NEUROCOGNITVE

DISORDERS
ETIOLOGY AND TREATMENT
PRESENTED BY :
EMAAN AQEEL
ETIOLOGY OF NEUROCOGNITIVE
DISORDERS:
• Neurocognitive disorder is a general term that describes decreased
mental function due to a medical disease other than a psychiatric
illness.
• Neurocognitive disorders are a group of conditions that frequently
lead to impaired mental function. Organic brain syndrome used to be
the term to describe these conditions, but neurocognitive disorders is
now the more commonly used term.
• Neurocognitive disorders most commonly occur in older adults, but
they can affect younger people as well.
• Here are some common causes of neuro cognitive disorders.
NEURO-COGNITIVE
DISORDERS CAUSES:
 BIOLOGICAL/PHISIOLOGICAL CAUSES:
• In people under age 60, however, neurocognitive disorders are more likely to occur after
an injury or infection. Non degenerative conditions that may cause neurocognitive
disorders include:
• a concussion
• traumatic brain injury that causes bleeding in the brain or space around the brain
• blood clots
• meningitis
• encephalitis
• septicemia
• drug or alcohol abuse
• vitamin deficiency
1) CONCUSSION :
A concussion is a traumatic brain injury that affects your brain function. Effects are usually temporary but can
include headaches and problems with concentration, memory, balance and coordination.
Concussions are usually caused by a blow to the head. Violently shaking of the head and upper body also can
cause concussions.

2)Traumatic Subarachnoid Hemorrhage (tSAH):
tSAH is bleeding into the space that surrounds the brain. This space is normally filled with cerebrospinal fluid
(CSF), which acts as a floating cushion to protect the brain. Traumatic SAH occurs when small arteries tear
during the initial injury. The blood spreads over the surface of the brain causing widespread effects.

3) BLOOD CLOT:
A blood clot is a clump of blood that has changed from a liquid to a gel-like or semisolid state. Clotting is a
necessary process that can prevent you from losing too much blood in certain instances, such as when you’re
injured or cut.
4) MENINGITUS:
• Pathogens infect meningeal layers.
• Meningitis is an inflammation of the meninges.
The meninges are the three membranes that cover
the brain and spinal cord.
• Meningitis can occur when fluid surrounding the
meninges becomes infected.

5) ENCEPHALITIS:
• Pathogens infect brain parenchyma.
• Encephalitis is inflammation of the brain.
• There are several causes, but the most common is a viral
infection.
• Encephalitis often causes only mild flu-like signs and
symptoms — such as a fever or headache — or no
symptoms at all.
6) SEPTICEMIA:
• Septicemia is a serious bloodstream infection. It’s also
known as blood poisoning.
• Septicemia occurs when a bacterial infection elsewhere
in the body, such as the lungs or skin, enters the
bloodstream. This is dangerous because the bacteria and
their toxins can be carried through the bloodstream to
your entire body.
7) DRUG OR ALCOHOL ABUSE:
• It occurs when you use alcohol, prescription medicine,
and other legal and illegal substances too much or in the
wrong way.
8) VITAMIN DEFICIENCY:
• VITAMIN B 12:
• Vitamin B12 deficiency is linked to impaired cognition and
memory along with a sensation of tingling and numbness, an
outcome of poor myelination.
• VITAMIN D: 
• In recent years, emerging evidence has linked vitamin D not only
to its known effects on calcium and bone metabolism, but also to
many chronic illnesses involving neurocognitive decline.
• . Recent studies have confirmed an association between cognitive
impairment, dementia, and vitamin D deficiency. 
DISEASES CAUSING
NEURO- COGNITIVE
DISORDERS
• 1) ALZIHMERS DISEASE 4) PRION DISEASE
• 2) PARKINSON DISEASE 5) MULTIPLE SCLEROSIS:
• 3) HUNTINGTON DISEASE 5) LEWY BODY DIMENTIA:
1) ALZIHMERS DISEASE:

• Alzheimer's disease is a progressive neurologic

disorder that causes the brain to shrink (atrophy) and
brain cells to die.
• Alzheimer’s disease is an irreversible, progressive
brain disorder that slowly destroys memory and
thinking skills and, eventually, the ability to carry
out the simplest tasks. 
• Alzheimer's disease is the most common cause of
dementia.
2) PARKINSON DISEASE:
• Parkinson's disease is a brain disorder that leads to
shaking, stiffness, and difficulty with walking,
balance, and coordination. 
• Parkinson’s disease affects the nerve cells in the
brain that produce dopamine. ( Dopaminergic
neurons of the midbrain are the main source
of dopamine )
• Low levels of dopamine and norepinephrine, a
substance that regulates dopamine, have been
linked with Parkinson’s.
• Parkinson's symptoms usually begin gradually and
get worse over time.
• As the disease progresses, people may have
difficulty walking and talking.
3) HUNTINGTON DISEASE:
• Huntington’s disease is a hereditary condition in which your brain’s
nerve cells gradually break down.
• Huntington's disease (HD) is a progressive brain disorder caused by
a defective gene on chromosome 4 — one of the 23 human
chromosomes that carry a person’s entire genetic code..
• .Huntington disease is caused by gradual degeneration of parts of
the basal ganglia called the caudate nucleus and putamen. The basal
ganglia are collections of nerve cells located at the base of the
cerebrum, deep within the brain. They help smooth out and
coordinate movements.
• This affects your physical movements, emotions, and cognitive
abilities.
• There is no cure, but there are ways to cope with this disease and its
symptoms.
4) PRION DISEASE:
• Prion diseases occur when normal prion protein, found on the surface of many cells,
becomes abnormal and clump in the brain, causing brain damage.
• This abnormal accumulation of protein in the brain can cause memory impairment,
personality changes, and difficulties with movement.
5) MULTIPLE SCLEROSIS:
• Multiple sclerosis (MS) is a chronic condition
involving your central nervous system (CNS).
• With MS, your immune system attacks myelin,
which is the protective layer around nerve fibers.
• MS causes inflammation and temporary lesions.
• It can also lead to lasting lesions caused by scar
tissue, which can make it hard for your brain to
send signals to the rest of your body.
5) LEWY BODY DIMENTIA:

