A Longitudinal Case Study of an Atypical Early-Onset Posterior Cortical Dementia with Hyperostosis Frontalis
|
|
- Valentine Haynes
- 6 years ago
- Views:
Transcription
1 A Longitudinal Case Study of an Atypical Early-Onset Posterior Cortical Dementia with Hyperostosis Frontalis Fernando Entenza, M.D., Univ. Central del Caribe, Puerto Rico Maria T. Margarida-Julia Psy.D., Univ. de Puerto Rico 29th International Conference of Alzheimer Disease International San Juan, Puerto Rico May 1-4, 2014
2 Disclosures Dr. Entenza No conflicts of interest Dr. Margarida-Julia No conflicts of interest No grants or other external funds used
3 Introduction Case study of an under-recognized focal degenerative syndrome which 1. Describes its earliest manifestations 2. Exemplifies the benefits of a multidisciplinary evaluation 3. Calls attention to special needs of this population 4. Raises questions about the nature of PCA & HFI
4 Background Information Right handed 54 year-old married man Doctorate degree Highly specialized professional Under my care since age 43 Presented for treatment of Bipolar Disorder Diagnosed Bipolar Disorder Type I at the age of 35 Claimed mood cycling since age 21 Medical conditions Metabolic syndrome Obesity Insulin-requiring DM-II Arterial hypertension Hypercholesterolemia Obstructive sleep apnea (using CPAP) Lumbar HNP
5 Family History Paternal grandfather Suspected AD Father Died due to AD in his 70's Apparent early-onset Older sister (58) Eldest daughter Atypical Bipolar Disorder since age 17 Another daughter High impulsivity Very poor judgment Possible mood cycling Undergoing dementia evaluation Initial symptom was memory loss
6 1. Atypical 11-Year Course BIPOLAR DISORDER Worsening over the 11-year span Abnormally persistent mood cycling Mixed-manic or mixed-depressive symptoms Abnormal auditory perceptions & ideas of reference (occasional) Anxiety (associated with new workplace challenges and with greater depressive symptoms) COGNITIVE SYMPTOMS Insidious over the past 3 years Adapting to new work procedures & routines, and driving routes Although learning proficiently in the end Navigation problems in familiar places These were initially present only during heightened depressive symptoms Brief medical leave-of-absences in the last 3 years
7 Treatment at Cognitive Evaluation Divalproex ER 2,750mg QHS Lamotrigine 200mg QD Bupropion XL 150mg a/w Bupropion SR 100mg QD Quetiapine XR 100 mg QAM mg QHS Clonazepam 0.25 mg QAM mg QHS
8 2. Findings Normal Physical & neurological exams Dementia laboratory workup HbgA1c = 6.4% Ceruloplasmin level Abnormal APOE є 3-4 genotype MRI neuroanatomy PET regional brain metabolism Neuropsychological testing M.R.A. E.E.G
9 Parietal Atrophy & Hyperostosis Frontalis Interna Axial views
10 Parietal Atrophy & Hypometabolism Coronal Oblique T1 views PET - Coronal view
11 Parietal Hypometabolism (L > R) Brain FDG-PET Axial views
12 Parietal Hypometabolism and Atrophy Sagittal views
13 Medial Temporal Lobe Unaffected Axial views
14 Hyperostosis Frontalis Interna Internal Growths Source:
15 Headache Evaluation 8 Years Earlier at Age 46 Earlier stages of HFI prefrontal compression and Parietal Atrophy
16 Healthy individuals Normal eye-tracking and fixation on mostly relevant aspects of the scene PCA patients (poor top-down guidance and control of saccadic movements) (1) May fixate on relatively uninformative aspects of the scene (2) May miss important contextual information Source: Crutch SJ, et al. The Lancet Neurology. February 2012, Vol.11(2):
17 Neuropsychological Testing SCALED SCORES Test EIWA-III (1) WAIS-III (2) Full Scale IQ Verbal Comprehension 84 (80-88) 14% Below average 95 Working Memory 98 Perceptual Organization Processing Speed (70-79) 4% Borderline 82 Below average 82 Below average 70 Borderline 76 Borderline (1) EIWA-III standardization for Puerto Rico, a translated version of WAIS III, consists of 330 adults divided in 3 age groups (16 to 19, 20 to 44 and 60 to 64). The sample used the 2000 Puerto Rico census and it is stratified by educational level). (Manual de Administración y Puntuación. (2) WAIS-III was normalized using a representative U.S. sample of 2,450 adults. Hispanic subjects represented 12-13% of the test's normative sample. Standardization and Norms Development, p ). SCALED SCORES Test EIWA-III (1) WAIS-III (2) Verbal IQ 86 Below aver. 81 Below aver. Verbal Comprehension Vocabulary Similarities Information Working Memory Arithmetic Digit span Letter-Number Sequencing Performance IQ 82 Below aver. 70 Borderline Perceptual Organization Picture Completion Block Design Reasoning Matrix Processing Speed Digit Symbol-Coding Symbol Search Average scores =
