Primary alcoholic dementia and alcohol-related dementia
|
|
- Christopher Lucas
- 5 years ago
- Views:
Transcription
1 Blackwell Publishing AsiaMelbourne, AustraliaPSYPsychogeriatrics Japanese Psychogeriatric Society? Original ArticleAlcoholic dementiay. Moriyama et al. PSYCHOGERIATRICS 2006; 6: REVIEW ARTICLE Primary alcoholic dementia and alcohol-related dementia Yasushi MORIYAMA, 1 Masaru MIMURA, 2 Motoichiro KATO 3 and Haruo KASHIMA 3 1 Department of Psychiatry, Komagino Hospital, Tokyo, 2 Department of Neuropsychiatry, Showa University School of Medicine, Tokyo, and 3 Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan Correspondence: Yasushi Moriyama, MD, Department of Psychiatry, Komagino Hospital, 273 Uratakao, Hachioji, Tokyo, , Japan. yamori@rg7.so-net.ne.jp Received 7 November 2005; accepted 3 April Key words: alcoholic dementia, amnesia, neuropathology, neuropsychology, Wernicke Korsakoff s syndrome. Abstract Clinicopathological issues regarding so-called alcoholic dementia remain under debate. Although clinical observation favors the diagnosis of primary alcohol dementia, caused by direct alcohol neurotoxicity, further confirmation from neuropathological and biochemical perspectives is warranted. Repeat episodes of subclinical Wernicke Korsakoff s syndrome may partially account for the chronic state of primary alcoholic dementia, thus supporting the notion that primary alcoholic dementia exists in continuum with chronic and subclinical types of Wernicke Korsakoff s syndrome. Diagnostic criteria for alcohol related dementia, as detailed by Oslin et al., represent a purer form of alcoholic dementia and are useful for the scientific discussion of this condition. INTRODUCTION Oslin et al. 1 have estimated that approximately onequarter of the dementia population have alcohol related problems. The relationship between alcohol use and dementia is complicated. In the present article, we describe three clinical entities of alcoholrelated dementia: primary alcoholic dementia, due to direct alcohol neurotoxicity; Wernicke Korsakoff s syndrome, due to thiamine deficiency; and the operational diagnostic criteria for alcohol-related dementia, which is clinically different from other dementias, such as Alzheimer s disease and vascular dementia. Primary alcoholic dementia Despite recent advances in understanding the clinicopathological correlates of various dementia illnesses, including Alzheimer s disease, frontotemporal dementia and vascular dementia, the clinicopathological issues regarding so-called alcoholic dementia remain under debate. The most important, but still unresolved, question concerning alcoholic dementia is if long-term alcohol use may have direct neurotoxic effects on the brain, leading to a characteristic dementia syndrome. Primary alcoholic dementia, or the direct neurotoxicity of alcohol, may be viewed from four different perspectives: neuropathological, biochemical, neuroradiological and clinical. First, from the neuropathological viewpoint, evidence of direct alcohol neurotoxicity is poor; whether or not chronic and excessive alcohol consumption results in neocortical neuronal loss is unclear. 2 4 The difficulty of using pathological methodology to determine alcoholic toxicity partially accounts for such inconsistency. Indeed, some authors have cast doubt on the existence of primary alcoholic dementia as a neuropathological entity and suggest that the majority of cases of alcoholic dementia are in fact Wernicke Korsakoff s syndrome. 5 Second, in contrast to the paucity of neuropathological findings, there exists some biochemical evidence regarding alcohol-induced brain damage, including withdrawal-nmda receptor hyperexitability 6 and hyperhomocysteinemia. 7 However, the relationship between such biochemical abnormalities and brain dysfunction/dementia is still unclear. Third, cerebral white matter is vulnerable to chronic alcohol consumption. According to both the neuropathological viewpoint and animal models of alcoholism, alcohol-related white matter loss can be related to demyelination or to shrinkage or loss of fibers 114
2 Alcoholic dementia caused by cell degeneration In contrast to the detailed analysis available by neuropathology, anatomic magnetic resonance imaging (MRI) data, to date, has been restricted to gross estimations of white matter volumes. But recently, new developments in magnetic resonance diffusion tensor imaging (DTI) permit in vivo quantification of the microstructual deterioration of white matter tracts. 12 Using these methods, Pfefferbaum et al. 13 investigated the relationships between regional DTI measures and tests of attention and working memory in alcoholic patients, and found that white matter fiber incoherence contributes to disturbance in attention and working memory in chronic alcoholism. However, these functional effects and deficits are subtle; thus, the relationship between such abnormalities and dementia remains unclear. Fourth, clinical observation suggests the presence of cases in which dementia is due to direct alcohol toxicity, but not alcohol-related secondary causes. For example, Kato 14 described a patient with primary alcoholic dementia who underwent detailed clinical, neuropsychological and neuroimaging examinations. Following an episode of binge drinking, the patient presented with abulia, blunt affect and progressive cognitive dysfunction including severe amnesia and frontal dysfunction, which mimicked those of an advanced stage of Alzheimer s disease. The patient s score on the Mini-Mental State Examination (MMSE) was 22 and full scale IQ on the Wechsler Adult Intelligence Scale-Revised (WAIS-R) was 64. He showed no signs of nystagmus, limited eye movement or ataxia, which are frequently observed in Wernicke s encephalopathy. A 18F-fluorodeoxyglucose Positron Emission Tomography (FDG PET) finding demonstrated hypometabolism in bilateral thalamic regions and medial prefrontal cortices, without hippocampal atrophies and vascular lesions on MRI. This dementia state, however, gradually