Memory disorders

Memory disorders

1. Memory

   • Nondeclarative
     • procedural
     • emotional
       • (fear conditioning)
         • PTSD
       • amygdala mPFC
       • concurrant w/ other systems
         • i.e. episodic
   • declarative
     • episodic
       • Alzheimer's
     • semantic

2. PTSD

   • ~7.8% prevalence
   • Witness injury/death, involve in disaster, life-threatening accident, childhood abuse, combat
   • DSMV
     • trauma/stress related disorder
       • require exposure traumatic event
       • symptoms
         • re-experiencing
           • flashback
           • gestalt memories
           • recurrent dreams
         • avoidance and numbing
         • arousal response
           • sleep difficulty
           • exaggerated startle
           • persistent vigilance
   • fear conditioning
     • poor contextual memory
       • CAN develop PTSD without episodic memory?
         • case
           • buried alive
             • anoxia
               • coma
                 • amnesia
                   • depression/ anxiety/ withdrawal
                   • flashbacks, nightmares, exaggerated startle
                   • occupational disability
                   • not just suppression of memory
                     • "truth serum"
                       • still no memory
         • emotional situation
           • amygdala
             • implicit/ emotional
           • hippocampal
             • expliit memory
         • increased amygdala activation inhibits hippocampal
           • occurs with higher emotional intensity
   • flashbulb
     • episodic AND emotional
       • hippocampus AND amygdala

3. Aging and Dementia

   • MCI
     • criteria
       • perception of decline
         • patient
         • informant
         • clinician
       • 1+ cog domain
         • ofton memory + executive activity
       • preserved everyday act
     • transitional condition?
       • 5-10% develop AD
   • Late-life AD
     • develop over preclinical (decades)
       • Amyloid-beta
         • peak before dementia
           • can exist w/o dementia
         • ~55-75
           • AD at 65
     • prevention?
   • Structure
     • most plastic and active most vulnerable
       • medial temporal lobe
         • perirhinal
         • parahippocampal
         • entorhinal
       • cortical association areas
         • sensory, aud, motor, visual, taste
   • classification
     • MCI
       • slight increase memory decline compared to aging peers
       • ^ risk AD
     • Age-associated
       • non-path
       • relative young adults
       • also drop aorund menopause :(
     • dementia
     • subjective cog impair
       • awareness decline
       • normal range objective memory performance
   • cognitive domains
     • working
     • long-term
     • conceptual/semantic
       • more AD specific
     • visual-spatial
     • phonological- decent

4. Obesity and AD

   • midlife overweight
     • increased dementia risk
       • especially AD
     • not APO e4
   • BMI/insulin/ Type II
     • associated with brain atrophy
       • frontal, anterior cingulate, hippocampus, thalamus
   • BMI predict brain energy level
   • central hypoinsulinemia
     • BBB receptor transport insensitivity
       • insulin rec
         • ACh, NE, DA
         • facilitate memory
         • clearance beta-amyloid
         • decrease inflammation
   • cerebral metabolic rate of glucose (CMRg)
     • reduced in Parkinson's, dementia, AD

5. Keytone therapy

   • ketones instead of glucose?
   • direct positives
     • greater metabolic efficiency and energy output
     • reduce AB, tau
     • reduce inflammation
     • increase autophagy
   • used by brain even in disease, injury, aging
   • older adults, 6 weeks
     • verbal paired associate learning (V-PAL)
       • increase
     • geriatric disease scale (GDS)
     • fasting insulin & fasting glucose
       • decrease
     • turn down for that repeated measures
     • myo-inositol
       • indicative of autophagy
       • track memory loss
       • Associated with IP3
       • increase

6. being healthy yields being healthier wow

   • prevention not treatment
   • mitochondrial cascade hypothesis
   • amyloid cascade hypothesis

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