18 Neuropsychological Testing Relatively preserved episodic memory Significant problems with attention and other executive functions GENERAL COGNITIVE FUNCTIONING Test Score Range MMSE 20/ 30 Dementia MOCA 14 / 30 Dementia INECO Frontal Screening 15.5 / 30 Frontal deficits Dementia Rating Scale (DRS-2) Initiation / Perseveration California Verbal Learning Test II (CVLT-II) Short-Term Free Recall Short-Term Cued Recall Long-Term Free Recall Long-Term Cued Recall Total Learning Curve (1-5) COWAT Verbal Fluidity (Total) Animals Fruits Vegetables Trail A Trail B Wisconsin Card Sort Total errors Non-perseverative errors Conceptual answers Completed categories SS (standard score): 3 MEMORY FUNCTIONS VERBAL FUNCTIONS EXECUTIVE FUNCTIONS 67 sec - < < 55 0 / 6 PE 3; 1% Severe Below average High average Below average High average Below average Severe Borderline Below average Below average Severe Severe 1% Severe 47% 1% Severe Severe
19 Most Significant Deficits NEUROPSYCHOLOGICAL TESTING Function Cognitive Test Level of Impairment Visuo-spatial processing EIWA-III Matrix subset MOCA cube & clock drawing MMSE pentagons Trails A (67 sec) & B (-) (visual tracking) Moderate Spatial memory INECO Spatial Working Memory subset Moderate Non-Visual Executive functions: Cognitive flexibility Planning Sustained & divided attention Memory & Learning Verbal fluency, naming, comprehension INECO Motor Series (motor programming) INECO Go-No-Go (inhibitory control) Wisconsin Card Sorting Test DRS-2 Initiation/Perseveration subset EIWA-III & INECO Frontal Screen CVLT-II COWAT Verbal abstraction tasks Moderate Mild Mild
20 Management & Outcome Developments 1-year following DX Improvements seen and reported Retirement Voluntarily stopped driving Acetylcholinesterase inhibitor Memantine Relocation to Central Florida Overall functioning and cognition MOCA = 23 / 30 (from 14 / 30) Except for episodic memory & visuospatial abilities -1 clock number placement -1 cube copy -4 recall Quality-of-life Anxiety & depressive symptoms Successful regime reductions Quetiapine discontinued Clonazepam reduced
21 Before Rx 01 / 2013 Age 54 After Rx Improved 10 / 2013 Age 55
22 Case Summary Premorbid chronic atypical neuropsychiatric disorder (bipolar disorder features) Metabolic syndrome Possible familial early-onset dementia pattern APO E4 risk factor Early-onset insidious degenerative disorder L > R (dorsal) parietal atrophy and hypometabolism Spared medial temporal lobe Pre-existent HFI compressing prefrontal areas Visuospatial + non-visual executive deficits Subjective and objective response to usual AD Rx But episodic retrieval-verbal recall deficits are worsening over time Without obvious hippocampus pathology
23 3. PCA Patients Special Needs Neuro-ophthalmologic evaluation Elements of Balint syndrome like simultagnosia (visual field perception), optic apraxia (reaching using vision), oculomotor apraxia (fixating eyes) Registration for financial and social benefits and services (SSDI, pension, DOT, etc.) Early safety measures (driving, machinery) Occupational therapy / sensory team evaluation Assistive equipment for the visually impaired (simplified displays, talking books and watches) Peer-support groups and psychotherapy Take advantage of the preserved memory and insight Neuropsychological testing Tests relying on intact vision are not valid Memory tests/tasks will underestimate clinical progression This & other PCA phenotypes may resemble frontal lobe syndromes
24 4. Discussion CASE PCA HFI Demographics 54 y/o MALE with metabolic syndrome Early-onset Post-menopausal, diabetic FEMALE Posterior atrophy & hypometabolism YES YES NO Visual processing problems Spatial memory Visual tracking (21) Visual perception Spatial memory Visual attention Visuospatial reasoning Possibly via FEF compression Frontal atrophy No functional evidence yet YES, in later stages Possibly via frontal compression Working memory YES Superior Parietal lesions (19) Both spatial & non-spatial (10), via DLPFC compression Episodic memory / retrieval Relatively preserved But worsening Relatively preserved, but often progressive Inferior PL (22) NO Other non-visual executive functions Cognitive flexibility Planning Sustained & divided attention Motor programming No evidence (21) Dorsal & Ventral PPC (22) Goal directed and reflective attention No evidence Neuropsychiatric syndrome Atypical Bipolar Anxiety syndrome (20) "Hyperactivity syndrome" in AD (16) (agitation, irritability, aberrant motor behavior, euphoria, and disinhibition) Depression, if any
25 Anterior and Inferior Parts of the Intra-Parietal Sulcus visual search in the absence of distractors (R) Temporo-Parietal Junction multisensory attention to a change in relevant information Functional Anatomy of the Parietal Cortex Superior Parietal Lobule top-down (goal-directed) spatial shifts in attention & working memory Precuneus (Medial PL) top-down (goal-directed) non-spatial shifts in attention Inferior Parietal Lobule & Inferior Parietal Sulcus episodic retrieval (22) Behrmann M, et al. Parietal Cortex and Attention. Curr Opin Neurobiol : (23) Hutchinson JB, et al. Posterior parietal cortex and episodic retrieval: Convergent and divergent effects of attention and memory. Learn Mem. 2009;16:
