NR 507 Week 7 Edapt Content; CNS Sensory and Motor Disorders

Week 7 CNS: Sensory and Motor Disorders Neurodegenerative Disorders (ALS, Alzheimer’s, Parkinson) Neurodegenerative Disorders Affecting Motor Function: progressive degeneration of the structure and function of the nervous system. Incurable, debilitating, leading to a gradual decline in cognitive, motor, or functional abilities. Inherited. Common pathological mechanisms: protein misfolding, neuroinflammation, oxidative stress, neuronal loss. Parkinson's: loss of dopaminergic neurons affecting substantia nigra in the basal ganglia. Tremors, rigidity, bradykinesia. Mostly for >600 yo Amyotrophic Lateral Sclerosis (ALS): diagnosed when patients are in their 40s or 50s. ALS targets motor neurons in the spinal cord and brain, leading to muscle weakness and atrophy. A progressive condition affecting the control of muscle movement. There is a genetic predisposition to this condition. Huntington's: degeneration of nerve cells in basal ganglia. Uncontrolled movements, emotional disturbances, cognitive decline, starting in 40s-50s yo. Multiple Sclerosis (MS): autoimmune that damages myelin sheath in the CNS. Wide range of neurological symptoms. Typically shows up when patients are in their 20s to 40s, may be caused by both environmental and genetics. Myasthenia Gravis (MG): autoimmune affecting the communication between nerves and muscles, leading to muscle weakness and fatigue. MG fluctuates in the nature and severity of symptoms, often affecting muscles controlling eye movements, facial expressions, and swallowing. Neurodegenerative Disorders Affecting Cognitive Function: types of dementia. Decline in memory, thinking, behavior, and reduced function. Alzheimer's: the most common. AD is marked by the accumulation of amyloid plaques and tau tangles in the brain, leading to neuronal death (memory and cognition areas). Progressive memory loss, confusion, and changes in behavior and personality. Vascular dementia: results from conditions that block or reduce blood flow to the brain. It often follows a stroke or series of mini-strikes. Symptoms vary depending on the affected brain region: impaired judgment, inability to plan, and loss of motivation. Lewy Body dementia: characterized by the presence of Lewy bodies, commonly seen in those with Parkingson's. Cognitive decline, fluctuating alertness, visual hallucinations, and Parkinsonian motor symptoms. Cognitive decline is more variable. Frontotemporal dementia: cell degeneration in those areas affects behavior, personality, and language (NOT memory). Socially inappropriate behavior, impulsivity, and language difficulties. Aphasia may occur. Patho of Alzheimer's: Neuronal damage and loss in the hippocampus and cortex, areas crucial for memory and cognitive functions. The disruption of neuronal communication, cell death, and brain atrophy contribute to the clinical manifestations of AD. Neuroinflammatory response, dysfunctional mitochondria, activated microglia, and oxidative stress are also involved in preventing the breakdown of beta-amyloid and the formation of plaque. Ultimately, the loss of synaptic plasticity and neural transmission leads to cholinergic dysfunction and the loss of neuronal repair and remodeling. Alzheimer's: Clinical Application IMPORTANT: AD may cause or coexist with MDD or bipolar. The cognitive decline in AD can exacerbate or trigger all types of emotional and behavioral symptoms. A neurobehavioral specialist can assist with care. Late in the process, AD patients need to be in specialized units. The tx of AD is as much about family support (respite care) as it is about the patient.