PCLCogEnhancers2010Bb - Cognitive Enhancers Dr. Nicole...

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Cognitive Enhancers Dr. Nicole Mittmann nicole.mittmann@sunnybrook.ca
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Definition Nootropics , popularly referred to as " smart drugs ", " smart nutrients ", " cognitive enhancers " and " brain enhancers ", are substances which claim to boost human cognitive abilities
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Objective of Cognitive Enhancers Used to enhance the cognitive processes of normal individuals Used to treat cognitive dysfunction in people with illnesses
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Dementia Alzheimer’s disease (AD) Vascular dementia Lewy body dementia Frontal lobe dementia
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Alzheimer’s Disease: Epidemiology Alzheimer's Disease (AD) is a neurodegenerative disease found in people over age 65. Canadian Study of Health and Aging Working Group (1996) 1 in 20 Canadians over age 65 is affected by Alzheimer's disease. 1 in 100 between ages 65-74 1 in 14 between ages 75-84 1 in 4 over age 85
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Symptoms Mild (Early) Patients have a tendency to become less energetic or spontaneous Other behavioral changes are outbursts of violence in people who have no previous history of such behavior. Moderate (Middle) Fluctuating forgetfulness Difficulty orienting oneself in space Difficulty navigating through familiar areas such as one's neighborhood Able to perform tasks independently May need assistance with more complicated activities Severe (Late) Deterioration of musculature and mobility Bed bound Incontinence Inability to feed or toilet Requires supervision Once identified, the average lifespan of patients living with Alzheimer's disease is approximately 7-10 years (range:4-21 years)
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Neuropathology Both amyloid plaques and neurofibrillary tangles are clearly visible by microscopy in AD brains. At an anatomical level, AD is characterized by gross diffuse atrophy of the brain and loss of neurons, neuronal processes and synapses in the cerebral cortex and certain subcortical regions. This results in gross atrophy of the affected regions, including degeneration in the temporal lobe and parietal lobe, and parts of the frontal cortex and cingulate gyrus. Levels of the neurotransmitter acetylcholine are reduced. Levels of the neurotransmitters serotonin and norepinephrine are also often reduced. Glutamate levels are usually elevated.
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Disease Mechanism in AD Cholinergic Theory Levels of the neurotransmitter acetylcholine are reduced. Amyloid beta plaques Plaque like substances in cortex NMDA receptors
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Alzhiemer’s Plaques
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Pharmacotherapy Diseased brain Cholinesterase inhibitors NMDA antagonists Well brain Vitamin E Ginko
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Cholinergic Hypothesis Normal Brain There are two main types of cholinergic receptors widely distributed throughout in the brain: muscarinic and nicotinic receptors. Muscarinic
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PCLCogEnhancers2010Bb - Cognitive Enhancers Dr. Nicole...

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