Memory Disorders

July 27, 2012 by Dr. Tangen Leave a Comment

Forgetting and age

I can’t remember. Why can’t I remember?

Memory disorders are not limited to the elderly. Several diseases can cause memory problems, some of them are more common as you age.

When you’re healthy, there are few problems with memory. Memory is a collection of several systems, it is not a single process. We store the memories in different parts of the brain. So losing one aspect of a system doesn’t always stop the other systems from working properly.

Here’s what is included in this lesson:

multiple systems for multiple tasks
aphasia, apraxia and ataxia
Alzheimer’s
stroke

Read chapter 14 of Kalat’s Biological Psychology

Some clips of Clive Wearing: Intro Early-Later Years

Here are the resources you need:

cluster
slides
terms
notes
quiz
video

SLIDES

TERMS

[dropdown_box expand_text=” Terms To Know” show_more=”More” show_less=”Less” start=”hide”]

abulia
acetylcholine activator drugs
acquired apraxia
acute onset
allochria
Alzheimer’s
amyloid protein
aneurysms = ballooning region
anticoagulation drugs
aphasia
apolipoprotein E
apraxia
Apraxia of speech
arteriovenous malformations (AVMs)
artial fibrillation
aspirin
ataxia
automatic-voluntary dissociation
Balint’s syndrome
blocked-clogged arteries
blood thinners
Broca’s area
buccofacial
cerebellum
cerebral embolism (stroke)
chromosome 1 & 14
chromosome 10 & 19
chromosome 21
clumsy
cocaine
conceptual apraxia
confused thinking
constraint-induced movement therapy
construction
CT scan
dementia
diabetes mellitus
Down’s syndrome
endarterectomy
fluent aphasia
gait apraxia
genetic components
global
headache
hemorrhagic stroke
high blood pressure
homocysteine
ideational
ideomotor apraxia
inability to understand language
inappropriate emotional response
inconsistent articulation errors
inter-neuron plaque
inverted T-wave
ischemic stroke
late onset
limb-kinetic
Mediterranean diet
memory
memory disorders
memory loss
motor planning
MRI
non-fluent aphasia
ocular apraxia
optic ataxia
orofacial apraxia
plaque
primary progressive aphasia
progressive disease
saccade moves
simultanagnosia
statins
stroke
stroke risk factors
stroke symptoms
Tau protein
telegraphic speech
thrombotic stroke
transicent ischemic attack
traumatic brain injury
unrecognizable words
violence
Wernicke aphasia
Yoruba people of Nigeria

[/dropdown_box]

NOTES

[dropdown_box expand_text=” For You” show_more=”Notes” show_less=”Less” start=”hide”]