26 References 1. Du, A-T, et al. Brain 2007; 130(4): Kemp PM, et al. J Neurol Neurosurg Psychiatry 2003; 74: Berthier ML, et al. J Neurol Neurosurg Psychiatry 1991; 54: Hof PR, et a. Acta Neuropathol 1993; 86(3): Ross SJ, et al. J Neurol Neurosurg Psychiatry 1996; 61: Galton CJ, et al. Brain 2000; 123(3): Crutch SJ, et al. Alzheimer s & Dementia 2013; Lehmann M, et al. Alzheimer s Dement 2012; 8: Attanasio F, et al. J Clin Endocrinol Metab 2013; 98(2): de Zubicaray GI, et al. J Neurol Neurosurg Psychiatry 1997; 63(3): Paulus KS, et al. Neurol Sci. 2002;22: Thomas G, et al. BJM Case Reports 2012; doi: /bcr de Souza LC, et al. Brain Jul; 134(Pt 7): Sitek EJ, et al. PLoS One. 2013; 8(4): e Quiroz YT, et al. J Neurol Neurosurg Psychiatry ; 84(5): Balthazar ML, et al. Hum Brain Mapp. 2014; 35(4): Snowden JD, et al. Cortex 2007; 43(7): Crutch SJ, et al. The Lancet Neurology. 2012; 11(2): Koenigs M, et al. The Journal of Neuroscien. 2009; 29(47): Everhart DE, et al. Applied Neuropsychology: Adult. 2012; 19(3): Aresi A, Giovagnoli AR. J Alzheimer's Disease. 2009; 18(1): Berhmann M, et al. Curr Opin Neurobiol. 2004; 14: Hutchinson JB, et al. Learn. Mem. 2009; 16:
The current state of healthcare for Normal Aging, Mild Cognitive Impairment, & Alzheimer s Disease
The current state of healthcare for Normal Aging, g, Mild Cognitive Impairment, & Alzheimer s Disease William Rodman Shankle, MS MD FACP Director, Alzheimer s Program, Hoag Neurosciences Institute Neurologist,
More informationTopic 11 - Parietal Association Cortex. 1. Sensory-to-motor transformations. 2. Activity in parietal association cortex and the effects of damage
Topic 11 - Parietal Association Cortex 1. Sensory-to-motor transformations 2. Activity in parietal association cortex and the effects of damage Sensory to Motor Transformation Sensory information (visual,
More informationExcellent Network Courses. Department of Neurology Affiliated hospital of Jiangsu University
Excellent Network Courses Department of Neurology Affiliated hospital of Jiangsu University Agnosia Visual Agnosia Lissauer (1890) described 2 types: a) Apperceptive Cannot see objects b) Associative Does
More informationM P---- Ph.D. Clinical Psychologist / Neuropsychologist
M------- P---- Ph.D. Clinical Psychologist / Neuropsychologist NEUROPSYCHOLOGICAL EVALUATION Name: Date of Birth: Date of Evaluation: 05-28-2015 Tests Administered: Wechsler Adult Intelligence Scale Fourth
More informationNeuropsychological Evaluation of
Neuropsychological Evaluation of Alzheimer s Disease Joanne M. Hamilton, Ph.D. Shiley-Marcos Alzheimer s Disease Research Center Department of Neurosciences University of California, San Diego Establish
More informationcorrelates with social context behavioral adaptation.
REVIEW OF FRONTAL LOBE STRUCTURES Main organization of frontal cortex: 1. Motor area (precentral gyrus). 2. Premotor & supplementary motor areas (immediately anterior to motor area). Includes premotor,
More informationAlzheimer's Disease An update on diagnostic criteria & Neuropsychiatric symptoms. l The diagnosis of AD l Neuropsychiatric symptoms l Place of the ICT
Alzheimer's Disease An update on diagnostic criteria & Neuropsychiatric symptoms State of the art lecture March 4-2012 Philippe H Robert, Philippe Nice - France Robert The diagnosis of AD Neuropsychiatric
More informationImaging of Alzheimer s Disease: State of the Art
July 2015 Imaging of Alzheimer s Disease: State of the Art Neir Eshel, Harvard Medical School Year IV Outline Our patient Definition of dementia Alzheimer s disease Epidemiology Diagnosis Stages of progression
More information02/04/2015. The structure of the talk. Dementia as a motor disorder. Movement, cognition & behaviour. Example 1. Example 2
The th Annual Memory Clinic Conference Dublin, Trinity College, 27 March 1 The structure of the talk Dementia as a motor disorder Thomas H. Bak Human Cognitive Neuroscience & Centre for Clinical Brain
More informationNEUROPSYCHOMETRIC TESTS
NEUROPSYCHOMETRIC TESTS CAMCOG It is the Cognitive section of Cambridge Examination for Mental Disorders of the Elderly (CAMDEX) The measure assesses orientation, language, memory, praxis, attention, abstract
More informationThe Frontal Lobes. Anatomy of the Frontal Lobes. Anatomy of the Frontal Lobes 3/2/2011. Portrait: Losing Frontal-Lobe Functions. Readings: KW Ch.
The Frontal Lobes Readings: KW Ch. 16 Portrait: Losing Frontal-Lobe Functions E.L. Highly organized college professor Became disorganized, showed little emotion, and began to miss deadlines Scores on intelligence
More informationCognitive Screening in Risk Assessment. Geoffrey Tremont, Ph.D. Rhode Island Hospital & Alpert Medical School of Brown University.
Cognitive Screening in Risk Assessment Geoffrey Tremont, Ph.D. Rhode Island Hospital & Alpert Medical School of Brown University Outline of Talk Definition of Dementia and MCI Incidence and Prevalence
More informationFTD basics! Etienne de Villers-Sidani, MD!
