PART 1: Essay plan
Paragraph 1: The severity of the Dementia with Lewy bodies (DLB) is seen in the major pathological changes it causes to the victims and the related clinical features.
Studies conducted shows that Lewy body with dementia is the third most common form of dementia. It causes a decline in cognitive abilities of an individual. It results from protein deposits in the brain regions which inhibits normal brain activities.
Paragraph 2: Factors related to protein deposits in the brain.
Though not specific, the deposit of protein particles in the brain is related to low levels of crucial chemicals in the brain such as dopamine, and acetylcholine. Also, it is linked with the death of nerve cells resulting from loss of connection between them (Turk & Fatemi, 2017).
Paragraph 3: Pathological changes caused by Lewy body dementia to the brain.
Some of the changes in the brain include depletion of key chemicals and neuron loss. The pathological changes in the brain result from protein deposits in the brain inner and outer regions (Ferman, 2013). Alpha-synuclein affects the cerebral cortex, limbic cortex, hippocampus, basal ganglia, and the midbrain, and the olfactory pathways (Halliday, 2014). Consequently, the cognitive, behavioral and physical functioning of the brain is affected.
Paragraph 8: Clinical features that occur in the chosen disease about the pathological features of the disease.
The pathological changes in the brain results to some clinical features, The clinical features of Lewy body with dementia are cognitive impairments, psychiatric disorders and physical disorders (Marti, Campdelacreu, & Tolosa, n.d.). Cognitive impairments affect the brain regarding perception, memory and thinking (Mori, 2016). Psychiatric or behavioral disorders include depression and visual hallucinations. The physical feature of Lewy body with dementia is the Parkinsonism. This effect is seen in movement disorders in the patient.
PART 2: Essay Example
Dementia with Lewy bodies (DLB)
Dementia is an overall term used to refer to the decline of mental ability that goes to the extent of interfering with the daily life of a person. Dementia can appear in many forms. One form of the condition is the Dementia with Lewy bodies (DLB). This type of dementia is progressive and results to decline in reasoning, thinking and independent function. It is as a result of microscopic deposits. In the brain. Research shows that this type of dementia is the third most common type of dementia and accounts for 10-25 percent of dementia cases. The severity of the Dementia with Lewy bodies (DLB) is seen in the major pathological changes it causes to the victims and the related clinical features.
The Lewy body dementia which affects many people worldwide is used to refer to two diagnoses; Parkinson's disease dementia (PDD) and dementia with Lewy bodies (DLB). Both diagnoses are types of dementia. The difference is that in DLB, cognitive symptoms show before physical symptoms (Halliday, 2014). The disease, which is as a result of a buildup of alpha-synuclein deposits in brain regions and hence affect personality, memory, thinking, and movement. The diseased is also referred to as Lewy body variant of Alzheimer's disease, cortical Lewy body disease, and the diffuse Lewy body disease (Ferman, 2013). The causes of the protein deposits in the mind are not specific. However, the following factors are linked to the deposits.
Low levels of crucial chemicals in the brain, mainly dopamine, and acetylcholine that help in information transmission in the brain (Turk & Fatemi, 2017). However, the depletion of these chemicals may also be as a result of the protein deposits.
The death of nerve cells resulting from loss of connection between them.
Chiefly, Lewy bodies get their name from Dr. Fredrich Lewy, a neurologist from Germany. The discovery of abnormal protein deposits in the brain in 1912 that disrupted the normal functioning of the brain led him to name this condition as Lewy bodies. This condition was evident in patients with Parkinson's disease. The protein, alpha-synuclein, is essential to the nerve cells that are located in the brain (Halliday, 2014). Majorly, they play a crucial role in the synapses: the communication medium of brain cells. The effect of Lewy bodies is that these protein deposits form clumps in the neurons and as a result affect movement and memory. The alpha-synuclein affects two main regions of the brain. First, the Lewy bodies can be deposited at the base of the brain causing movement problems (Kasanuki & Iseki, 2016). This effect forms the main symptoms of Parkinson's disease. Secondly, the deposits can occur in the brain's outer layer which results in cognitive impairments which are the major features of DLB (Ferman, 2013). However, whether the clumps are formed in the outer or the inner part of the brain, the following specific regions are affected (Tanaka, Musha, Kobayashi, Matsuzaki, & Kosugi, 2016).
- The cerebral cortex, which controls perception, thought, language and information in the brain.
- The limbic cortex. Its major role is in the behavior and emotions of an individual.
- The hippocampus. It is significant in the formation of new memories.
- The basal ganglia and the midbrain. These two are involved in the movement coordination.
- The brain stem. The brain stem regulates sleep and alert maintenance.
- Olfactory pathways. They are important regions for smell recognition.
Studies and research have been conducted on the pathological changes caused by the DLB to the brain. A series of the autopsy has been carried out by scientists on patients with dementia have shown that the disease affects the subcortical and cortical regions of the brain (Turk & Fatemi, 2017). For example, research shows that patients of Lewy body dementia posses enough hippocampal and neocortical senile plagues. Such patients are Lewy body variant of Alzheimer disease (Kasanuki & Iseki, 2016). Patients with brainstem or cortical Lewy bodies are referred to having diffuse Lewy body disease (Ferman, 2013). These patients have an inadequate number of senile plagues necessary for Alzheimer diagnosis.
