Progressive Neurodegenerative Disorders

This is a brief video on six neurodegenerative disorders, or diseases that cause progressive impairment of intellectual function affecting multiple cognitive domains.
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ADDITIONAL TAGS:
Progressive neurocognitive disorders
Progressive impairment of intellectual function affecting multiple cognitive domains
Alzheimer’s disease
Lewy body dementia
Pick’s disease
Vascular dementia
Alcoholic dementia
Creutzfeldt-
Jakob Disease
Degenerative
Nondegenerative (requires insult)
Alzheimer’s disease
Most common cause of dementia
Mostly sporadic, some familial variants
Symmetric atrophy of frontal, temporal, parietal lobe; occipital spared
Hydrocephalus ex vacuo
Extracellular plaques called neuritic plaques (aka senile plaques) made of beta-amyloid
Central amyloid surrounded by dystrophic neuritic processes
Intracellular plaques called neurofibrillary tangles made of tau protein
Polymerized hyperphosphorylated tau protein
Sticks in a neuron
Lewy body dementia (aka DLB)
Second most common cause of dementia
Symptoms: cognitive impairment, parkinsonism, visual hallucinations, sleep disorders
Lewy body accumulation in neocortex, limbic system, and brainstem
Made of synuclein
Parkinson’s disease has Lewy bodies in substantia nigra
Alzheimer’s disease
Lewy body dementia
Pick’s disease
Vascular dementia
Alcoholic dementia
Creutzfeldt-
Jakob Disease
By Dr. Andreas Becker upload here Penarc - Own work, CC BY-SA 3.0, commons.wikimedia.org/w/index...
By Suraj Rajan - Own work, CC BY-SA 3.0, commons.wikimedia.org/w/index...
Frontotemporal dementia
(aka Pick’s disease)
Asymmetric atrophy of frontal and temporal lobes; spares parietal protein
More prominent personality changes, including apathy, disinhibition, loss of emotional control
Earlier onset and faster progression than AD
Intracellular spherical inclusions called Pick bodies made of tau protein
Ballooned neurons, dissolution of chromatin
Alzheimer’s disease
Lewy body dementia
Pick’s disease
Vascular dementia
Alcoholic dementia
Creutzfeldt-
Jakob Disease
By Mikhail Kalinin - Own work, CC BY-SA 3.0, commons.wikimedia.org/w/index...
Vascular dementia
Caused by cerebrovascular disease (multiple ischemic lesions)
In hippocampus and other areas involved with memory
Stepwise decline in cognitive function (worse with each infarct)
Radiology: absence of infarcts rules out vascular dementia, but presence of them doesn’t confirm it
Treatment: reduce risk factors (hypertension, hyperlipidemia), anticoagulants
Alzheimer’s disease
Lewy body dementia
Pick’s disease
Vascular dementia
Alcoholic dementia
Creutzfeldt-
Jakob Disease
By Blausen Medical Communications, Inc. - Donated via OTRS, see ticket for details, CC BY 3.0, commons.wikimedia.org/w/index...
Alcoholic dementia
Alcoholics have higher risk of dementia and brain atrophy
Not sure if alcohol toxicity directly causes dementia or increases risk of other causes
Lesions include
Trauma, including chronic subdural hematomas (high risk of falls)
Vascular disease (comorbid with smoking and htn in alcoholics)
Alzheimer’s (increased accumulation of Alzheimer’s proteins in alcoholics)
Wernicke-Korsakoff syndrome → thiamine deficiency causing bilateral hemorrhage/necrosis of mammillary bodies and other regions
Triad: confusion, ophthalmoplegia, gait ataxia
Anterograde, retrograde amnesia; confabulation
Treat with thiamine
Alzheimer’s disease
Lewy body dementia
Pick’s disease
Vascular dementia
Alcoholic dementia
Creutzfeldt-
Jakob Disease
Creutzfeldt-Jakob Disease (CJD)
Most common human prion disease
Caused by infectious particles made of protein
Gross: prominent cortical atrophy
Histo: spongiform changes with amyloid plaques and atrophic neurons
sCJD - sporadic; dementia, myoclonus, ataxia
fCJD - familial; autosomal dominant
vCJD - variant; mad cow disease (meat products)
iCJD - iatrogenic; exposure to contaminated cadavers, dural grafts, corneal transplants, surgical instruments
Alzheimer’s disease
Lewy body dementia
Pick’s disease
Vascular dementia
Alcoholic dementia
Creutzfeldt-
Jakob Disease
By DRdoubleB - Own work, CC BY-SA 3.0, commons.wikimedia.org/w/index...

[@jaumepp1975]

The thing I don’t agree with is the fact that Vascular dementia is not the 1st or 2nd cause of dementia.

[@ldjt6184]

Great video. How come multiple sclerosis is not one on your list?

[@ldjt6184]

MS is a neurodegenerative disease as well as being a demyelinating disease. It should be included here.

[@aldegid9307]

It was said at the very beginning of the video that it's about those disorders that mostly affect cognitive functions, when multiple sclerosis is usually associated with motor and sensitive changes. I guess that's the reason.

[@ldjt6184]

@@aldegid9307 Yes, I guess so.

[@okidoki3201]

So meds and food cause this.

[@okidoki3201]

Treatment? Mask symptoms with neuroleptics