When you have problems with memory
- Don’t lose all aspects equally
- Several independent systems
1. Balint’s Syndrom
- Rare neurological disorder
- Can’t do common tasks
- First described in 1909
- Typically
  - Acute onset
  - 2+ strokes in same place?
- 3 impairments at once
  - Simultanagnosia
  - See parts, not whole
    - e.g., 40 degrees off axis
  - Optic ataxia
  - Can’t use vision to guide hand
  - Ocular apraxia
  - Difficulty fixating eyes
  - Hard to read or watch
2. Apraxia
- Movements of hand
  - damage to left hemisphere
  - organizes move for both hands
- Understand command
  - Willing to do it & muscles work
  - Can’t perform tasks when asked
  - Can’t execute movements
- Disorder of motor planning
  - Can’t remember
    - how to brush teeth
    - wave goodbye
- Caused by
  - Brain tumor
  - Gradual worsening
  - Traumatic brain injury
  - Stroke
  - Dementia
  - Damage to cerebellum
  - Not lack of coordination (ataxia)
  - Not unable to produce (aphasia)
  - Not lack of desire (abulia)
  - Not confused about which side to move (allochria)
- Often lesion in left hemisphere
  - Parietal or frontal
  - Often due to stroke
- Can be from birth
  - Appears as child grows
  - Cause unknown
  - Mostly “acquired apraxia”
- Treatment
  - Practice, practice, practice
  - Repeating sounds over & over
    - teach mouth movements
  - Slow down when talk
  - Communication techniques
- Frustration, profanity & depression
- Symptoms
  - Unable to do muscle movements
  - Different word than intended
  - Usually aware of error
- Buccofacial
  - Also called orofacial apraxia
  - Can’t lick lips or whistle
  - Can’t move face on demand
  - Stick out tongue
- Ideational
  - Also called conceptual apraxia
  - Can’t sequence properly
  - Butter bread before toaster
  - Socks or shoes first?
  - Comb hair with toothbrush
- Ideomotor
  - Automatic-voluntary dissociation
  - Can’t pretend to answer phone
  - Answer phone when it rings
  - Plan or complete motor actions
  - Last of semantic memory
  - Can explain how to do it
  - Can’t imagine doing it
  - Can’t actually do it
  - Can’t
    - Pretend to brush your teeth
    - Puck like sucking a sour lemon
  - Try to write with screwdriver
- Limb-kinetic
  - Arms & legs don’t go where want
  - Also called gait apraxia
  - Can’t move arms & legs precisely
- Construction
  - Can’t draw pentagons
  - Can’t make intersecting figures
- Oculomotor
  - Difficulty with saccade moves
- Apraxia of speech:
  - Can say common phrases
  - How are you?
  - Can write better than speak
  - Can’t
    - Sounds & words
    - distorted, repeated or omitted
    - Hard to put in right order
    - Struggle to find right word
    - Longer words more difficult
Apraxia & Aphasia
- Often go together
- Symptoms
  - Inconsistent articulation errors
  - Can’t find right mouth position
  - More errors with longer phrases
3. Aphasia
- What is it?
- Inability to understand language
- Inability to write
- Inability to speak
- Symptoms
  - Sentences that don’t make sense
  - Don’t understand conversations
  - Short or incomplete sentences
  - Unrecognizable words
  - Understand but not express
  - Take things literally
  - Spelling errors
- 3 Types
  - 1. Non-fluent
    - Usually aware of difficulty
    - Broca’s area
    - Often have right-side weakness-paralysis
    - Struggle to get words out
    - Telegraphic speech
    - Walk park
  - 2. Fluent
    - Middle left side of brain
    - Wernicke aphasia
    - Long, complex sentences
    - that don’t make sense
    - Don’t realize not making sense
    - Don’t understand other’s speaking well
  - 3. Global
    - Several areas damaged
    - Frontal, temporal & parietal
    - Difficulties in both
    - Expression
    - Comprehension
- Primary progressive aphasia
- Language problems that gradually develop
- Brain cell degeneration
- Can progress to dementia
4. Stroke
- Diagnosis
  - CT scan of cerebral artery
    - Usually without contrast
  - Neurological examination
  - Doppler ultrasound
  - Inverted T-wave
  - MRI
- Lasts 24+ hours
  - Same symptoms
- Transicent Ischemic Attack
  - Less than 24 hours
  - Stroke symptoms
  - Unless you die = stroke
- Two major risk factors
  - High blood pressure
  - Atrial fibrillation
- Other risk factors
  - Alcohol & drug use
  - Cigarettes
  - Diabetes
  - Cocaine
  - Diet?
  - Blood lipids
    - High cholesterol levels?
    - Inconsistent data
    - Statins reduce risk
    - Maybe not by lipids
  - Diabetes mellitus
    - High levels of sugar in blood
    - Stroke 2-3 times more likely
    - Often have hypertension
- Treating Stroke
  - Aspirin works well
  - Anticoagulation drugs
    - Such as warfarin
    - Used for over 50 years
  - Surgery
    - Remove significant narrowing
  - Endarterectomy
  - Nutrition
    - Mediterranean Diet
    - Reduce risk by half?
  - Folic Acid
    - To lower homocysteine
    - Non-protein amino acid
    - Reduce risk by half?
What is a stroke
- Blood flow disruption
- Brain’s version of a heart attack
- Cells die
- Brain attack?
1. Ischemic Stroke
- Blocked-Clogged Arteries
- A. Thrombotic stroke
  - Blocking narrow artery
- B. Cerebral embolism (stroke)
  - Clot breaks off & travel to brain
2. Hemorrhagic stroke
- Weak blood vessel in brain bursts
- Blood leaks into brain
- Two types
  - Aneurysms = ballooning region
  - Arteriovenous malformations (AVMs) = bleeding from cluster of abnormally formed blood vessels
Stroke Risk Factors
- High blood pressure
  - Biggest risk factor
- Family history of stroke
- Diabetes
- Artial fibrillation
  - Irregular, rapid heart rate
- Narrow arteries in other parts of body
  - Legs
  - Heart
- Too much food, alcohol, smoking, drugs
- Birth control pills
  - In women over 35
Symptoms
- Depends which part of brain
- Symptoms appear rapidly (usual)
- Can get gradually worse, gradually better or on and off
  - Difficult to diagnose
- Coma, unconscious, sleepy
- Confused
- Clumsy
- Headache
- Starts suddenly
- Hurts most when lying flat
- Hurts when you cough or move
- Changes in sensory input
- Vision, hearing, taste, pain
- Changes in output
- Writing, speaking, walking
What to do
- 911
- Hospital within 3 hours
  - CT scan
  - Drugs to breakup clots
  - Blood thinners
After the stroke
- Most people need rehab
  - 50% have arm or hand problems
- Calcium
- Biofeedback
- Constraint-Induced Movement Therapy
  - Daily sessions, 2-3 weeks
  - Forced to use affected arm
- Cyclic Electrical Neuromuscular $
  - Electrically stimulate muscles
  - Improve range of movement
  - Make muscles stronger
5. Alzheimer’s
- Progressive disease
- Symptoms get worse with time
- Symptoms
  - Inappropriate emotional R
  - Decline in intellect
  - Confused thinking
  - Memory loss
  - Repeated questioning
  - Inappropriate emotional R
  - Violence
- Memory
  - Better procedural vs declarative
  - Better implicit vs explicit
  - Acquire new skills but not remember learning them
- Age related
  - Likelihood increases with age
  - Strikes 50% of those over 85
- Genetic components
  - Person with Down’s syndrome
    - (3 copies of chromosome 21)
    - Always acquire Alzheimer’s in middle age
  - Early onset
    - chromosome 1 & 14
  - Late onset
    - chromosome 10 & 19
- Environmental component
  - 50% no relatives with disease
  - Yoruba people of Nigeria
    - high-risk genes
    - low incidence
    - Maybe due to diet?
      - low-calorie, low fat, low salt diet
- Brain proteins fold abnormally
  - Clump together
  - Interfere with neuronal activity
  - Amyloid protein
    - Cause plaque between neurons
  - Apolipoprotein E
    - Causes cell loss
  - Prevents plague removal
  - Tau protein
- Tangles in cell bodies
Treatment to improve memory
- Increase glucose & insulin
- Acetylcholine activator drugs
- Diet rich in antioxidants?
- Block Aß42 production, inoculate with small amounts of Aß42
- Inter-neuron plaque

Memory Disorders

I can’t remember. Why can’t I remember?

SLIDES

TERMS

NOTES

QUIZ

VIDEO

DISCUSSION ITEM

I can’t remember. Why can’t I remember?

SLIDES

TERMS

NOTES

QUIZ

VIDEO

DISCUSSION ITEM

Leave a Reply Cancel reply