Neurobiology of Cognition

Question 1

What is the mind, and is it different from the brain?

Answer 1

The mind is in charge of cognitive faculties

Question 2

What is metacognition?

Answer 2

Thinking about your own thinking

Question 3

What is Wernicke’s area responsible for?

Answer 3

The comprehension of language/speech

Question 4

What does a problem with Wernicke’s area result in?

Answer 4

Receptive aphasia – person won’t understand what’s being asked

Question 5

What is Broca’s area responsible for?

Answer 5

The production of speech

Question 6

What does a problem with Broca’s area result in?

Answer 6

Expressive aphasia – person will understand what’s being said, but has difficulty finding the correct words to answer with

Question 7

How many items can you keep in short term memory?

Answer 7

7 +/- 2

Question 8

What is semantic memory?

Answer 8

Long term memory of facts and info

Question 9

Implicit/Procedural is acquired or used unconsciously

Answer 9

TRUE

Question 10

What is dementia?

Answer 10

A progressive irreversible global cognitive decline (NOT just associated with memory loss)

Question 11

How many components of cognition must be affected for someone to be diagnosed with dementia?

Answer 11

At least 2

Question 12

Alzheimer’s is the most common type of dementia

Answer 12

TRUE

Question 13

What is the average year survival of someone with dementia post diagnosis?

Answer 13

7 years

Question 14

Aside from memory, what else does Alzheimer’s affect?

Answer 14

Orientation to task
Ability to make sense of what they see,
Control of motor function

Question 15

What type of memory is particularly affected in Alzheimer’s?

Answer 15

Short term

Question 16

Carrying out well rehearsed tasks is not usually affected in Alzheimer’s

Answer 16

TRUE

Question 17

Outline the 2 main neuronal changes seen in Alzheimer.

Answer 17

• Amyloid plaques

* Neurofibrillary tangles

Question 18

What can often be difficult in people with Alzheimers?

Answer 18

Learning and remembering new things

Question 19

What other things do people with Alzheimers have?

Answer 19

Dysphasia
Dyspraxia
Aphasia
Mood problems (incl. psychosis)

Question 20

Describe the extracellular amyloid plaques that occur in people with Alzheimers.

Answer 20

These are insoluble misfolded proteins, and are associated with inflammation

Question 21

How do neurofibrillary tangles form?

Answer 21

Hyperphosphorylation of tau protein in microtubules

Question 22

Name 4 cholingeric projections in the brain.

Answer 22

• Striatal interneurons – motor control.
• Nucleus basalis of meyenert – attention/arousal.
• Medial septal nucleus – learning and memory.
• Brain stem nuclei.

Question 23

What cholingeric receptor is affected first in Alzheimer’s?

Answer 23

Nucleus basalis of meyenert

Question 24

What drugs are used in the tx of alzheimer’s and lewy body dementia?

Answer 24

Acetylcholinesterase inhibitors

Question 25

What do acetylcholinesterase inhibitors do?

Answer 25

Boost cholinergic transmission, but don’t treat the underlying pathological process

Question 26

Give examples of acetylcholinesterase inhibitors.

Answer 26

* Donepizil * Galantamine * Rivastigmine

Question 27

What – in terms of mode of action does memantine do?

Answer 27

A low-affinity voltage-dependent non-competitive antagonist of NMDA receptors

Question 28

What is memantine licensed for?

Answer 28

The treatment of all stages of Alzheimer’s disease

Question 29

What may memantine preferentially inhibit?

Answer 29

Excessive NMDA receptor activation associated with excitotoxicity and spare normal function

Question 30

What is memantine a weak antagonist for?

Answer 30

Other amine inhibitors

Question 31

Where is a common site of damage in vascular dementia?

Answer 31

Peri-ventricular

Question 32

What are the majority of cases of vascular dementia caused by?

Answer 32

Gradual stroke damage – small vessel disease – which has not been recognised

Question 33

What are lewy bodies?

Answer 33

Clumps of alpha synuclein and ubiquitin

Question 34

What does loss of dopamine producing neurones in the substantia nigra in this condition result in?

Answer 34

Parkinsons symptoms

Question 35

What does loss of ACh result in?

Answer 35

Memory problems

Question 36

Outline the key features of lewy body dementia.

Answer 36

* Confusion * Parkinson’s sx * REM sleep disorder * Visual disturbance * Autonomic instability, especially hypotension

Question 37

What did frontotemporal dementia used to be known as?

Answer 37

Picks disease

Question 38

When does frontotemporal dementia usually start?

Answer 38

55-65 years, so think ‘younger pt with dementia.’

Question 39

What are the 5 main symptoms of frontotemporal dementia?

Answer 39

* Disinhibition * Loss of memory (occurs later on) * Behavioural changes * Progressive non-fluent aphasia * Somatic dementia

Question 40

Wernicke's encephalopathy is an _______ related dementia

Answer 40

ALCOHOL

Question 41

What is Wernicke's encephalopathy due to?

Answer 41

A thiamine deficiency

Question 42

What is thiamine essential for?

Answer 42

Krebs cycle

Question 43

What is the classic triad of Wernicke's encephalopathy?

Answer 43

1. Ophthalmoplegia 2. Confusion 3. Ataxia

Question 44

Wernicke's encephalopathy is due to __________ problems

Answer 44

CEREBELLAR

Question 45

What other symptoms are associated with Wernicke's encephalopathy?

Answer 45

``` Visual impairment Hearing impairment Reduced conscious level Hypothermia Lactic acidosis Circulatory changes ```

Question 46

Remember to replace ________ in Wernicke's encephalopathy

Answer 46

THIAMINE