HP4 Lecture 8

1

Which of the following is NOT a generally recognised cause of memory impairment?


  Surgical resection

  Temporal lobe epilepsy

  Bilateral thalamic infarction

  Chronic alcoholism

  Statins


E is correct: Statins such as Lipitor were a subject of controversy regarding sudden-onset memory impairment, but subsequent studies have shown them to be safe.

2

Which of the following statements about memory systems is INCORRECT?


  The declarative and procedural systems can become impaired independently

  Skill acquisition is part of procedural memory

  Working memory is important in executive function

  Episodic memory is heavily dependent on temporal, spatial and emotional context

  Damage to the prefrontal cortex will most likely affect procedural memory


Damage to the prefrontal and dorsolateral cortices is associated with working memory deficiencies.

3

Which of the following statements about lesion-associated memory impairment is CORRECT?


  Retrograde amnesia refers to the inability to recall events that happened after an amnesia-inducing injury

  Episodic memory impairment is often associated with lesions to neocortical areas of the brain

  Amnesia is often observed following unilateral hippocampal resection

  Patient HM's anterograde amnesia was responsible for his inability to recognise people he had recently met

  The enterorhinal cortex is not associated with amnesia-inducing lesions


A is incorrect: This is anterograde amnesia B is incorrect: Episodic memory structures are 'all' midline structures, not neocortical C is incorrect: Unilateral hippocampal resection is a viable epilepsy treatment and often does not significantly affect memory D is correct: See A E is incorrect: The enterorhinal cortex is a major hub in the memory network of the brain (it was one of the structures removed in patient HM)

4

Mild cognitive impairment (MCI) does not typically result in:


  Complaints of problems with object-place associations

  Reduced ability to cope with everyday activities

  Objective memory impairment

  A subsequent transition to dementia


MCI differs from dementia in that general cognitive and functional abilites are preserved.

5

Alzheimer's disease (AD) is the commonest cause of dementia. Which ONE of the following statements regarding AD is INCORRECT?


  It is graded in stages

  It involves significant observable changes in the hippocampus compared with normal controls

  Both encoding and retrieval of memories appears to be affected

  Glucose uptake is impaired, especially in the temporo-occipital association cortex

  Launguage impairment in AD is most often 'Wernicke'-type, i.e. fluent.


A is correct: The Braak and Braak staging schema is an example. B is correct: These are visible using radiographic imaging. C is correct: Especially in late stages, and can result in confabulation. D is incorrect: Glucose uptake is impaired in the temporo-parietal association cortex. E is correct: Speech is often "empty", dysnomia being a prominent feature.

6

The pathophysiology of AD includes the formation of 'neurofibrillary tangles'. Which one of the following is this NOT associated with?


  Genetic predisposition, the profile of which appears to vary between the senile and non-senile onset forms of AD

  Plaque formation between cells

  Overproduction of β-amyloid protein

  Apolipoprotein E1

  Collapsed microtubules and cell death


Apolipoprotein E4 and E2 have a recognised role in AD - E3 is the "normal" isoform. E1 is very rare in humans.