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week 11 Flashcards

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1
Q

Cortical areas associated with language processing

A
  • Left hemisphere is considered the language dominant hemisphere
  • Broca’s area and Wernicke’s area are the major cortical language areas for production and
    comprehension
  • Right hemisphere does play some role in language and cognitive control of language
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2
Q

what does the arculate fasciculus connect

A

broca’s and wernickes area

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3
Q

What is aphasia?

A
  • Aphasia results from damage to cortical language centres in left hemisphere of the brain
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4
Q

Wernicke’s aphasia

A
  • A “fluent” type of aphasia, with animpairment of “receptive” language
  • difficulty understanding language they hear to read
  • Superior temporal gyrus, supplied by MCA
  • Fluent, copious verbal output
  • Frequent word errors
  • Impaired naming and repetition
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5
Q

Broca’s aphasia

A
  • A type of non-fluent aphasia, with an impairment of “expressive” language
  • Limited verbal output, effortful and agrammatic
  • Broca’s area and surrounding areas in the inferior
    frontal gyrus supplied by left MCA
  • Relatively good auditory comprehension
  • Difficulty with naming
  • Repetition usually poor
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6
Q

Conduction aphasia

A
  • A lesion to the cortical region supramarginal gyrus and white matter pathways of arcuate fasiculus
  • Fluent speech with relatively intact receptive language
  • Poor repetition
  • Phonemic errors in spoken output
  • Naming difficulties
  • Awareness of errors
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7
Q

Global aphasia

A
  • Extensive damage to frontal, temporal and parietal regions, distribution of MCA
  • Severe receptive + expressive impairments
  • Almost totally absent speech
  • May be able to express oneself through facial expression, intonation and gesture.
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8
Q

Cognitive-communication disorders are?

A

problems with communication that have an underlying cause in a cognitive deficit rather than a primary language or speech deficit.

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9
Q

A cognitive communication disorder arises from

A

disruption in one or more of the
following cognitive domains (just to name a few of the cognitive processes)
* Attention
* Memory
* Executive function (planning, problem solving, reasoning)

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10
Q

Neurological conditions associated with cognitive communication disorders include;

A

traumatic brain injury, dementias, Parkinson’s disease, Huntington’s disease,
multiple sclerosis

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11
Q

Changes in cognition influence the success of communication?

A

changes in attention- Difficulty staying on topic during conversation or narrative
memory- Difficulty accessing known information
Executive function (planning, problem solving, reasoning)- difficulties with turn-taking, social judgement (disinhibition), and adopting another’s perspective

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12
Q

Consciousness

A

is having subjective experiences. It is a state of awareness of the self and the environment
* Also influenced by altered states of consciousness such as during meditation, after taking certain medication/drugs, or due to mental health concerns

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13
Q

Aspects of consciousness include:

A
  • General level of arousal
  • Attention
  • Selection of object of attention (based on goals)
  • Motivation and initiation
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14
Q

Attention is

A

the concentration of awareness/focus on some phenomenon to the exclusion of other stimuli.
Attention can relate to thoughts, vision, hearing

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15
Q

Attention has five related aspects:

A
  1. Orienting
  2. Divided
  3. Selective
  4. Sustained
  5. Switching
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16
Q

Orienting attention

A

the ability to locate specific sensory information from among many stimuli.
e.g. locating the traffic light while driving,

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17
Q

Divided attention

A

the ability to attend to two or more things simultaneously.
e.g. driving and talking (hands free)

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18
Q

Selective attention

A

the ability to attend to important information and ignore distractions.
e.g. focusing on your conversation with a patient in a noisy hospital/clinic

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19
Q

Sustained attention

A

the ability to continue an activity over time.
e.g. reading

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20
Q

Switching attention

A

the ability to change from one task to another successfully.
* e.g. switching following a recipe to speaking on the phone to returning to the recipe

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21
Q

Memory is

A

the formation of records of new experiences and the use of the information to guide
subsequent activities.

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22
Q

Short-term (working) memory

A
  • Maintains goal-relevant information for a short time.
  • Essential for language, problem solving, mental navigation, and reasoning.
  • Mental multitasking requires working memory and is central to cognition.
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23
Q

Declarative (explicit/conscious) memory (long term memory)

A

refers to recollections (memories) that can be
easily verbalized/declared.

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24
Q

Episodic (Declarative) memory

A

Episodic memory is the collection of specific personal events (who, what, when, where & why)