improved and almost completely resolved in 6 years. This patient was unique in that the clinical and cognitive impairments of his dementia slowly recovered, and his functional lesions included the bilateral thalami and the medial and orbital regions of the prefrontal cortex. His clinical symptoms at onset could not be explained by the typical Wernicke-Korsakoff lesions. Moreover, the patient s severe cognitive dysfunction (specifically frontal dysfunction) was reversible, while the cognitive deficits of typical Wernicke Korsakoff s syndrome are permanent. The findings in this patient suggest that from a clinical viewpoint, primary alcoholic dementia does exist, although it is rare. Wernicke Korsakoff s syndrome Wernicke s encephalopathy is an acute neurological disorder caused by thiamine (vitamin B1) deficiency. It is characterized clinically by oculomotor abnormalities, cerebellar dysfunction and an altered mental state, and pathologically by hemorrhagic lesions in the wall of the third and fourth ventricles. Korsakoff s syndrome is characterized by profound amnesia, disorientation and frequent confabulation. Because Korsakoff s syndrome often follows Wernicke s encephalopathy, and both appear to share common pathological substrates, a number of researchers describe this continuum as Wernicke Korsakoff s syndrome. 5,15 Although typical Korsakoff s syndrome presents as a pure amnesic state without significant intellectual decline, some patients are reported to show remarkable and overall dementia ( burned-out Wernicke Korsakoff s syndrome ). 5,15 Although the pathophysiology of Wernicke Korsakoff s syndrome is well understood, misdiagnosis occasionally occurs. Current criteria for diagnosing Wernicke s encephalopathy require the presence of three clinical signs (oculomotor abnormalities, cerebellar dysfunction and altered mental state), 16 although a considerable number of patients do not fulfill all the criteria. Caine et al. 17 proposed new criteria for Wernicke s encephalopathy, which require two of the following four signs: (i) dietary deficiencies; (ii) oculomotor abnormalities; (iii) cerebellar dysfunction; and (iv) either an altered mental state or memory impairment. The criteria Caine et al. 17 proposed appear to have high specificity for identifying antemortem patients with Wernicke s encephalopathy. Repeat episodes of Wernicke Korsakoff s syndrome Burned-out Wernicke Korsakoff s syndrome is difficult to differentiate from primary alcoholic dementia, as both conditions present with overall cognitive decline/dementia. However, the onset pattern provides useful information. Burned-out Wernicke Korsakoff s syndrome presents with acute onset (with nystagmus, ataxia and disturbance in consciousness) while primary alcoholic dementia presents with gradual onset 18 However, Harper 19 suggests another view, 115
3 Y. Moriyama et al. based on the pathological findings that Wernicke Korsakoff s syndrome may occur with gradual onset, without the apparent clinical signs of Wernicke s encephalopathy. Repeated subclinical Wernicke- Korsakoff s episodes could be an underlying cause of so-called primary alcoholic dementia. 20 Although this account of repeated subclinical Wernicke-Korsakoff s episodes, leading to alcoholic dementia, is intriguing, clinical observation hardly provides evidence for such repeat episodes of Wernicke Korsakoff s syndrome. In fact, to our knowledge, no cases of this nature had been documented until we reported one such patient, who demonstrated typical Wernicke s episodes which fulfilled clinical diagnostic criteria. 21 Following the first episode, our patient displayed amnesia and frontal lobe dysfunction, with other cognitive domains spared. This pattern of cognitive deficit remained essentially unchanged even after the second episode; neuropsychological examination of this particular patient demonstrated little change in cognitive dysfunction between the first and second episodes. However, duplicated Wernicke s episodes resulted in emotional and behavioral changes including deteriorated motivation/spontaneity together with occasional compulsive behavior (compulsive washing of clothes). Accordingly, Wernicke-Korsakoff s episodes clinically do repeat, although quite rarely. The accumulation in the literature of similar cases of overt or covert repetition of Wernicke-Korsakoff s episodes may provide clinical evidence supporting the notion of a continuum containing both Wernicke Korsakoff s syndrome and primary alcoholic dementia. Because Wernicke Korsakoff s syndrome presents with variable manifestations, caution should be paid to not overlook or miss the diagnosis. Alcohol-related dementia Although alcohol-induced persisting dementia is included in the Diagnostic and Statistic Manual of Mental Disorders, 4th edition (DSM-IV) 22 (Table 1), validity or reliability studies have not been published using these criteria. 1 The criteria for alcohol-induced persisting dementia are problematic for several reasons. First, the terms that describe abnormal alcohol use are ambiguous; for example, heavy alcohol use, problem alcohol use, or alcohol dependence. It is well known that patient reports of abuse and dependence do not necessarily correlate with the quantity and frequency of alcohol use, especially among older patients. Second, reported duration of abstinence may also be uncertain. Duration of abstinence is important in that subacute withdrawal effects can cause deterioration in cognitive functions. Clinicians often consider alcohol-related issues and dementia independently in evaluating cases of dementia. Third, the qualitative differences between alcohol-induced persisting dementia and Alzheimer s disease or vascular dementia are unclear. Based on these critical problems, and in an attempt to reduce subjective bias and standardize DSM-IV criteria, Oslin et al. 1 proposed diagnostic criteria to improve the validity and reliability of the diagnosis of alcohol related dementia (ARD). Oslin et al. 1 emphasized that ARD still remains controversial and not