Abnormal Psychobiology Exam 2 Part 3

Delirium

Which neurocognitive disorder has most cases recover fully with or without treatment?

• Traumatic brain injury (TBI)

• Alzheimer’s disease (AD)

• Parkinson’s disease

• Delirium

delirium tremens (DT)

the most severe form of ethanol withdrawal; global confusion, whole body tremors, vomiting, hallucinations; requires heavy alcohol dependence

dementia

significant decline in overall cognitive functioning and the ability to independently perform activities of daily living (ADLs) such as eating and personal hygiene; has been renamed major neurocognitive disorder (NCD) in the DSM-5

mild neurocognitive disorder

modest decline in cognitive functioning with no interference in one’s ability to complete ADLs

degeneration

Mild neurocognitive disorder may mark the beginning of __________ into major NCD or recovery of some function following brain injury.

Parkinson’s disease

characterized primarily by motor-related symptoms, but cognitive symptoms often come first; dopamine reduced by neuron death in the substantia nigra

false

True or false?

Newer, atypical antipsychotic drugs tended to induce Parkinson’s-like symptoms early on in treatment by blocking dopamine D2 receptors.

L-dopa

a dopamine precursor given to Parkinson’s patients that can trigger schizophrenia-like symptoms and/or problematic compulsive behavior

detachment

Although both schizophrenia spectrum disorder and NCD are primarily thought/cognitive disturbances, NCD are not marked by __________ from reality (psychosis).

Alzheimer’s disease (AD)

major NCD characterized by progressive loss of memory (especially recent events) and other cognitive functions; general loss of cognitive abilities severe enough to interfere with daily life

65; 85

Alzheimer’s disease occurs in ~11% of people over age _____ and ~32% (may be as high as ~50%) of people older than _____.

amyloid; tangles

Abnormal structures that develop in Alzheimer’s disease include ________ plaques and neurofibrillary ________.

acetylcholine

Alzheimer’s disease shows widespread neural degeneration, affecting __________-producing neurons first (especially around the basal forebrain). This neurotransmitter in especially important in memory and attention.

amyloids

previously healthy proteins that lose their normal structure and physiological functions (misfolding), forming deposits (plaques) which can disrupt the functioning of tissues and organs; associated with Alzheimer’s disease (AD), Huntington’s disease, and Parkinson’s disease (and others)

37

______ human proteins have been found to form amyloids in pathology and be associated with well-defined diseases.

amyloid plaques

extracellular deposits in Alzheimer’s disease; dense core of beta-amyloid that contains the defective form of the protein

beta-amyloid

produced from amyloid precursor protein (APP) which is cut into two places by different enzymes

beta-secretase

removes extracellular “tail” of APP to prepare it to become beta-amyloid

gamma-secretase

removes “head” of APP to prepare it to become beta-amyloid; determines which form of the protein is produced: short form (40 amino acids) or long form (42 amino acids)

short; long; long

Normally, 90-95% of beta-amyloid proteins are _______ form and 5-10% are _______ form. In AD patients, up to 40% are ______ form.

true

True or false?

The long form of beta-amyloid is prone to misfolding.

ubiquitin; proteasomes

Normal levels of misfolded beta-amyloid can be tagged by _________ and broken down by __________. In AD, long form beta-amyloid can’t be removed from the cell fast enough and it begins to form aggregations.

neurofibrillary tangles

altered tau disrupts intracellular transportation, eventually killing the cell and leaving behind a tangle of protein; caused by excess phosphate attaching to tau proteins in AD

tau protein

a normal component of microtubules involved in intracellular transport

early onset

AD that occurs before age 65; typically hereditary

Down syndrome

~50% of individuals with ___________ develop AD by their 60s.

apolipoprotein E (ApoE)

transports cholesterol in blood and is involved in cellular repair; gene allele interferes with removal of long form of beta-amyloid and increases the risk of AD

increase

Acetylcholinesterase inhibitors (that ________ ACh) provide modest improvement of cognitive symptoms, but fail to prevent neural degradation.