FTD basics! Etienne de Villers-Sidani, MD! Frontotemporal lobar degeneration (FTLD) comprises 3 clinical syndromes! Frontotemporal dementia (behavioral variant FTD)! Semantic dementia (temporal variant
More informationCognitive Neuroscience of Memory
Cognitive Neuroscience of Memory Types and Structure of Memory Types of Memory Type of Memory Time Course Capacity Conscious Awareness Mechanism of Loss Sensory Short-Term and Working Long-Term Nondeclarative
More informationNeuropsychiatric Manifestations in Vascular Cognitive Impairment Patients with and without Dementia
86 Neuropsychiatric Manifestations in Vascular Cognitive Impairment Patients with and without Dementia Pai-Yi Chiu 1,3, Chung-Hsiang Liu 2, and Chon-Haw Tsai 2 Abstract- Background: Neuropsychiatric profile
More informationNature, prevalence and clinical significance. Barcelona, Spain
Nature, prevalence and clinical significance Jaime Kulisevsky Barcelona, Spain 1 Non motor (neuropsychiatric) symptoms are an integral part of Parkinson s s disease (PD) Affective disorders And are associated
More informationUse a diagnostic neuropsychology HOW TO DO IT PRACTICAL NEUROLOGY
170 PRACTICAL NEUROLOGY HOW TO DO IT Pract Neurol: first published as 10.1046/j.1474-7766.2003.08148.x on 1 June 2003. Downloaded from http://pn.bmj.com/ Use a diagnostic neuropsychology on 16 October
More informationMild Cognitive Impairment (MCI)
October 19, 2018 Mild Cognitive Impairment (MCI) Yonas E. Geda, MD, MSc Professor of Neurology and Psychiatry Consultant, Departments of Psychiatry & Psychology, and Neurology Mayo Clinic College of Medicine
More informationCapacity and Older Adults. Kenneth I. Shulman
Capacity and Older Adults Kenneth I. Shulman Increased Requests for Contemporaneous Assessments of Testamentary Capacity Increase in challenges to testamentary capacity Demographics/Economics Prevalence
More informationbattery assessing general cognitive functioning (Mini-Mental State Examination, MMSE),
SUPPLEMENTARY MATERIAL Neuropsychological battery Patients tested at the Rotman Research Institute were administered a neuropsychological battery assessing general cognitive functioning (Mini-Mental State
More informationBrain Structure and Function in Nephropathic Cystinosis
Brain Structure and Function in Nephropathic Cystinosis Doris A. Trauner M.D. Professor, Depts. of Neurosciences and Pediatrics University of California San Diego School of Medicine La Jolla, CA USA Cystinosis
More informationDementia Update. October 1, 2013 Dylan Wint, M.D. Cleveland Clinic Lou Ruvo Center for Brain Health Las Vegas, Nevada
Dementia Update October 1, 2013 Dylan Wint, M.D. Cleveland Clinic Lou Ruvo Center for Brain Health Las Vegas, Nevada Outline New concepts in Alzheimer disease Biomarkers and in vivo diagnosis Future trends
More informationMontreal Cognitive Assessment (MoCA) Overview for Best Practice in Stroke and Complex Neurological Conditions March 2013
Montreal Cognitive Assessment (MoCA) Overview for Best Practice in Stroke and Complex Neurological Conditions March 2013 1 MoCA 2 Overview of the MoCA Takes approximately 15 minutes to administer Requires
More informationSupplementary Online Content
Supplementary Online Content Devenney E, Bartley L, Hoon C, et al. Progression in behavioral variant frontotemporal dementia: a longitudinal study. JAMA Neurol. Published online October 26, 2015. doi:10.1001/jamaneurol.2015.2061.
More informationNEUROPSYCHOLOGICAL ASSESSMENT S A R A H R A S K I N, P H D, A B P P S A R A H B U L L A R D, P H D, A B P P
NEUROPSYCHOLOGICAL ASSESSMENT S A R A H R A S K I N, P H D, A B P P S A R A H B U L L A R D, P H D, A B P P NEUROPSYCHOLOGICAL EXAMINATION A method of examining the brain; abnormal behavior is linked to
More informationHuman Paleoneurology and the Evolution of the Parietal Cortex
PARIETAL LOBE The Parietal Lobes develop at about the age of 5 years. They function to give the individual perspective and to help them understand space, touch, and volume. The location of the parietal
More informationAlzheimer s disease dementia: a neuropsychological approach
Alzheimer s disease dementia: a neuropsychological approach Dr. Roberta Biundo, PhD Neuropsychology Coordinator at Parkinson s disease and movement disorders unit of San Camillo rehabilitation hospital
More informationCognitive Rehabilitation with Current Research and Transition of Care
Cognitive Rehabilitation with Current Research and Transition of Care Mike Dichiaro, MD Pediatric Rehabilitation Medicine Carin Rowan, MPT Pediatric Physical Therapy Financial Disclosures No relevant financial
More informationDiagnosis and management of non-alzheimer dementias. Melissa Yu, M.D. Department of Neurology
Diagnosis and management of non-alzheimer dementias Melissa Yu, M.D. Department of Neurology AGENDA Introduction When to think of alternate diagnoses Other forms of dementia Other reasons for confusion
More informationshows syntax in his language. has a large neocortex, which explains his language abilities. shows remarkable cognitive abilities. all of the above.