fully understood in terms of epidemiology and Table 1 Criteria for alcohol-induced persisting dementia in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), 4th edition, cited with modification from the American Psychiatric Association 15 A. The development of multiple cognitive deficits manifested by both: (1) Memory impairment (impaired ability to learn new information or to recall previously learned information) (2) One (or more) of the following cognitive disturbances: (a) Aphasia (language disturbance) (b) Apraxia (impaired ability to carry out motor activities despite intact motor function) (c) Agnosia (failure to recognize or identify objects despite intact sensory function) (d) Disturbance in executive functioning (i.e. planning, organizing, sequencing, abstracting) B. The cognitive deficits in Criteria A1 and A2 each cause significant impairment in social or occupational functioning and represent a significant decline from a previous level of functioning. C. The deficits do not occur exclusively during the course of a delirium and persist beyond the usual duration of substance intoxication or withdrawal. D. There is evidence from the history, physical examination, or laboratory findings that the deficits are etiologically related to the persisting effects of substance use (e.g. a drug of abuse, a medication) 116
4 Alcoholic dementia Table 2 Diagnostic criteria for alcohol related dementia, cited with modification from Oslin et al. 1 Definite alcohol related dementia At the current time there are no acceptable criteria to definitively define alcohol related dementia Probable alcohol related dementia A. The criteria for the clinical diagnosis of probable alcohol related dementia include the following: (1) A clinical diagnosis of dementia at least 60 days after the last exposure to alcohol (2) Significant alcohol use as defined by a minimum average of 35 standard drinks per week for men (28 for women) for greater than a period of 5 years. The period of significant alcohol use must occur within 3 years of the initial onset of dementia B. The diagnosis of alcohol related dementia is supported by the presence of any of the following: (1) Alcohol related hepatic, pancreatic, that is, other end organ damage. (2) Ataxia or peripheral sensory polyneuropathy (3) Beyond 60 days of abstinence, the cognitive impairment stabilizes or improves (4) After 60 days of abstinence, any neuroimaging evidence of ventricular of sulcal dilatation improves (5) Neuroimaging evidence of cerebellar atrophy, especially the vermis C. The following clinical features cast doubt on the diagnosis of alcohol related dementia: (1) The presence of language impairment (2) The presence of focal neurological signs or symptoms (3) Neuroimaging evidence for cortical or subcortical infarction, subdural hematoma (4) Elevated Hachinski Ischemia Scale Score D. Clinical features that are neither supportive nor cast doubt on the diagnosis of alcohol related dementia include: (1) Neuroimaging evidence of cortical atrophy (2) The presence of periventricular or deep white matter lesions, upon neuroimaging, in the absence of focal infarct (3) The presence of the apoprotein e4 allele One standard drink is equal to one middle size bottle of beer or two glasses of wine. pathophysiology. The authors of that study aimed to further promote studies on the etiology of putative ARD by refining its diagnostic criteria. The proposed criteria were modeled after those of the National Institute of Neurologic and Communicative Disorders and Stroke/Alzheimer s Disease and Related Disorders Association (NINCDS/ADRDA) 23 for Alzheimer s disease, providing the categories definite, probable, and possible (Table 2). Using these criteria, Oslin et al. 24 reported that individuals with ARD are less cognitively impaired and more often unmarried than patients with Alzheimer s disease, and that their cognitive and functional status both frequently stabilize. ARD is different from alcohol-induced dementia (DSM-IV) in that the presence of language impairment (aphasia) is less likely in ARD. The absence of aphasia in ARD is of clinical importance for the potential differentiation from Alzheimer s disease, frontotemporal dementia and vascular dementia. Although not all cases of Alzheimer s disease involve language impairment, the symptom of progressive deterioration of language favors the diagnosis of Alzheimer s disease. Oslin et al. s criteria 1 exclude dementia secondary to focal vascular lesions and head trauma, cases with multi risk factors and multiple brain infarctions, and those that occur after 10 years abstinence from alcohol use. Accordingly, the diagnostic criteria represent purer alcohol related dementia including Wernicke Korsakoff s syndrome, Marchiafava-Bignami disease, pellagrous encephalopathy, acquired hepatocerebral degeneration, and primary alcoholic dementia. CONCLUSION Clinicopathological issues regarding so-called alcoholic dementia remain under debate. Although clinical observation favors the diagnosis of primary alcohol dementia, as caused by direct alcohol neurotoxicity, further confirmation from neuropathological and biochemical perspectives is warranted. Repeat episodes of subclinical Wernicke Korsakoff s syndrome may partially account for the chronic state of primary alcoholic dementia, thus supporting the notion that primary alcoholic dementia exists in continuum with chronic and subclinical types of Wernicke Korsakoff s syndrome. Diagnostic criteria for alcohol related dementia, as detailed by Oslin et al., represent a purer form of alcoholic dementia and are useful for the scientific discussion of this condition. REFERENCES 1 Oslin D, Atkinson RM, Smith DM et al. Alcoholic related dementia: proposed clinical criteria. Int J Geriatr Psychiatry 1998; 13:
