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PSYC 207
Michael Souza

MMSE Mini mental status exam out of 30 points - 1st 2 quesitons: about orientation, 10 points total - 1st 2 wuetions strong indicatorsà with dememntia you get confused - score is predictive of time course of AD and other dementias biological changes: - cortical atrophy - temporal and parietal lobes first - gyri get thinner, sulci get wider - lets you differentiate between AD and different types of dememtia - even AD you can get a definitive diagnosis until autopsy - only get a probable diagnosis while they are alive Alzheimers Biological Changes: corticall atrophy - First part is tempora and parietal lobes begin to die - What you can see is that the temporal and parietal lobes begin o The gyri are getting thinner o The spaces of the cortex (sulci) are getting wider - This happens FIRST in temporal/parietal lobes - This is one way diagnostically t hat can help to differentiate between Alzheimers and other types of dementia - You can’t get a DEFINITIVE diagnosis of alzheimers while they are alive - You can get a PROBABLE diagnosis – based on behavior, and decreased brain matter Cortical Atrophy - Frontal lobes (look fine) - However, Pick’s attack front not back - Useful for diagnosis - Memory/Language Problems + Temporal/Parietal = probable altzheimers Biological changes: pathology of Alzheimers - Neurofibirillary tangles - Beta-amyloid plaques o Junk that builds up (not there in normal brain) o But, no relationship between the AMOUNT of plaques and how severe the disease it o This is scary, because if you think that the plaques are causing death = more plaques more brain death (but this doesn’t seem to be true) o Maybe the tangles are more problematic - o Neurons become disconnected and eventually die o Causes the brain to shrink and lose function - Temporal & Pareital Lobes o Symptoms – problem with language (temporal) o Problem with memory (temporal) o Problem with visuospatial (parietal) o Loss of neurons maps on perfectly with what we think lobes are doing Biological changes: pathology of Alzheimers - Basal Forebrain – creates ACH (Acetocoline) o Essential for learning & memory o This nucleus is destroyed in Alzheimers o ACH declines o This corresponds to reductions in memory behaviorally o Normal brain = lots of ACH in normal brain o AD = temporal lobe ACH is wiped out  This isn’t even developed AD, but will o Before person has become symptomatic you can PREDICT what is going to happen o These neurochemical changes happen before a person becomes symptomatic o MAYBE – we can solve the problem here (before symptoms) - There is no cure, but there are treatments o Ariscept  Drug that increases ACH levels in brain  Improves quality of life for years  Eventually everybody stops responding to these drugs  But, it extends quality of life  Drug stopes working = dramatic decline in function - There is a cause: o 1/10 causes are genetic are familial o 9/10 don’t know o Linked to 5 other chromosomes o People with downs are more likely to get AD  Chromosome 21  3 Chromosomes at 21, instead of 2  Very consistently get alzheiemrs much YOUNGER than anyone else, makes you think that 21 has something to do with AD o Doesn’t often CAUSE death (usually die from secondary causes) o Sometimes drugs developed for animals for AD don’t work in humans - Emotion, the amydgala, OFC o Tonks et al 2009 ** READING o One rule of thumb – if you are going to have a brain injury, the EARLIER you have it the BETTER  The brain is more plastic early on in life  If you lose a function, the young brain is more likely to be able to fix itself, and regain that function  But, that’s not true for EVERY function o Orbitofrontal Cortex  When children damage this region, they may never learn what is MORALLY acceptable o Circle of Papex  A proposed mechanism of emotion  Set of brain regions that work together that seem to support emotion o Theory based on  He looked at the progression of rabies  Rabies = is very serious  Rabies  bite  2-10 weeks  You have high fever, headache, tired, sore throat  Then, overactive, agitated, extremely afraid (of water), screans, curses, throat spasms, seizures and death  Rabies virus RAVAGES the circle of Papex  A lot of these symptoms are linked to emotional instability  If all these regions together – must be affected – they must share a common purpose o Areas of Circle of Papez  Amygdala  It is the structure at the END of the hippocampus  It is important for memory  When you damage this, it causes certain symptoms  Kluver Bucy sundrome  Bilateral temporal leisons, including Amygdala Damage o Hypersexual (mount anything) o Loss of social position  See monkeys  w/ KB – will have NO problem walking up to the top monkey and slapping it in the face (something that monkey would NEVER do) (no fear) o You lose fear of everything and you will DO anything o Decreased fear response  There is a loss of social pos
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