Section: Chapter 14: Multiple Choice 1. Alex the parrot: pp.529-530 shows syntax in his language. has a large neocortex, which explains his language abilities. shows remarkable cognitive abilities. all
More informationGERIATRIC MENTAL HEALTH AND MEDICATION TREATMENT
Psychiatry and Addictions Case Conference UW Medicine Psychiatry and Behavioral Sciences GERIATRIC MENTAL HEALTH AND MEDICATION TREATMENT RUTH KOHEN ASSOCIATE PROFESSOR UW DEPARTMENT OF PSYCHIATRY 5-4-2017
More informationFrontal Contributions to Memory Encoding Before and After Unilateral Medial Temporal Lobectomy
Frontal Contributions to Memory Encoding Before and After Unilateral Medial Temporal Lobectomy Jeff Ojemann, MD Department of Neurological Surgery University of Washington Children s Hospital & Regional
More informationHippocampal brain-network coordination during volitionally controlled exploratory behavior enhances learning
Online supplementary information for: Hippocampal brain-network coordination during volitionally controlled exploratory behavior enhances learning Joel L. Voss, Brian D. Gonsalves, Kara D. Federmeier,
More information21/05/2018. Today s webinar will answer. Presented by: Valorie O Keefe Consultant Psychologist
Today s webinar will answer. 1. What is the RBANS, and how is the updated version different than the original version? 2. What are the neurocognitive areas assessed by the RBANS and what scores are available?
More informationLearning objectives 6/20/2018
Cognitive impairment of patients with chronic migraine, in a neuropsychological assessment, does not depend on the use of topiramate or comorbidities Ferreira KS, MD, PhD Professor, Neurology Clinic, Medicine
More informationCortical Visual Symptoms
대한안신경의학회지 : 제 6 권 Supplement 2 ISSN: 2234-0971 Jeong-Yoon Choi Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea Jeong-Yoon Choi. MD. PhD. Department of Neurology, Seoul
More informationREPORT OF NEUROPSYCHOLOGICAL ASSESSMENT
Gary G. Kay, Ph.D. Clinical Neuropsychologist WASHINGTON NEUROPSYCHOLOGICAL INSTITUTE, LLC 4900 MASSACHUSETTS AVE, NW SUITE 240 WASHINGTON, DC 20016 PH. 202-686-7520 FAX 202-686-8802 REPORT OF NEUROPSYCHOLOGICAL
More informationRussell M. Bauer, Ph.D. February 27, 2006
1 Neuropsychological Aspects of Frontal Lobe Function Russell M. Bauer, Ph.D. February 27, 2006 2 Important Concepts Phylogenetically newest area of cortex Exquisite connectivity based on feedback loops
More informationDEMENTIA, THE BRAIN AND HOW IT WORKS AND WHY YOU MATTER
OVERCOMING THE CHALLENGES OF MANAGING CHRONIC DISEASES IN PERSONS WITH DEMENTIA DEMENTIA, THE BRAIN AND HOW IT WORKS AND WHY YOU MATTER LEARNING OBJECTIVES Be familiar with the diagnostic criteria for
More informationDementia and Alzheimer s disease
Since 1960 Medicine Korat โรงพยาบาลมหาราชนครราชส มา Dementia and Alzheimer s disease Concise Reviews PAWUT MEKAWICHAI MD DEPARTMENT of MEDICINE MAHARAT NAKHON RATCHASIMA HOSPITAL 1 Prevalence Increase
More informationWhite matter hyperintensities correlate with neuropsychiatric manifestations of Alzheimer s disease and frontotemporal lobar degeneration
White matter hyperintensities correlate with neuropsychiatric manifestations of Alzheimer s disease and frontotemporal lobar degeneration Annual Scientific Meeting Canadian Geriatric Society Philippe Desmarais,
More informationMeniere s Disease Case. Suzanne Beason-Hazen, Ph.D.
Meniere s Disease Case Suzanne Beason-Hazen, Ph.D. IDENTIFYING INFORMATION 64-year-old man, 15 years of education (three years of college, did not complete a degree) Employed as airline transport pilot
More informationThe Neuropsychology of
The Neuropsychology of Stroke Tammy Kordes, Ph.D. Northshore Neurosciences Outline What is the Role of Neuropsychology Purpose of Neuropsychological Assessments Common Neuropsychological Disorders Assessment
More informationMethod. NeuRA Schizophrenia and bipolar disorder April 2016
Introduction Schizophrenia is characterised by positive, negative and disorganised symptoms. Positive symptoms refer to experiences additional to what would be considered normal experience, such as hallucinations
More informationNEUROCOGNITIVE, OUTCOMES IN PKU: IT S TIME TO RAISE THE BAR
NEUROCOGNITIVE, OUTCOMES IN : IT S TIME TO RAISE THE BAR KEY POINTS 1. High Phenylalanine (Phe) levels harm the brain.. Traditional therapies do not completely protect individuals with. 3. New approaches
More informationA Fresh View of Cognitive Disorders in Older Adults: New Classification and Screening Strategies
A Fresh View of Cognitive Disorders in Older Adults: New Classification and Screening Strategies Lynda Mackin, PhD, AGPCNP-BC, CNS University of California San Francisco School of Nursing 1 Alzheimer s
More informationPamela S. Klonoff, PhD Clinical Director Center for Transitional Neuro-Rehabilitation Barrow Neurological Institute, Phoenix, Arizona
Neuropsychology Pamela S. Klonoff, PhD Clinical Director Center for Transitional Neuro-Rehabilitation Barrow Neurological Institute, Phoenix, Arizona Top Ten Ways to Understand and Cope with a Brain Tumor
More informationExecutive Function Impairment in Patients with Medical Illness. Jason E. Schillerstrom, M.D. UTHSCSA
Executive Function Impairment in Patients with Medical Illness Jason E. Schillerstrom, M.D. UTHSCSA schillerstr@uthscsa.edu Disclosure Clinical Trials: Myriad, Pfizer, GSK, Neurochem CLOX and EXIT25 were
More informationSupplementary Material S3 Further Seed Regions
Supplementary Material S3 Further Seed Regions Figure I. Changes in connectivity with the right anterior insular cortex. (A) wake > mild sedation, showing a reduction in connectivity between the anterior
More informationProcess of a neuropsychological assessment
Test selection Process of a neuropsychological assessment Gather information Review of information provided by referrer and if possible review of medical records Interview with client and his/her relative
More informationPiano playing skills in a patient with frontotemporal dementia: A longitudinal case study
International Symposium on Performance Science ISBN 978-94-90306-01-4 The Author 2009, Published by the AEC All rights reserved Piano playing skills in a patient with frontotemporal dementia: A longitudinal
More informationAGED SPECIFIC ASSESSMENT TOOLS. Anna Ciotta Senior Clinical Neuropsychologist Peninsula Mental Health Services
AGED SPECIFIC ASSESSMENT TOOLS Anna Ciotta Senior Clinical Neuropsychologist Peninsula Mental Health Services Issues in assessing the Elderly Association between biological, psychological, social and cultural
More informationOverview. Case #1 4/20/2012. Neuropsychological assessment of older adults: what, when and why?