5 Y. Moriyama et al. 2 Kril JJ, Haliday GM, Svoboda MD et al. The cerebral cortex is damaged in chronic alcoholics. Neuroscience 1997; 79: Jensen GB, Pakkenberg B. Do alcoholics drink their neurons away? Lancet 1993; 342: Brun A, Andersson J. Frontal dysfunction and frontal cortical synapse loss in alcoholism the main cause of alcohol dementia? Dement Geriatr Cogn Disord 2001; 12: Victor M. Alcoholic dementia. Can J Neurol Sci 1994; 21: Tsai G, Gastfriend DR, Coyle JT. The glutamatergic basis of human alcoholism. Am J Psychiatry 1995; 152: Bleich S, Bandelow B, Javaheripour K et al. Hyperhomocysteinemia as a new risk factor for brain shrinkage in patients with alcoholism. Neurosci Lett 2003; 335: De la Monte SM. Disproportionate atrophy of cerebral white matter in chronic alcoholics. Arch Neurol 1988; 45: Harper CG, Kril J. Neuropathology of alcoholism. Alcohol Alcohol 1990; 25: Lancaster FE. Alcohol and white matter development a review. Alcohol Clin Exp Res 1994; 18: Langlais PJ, Zhang SX. Cortical and subcortical white matter damage without Wernicke s encephalopathy after recovery from thiamine deficiency in the rat. Alcohol Clin Exp Res 1997; 21: Rosenbloom M, Sullivan EV, Pfefferbaum A. Using magnetic resonance imaging and diffusion tensor imaging to assess brain damage in alcoholics. Alcohol Res Health 2003; 27: Pfefferbaum A, Dullivan EV, Hedehus M et al. In vivo detection and functional correlates of white matter microstructural disruption in chronic alcoholism. Alcohol Clin Exp Res 2000; 24: Kato M. A case with primary alcoholic dementia An investigation of dementia associated with alcoholism. Jpn J Psychiatr Res Alcohol 1996; 5: Kato M. Korsakoff syndrome. In: Matsusita M, ed. Encyclopedia of Clinical Psychiatry S2. Tokyo: Nakayama Shotenn, 1999; (in Japanese). 16 Victor M, Adams RD, Collins GH. The Wernicke Korsakoff Syndrome. Philadelphia: FA Davis Co, 1971; Caine D, Halliday GM, Krill JJ et al. Operational criteria for the classification of chronic alcoholics: identification of Wernicke s encephalopathy. J Neurol Neurosurg Psychiatry 1997; 62: Cutting J. The relationship between Korsakov s syndrome and alcoholic dementia. Br J Psychiat 1978; 132: Harper C. The incidence of Wernicke s encephalopathy in Australia - a neuropathological study of 131 cases. J Neurol Neurosurg Psychiatry 1983; 46: Bowden SC. Separating cognitive impairment in neurologically asymptomatic alcoholism from Wernicke Korsakoff syndrome; Is the neuropsychological distinction justified? Psychol Bull 1990; 107: Moriyama Y, Muramatsu T, Kato M et al. Repeated clinical episodes of Wernicke Korsakoff syndrome. Aust NZ J Psychiatry 2004; 38: American Psychiatric Association. Diagnostic Criteria from DSM IV. Washington DC: American Psychiatric Association, Mckhann G, Drachman D, Folstein M et al. Clinical diagnosis of Alzheimer s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer s Disease. Neurology 1984; 34: Oslin D, Cary MS. Alcohol related dementia: validation of diagnostic criteria. Am J Geriatr Psychiatry 2003; 11:
Dementia. Assessing Brain Damage. Mental Status Examination
Dementia Assessing Brain Damage Mental status examination Information about current behavior and thought including orientation to reality, memory, and ability to follow instructions Neuropsychological
More informationClinical Diagnosis. Step 1: Dementia or not? Diagnostic criteria for dementia (DSM-IV)
Step 1: Dementia or not? Diagnostic criteria for dementia (DSM-IV) A. The development of multiple cognitive deficits manifested by both 1 and 2 1 1. Memory impairment 2. One (or more) of the following
More informationCognitive disorders. Dr S. Mashaphu Department of Psychiatry
Cognitive disorders Dr S. Mashaphu Department of Psychiatry Delirium Syndrome characterised by: Disturbance of consciousness Impaired attention Change in cognition Develops over hours-days Fluctuates during
More informationRecreational alcohol and brain. GP Study Day 12 th March 2019 Anya Topiwala
Recreational alcohol and brain GP Study Day 12 th March 2019 Anya Topiwala Acute Intoxication Behavioural disinhibition Disrupted socio-emotional processing Impaired psychomotor performance Reduced prefrontal
More informationAnosognosia, or loss of insight into one s cognitive
REGULAR ARTICLES Anosognosia Is a Significant Predictor of Apathy in Alzheimer s Disease Sergio E. Starkstein, M.D., Ph.D. Simone Brockman, M.A. David Bruce, M.D. Gustavo Petracca, M.D. Anosognosia and
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 informationARBD Assessment, Diagnosis and MCA
ARBD Assessment, Diagnosis and MCA Dr Julia Lewis Consultant Addiction Psychiatrist Aneurin Bevan University Health Board Assessment Acute Medical Stage Acute Global Confusion Non-permanent Cognitive Dysfunction
More informationTOXIC AND NUTRITIONAL DISORDER MODULE
TOXIC AND NUTRITIONAL DISORDER MODULE Objectives: For each of the following entities the student should be able to: 1. Describe the etiology/pathogenesis and/or pathophysiology, gross and microscopic morphology
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 informationThe motor regulator. 2) The cerebellum
The motor regulator 2) The cerebellum Motor control systems outside the cortex Cerebellum -controls neural programs for the executionl of skilled movements Feed-back and feed-forward control circuits By
More informationAlzheimer s Disease. Clinical characteristics of late-onset Alzheimer s disease (LOAD) A/Prof David Darby
Alzheimer s Disease Clinical characteristics of late-onset Alzheimer s disease (LOAD) A/Prof David Darby Florey Institute of Neuroscience and Mental Health 28-6-2013 The burden of late-onset Alzheimer
More informationThe motor regulator. 2) The cerebellum
The motor regulator 2) The cerebellum Motor control systems outside the cortex Cerebellum -controls neural programs for the executionl of skilled movements Cerebellar Peduncles Atlas Fig. 2-31 Atlas Fig.
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 informationMarchiafava Bignami Disease (MBD) and Diffusion Tensor Image (DTI) Tractography. Priscilla Chukwueke, MD, MPH
Marchiafava Bignami Disease (MBD) and Diffusion Tensor Image (DTI) Tractography Priscilla Chukwueke, MD, MPH INTRODUCTION Definition: A rare CNS disease characterized by demyelination of the Corpus Callosum.
