Week 1 - Memory Disorders

Question 1

what differentiates a major from a mild neurcognitive disorder? what are the other two things that determine it’s a neurocognitive disorder?

Answer 1

major: significant decline from previous level of performance in one+ cognitive domains
- concern that there has been significant decline
- substantial impairment in cognitive performance (documented by standardized neurological testing)
- deficits interfere with independence of every day activities

minor: modest declines, modest impairments, and doesn’t interfere with independence
determinants: cognitive deficits don’t occur exclusively in the contest of delirium, and are not better explained by another mental disorder

Question 2

what are the cognitive domains measured for neurocognitive disorders?

Answer 2

complex attention
executive function
*learning and memory*
language
perceptual-motor
social cognition

Question 3

neurocognitive disorder prevalence for mild/major depending on

• age
• gender
• race
• education

Answer 3

there’s always more mild than major

• increases with age
• equal male:female
• more in Hispanics > Africans > White/other
• inverse relationship with education

Question 4

major risk factors for TBIs

Answer 4

• males are 1.5-2x more likely
• ages 0-4 (child abuse), 15-19 (driving accidents), elderly (falling)
• military (PTSD)
• contact sports

Question 5

is a concussion a TBI?

Answer 5

yes, it is a mild TBI

Question 6

what do 1 year and 8 year post TBI brains look like compared to controls?

Answer 6

loss of axons and axonal connections (thinner corpus callosum)

Question 7

what do Alzheimer’s brains look like?

Answer 7

decline in memory from atrophy of hippocampus

Question 8

what are neurophychological assessments based on?

Answer 8

based on demonstrated links between brain anatomy/function and behavior

• test some aspect of behavior (anything we can measure and quantify, like attention, language, memory)
• infer something about brain function (location, type, and/or degree of impairment

Question 9

what neurologists focus on versus neuropsychcologists

Answer 9

neurologists: structure and physiological consequences of injury/illness
neuropsychologists: cognitive and behavioral consequences of injury/illness, and functional capacities

Question 10

what are referrals usually for?

Answer 10

to determine nature and degree of imapirment, rather than if there is an impairment

Question 11

when would referrals be given?

Answer 11

• after TBI (accident, gunshot, etc.)
• brain tumors, infectious, strokes
• neurological disorders
• medical diseases
• developmental disorders
• part of comprehensive psychological or psychoeducational evaluation (trouble learning in school)

Question 12

what is the Rey-Osterrieth complex figure used for?

Answer 12

spatial or non-verbal long term memory (LTM) testing

• copy a complex figure using 4 different colors (given at different intervals)
• redraw it from memory with one color

Question 13

how do control brains differ from Alzheimer’s and TBI?

Answer 13

ventricles: larger in TBI, then Alzheimer’s, then control
gyrification: more intense in Alzheimer’s, then TBi, then control

Question 14

what kind of approach do TBI and Alzheimer’s patients take to the RO figure?

Answer 14

parts orientation approach (draw figure in parts, and only remember certain parts, not really the whole Gestalt approach)

Question 15

what memory is the California Verbal Learning test used for? how is it performed?

Answer 15

auditory or verbal long term memory (LTM)

1. say list of 16 words 5 times (normal recall 8 –> 9 –> 10 –> 11 –> 12)
2. another list of 16 words (normal recall 6)
3. ask to remember first list of 16 (normal recall 12)
4. tell to clump in groups of items (if not already done so)

Question 16

what do dementia patients usually do better on for the CVL test?

Answer 16

everyone has better recognition than recall, but the discrepancy is bigger for dementia patients

Question 17

what is the purpose of the CVLT-II?

Answer 17

1. distinguish between learning/attention problem and memory impairment
2. ability to learn/retain verbal information
3. differentiation between depression and neurological disorders
4. detect brain damage in TBI, drug abuse, etc.
5. characterize memory profiles in patients with schizophrenia, depression
6. detection of inadequate effort or malingering

Question 18

what part of the brain does working memory test?

Answer 18

prefrontal cortex

Question 19

what is an example of a working memory test?

Answer 19

“N-back task” usually N = 2

• show series of pictures, and must press button if the picture is the same as picture 2 back (can also be for spoken letters)
• usually don’t use 3 or 4 back b/c already have problems at 2
• include a test for attention to ensure paying proper attention