Cortical Dementia

15 important questions on Cortical Dementia

What are the diagnostic criteria for definite FTD-bv?

- Progressive detorioration of behavior and/or cognition.
- Histopathological evidence and/or pathogenix mutation.

What is found in NPA in FTD?

- Executive functioning: disinhibition, deficits in planning, perseveration.
- Visuoconstruction: perseveration.
- Memory is relatively intact.

What brain areas are affected in FTD?

Degeneration of prefrontal and anterior temporal areas.
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What are the diagnostic criteria for PPA?

- Difficulty in language as most prominent clinical feature.
- Principle cause of impaired ADL.
- Aphasia most prominent deficit at the onset and initial phase.

What are exclusion criteria for PPA?

- Deficits better accounted for by neurological condition.
- Cognitive disturbance better accounted for by psychiatric diagnosis.
- Prominent initial episodic or visual memory and visuoperceptual impairment.
- Prominent initial behavioral disturbance.

What are the three subtypes of PPA?

- PPA-non fluent
- PPA semantic dementia
- PPa logopenic progressive aphasia

What are the diagnostic criteria o PPA non-fluent?

One of: agrammatism, or efforfull, halting speech.
Two of: Impaired comprehension syntactically complex sentences, spared single-word comprehension, or spared object knowledge.

What are the diagnostic criteria for PPA semantic dementia?

One of: impaired confrontation naming, or impaired single-word comprehension.
Three of: impaired object knowledge, surface dyslexia/dysgraphia, spared repetition, or spared speech production.

What are the diagnostic criteria for PPA logopenic progressive aphasia?

Two of: impaired single-word retrieval in spontaneous speech and naming, and impaired repetition of sentences and phrases.
Three of: phonological speech errors, spared single-word comprehension and object knowledge, spared motor speech, and absence of frank agrammatism.

Which brain areas are affected in PPA?

NaPPA: left fronto-insular
SD: anterior temporal
LPA: left posterior perusylvian or parietal

What are the core features of Lewy Bodies dementia?

- Fluctuating cognition
- Recurrent visual hallucinations
- REM sleep behavior disorder
- Spontaneous features of parkinsonism

What are supportive features of Lewy Bodies dementia?

- Severe sensitivity to antipsychotic agents
- Repeated falls, postural instability and syncope
- Transient, unexplained loss of consiousness
- Severe autonomic dysfunction
- Hallucinations other modalities
- Systematized delusions
- Depression, apathy, anxiety

What are indicative biomarkers for Lewy Bodies dementia?

- Reduced dopamine transporter uptake in the basal ganglia.
- Abnormal uptake in myocardial scintigraphy
- REM sleep confirmation Polysomnographic

What are supportive biomarkers for Lewy Bodies dementia?

- MRI: perseveration MTL, hippocampus, amygdala. Atrophy of the putamen.
- SPECT: parieto-occipital hypoperfusion
- Slow-wave EEG with period fluctuations

What is found in NPA in Lewy Bodies dementia?

- Visuoconstruction
- Attention
- Executive functioning:  mental inflexibility, attention
- Memory, later stages: variable learning curves

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