More informationIntroduction, use of imaging and current guidelines. John O Brien Professor of Old Age Psychiatry University of Cambridge
Introduction, use of imaging and current guidelines John O Brien Professor of Old Age Psychiatry University of Cambridge Why do we undertake brain imaging in AD and other dementias? Exclude other causes
More informationQuantitative analysis for a cube copying test
86 99 103 2010 Original Paper Quantitative analysis for a cube copying test Ichiro Shimoyama 1), Yumi Asano 2), Atsushi Murata 2) Naokatsu Saeki 3) and Ryohei Shimizu 4) Received September 29, 2009, Accepted
More informationscientifically.org ALCOHOL RELATED BRAIN DAMAGE DR RAMAN SAKHUJA
scientifically.org ALCOHOL RELATED BRAIN DAMAGE DR RAMAN SAKHUJA OVERVIEW Epidemiology & Definitions Basic Neuroanatomy Neuropathology WKS Part 2 Management approach- Current Evidence Future EPIDEMIOLOGY
More informationDementia. Stephen S. Flitman, MD Medical Director 21st Century Neurology
Dementia Stephen S. Flitman, MD Medical Director 21st Century Neurology www.neurozone.org Dementia is a syndrome Progressive memory loss, plus Progressive loss of one or more cognitive functions: Language
More informationALZHEIMER S DISEASE. Mary-Letitia Timiras M.D. Overlook Hospital Summit, New Jersey
ALZHEIMER S DISEASE Mary-Letitia Timiras M.D. Overlook Hospital Summit, New Jersey Topics Covered Demography Clinical manifestations Pathophysiology Diagnosis Treatment Future trends Prevalence and Impact
More informationDr Tony Rao Consultant Community Old Age Psychiatrist South London and Maudsley NHS Foundation Trust and Institute of Psychiatry Psychology and
Dr Tony Rao Consultant Community Old Age Psychiatrist South London and Maudsley NHS Foundation Trust and Institute of Psychiatry Psychology and Neurology It would be too optimistic to suppose that the
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 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 informationBrain imaging for the diagnosis of people with suspected dementia
Why do we undertake brain imaging in dementia? Brain imaging for the diagnosis of people with suspected dementia Not just because guidelines tell us to! Exclude other causes for dementia Help confirm diagnosis
More informationDementia Prepared by: Joanne Leung Psychiatry Resident, University of Toronto
Dementia Prepared by: Joanne Leung Psychiatry Resident, University of Toronto Dementias are acquired neurodegenerative disorders involving a syndrome of cognitive impairment accompanied with social and
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 informationConfusional state. Digit Span. Mini Mental State Examination MMSE. confusional state MRI
10 304 29 3 confusional state MRI 29 3 304 311 2009 Key Words memory test attention brain region causative disease subcortical dementia 1 Confusional state Digit Span 1 1 5 4 Mini Mental State Examination
More informationDiffusion Tensor Imaging in Psychiatry
2003 KHBM DTI in Psychiatry Diffusion Tensor Imaging in Psychiatry KHBM 2003. 11. 21. 서울대학교 의과대학 정신과학교실 권준수 Neuropsychiatric conditions DTI has been studied in Alzheimer s disease Schizophrenia Alcoholism
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 informationIntroduction to Dementia: Diagnosis & Evaluation. Created in March 2005 Duration: about 15 minutes
Introduction to Dementia: Diagnosis & Evaluation Created in March 2005 Duration: about 15 minutes Axel Juan, MD The Geriatrics Institute axel.juan@med.va.gov 305-575-3388 Credits Principal medical contributor:
More informationMental Health Disorders Civil Commitment UNC School of Government
Mental Health Disorders 2017 Civil Commitment UNC School of Government Edward Poa, MD, FAPA Chief of Inpatient Services, The Menninger Clinic Associate Professor, Baylor College of Medicine NC statutes
More informationMemory Disorders. 1. Episodic: memory for time and places. 2. Semantic: memory for facts and knowledge (language, numbers, etc).
I. Types of memory: A. Declarative memory: Memory Disorders 1. Episodic: memory for time and places. 2. Semantic: memory for facts and knowledge (language, numbers, etc). B. Procedural memory: - examples:
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 informationThe Person: Dementia Basics
The Person: Dementia Basics Objectives 1. Discuss how expected age related changes in the brain might affect an individual's cognition and functioning 2. Discuss how changes in the brain due to Alzheimer
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 informationMen and women are affected Male and Female larger amounts of intracranial CSF
Male and Female Sensitivity to Alcohol-Induced Brain Damage Daniel W. Hommer, M.D. are more vulnerable than men to many of the medical consequences of alcohol use. Although research has shown that male
More informationUnderstanding Brain-Behavior Relationships in Children p. 123 Medical and Neurological Disorders of Childhood p. 124 Issues Particular to Pediatric
Contributors About this handbook p. 3 Clinical Neuropsychology: General Issues The Medical Chart: Efficient Information-Gathering Strategies and Proper Chart Noting p. xix The Chart Review p. 10 The Progress
More informationOverview of neurological changes in Alzheimer s disease. Eric Karran
Overview of neurological changes in Alzheimer s disease Eric Karran Alzheimer s disease Alois Alzheimer 1864-1915 Auguste D. 1850-1906 Case presented November 26 th 1906 Guildford Talk.ppt 20 th March,
More informationNon Alzheimer Dementias
Non Alzheimer Dementias Randolph B Schiffer Department of Neuropsychiatry and Behavioral Science Texas Tech University Health Sciences Center 9/11/2007 Statement of Financial Disclosure Randolph B Schiffer,,
More information13/01/2018 CONFLICT OF INTEREST ALCOHOL USE DISORDER (AUD): EPIDEMIOLOGY
NEUROPSYCHOLOGY AND NEUROIMAGING OF ALCOHOL USE DISORDER WITH AND WITHOUT KORSAKOFF S SYNDROME: A BETTER UNDERSTANDING FOR A BETTER TREATMENT Anne Lise PITEL CONFLICT OF INTEREST No conflict of interest
More informationDiagnosis and Treatment of Alzhiemer s Disease
Diagnosis and Treatment of Alzhiemer s Disease Roy Yaari, MD, MAS Director, Memory Disorders Clinic, Banner Alzheimer s Institute 602-839-6900 Outline Introduction Alzheimer s disease (AD)Guidelines -revised
More informationDelirium, Dementia, and Amnestic Disorders. Dr.Al-Azzam 1