Neuropsychological assessment of older adults: what, when and why? Benjamin Mast, Ph.D. Associate Professor & Vice Chair, Psychological & Brain Sciences Associate Clinical Professor, Family & Geriatric
More informationControl of visuo-spatial attention. Emiliano Macaluso
Control of visuo-spatial attention Emiliano Macaluso CB demo Attention Limited processing resources Overwhelming sensory input cannot be fully processed => SELECTIVE PROCESSING Selection via spatial orienting
More informationPharmacologyonline 3: (2010)
PERSEVERATIONS IN ALZHEIMER DISEASE: ANALYSIS OF THE DISTURBANCE AND POSSIBLE CORRELATIONS M. D Antonio¹, L. Trojano², M. R. De Riso², D. Grossi ² and A. M. Fasanaro¹, ¹Alzheimer Unit, Neurology Department,
More informationCHAPTER 5 NEUROPSYCHOLOGICAL PROFILE OF ALZHEIMER S DISEASE
CHAPTER 5 NEUROPSYCHOLOGICAL PROFILE OF ALZHEIMER S DISEASE 5.1 GENERAL BACKGROUND Neuropsychological assessment plays a crucial role in the assessment of cognitive decline in older age. In India, there
More informationWHAT IS DEMENTIA? An acquired syndrome of decline in memory and other cognitive functions sufficient to affect daily life in an alert patient
DEMENTIA WHAT IS DEMENTIA? An acquired syndrome of decline in memory and other cognitive functions sufficient to affect daily life in an alert patient Progressive and disabling Not an inherent aspect of
More informationBiological Risk Factors
Biological Risk Factors Ms Angelina Crea Provisional Psychologist Academic Child Psychiatry Unit Royal Children s Hospital Professor Alasdair Vance Head Academic Child Psychiatry Department of Paediatrics
More informationAttention Response Functions: Characterizing Brain Areas Using fmri Activation during Parametric Variations of Attentional Load
Attention Response Functions: Characterizing Brain Areas Using fmri Activation during Parametric Variations of Attentional Load Intro Examine attention response functions Compare an attention-demanding
More informationAging with Bipolar Disorder. Neha Jain, MD, FAPA Assistant Professor of Psychiatry, UConn Health
Aging with Bipolar Disorder Neha Jain, MD, FAPA Assistant Professor of Psychiatry, UConn Health Objectives Define bipolar disorder in the elderly Review comorbidities How does it differ from bipolar in
More informationIntroduction to the diagnosis of dementia
Introduction to the diagnosis of dementia Serge Gauthier and Pedro Rosa-Neto This chapter will outline general strategies to establish the presence and the differential diagnosis of dementia, and the case
More informationCognitive Assessment. Part Two: Assessing Capacity, Beyond The Basics. Using Information To Make Decisions (Appreciating) What s s The Correct Method?