Most patients of Parkinson's disease have the Lewy bodies in their brains. As a result, these clusters cause the motor symptoms of Parkinson's disease, alert problems, cognitive problems, and visual hallucinations. The Dementia with Lewy bodies (DLB) is associated with specific depletion of particular brain neurotransmitters. Firstly, it results in the reduction of dopamine (Kasanuki & Iseki, 2016). This neurotransmitter is necessary for sending signals that control muscle movement. The block of this neurotransmitter by Lewy bodies' causes hallmark movement issues of Parkinson's disease (Tanaka, Musha, Kobayashi, Matsuzaki, & Kosugi, 2016). Secondly, the depletion of acetylcholine causes memory, processing, and thinking complications. Consequently, the buildup of Lewy bodies causes dementia.
One of the significant pathological changes to the brain is a neuronal loss in the brainstem. This loss is further in the pigmented nuclei, ubiquitin-positive hippocampal neuritis, and numerous cortical Lewy bodies (Tanaka, Musha, Kobayashi, Matsuzaki, & Kosugi, 2016). The neuronal loss in the cerebral cortex and brainstem is evident with many Lew bodies. Neuritic and neurofibrillary tangles though rare are also present in the cerebral cortex and brainstem for such patients.
Primarily, DLB causes a progressive decrease in the cognitive functioning of an individual. Such cognitive functions include thinking, memory and problem-solving (Mizuno, 2016). These effects on the cognitive functioning of the patient dramatically affect the normal daily activities. Some of the features related to DLB are visual hallucinations, fluctuations in attention and alertness and movement symptoms (O'Brien, 2012). Further, the patients suffer from depression, sleep disorder, and dizziness.
As a result, about the above pathological changes in the brain, various clinical features occur. Clinical features of DLB can be categorized into cognitive impairments, a psychiatric/behavioral phenomena, and physical symptoms. The cognitive impairments are cognitive fluctuations and non- amnestic cognitive impairments (Marti, Campdelacreu, & Tolosa, n.d.). On the other hand, visual hallucinations, delirium, depression, and REM sleep behavior disorder are psychiatric disorders. Further, physical disorders are characterized by hyposmia, constipation, Parkinsonism and orthostatic hypotension (Tanaka, Musha, Kobayashi, Matsuzaki, & Kosugi, 2016). Notably, these clinical features of DLB are similar to Parkinson's disease (PDD).
Cognitive impairments are the major clinical features of DLB. People with Mild cognitive impairment (MCI) are more likely to develop dementia. The core feature of DLB is the fluctuation attention (Mori, 2016). Further, the earliest manifestations of DLB are delirium and transient disturbances. Fluctuations in alertness and concentration result from the deposit of alpha-synuclein in the brain stem (Marti, Campdelacreu, & Tolosa, n.d.). The primary role of the brain stem is the regulation of alert maintenance. As a result, the patient experiences drowsiness episodes, long stares into space, disorganized speech and long naps during the daytime.
Non-cognitive symptoms may present themselves before the manifestation of cognitive impairments. These symptoms include depression and visual hallucinations. Visual hallucinations come as a result of these deposits in the brain regions (Mori, 2016). Most people with DLB experience these hallucinations (McKeith, 2017). These behavioral symptoms are also characterized by the enactment of dreams that more often cause injury to the patients. Further, cases of anxiety and depression are also present in most of the patients.
The core physical feature of DLB is the Parkinsonism. The deposition of the protein deposits in the brainstem, olfactory bulb, and the peripheral nervous system results in some physical symptoms (Mizuno, 2016). These symptoms include a reduced sense of smell, increased salivation, orthostatic dizziness, and constipation (McKeith, 2017. These features can be present in patient years before the onset of memory impairment (Marti, Campdelacreu, & Tolosa, n.d.). Further, movement systems such as falls, tremors, rigidity and slow movement are evident in people with DLB. This effect is as a result of alpha-synuclein deposit in the basal ganglia and the midbrain. Finally, sleep disorders causing vivid dreams with body movement is another pathological change caused by DLB.
In conclusion, Dementia with Lewy bodies (DLB) is a brain disorder that affects the normal cognitive functioning of an individual. Although the disease is closely related to Parkinson, it differs in that the primary features are cognitive as opposed to physical. However, physical impairments develop later after cognitive disorders. Some pathological changes occur in the brain as a result of Dementia with Lewy bodies (DLB). Chiefly, the significant difference in the brain is the deposit of protein particles in the brain regions which affects the normal functioning of the brain. The specific affected areas are the brain stem, the cerebral cortex, limbic cortex, hippocampus, basal ganglia and the midbrain, and the olfactory pathways.
Consequently, the protein deposit results in clinical features such as cognitive impairments, psychiatric and physical disorders. Physical disorders include movement problems, while cognitive issues are related to thinking, memory, and perception. On the other hand, mental disorders include visual impairments.
Ferman, T. (2013). Clinical and neurocognitive features of early Dementia with Lewy Bodies (DLB). Alzheimer's &am...
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