Dementia & Cognition

•Regulating emotions, social interactions, and personality.

•The frontal lobes are critical for more difficult decisions and interactions that are essential for human behavior.

•Damage to this area may result in disinhibition and deficits in concentration, orientation, and judgment.

Frontal Lobe

•The temporal lobe processes sensory input into

derived meanings for the appropriate retention of emotions, visual memory, and language comprehension.

•Primary auditory cortex

which is involved in processing sound.

•Wernicke's area is

located in the dominant hemisphere and manages the comprehension of language.

The parietal lobe is responsible for

perception, sensation, and integrating sensory input with the visual system.

•Somatosensory cortex

•It is responsible for receiving contralateral sensory information

•Damage to the dominant parietal cortex (usually left) leads to

•Agraphia (Difficulty with writing)

•Acalculia

Left-right Disorientation

Center for the processing of visual input in humans.

The primary visual cortex is located in Brodmann Area 17, on the medial side of the occipital lobe within the calcarine sulcus.

Damage to a single occipital lobe can result in homonymous hemianopsia (loss of vision in half the visual field) as well as visual hallucinations.

Bilateral damage to the primary visual cortex can cause blindness (cortical blindness).

Occipital Lobe

•Impairment in intellectual function affectingmore than one cognitive domains

•Interferes with social or occupational function

•Decline from a previous level

•Not explained by delirium or majorpsychiatric disease

Dementia

•Cognitive declineabnormal for age andeducation but  does not interfere with  functionand activities

•“At risk” state todevelop a degenerativedementia

•When memoryloss predominates,termed AmnesticMCI. This has

~15%per year of conversion to AD.

MCI

•FTD

Frontotemporal dementia

•The earliest cognitive symptoms are usuallypoor short-term memory, anterograde amnesia, and loss of orientation.

•Mood disorders.

•Smooth, usually slow decline withoutdramatic short-term fluctuations

•Other domains are involved with the progression of the disease

AD Clinical Features

•Relatively earlier occipital and basal

ganglia degeneration

•Similar to Parkinson disease dementia: α-synuclein and ubiquitine aggregates (Lewybodies) in postmortem studies

•Concurrent AD pathology is common

Dementia with Lewy bodies

Frontotemporal dementia (FTD) is a spectrum of clinical syndromes characterized by neuronal degeneration involving the frontal and anterior temporal lobes of the brain

Frontotemportal Dementia