NMDA receptor antagonists

provide slight improvement of cognitive symptoms by slowing excitotoxic (excess Ca2+) destruction of ACh neurons

All of the above

Which of the following is a risk factor for Alzheimer’s disease?

• Age

• Traumatic brain injury

• Obesity, hypertension, high cholesterol levels, and diabetes

• Lower levels of formal education

• All of the above

REM sleep behavior disorder

paralysis does not occur during REM sleep and dreams are acted out; may mark beginning of neurodegeneration in Parkinson’s disease or neurocognitive disorder

major; delusions

Individuals with ________ neurocognitive disorder (MND), formerly called dementia, often experience ________.

bizarre delusion

a delusion that is highly implausible or impossible; a belief that is clearly fantastic but is maintained with conviction; ex. someone has removed an organ from their body without any physical evidence of the procedure

non-bizarre delusion

a delusion that could occur in reality

cerebrovascular accident (stroke)

occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts (ruptures); likelihood increases with age; second most common cause of NCD (after Alzheimer’s)

hemorrhagic stroke

caused by bleeding in the brain; blood vessels may be weakened by high blood pressure or naturally malformed

ischemic stroke

obstructs the blood flow

thrombus

a blood clot in the blood vessel

embolus

a piece of material that breaks off and lodges in an artery that is too small to pass through

glutamate

The ultimate cause of neuronal death is depletion of oxygen and glucose due to excess _________.

transporters; depolarize

Without an energy source (ATP), sodium-potassium __________ stop functioning, membranes ________, and glutamate is released (excitotoxicity).

desmoteplase

from the saliva of a vampire bat; administered as an anticoagulant drug; experimental treatment for ischemic stroke; long-term effects are unknown

reperfusion

restoration of cerebral blood flow to affected area

traumatic brain injury (TBI)

dysfunction in the brain caused by an outside force; include open-head injuries, closed-head injuries, and chronic traumatic encephalopathy (CTE)

concussions; CTE

___________ are acute injuries caused by a single impact, while ______ is a progressive, degenerative brain disease linked to repeated head trauma, often appearing years after the injuries

open-head TBI

damage directly to the brain and/or blood vessels that supply other areas of the brain; also called penetrating brain injury

closed-head TBI

no penetration of the brain; can experience coup and contrecoup as the brain hits both sides of the skull; tear axons, rupture blood vessels, CSF can distort ventricle walls; seizures may occur months later

chronic traumatic encephalopathy (CTE)

repeated head trauma; common in contact sport athletes; mood and cognitive impairment years after injury; abnormal tau protein in cortex can tangle (similar to Alzheimer’s)

Korsakoff’s syndrome

a substance/medication-induced major or mild neurocognitive disorder characterized by dementia (non-progressive); problems learning new information, inability to remember recent events (anterograde amnesia)

mammillary bodies; environmental

Korsakoff’s syndrome shows deterioration in the _____________ of the posterior hypothalamus and is caused strictly by _________ factors.

frontotemporal dementia (Pick’s disease or FTD)

lacks the amyloid plaque buildup characteristic of Alzheimer’s disease; a neurodegenerative disorder primarily caused by the accumulation of tau proteins

FTD; Alzheimer’s

_________ causes behavioral and language changes early, while _________ typically starts with memory problems.

Huntington’s disease

disease characterized by clumps of mutant protein that form inclusion bodies in the nucleus; role of these bodies is unclear (could be protective, preventing mutant Htt from spreading to other parts of the cell)

nigrostriatal; Lewy

Parkinson’s disease is characterized by near-disappearance of _________ dopaminergic neurons; surviving dopaminergic neurons show _______ bodies.

Lewy bodies

abnormal spherical structures in the cell cytoplasm that displace other cell components