is AchE?

Answer 36

Cholinesterase - an enzyme that breaks down the neurotransmitter acetylcholine. In other words, prevents acetylcholine from continuing to act on the neurons. Inhibiting AchE increases the effect of acetylcholine on the neurons

Question 37

What are the main drugs for AD?

Answer 37

Cholinesterase inhibitors Donepezil hydrochloride (Aricept) Rivatigmine (Exelon) Galantamine (Reminyl)