Delirium, Dementia, and Amnestic Disorders Dr.Al-Azzam 1 Introduction Disorders in which a clinically significant deficit in cognition or memory exists The number of people with these disorders is growing
More information7/3/2013 ABNORMAL PSYCHOLOGY SEVENTH EDITION CHAPTER FOURTEEN CHAPTER OUTLINE. Dementia, Delirium, and Amnestic Disorders. Oltmanns and Emery
ABNORMAL PSYCHOLOGY SEVENTH EDITION Oltmanns and Emery PowerPoint Presentations Prepared by: Ashlea R. Smith, Ph.D. This multimedia and its contents are protected under copyright law. The following are
More informationNeuroimaging for Diagnosis of Psychiatric Disorders
Psychiatric Disorder Neuroimaging for Diagnosis of Psychiatric Disorders JMAJ 45(12): 538 544, 2002 Yoshio HIRAYASU Associate Professor, Department of Neuropsychiatry Kyorin University School of Medicine
More informationVascular Dementia. Laura Pedelty, PhD MD The University of Illinois at Chicago and Jesse Brown VA Medical Center
Vascular Dementia Laura Pedelty, PhD MD The University of Illinois at Chicago and Jesse Brown VA Medical Center none Disclosures Objectives To review the definition of Vascular Cognitive Impairment (VCI);
More informationOrganic Mental Disorders. Organic Mental Disorders. Axes. Damrongsak Bulyalert Department of Internal Medicine
Organic Mental Disorders Damrongsak Bulyalert Department of Internal Medicine www.metadon.net 1 Organic Mental Disorders In DSM (Diagnostic and Statistical Manual of Mental Disorders), OMD includes Delirium,
More informationDisentangling Delirium and Dementia
Disentangling Delirium and Dementia Sharon K. Inouye, M.D., M.P.H. Professor of Medicine Beth Israel Deaconess Medical Center Harvard Medical School Milton and Shirley F. Levy Family Chair Director, Aging
More informationA RARE CASE OF: MARCHIAFAVA-BIGNAMI DISEASE Manisha Panchal 1, Maulik Jethva 2, Anjana Trivedi 3, Pinkal Patel 4, Manish Yadav 5
A RARE CASE OF: MARCHIAFAVA-BIGNAMI DISEASE Manisha Panchal 1, Maulik Jethva 2, Anjana Trivedi 3, Pinkal Patel 4, Manish Yadav 5 HOW TO CITE THIS ARTICLE: Manisha Panchal, Maulik Jethva, Anjana Trivedi,
More informationI do not have any disclosures
Alzheimer s Disease: Update on Research, Treatment & Care Clinicopathological Classifications of FTD and Related Disorders Keith A. Josephs, MST, MD, MS Associate Professor & Consultant of Neurology Mayo
More informationt~ JOURMEUNAL l NEUROPHYSIOLOGICAL INVESTIGATION OF NINE CASES by HELEN J. HARBINSON Purdysburn Hospital, Saintfield Road, Belfast
PBSDOTHEU t~ JOURMEUNAL l PUBLISHED ON BEHALF OF THE ULSTER MEDICAL SOCIETY VOLUME 53 1984 No. 2 ALCOHOLIC KORSAKOFF'S PSYCHOSIS: A PSYCHOMETRIC, NEURORADIOLOGICAL AND NEUROPHYSIOLOGICAL INVESTIGATION
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 informationForm D1: Clinician Diagnosis
Initial Visit Packet Form D: Clinician Diagnosis NACC Uniform Data Set (UDS) ADC name: Subject ID: Form date: / / Visit #: Examiner s initials: INSTRUCTIONS: This form is to be completed by the clinician.
More informationDelirium & Dementia. Nicholas J. Silvestri, MD
Delirium & Dementia Nicholas J. Silvestri, MD Outline Delirium vs. Dementia Neural pathways relating to consciousness Encephalopathy Stupor Coma Dementia Delirium vs. Dementia Delirium Abrupt onset Lasts
More informationDISCLAIMER: ECHO Nevada emphasizes patient privacy and asks participants to not share ANY Protected Health Information during ECHO clinics.
DISCLAIMER: Video will be taken at this clinic and potentially used in Project ECHO promotional materials. By attending this clinic, you consent to have your photo taken and allow Project ECHO to use this
More informationRegulatory Challenges across Dementia Subtypes European View
Regulatory Challenges across Dementia Subtypes European View Population definition including Early disease at risk Endpoints in POC studies Endpoints in pivotal trials 1 Disclaimer No CoI The opinions
More informationC81ADD Psychology of Addiction. Alcohol. Ethyl alcohol (ethanol) School of Psychology. Tobias Bast.
C81ADD Psychology of Addiction Alcohol Ethyl alcohol (ethanol) Tobias Bast School of Psychology tobias.bast@nottingham.ac.uk 1 Selected aspects of the psychopharmacology of alcohol (ethanol) Primary neuropharmacological
More informationMild Cognitive Impairment or Mild Neurocognitive Disorder: Implications for Clinical Practice. Hypothesized Key Players in the Pathogenesis of AD
AD is a Neurodegenerative Disease as Seen in the PET Scan and is Characterized by Amyloid Plaques and Neurofibrillary Tangles Mild Cognitive Impairment or Mild Neurocognitive Disorder: Implications for
More informationChronic Traumatic Encephalopathy Provider and Parent Essentials
Chronic Traumatic Encephalopathy Provider and Parent Essentials Concussion Global Cast July 30, 2014 John Lockhart, MD Seattle Children s Hospital Chronic Traumatic Encephaly (CTE) Working Definition Chronic
More informationNeuropsychological Testing (NPT)
Neuropsychological Testing (NPT) POLICY Psychological testing (96101-03) refers to a series of tests used to evaluate and treat an individual with emotional, psychiatric, neuropsychiatric, personality
More informationNew life Collage of nursing Karachi
New life Collage of nursing Karachi Presenter: Zafar ali shah Faculty: Raja khatri Subject: Pathophysiology Topic :Alzheimer s Disease Post RN BScN semester 2 nd Objective Define Alzheimer s Describe pathophysiology
More informationComparison of clock drawing with Mini Mental State Examination as a screening test in elderly acute hospital admissions
Postgrad Med J (1993) 69, 696-700 A) The Fellowship of Postgraduate Medicine, 199: Comparison of clock drawing with Mini Mental State Examination as a screening test in elderly acute hospital admissions
More informationPick Paterson 1944
383 33 1 1 28 4 383 391 2008 Key Words reduplicative paramnesia geographical mislocation double orientation identity right frontal lobe reduplicative paramnesia Pick 1901 1903 2 Ruff 1981 Staton 1982 Patterson
More informationClinical Research on Treating Senile Dementia by Combining Acupuncture with Acupoint-Injection
Clinical Research on Treating Senile Dementia by Combining Acupuncture with Acupoint-Injection Yemeng Chen, M.D. Acupuncture Department, Huashan Hospital Shanghai Medical University, Shanghai 20040, P.