AUTONOMY, CAPACITY AND UNDUE INFLUENCE: KEMP Page 1 of 9 Part Two: Assessing Capacity, Beyond The Basics Cognitive Assessment Bryan Kemp, Ph. D. Center of Excellence in Elder Abuse and Neglect UC Irvine
More informationErin Cullnan Research Assistant, University of Illinois at Chicago
Dr. Moises Gaviria Distinguished Professor of Psychiatry, University of Illinois at Chicago Director of Consultation Liaison Service, Advocate Christ Medical Center Director of the Older Adult Program,
More informationNeuropsychology in Spina Bifida. Dr Ellen Northcott Clinical Neuropsychologist Kids Rehab, CHW
Neuropsychology in Spina Bifida Dr Ellen Northcott Clinical Neuropsychologist Kids Rehab, CHW Who are neuropsychologists? Undergraduate Degree (eg. BPsych, BSc, BA) Honours in Psychology Master or Doctor
More informationLecture 35 Association Cortices and Hemispheric Asymmetries -- M. Goldberg
Lecture 35 Association Cortices and Hemispheric Asymmetries -- M. Goldberg The concept that different parts of the brain did different things started with Spurzheim and Gall, whose phrenology became quite
More informationSupplementary Note. Patient #1 Additional Details
Supplementary Note Patient #1 Additional Details Past medical history: The patient was ambidextrous. She had a history of hypertension, hyperlipidemia, migraines, and remote history of an ANA-positive
More informationA CONVERSATION ABOUT NEURODEVELOPMENT: LOST IN TRANSLATION
A CONVERSATION ABOUT NEURODEVELOPMENT: LOST IN TRANSLATION Roberto Tuchman, M.D. Chief, Department of Neurology Nicklaus Children s Hospital Miami Children s Health System 1 1 in 6 children with developmental
More informationCaring Sheet #11: Alzheimer s Disease:
CARING SHEETS: Caring Sheet #11: Alzheimer s Disease: A Summary of Information and Intervention Suggestions with an Emphasis on Cognition By Shelly E. Weaverdyck, PhD Introduction This caring sheet focuses
More informationImproving the Methodology for Assessing Mild Cognitive Impairment Across the Lifespan
Improving the Methodology for Assessing Mild Cognitive Impairment Across the Lifespan Grant L. Iverson, Ph.D, Professor Department of Physical Medicine and Rehabilitation Harvard Medical School & Red Sox
More informationChanging diagnostic criteria for AD - Impact on Clinical trials
Changing diagnostic criteria for AD - Impact on Clinical trials London, November 2014 Bruno Dubois Head of the Dementia Research Center (IMMA) Director of INSERM Research Unit (ICM) Salpêtrière Hospital
More informationKorean-VCI Harmonization Standardization- Neuropsychology Protocol (K-VCIHS-NP)
Korean-VCI Harmonization Standardization- Neuropsychology Protocol (K-VCIHS-NP) Yeonwook Kang, Ph.D. Department of Psychology, Hallym University Department of Neurology, Hallym University Sacred Heart
More informationCollaborative Consultation Interdisciplinary Treatment of Multiple Sclerosis
Collaborative Consultation Interdisciplinary Treatment of Multiple Sclerosis Multiple sclerosis (MS) is an immune mediated process directed against the central nervous system (CNS) brain, spinal cord and
More informationVirtual Mentor American Medical Association Journal of Ethics August 2014, Volume 16, Number 8:
Virtual Mentor American Medical Association Journal of Ethics August 2014, Volume 16, Number 8: 626-630. STATE OF THE ART AND SCIENCE Use of Art Making in Treating Older Patients with Dementia Laura T.
More informationEvaluation and Treatment of Dementia
Evaluation and Treatment of Dementia Jeffrey M. Burns, MD Edward H. Hashinger Professor of Neurology Co-Director, KU Alzheimer s Disease Center Director, Clinical and Translational Science Unit Disclosures
More informationThe origins of localization
Association Cortex, Asymmetries, and Cortical Localization of Affective and Cognitive Functions Michael E. Goldberg, M.D. The origins of localization The concept that different parts of the brain did different
More informationDementia. Aetiology, pathophysiology and the role of neuropsychological testing. Dr Sheng Ling Low Geriatrician
Dementia Aetiology, pathophysiology and the role of neuropsychological testing Dr Sheng Ling Low Geriatrician Topics to cover Why is dementia important What is dementia Differentiate between dementia,
More informationThe Role of Cognitive Reserve in the clinical presentation of Alzheimer s Disease Dorene M. Rentz, PsyD
The Role of Cognitive Reserve in the clinical presentation of Alzheimer s Disease Dorene M. Rentz, PsyD Division of Cognitive and Behavioral Neurology, Brigham and Women s Hospital Co-Director of the Center
More informationDecreased Acetylcholine in the Basal Forebrain: Insight to the Neurocognitive Deficits in the Subarachnoid Hemorrhage Patient
Decreased Acetylcholine in the Basal Forebrain: Insight to the Neurocognitive Deficits in the Subarachnoid Hemorrhage Patient Erol Veznedaroglu, MD Department of Neurosurgery/Division of Cerebrovascular
More informationObjectives. Objectives continued: 3/24/2012. Copyright Do not distribute or replicate without permission 1
Frontotemporal Degeneration and Primary Progressive Aphasia Caregiver and Professional Education Conference Diana R. Kerwin, MD Assistant Professor of Medicine-Geriatrics Cognitive Neurology and Alzheimer
More informationCISC 3250 Systems Neuroscience
CISC 3250 Systems Neuroscience Levels of organization Central Nervous System 1m 10 11 neurons Neural systems and neuroanatomy Systems 10cm Networks 1mm Neurons 100μm 10 8 neurons Professor Daniel Leeds
More informationMeta-analyses of cognitive functioning in euthymic bipolar patients and their first-degree relatives
SUPPLEMENTARY MATERIAL Meta-analyses of cognitive functioning in euthymic bipolar patients and their first-degree relatives B. Arts 1 *, N. Jabben 1, L. Krabbendam 1 and J. van Os 1,2 1 Department of Psychiatry
More informationA Neuropsychiatric, Neuroradiological, and Neuropsychological Profile of a Cohort of Patients with Vascular Dementia
A Neuropsychiatric, Neuroradiological, and Neuropsychological Profile of a Cohort of Patients with Vascular Dementia Moises Gaviria, MD University of Illinois at Chicago Advocate Christ Medical Center
More informationAssociation Cortex, Asymmetries, and Cortical Localization of Affective and Cognitive Functions. Michael E. Goldberg, M.D.