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25
Neural structures associated with attention
Frontal eye field, Superior parietal lobe
26
Semantic (declarative) memory
common knowledge, not based on personal experience. E.g. names of countries
27
Declarative memory has 3 stages what are they
encoding, consolidation & retrieval.
28
encoding stage for memory
Encoding - processes information into a memory representation. Enhanced by attention & arousal and linking new information to other related information
29
Consolidation stage for memory
stabilizes memories. Synaptic (long-term potentiation) and systems consolidation (reorganises memory information).
30
Retrieval stage of memory
– ability to find and accurately recall memories.
31
Procedural (implicit/nonconscious) memory
* Refers to recall of skills and habits. * Also includes perceptual and cognitive skill learning. Perceptual skills include object, pattern, and face recognition. Cognitive skills include reasoning and logic. * Practice is required to store procedural memories. Once the skill or habit is learned, less attention is required while performing the task.
32
Neural structures associated with memory short term memory
temporoparietal assosiation cortex lateral prefrontal cortex
33
Neural structures associated with memory declaritive memory
lateral pre-frontal cortex medial temporal lobe temporoparietal assosiation cortex
34
Memory loss - amnesia
* Amnesia is the loss of declarative memory * Most common causes * Head injury
35
Retrograde amnesia is
the loss of memories for events that occurred before the trauma/disease
36
Anterograde amnesia is
the loss of memories for events FOLLOWING the trauma/disease
37
Learning vs memory
is the acquisition of skill or knowledge, while memory is the expression of what you’ve acquired.
38
Learning will be influenced by
attention, current memories/knowledge and your ability to remember or associate new information
39
Healthy ageing is associated with structural & functional changes in the brain:
* Reduced brain volume * Grey matter atrophy * White matter atrophy – loss of myelin * Synaptic degeneration and alterations * Blood flow reduction - cerebral blood decreases * Neurochemical alterations – lipids in neurons, iron accumulation in striatal region, amyloid plaque and neurofibrillary tangles (Tau) in neurons
40
ageing Cognitive changes occur in:
* Visual perception and Attention * Episodic memory * Working (short term) memory & Executive function
41
ageing Cognitive changes due to deficits in:
* Attention resources * Processing speed * Inhibition
42
Major Neurocognitive Disorder
Significant acquired cognitive decline in one or more cognitive domains Cognitive deficits interfere with independence in everyday activities The cognitive deficits are not due to delirium or other mental disorder (schizophrenia etc)
43
Mild Neurocognitive Disorder
a) Modest acquired cognitive decline in one or more cognitive domains b) Cognitive deficits do not impact ability to be independent on everyday activities
44
Dementia is
the term used to describe the symptoms of a large group of illnesses which cause a progressive decline in a person’s functioning. It is a broad term used to describe a loss of memory, intellect, rationality, social skills and physical functioning.
45
Dementia subtypes
* Alzheimer’s Disease (AD) * Fronto-Temporal Degeneration (FTD) * Lewy body dementias (including Parkinson’s Disease dementia) * Vascular Dementia
46
Alzheimer’s disease Diagnostic criteria
a) Meets criteria for Major (or Minor) Neurocognitive disease b) Insidious onset and gradual progression of cognitive impairment c) Criteria met for diagnosis of probable AD: * Clear evidence of decline in memory and learning and at least 1 other cognitive domain * Steadily progressive, gradual decline in cognition without extended plateaus * No evidence of mixed etiology (stroke, other neurodegenerative disorder etc)
47
Characteristics of dementia types - Alzheimer’s disease
* Amyloid/neuritic plaques & neurofibrillary tangles (Tau) - Interfere with communication between neurons * Cortical atrophy * Reduced size of hippocampus * Enlarged ventricles
48
Alzheimer’s disease Common symptoms MEMORY
* Primary deficit in episodic memory (who, what, when…) * Persistent and frequent short-term memory loss * Repeatedly saying the same thing * Difficulty in learning new information * Procedural memory usually better intact compared to episodic memory
49
Common symptoms Other potential symptoms Alzheimer’s disease
* Language (word finding difficulties) * Visuo-spatial perception * Planning, reasoning and problem solving * Abstract thinking * Orientation (disorientation to time, place and person) * Changes in behaviour and mood * Delusions / Paranoia * Aggression and agitation * Reduced motivation & difficulty initiating tasks
50
Characteristics of – Frontotemporal dementia
commonly diagnosed in patients younger than 65 years. * Progressive atrophy of frontal and temporal regions Behavioural variant Bilateral frontal lobe atrophy Personality changes, disinhibition, and apathy
51
– Frontotemporal dementia is
An umbrella clinical term that encompasses a group of neurodegenerative diseases characterised by progressive deficits in behaviour, executive function, or language.
52
Behavioural variant of – Frontotemporal dementia
* Personality changes, disinhibition, and apathy. * Behavioural disinhibition can result in socially inappropriate behaviour (eg, no respect for physical and social boundaries); impulsive actions (such as reckless spending); new criminal behaviours (eg, theft, urination in public). * Language typically intact.
53
2. Non-fluent variant progressive aphasia of – Frontotemporal dementia
* Non-fluent, effortful speech but relatively preserved cognition. * Inconsistent speech sound errors * Anomia (unable to name objects)
54
3. Semantic variant progressive aphasia of Frontotemporal dementia
* Selective impairment of semantic memory * Progressive impairment of word meaning & word finding * Fluent but empty speech (“I don’t know, it’s that thing…”) * May show some behavioural changes
55
Lewy body dementia is
umbrella term that includes clinically diagnosed dementia with Lewy bodies and Parkinson’s disease dementia. * Lewy bodies are the abnormal deposits of the protein alpha-synuclein in the brain. * The accumulation of Lewy bodies is associated with neuronal loss in substantia nigra and reduced production of important neurotransmitters (acetylcholine & dopamine)
56
Lewy body dementia Common symptoms
* Executive dysfunction * Difficulties with selective attention * Deficits with visuospatial function * Deficits in episodic memory * Verbal recall difficulty * Apathy, depression, hallucinations, delusions
57
Vascular dementia
Cognitive loss associated with cerebrovascular damage
58
Vascular dementia diagnostic criteria
* Onset of cognitive deficits are related to one or more cerebrovascular events, and/or * Evidence of decline in complex attention (processing speed) and frontal-executive function
59
Vascular dementia Patient presentation
more variable (depends on the amount and location of damaged tissue) * Usually occurs after an abrupt onset (e.g. stroke) but progression can be variable * Often people with vascular dementia have a mixed vascular and Alzheimer’s pathology
60
– Vascular dementia Common symptoms
* Attention deficits * Executive dysfunction * Deficits in working memory, procedural and episodic memory * Gait abnormalities * Exaggerated reflexes
61
Common general cognitive assessments
- mini mental state exam - mini cog
62
Common Memory specific assessments
memory impairment screen - wechsler memory scales revised

neuro (18 decks)

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