Dementia

Question 1

What are the types of neurodegenerative dementias?

Answer 1

• Alzheimer’s
• Lewy body
• Frontotemporal
• Progressive supranuclear palsy
• Huntington’s disease

Question 2

Name 2 other types of dementia

Answer 2

• Vascular

- Prion disease

Question 3

How are some neuro conditions genetically classified?

Answer 3

• Tauopathies= Corticobasal, frontotemporal, alzheimer’s
• Ubiquinopathies= semantic dementia
• Synucleinopathies= Dementia with lewy bodies, parkinson’s, MSA

Question 4

What are the 2 types of normal pressure hydrocephalus?

Answer 4

• NPH with preceding cause (SAH, meningitis, trauma, radiation-induced)
• NPH without preceding cause

Question 5

What is the triad of normal pressure hydrocephalus?

Answer 5

• Dementia
• Gait disturbance
• Urinary incontinence

Question 6

What is seen on an MRI for a patient with vCJD?

Answer 6

-Abnormality in posterior thalamic region= pulvinar sign

Question 7

What are clinical features of VGKC Ab.LE?

Answer 7

• Voltage-gated Potassium Channel antibody associated limbic encephalitis
• Subacute memory loss
• Hyponatraemia
• Seizures
• Psychiatric/behavioural disturbances

Question 8

What are executive functions?

Answer 8

• Motor
• Planning
• Strategic thinking

Question 9

What functions are associated with the limbic system?

Answer 9

• Arousal
• Emotion
• Motivation
• Attention
• Memory

Question 10

Define cognition

Answer 10

Sum of brain functions which allows us to integrate in the environment

Question 11

Name intellectual skills

Answer 11

• Learning & memory
• Emotion
• Personality
• Language
• Visuospatial skills

Question 12

Name some cognitive neuro disorders

Answer 12

• Temporal, parietal, frontal degeneration=Alzheimer’s
• Frontal temporal degeneration
• Multifocal degeneration= corticobasal degeneration
• Cognition & movement= dementia with levy bodies

Question 13

What proteins are involved in dementia?

Answer 13

• B-amyloid
• Tau
• Ubiquitin
• α-synclein

Question 14

What are amyloid proteins?

Answer 14

• Insoluble fibrous protein aggregates sharing specific structural traits
• Arise from inappropriately folded natural proteins & polypeptides
• Misfold alter configuration forming insoluble fibrils
• In organs leads to amyloidosis

Question 15

What are Tau proteins?

Answer 15

• Group of proteins that stabilise microtubules in neurons
• 6 isoforms
• When defective microtubules become unstable & dysfunctioning

Question 16

What is the pathogenesis of dementia

Answer 16

• Oxidative stress=free radicals
• Excitotoxicity=glutamine stimulation
• Apoptosis
• Cytokine=inflammatory response
• Genetics= gene mutations
• Ageing= age-related decline in efficiency of metabolic pathways
• Accumulation of abnormal proteins= intra/extracellular

Question 17

Which proteins accumulate intra/extracellularly?

Answer 17

• I= Tau, α-synuclein, ubiquitin, polyglutamine

- E=amyloid

Question 18

What are neuropathological findings in Alzheimer’s?

Answer 18

• Macro= dec brain weight, atrophy of gyri, widening sulci: frontal, temporal, parietal, hippocampus, ventricular dilatation
• Micro=neuronal loss, neuritic plaques, Neurofibrillary tangle & neuropil threads

Question 19

What are neuropathological findings in Dementia with levy bodies?

Answer 19

• Macro= pale, atrophy in amygdala, cingulate gyrus, temporal, parietal & frontal lobes
• Micro= neuronal loss, accumulation of α-synuclein

Question 20

What are the types of vascular dementia?

Answer 20

• Multi-infarct dementia
• Binswanger’s disease
• Arteriolosclerosis