Association Cortex, Asymmetries, and Cortical Localization of Affective and Cognitive Functions Michael E. Goldberg, M.D. The origins of localization The concept that different parts of the brain did different
More informationWhat APS Workers Need to Know about Frontotemporal, Lewy Body and Vascular Dementias
What APS Workers Need to Know about Frontotemporal, Lewy Body and Vascular Dementias Presenter: Kim Bailey, MS Gerontology, Program & Education Specialist, Alzheimer s Orange County 1 1 Facts About Our
More informationTopics in Spatial Cognition from Barbara Hidalgo-Sotelo
Topics in Spatial Cognition from Barbara Hidalgo-Sotelo Spatial frames of reference Structure of space Arriving at a unified sense of space is complex Three cases: (1)Hemispatial Neglect (2)Visual form
More informationFunctional Neuroanatomy and Traumatic Brain Injury The Frontal Lobes
Functional Neuroanatomy and Traumatic Brain Injury The Frontal Lobes Jessica Matthes, Ph.D., ABN Barrow TBI Symposium March 23, 2019 jessica.matthes@dignityhealth.org Outline TBI Mechanisms of Injury Types
More informationCortical Organization. Functionally, cortex is classically divided into 3 general types: 1. Primary cortex:. - receptive field:.
Cortical Organization Functionally, cortex is classically divided into 3 general types: 1. Primary cortex:. - receptive field:. 2. Secondary cortex: located immediately adjacent to primary cortical areas,
More informationExam 1 PSYC Fall 1998
Exam 1 PSYC 2022 Fall 1998 (2 points) Briefly describe the difference between a dualistic and a materialistic explanation of brain-mind relationships. (1 point) True or False. George Berkely was a monist.
More informationEarly intervention in Bipolar Disorder
Early intervention in Bipolar Disorder Lakshmi N. Yatham MBBS, FRCPC, MRCPsych Professor of Psychiatry, University of British Columbia, Vancouver, Canada Early Intervention in Bipolar Disorder High Risk
More informationHow can the new diagnostic criteria improve patient selection for DM therapy trials
How can the new diagnostic criteria improve patient selection for DM therapy trials Amsterdam, August 2015 Bruno Dubois Head of the Dementia Research Center (IMMA) Director of INSERM Research Unit (ICM)
More informationDISCLOSURES. Objectives. THE EPIDEMIC of 21 st Century. Clinical Assessment of Cognition: New & Emerging Tools for Diagnosing Dementia NONE TO REPORT
Clinical Assessment of Cognition: New & Emerging Tools for Diagnosing Dementia DISCLOSURES NONE TO REPORT Freddi Segal Gidan, PA, PhD USC Keck School of Medicine Rancho/USC California Alzheimers Disease
More informationUDS version 3 Summary of major changes to UDS form packets
UDS version 3 Summary of major changes to UDS form packets from version 2 to VERSION 3 february 18 final Form A1: Subject demographics Updated question on principal referral source to add additional options
More informationfmri and Voxel-based Morphometry in Detection of Early Stages of Alzheimer's Disease
fmri and Voxel-based Morphometry in Detection of Early Stages of Alzheimer's Disease Andrey V. Sokolov 1,3, Sergey V. Vorobyev 2, Aleksandr Yu. Efimtcev 1,3, Viacheslav S. Dekan 1,3, Gennadiy E. Trufanov
More informationRight Anterior Thalamic Infarction Presenting Only with Cognitive Dysfunction
Right Anterior Thalamic Infarction Presenting Only with Cognitive Dysfunction Sun Ah Park, Dong Chul Park*, Yeonwook Kang**, Kyoon Huh Department of Neurology, Ajou University School of Medicine, Yonsei
More informationInformation Gathering Obtaining history is the most critical first step Patient-provided history may not be reliable Need info from relatives, friends
ASSESSING COMPETENCE Michael A Hill MD UNC Psychiatry 2008 Information Gathering Obtaining history is the most critical first step Patient-provided history may not be reliable Need info from relatives,
More informationMOS SF-36 health survey (Ware &
Biomedical and Physical Functioning General Health Height Weight Waist Circumfernece % Body Fat Tanita scale BMI Self-rated Health - overall clinical protocol Self-rated Health - rel. to age clinical protocol
More informationSensorimotor Functioning. Sensory and Motor Systems. Functional Anatomy of Brain- Behavioral Relationships
Sensorimotor Functioning Sensory and Motor Systems Understanding brain-behavior relationships requires knowledge of sensory and motor systems. Sensory System = Input Neural Processing Motor System = Output
More informationEuropean Prevention of Alzheimer s Dementia (EPAD)
European Prevention of Alzheimer s Dementia (EPAD) Ron Marcus, MD ISCTM Adaptive Design Workshop February 20, 2018 1 EPAD Goal The European Prevention of Alzheimer's Dementia (EPAD) project aims to develop
More informationMorris water maze: standard test for spatial memory in rodents
Vertebrate Models: The Hippocampus 34 Vertebrate Models: The Hippocampus 35 Vertebrate Models: The Hippocampus 36 Vertebrate Models: The Hippocampus 37 Animal Models of Learning (Vertebrates) Morris water
More informationVisual Dysfunction in Alzheimer s Disease and Parkinson s Disease
Visual Dysfunction in Alzheimer s Disease and Parkinson s Disease Victoria S. Pelak, MD Professor of Neurology and Ophthalmology Divisions of Neuro-ophthalmology and Behavioral Neurology University of
More information