Summary: Lecture 5 Subcortical Dementia

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  • 1 Lecture 5 Subcortical dementia

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  • Which subcortical areas are involved in executive dysfunction?

    - Dorsolateral prefrontal cortex
    - Caudate nucleus
    - Globus pallidus
    - Thalamus
  • Which subcortical areas are involved in apathy?

    - Medial frontal cortex
    - Nucleus accumbens
    - Globus pallidus
    - Thalamus
  • What are risk factors for Parkinson's?

    Age, male gender
    Genes: two rare dominant mutations and several recessive mutations
  • What are non-motor symptoms occuring in Parkinson's?

    - Olfactory dysfunction
    - Changes in personality and mood
    - Excessive daytime sleepiness
    - Autonomic dysfunction
    - Psychotic symptoms (visual hallucinations)
    - Pain
    - Cognitive impairment
    - Demantia (30-70%)
  • How is Parkinson's diagnosed post-mortem?

    - Depigmentation of the substantia nigra
    - Lewy bodies in the brain stem
  • Which neurotransmitter systems are involved in Parkinson's?

    - Dopaminergic system
    - Noradrenergic system
    - Serotonergic system
    - Cholinergic system
  • What are clinical substypes of Parkinson's and what characterizes them?

    - Termor-dominant: mild disease progression
    - Akinetic-rigid: more severe cognitive impairment
    - Postural instability and gait difficulty: cognitive impairment and severe disease progression
  • What is found in NPA in Parkinson's?

    - Executive functioning: difficulties in initiation, planning, concept formation, rule finding, set-shifting, and attention. Bradyphrenia (slowing)
    - Memory: retrieval inefficiencies, but relative intact recognition
    - Micrographia
  • What are the core criteria for the diagnosis Parkinson's Disease Dementia?

    - Diagnosis of Parkinson's
    - Dementia syndrome with insidious onset and slow progression: more than 1 cognitive domain affected, decline from premorbid level, impairment in daily life.
  • What are associated clinical features in the diagnosis of Parkinson's Disease Dementia?

    Cognitive:
    - Attention: fluctuating, spontaneous and focussed
    - EF: planning, concept formation, rule finding, set shifting and maintenance, mental speed
    - Visuospatial: orientation, perception, construction
    - Memory: free recall less than recognition
    - Language: preserved, some word finding difficulties
    Behavior:
    - Apathy, hallucinations, delusions, sleepiness, change in personality and mood
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