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7.4: Disorders and Malfunctions

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    Reading about the disorders concerning memory and language one might possibly think about amnesia or aphasia, both common diseases in the concerned brain regions. But when dealing with the correlation of memory and language we want to introduce only diseases which affect loss of memory as well as loss of language.

    Alzheimer's Disease

    Discovered in 1906 by Alois Alzheimer, this disease is the most common type of dementia. Alzheimer’s is characterised by symptoms like loss of memory, loss of language skills and impairments in skilled movements. Additionally, other cognitive functions such as planning or decision-making which are connected to the frontal and temporal lobe can be reduced. The correlation between memory and language in this context is very important because they work together in order to establish conversations. When both are impaired, communication becomes a difficult task. People with Alzheimer’s have reduced working memory capability, so they cannot keep in mind all of the information they heard during a conversation. They also forget words which they need to denote items, their desires and to understand what they are told. Affected persons also change their behaviour; they become anxious, suspicious or restless and they may have delusions or hallucinations. In the early stages of the disorder, sick persons become less energetic or suffer little loss of memory. But they are still able to dress themselves, to eat and to communicate. Middle stages of the disease are characterised by problems of navigation and orientation. They do not find their way home or even forget where they live. In the late stages of the disease, the patients’ ability to speak, read and write decreases enormously. They are no longer able to denote objects and to talk about their feelings and desires. So their family and the nursing staff have great problems to find out what the patients want to tell them. In the end-state, the sick persons do not show any response or reaction. They lie in bed, have to be fed and are totally helpless. Most of them die after four to six years after diagnosis, although the disease can endure from three to twenty years. A cause for this is the difficulty to distinguish Alzheimer’s from other related disorders. Only after death when seeing the shrinkage of the brain one can definitely say that the person was affected by Alzheimer’s disease.

    "Genetic Science Learning Center, University of Utah, http://learn.genetics.utah.edu/ A comparison of the two brains:
    In the Alzheimer brain:
    · The cortex shrivels up, damaging areas involved in thinking, planning and remembering.
    · Shrinkage is especially severe in the hippocampus, an area of the cortex that plays a key role in formation of new memories.
    · Ventricles (fluid-filled spaces within the brain) grow larger.

    Scientists say that long before the first symptoms appear nerve cells that store and retrieve information have already begun to degenerate. There are two theories giving an explanation for the causes of Alzheimer’s disease. The first describes plaques as protein fragments which defect the connection between nerve cells. They arise when little fragments release from nerve cell walls and associate with other fragments from outside the cell. These combined fragments, called plaques, append to the outside of nerve cells and destroy the connections. Then the nerve cells start to die because they are no longer provided with nutrients. As a conclusion the stimuli are no longer transferred. The second theory explains that tangles limit the functions of nerve cells. They are twisted fibers of another protein that form inside brain cells and destroy the vital cell transport made of proteins. But scientists have not yet found out the exact role of plaques and tangles.

    "Genetic Science Learning Center, University of Utah, http://learn.genetics.utah.edu/
    - Alzheimer tissue has many fewer nerve cells and synapses than a healthy brain.
    - Plaques, abnormal clusters of protein fragments, build up between nerve cells.
    Dead and dying nerve cells contain tangles, which are made up of twisted fibers of another protein.

    Alzheimer’s progress is separated into three stages: In the early stages (1), tangles and plaques begin to evolve in brain areas where learning, memory, thinking and planning takes place. This may begin 20 years before diagnosis. In the middle stages (2), plaques and tangles start to spread to areas of speaking and understanding speech. Also the sense of where your body is in relation to objects around you is reduced. This may last from 2–10 years. In advanced Alzheimer’s disease (3), most of the cortex is damaged, so that the brain starts to shrink seriously and cells begin to die. The people lose their ability to speak and communicate and they do not recognise their family or people they know. This stage may generally last from one to five years.

    Today, more than 18 million people suffer from Alzheimer’s disease, in Germany there are nearly 800,000 people. The number of affected persons increases enormously. Alzheimer’s is often only related to old people. Five percent of the people older than 65 years and fifteen to twenty percent of the people older than 80 years suffer from Alzheimer’s. But also people in the late thirties and forties can be affected by this heritable disease. The probability to suffer from Alzheimer’s when parents have the typicall old-generation-Alzheimer’s is not very high.

    Autism

    Autism is a neurodevelopment condition, which causes neurodevelopmental disorders in several fields. For the last decade, autism has been studied in light of Autistic Spectrum Disorders, including mild and severe autism, as well as Asperger's syndrome. Individuals with autism, for example, have restricted perception and problems in information processing. The often associated intellectual giftedness only holds for a minority of people with autism, whereas the majority possesses a normal amount of intelligence or is below the average.
    There are different types of autism, i.a.:

    • Asperger’s syndrome – usually arising at the age of three
    • infantile autism – arising between nine and eleven months after birth

    The latter is important because it shows the correlation between memory and language in the children's behaviour very clearly. Two different types of infantile autism are the low functioning autism (LFA) and the high functioning autism (HFA). The LFA describes children with an IQ lower than 80, the HFA those with an IQ higher than 80. The disorders in both types are similar, but they are more strongly developed in children with LFA.
    The disorders are mainly defined by the following aspects:

    1. the inability of normal social interaction, e.g. amicable relations to other children
    2. the inability of ordinary communication, e.g. disorder of spoken language/idiosyncratic language
    3. stereotypical behaviour, e.g. stereotypical and restricted interests with an atypical content

    To demonstrate the inability to manage normal communication and language, the University of Pittsburgh and the ESRC performed experiments to provide possible explanations. Sentences, stories or numbers were presented to children with autism and to normal children. The researchers concluded that the disorders in people with HFA and LFA are caused by an impairment in declarative memory. This impairment leads to difficulties in learning and remembering sentences, stories or personal events, whereas the ability to learn numbers is available. It has been shown that these children are not able to link words they heard to their general knowledge, thus the words are only partially learnt, with an idiosyncratic meaning. This explains why LFA and HFA affected children differ in their way of thinking from sane children. It is often difficult for them to understand others and vice versa. Furthermore scientists believe that the process of language learning depends on an initial vocabulary of fully meaningful words. It is assumed that these children do not possess such a vocabulary, thus their language development is impaired. In a few cases the acquisition of language fails completely, therefore in some cases the children are not able to use language in general. The inability of learning and using language can be a consequence of an impairment of declarative memory. It might also cause a low IQ because the process of learning is language-mediated. In HFA the IQ is not significantly lower than the IQ of sane children. This correlates well with their better understanding of word meanings. They have a milder form of autism. The experiments have also shown that adults do not have problems with the handling of language. A reason for that might be that they have been taught to use it during development or maybe they acquired this ability through reading and writing. The causes of autism are not yet explored appropriately to get some idea how to help and support those people having autism in everyday-life. It is still not clear whether the diseases are really caused by genetic disorders. It is also possible that other neurological malfunctions like brain damages or biochemical specialties are responsible for autism. The research just started to get answers to those questions.


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