More informationDVHIP. TBI: Clinical Issues, Controversies, and Learning from Patients. Defense and Veterans Head Injury Program. What is Neuropsychology?
TBI: Clinical Issues, Controversies, and Learning from Patients DVHIP Defense and Veterans Head Injury Program Richard A. Lanham, Jr., Ph.D. Assistant Professor Division of Medical Psychology Psychiatry
More informationCASE 49. What type of memory is available for conscious retrieval? Which part of the brain stores semantic (factual) memories?
CASE 49 A 43-year-old woman is brought to her primary care physician by her family because of concerns about her forgetfulness. The patient has a history of Down syndrome but no other medical problems.
More informationFRONTOTEMPORAL DEGENERATION: OVERVIEW, TRENDS AND DEVELOPMENTS
FRONTOTEMPORAL DEGENERATION: OVERVIEW, TRENDS AND DEVELOPMENTS Norman L. Foster, M.D. Director, Center for Alzheimer s Care, Imaging and Research Chief, Division of Cognitive Neurology, Department of Neurology
More informationMild Cognitive Impairment
Mild Cognitive Impairment Victor W. Henderson, MD, MS Departments of Health Research & Policy (Epidemiology) and of Neurology & Neurological Sciences Stanford University Director, Stanford Alzheimer s
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 informationNACC Minimum Data Set (MDS) Public Data Element Dictionary
Department of Epidemiology, School of Public Health and Community Medicine, University of Washington 4311 11 th Avenue NE #300 Seattle, WA 98105 phone: (206) 543-8637; fax: (206) 616-5927 e-mail: naccmail@u.washington.edu
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 informationMultimodal Imaging in Extratemporal Epilepsy Surgery
Open Access Case Report DOI: 10.7759/cureus.2338 Multimodal Imaging in Extratemporal Epilepsy Surgery Christian Vollmar 1, Aurelia Peraud 2, Soheyl Noachtar 1 1. Epilepsy Center, Dept. of Neurology, University
More informationCHAPTER 17: HEALTH PSYCHOLOGY CHAPTER 18: NEUROPSYCHOLOGY
OUTLINE CHAPTER 17: HEALTH PSYCHOLOGY Role of Health Psychologists Stress & Illness Pain Management CHAPTER 18: NEUROPSYCHOLOGY Brain trauma Disorders of brain atrophy Neuro-assessment Professor Fazakas-DeHoog
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 informationDSM-5 MAJOR AND MILD NEUROCOGNITIVE DISORDERS (PAGE 602)
SUPPLEMENT 2 RELEVANT EXTRACTS FROM DSM-5 The following summarizes the neurocognitive disorders in DSM-5. For the complete DSM-5 see Diagnostic and Statistical Manualof Mental Disorders, 5th edn. 2013,
More informationMarchiafava-Bignami Disease
Bahrain Medical Bulletin, Vol. 36, No. 4, December 2014 Marchiafava-Bignami Disease Fahd Al-Khamis, MBBS, UODFN* Fozaih Al-Shamrani, MBBS, UODFN** Ibrahim Al- Ghanimi, MBBS, UODFN*** Sarah Abdulhafiz,
More informationPalliative Approach to the Person with Advanced Dementia
Mid North Coast Rural Palliative Care Project Link Nurse Education 2004 Palliative Approach to the Person with Advanced Dementia Anne Sneesby CNC - ACAT To care for the dying is a very human opportunity
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 informationFrégoli Syndrome Accompanied with Prosopagnosia in a Woman with a 40-year History of Schizophrenia.
Case Report Frégoli Syndrome Accompanied with Prosopagnosia in a Woman with a 40-year History of Schizophrenia. Yasushi Moriyama, 1 Taro Muramatsu, 2 Motoichiro Kato, 2 Masaru Mimura, 3 Tomoko Akiyama,
More informationBehavioral and psychological symptoms of dementia characteristic of mild Alzheimer patients
Blackwell Science, LtdOxford, UKPCNPsychiatry and Clinical Neurosciences1323-13162005 Blackwell Publishing Pty Ltd593274279Original ArticleDementia and mild AlzheimersJ. Shimabukuro et al. Psychiatry and
More informationCommi ee Lecture: Neurocogni ve Disorders TBI : Trauma c Brain Disorders. William L. Bograkos, MA, DO, FACOEP
Commi ee Lecture: Neurocogni ve Disorders TBI : Trauma c Brain Disorders Toxic Brain Disorders William L. Bograkos, MA, DO, FACOEP TBI: Traumatic Brain Injury / Toxic Brain Injury (Trauma and Substance
More informationDiffusion Tensor Imaging in Dementia. Howard Rosen UCSF Department of Neurology Memory and Aging Center
Diffusion Tensor Imaging in Dementia Howard Rosen UCSF Department of Neurology Memory and Aging Center www.memory.ucsf.edu Overview Examples of DTI findings in Alzheimer s disease And other dementias Explore
More informationDementia is defined as a general loss of
CURRENT STANDARDS FOR ASSESSMENT AND DIAGNOSIS OF ALZHEIMER S DISEASE: A NURSE S PERSPECTIVE Carol Fedor, ND* ABSTRACT Clinically, dementia, in particular Alzheimer s disease (AD), is defined as the progressive
More informationThe Australian Imaging, Biomarkers and Lifestyle Flagship Study of Ageing an example of Australian research on Alzheimer s disease
The Australian Imaging, Biomarkers and Lifestyle Flagship Study of Ageing an example of Australian research on Alzheimer s disease AIBL: Two site collaborative study Study is conducted at two sites: Perth
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 informationClinicopathologic and genetic aspects of hippocampal sclerosis. Dennis W. Dickson, MD Mayo Clinic, Jacksonville, Florida USA