• Lewy body dementia (LBD) is a disease associated with abnormal deposits of a protein

called alpha-synuclein (Alpha-synuclein is a synuclein protein of unknown function primarily found
in neural tissue, making up as much as 1% of all proteins in the cytosol of brain cells. It is predominantly
expressed in the neocortex, hippocampus, substantia nigra, thalamus, and cerebellum) in the brain.
• These deposits, called Lewy bodies, affect chemicals in the brain whose changes, in
turn, can lead to problems with thinking, movement, behavior, and mood.
 7) Frontotemporal Lobar Degeneration
• Frontotemporal lobar degeneration (FTLD) is a pathological
process that occurs in Frontotemporal dementia.
• FTLD causes progressive declines in language or behavior due
to the degeneration in the frontal and temporal lobes of the
brain parietal and occipital lobes
• Symptoms of FTLD include significant changes in behavior or
language. Individuals may present with apathy or disinhibition.
Additionally, they may lose interest in socialization as they
often lose empathy and sympathy for others.
•  Cognitive decline is generally not as prominent as the
behavioral and language changes
8) HIV DISEASE
• HIV (human immunodeficiency virus) is a virus that attacks the
body's immune system..
• cognitive impairment is sometimes the first symptom of untreated
HIV.
• While symptoms vary among individuals, slower mental
processing, difficulty with complex tasks, and difficulty
concentrating and learning new information are among the most
common early signs
• When HIV becomes active in the brain, significant alterations of
mental processes occur, thus leading to a diagnosis
of neurocognitive disorder due to HIV infection. Significant
impairment can also occur due to HIV-infection related
inflammation throughout the central nervous system
TREATMENT OF NEURO -
COGNITIVE DISORDERS
• Pharmacological
• Psychological
• Support for Caregivers
Pharmacological
Pharmacological interventions, and more specifically medications designed to target acetylcholine and
glutamate, the primary neurotransmitters affected by the disease, have been the most effective treatment
options in alleviating symptoms and reducing the speed of cognitive decline within individuals diagnosed
with Alzheimer’s disease.

Specific medications such as 

donepezil (Aricept), 
rivastigmine (Exelon), 
alantamine (Razadyne), and 
memantine (Namenda) are among the most commonly prescribed (Alzheimer’s Association, 2017a).
Due to possible negative side effects of the medications, these drugs are prescribed to individuals in the early
or middle stages of Alzheimer’s as opposed to those with advanced disease.
Researchers have also explored treatment options aimed at preventing the build-up of beta-amyloid and
neurofibrillary tangles; however, this research is still in its infancy (Alzheimer’s Association, 2017a
Parkinson’s disease has also found success in pharmacological treatment options.
The medication levodopa increases dopamine availability, which provides relief of both
physical and cognitive symptoms.
Unfortunately, there are also significant side effects such as hallucinations and
psychotic symptoms; therefore, the medication is often only used when the benefits
outweigh the negatives of the potential risks (Poletti & Bonuccelli, 2013).
Selective Serotonin Reuptake Inhibitors
Selective serotonin reuptake inhibitors (SSRIs) have also been studied for treatment of
BPSD.
Several trials that included
sertraline (50-200 mg/d), c
italopram (20-30 mg/d), or
escitalopram (10 mg/d) have found these medications to be more effective than placebo
or just as effective as antipsychotics for agitation and irritability.
Cognitive Enhancers
Cholinesterase inhibitors and memantine are primarily used in dementias to help slow
cognitive decline.
Cholinesterase inhibitors are recommended for neurocognitive disorders due to Parkinson
disease, Lewy body disease, and Alzheimer disease, whereas memantine is indicated only for
moderate to severe Alzheimer disease.
Psychological
Among the most effective psychological treatment options for individuals with
neurocognitive disorders are the use of cognitive and behavioral strategies.
More specifically, engaging in various cognitive activities such as computer-based
cognitive stimulation programs, reading books, and following the news, have been
identified as effective strategies in preventing or delBoyleaying the onset of Alzheimer’s
disease (Szalavits, 2013; Wilson, Segawa,, & Bennett, 2012).
Engaging in social skills and self-care training are additional behavioral strategies used
to help improve functioning in individuals with neurocognitive deficits.
For example, by breaking down complex tasks into smaller, more attainable goals, as
well as simplifying the environment (i.e., labeling location of items, removing clutter),
individuals can successfully engage in more independent living activities.
 Support for Caregivers
Supporting caregivers is an important treatment option to include as the emotional and
physical toll on caring for an individual with a neurocognitive disorder is often
underestimated.
According to the Alzheimer’s Association (2017b), nearly 90% of all individuals with
Alzheimer’s disease are cared for by a relative.
The emotional and physical demands on caring for a family member who continues to
cognitively and physically decline can lead to increased anger and depression in a
caregiver (Kang et al. 2014). It is important that medical providers routinely assess
caregivers’ psychosocial functioning, and encourage caregivers to participate in caregiver
support groups, or individual psychotherapy to address their own emotional needs.
ANY QUESTIONS?

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