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 ofParkinson's
-Dementia syndrome with insidious onset and slowprogression : 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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