Clinicopathologic and genetic aspects of hippocampal sclerosis Dennis W. Dickson, MD Mayo Clinic, Jacksonville, Florida USA The hippocampus in health & disease A major structure of the medial temporal
More informationElderly Mental Health and Substance Abuse. Case 1. Dr. John McCahill, MRCPsych, FRCPC Alberta Hospital Edmonton September 11, 2008 Case Studies
Elderly Mental Health and Substance Abuse Dr. John McCahill, MRCPsych, FRCPC Alberta Hospital Edmonton September 11, 2008 Case Studies Case 1 69 y/o woman,recently divorced Presenting complaint: admitted
More informationEARLY ONSET FRONTOTERMPORAL DEMENTIA AND ALZHEIMERS DISEASE: DIAGNOSIS, TREATMENT AND CARE
EARLY ONSET FRONTOTERMPORAL DEMENTIA AND ALZHEIMERS DISEASE: DIAGNOSIS, TREATMENT AND CARE John Rudge, BA Hons This thesis is presented as partial requirement for the degree of Doctor of Psychology at
More informationBrain Imaging studies in substance abuse. Jody Tanabe, MD University of Colorado Denver
Brain Imaging studies in substance abuse Jody Tanabe, MD University of Colorado Denver NRSC January 28, 2010 Costs: Health, Crime, Productivity Costs in billions of dollars (2002) $400 $350 $400B legal
More informationNeuroimaging for dementia diagnosis. Guidance from the London Dementia Clinical Network
Neuroimaging for dementia diagnosis Guidance from the London Dementia Clinical Network Authors Dr Stephen Orleans-Foli Consultant Psychiatrist, West London Mental Health NHS Trust Dr Jeremy Isaacs Consultant
More informationInternational Conference on Biological Sciences and Technology (BST 2016)
International Conference on Biological Sciences and Technology (BST 2016) A Better Characterization of Brain Damage in Carbon Monoxide Intoxication Assessed in Vivo Using Diffusion Kurtosis Imaging Wen-Yao
More informationHow preserved is episodic memory in behavioral variant frontotemporal dementia?
How preserved is episodic memory in behavioral variant frontotemporal dementia? M. Hornberger, PhD O. Piguet, PhD A.J. Graham, PhD, MRCP P.J. Nestor, MD, FRACP J.R. Hodges, MD, FRCP Address correspondence
More informationDisorders of language and speech. Samuel Komoly MD PhD DHAS Professor and Chairman Department of Neurology
Disorders of language and speech Samuel Komoly MD PhD DHAS Professor and Chairman Department of Neurology http://neurology.pote.hu major categories disorders of language and speech cortical types aphasias
More informationRole of MRI in acute disseminated encephalomyelitis
Original Research Article Role of MRI in acute disseminated encephalomyelitis Shashvat Modiya 1*, Jayesh Shah 2, C. Raychaudhuri 3 1 1 st year resident, 2 Associate Professor, 3 HOD and Professor Department
More informationStudy (s) Degree Center Acad. Period Grado de Psicología FACULTY OF PSYCHOLOGY 4 Second term
COURSE DATA Data Subject Code 33338 Name Neuropsychology Cycle Grade ECTS Credits 4.5 Academic year 2016 2017 Study (s) Degree Center Acad. Period year 1319 Grado de Psicología FACULTY OF PSYCHOLOGY 4
More informationForensic Aspects of Ethanol. William Bligh-Glover M.D. Lorain County Coroner s s Office CWRU Department of Anatomy
Forensic Aspects of Ethanol William Bligh-Glover M.D. Lorain County Coroner s s Office CWRU Department of Anatomy Definitions Alcohol Ethyl alcohol CH 3 CH 2 OH Proof 1/2 of 1 percent Drink Equivalent
More informationIt s Always a Stroke; Except For When It s Not..
It s Always a Stroke; Except For When It s Not.. TREVOR PHINNEY, D.O. Disclosures No Relevant Disclosures 1 Objectives Discuss variables of differential diagnosis for stroke Review when to TPA and when
More informationWhat is Korsakoff s Syndrome
PBO 930022142 NPO 049-191 What is Korsakoff s Syndrome Korsakoff s syndrome is a brain disorder associated with heavy drinking over a long period. While not strictly speaking a dementia, those with the
More informationThe nucleus basalis (Ch4) in the alcoholic Wernicke-KorsakoV syndrome: reduced cell number in both amnesic and non-amnesic patients
Journal of Neurology, Neurosurgery, and Psychiatry 1997;63:315 320 315 Department of Pathology, Neuropathology Division, The University of Sydney 2006, NSW 2006, Australia K M Cullen G M Halliday JJKril
More informationStroke School for Internists Part 1
Stroke School for Internists Part 1 November 4, 2017 Dr. Albert Jin Dr. Gurpreet Jaswal Disclosures I receive a stipend for my role as Medical Director of the Stroke Network of SEO I have no commercial
More informationOLD AGE PSYCHIATRY. Dementia definition TYPES OF DEMENTIA. Other causes. Psychiatric disorders of the elderly. Dementia.
Psychiatric disorders of the elderly OLD AGE PSYCHIATRY Dementia Depression Delusional disorder/late onset schizophrenia Delirium Dementia definition LOCALISATION OF CEREBRAL FUNCTION Impairment of multiple
More informationToxic and Metabolic Disease of Nervous System
Toxic and Metabolic Disease of Nervous System Reid R. Heffner, MD Distinguished Teaching Professor Emeritus Department of Pathology and Anatomy January 14, 2019 1 I HAVE NO CONFLICTS OF INTEREST OR DISCLOSURES
More information