The Cortical atrophy Refers to the degeneration of the uppermost regions of the brain , Especially to the structures of the cerebral cortex . In contrast, subcortical atrophy is characterized by affecting the innermost regions of the brain.
The Cerebral atrophy Is a neurological condition characterized by the progressive death of brain neurons. This pathology is characterized by affecting specific regions of the brain, which is why it can be divided between cortical atrophy and subcortical atrophy.
Cortical atrophy in Alzheimer's patient's brain.
Since the functions of the cortical regions of the brain are different from those performed by subcortical structures, the symptoms of cortical atrophy are often different from those of subcortical atrophy.
In general, the symptomatology of cortical atrophy tends to cause memory , Impairment of language, decreased ability to learn, decreased concentration and attention and, in some cases, behavioral alterations.
In contrast, subcortical atrophy usually affects other functions such as psychological factors, movement processes or some systems concerning the physical functioning of the organism.
In this article we review the general characteristics of cerebral atrophy. We explain the structures of the brain that are involved in each of these alterations and discuss the etiological and symptomatological differences between cortical atrophy and subcortical atrophy.
General characteristics
Cerebral atrophy refers to a decrease and / or loss of brain functionality. This condition can be caused by different diseases.
Most of them are usually neurodegenerative pathologies, although other affections like the traumatisms or situations like the aging can also give rise to this neuronal alteration.
Another important element of brain atrophy is that it affects specific regions of the brain. For this reason, cortical atrophy (affecting the upper regions of the brain) and subcortical atrophy (affecting the lower regions) can be distinguished.
In general, certain pathologies such as Alzheimer disease wave Lewy Body Dementia Are characterized by affecting the cortical regions and, therefore, cause cortical atrophy. On the other hand, pathologies such as Parkinson's wave Multiple sclerosis Tend to generate subcortical atrophy.
However, since most pathologies that cause brain atrophy are characterized by being neurodegenerative, although brain deterioration begins in one area or another (cortical or subcortical), atrophy tends to be generalized by all structures with the passage of weather.
For this reason, when speaking of cortical atrophy or subcortical atrophy, there is no reference to a specific disease. Rather, the brain damage caused by a particular pathology is specified.
Cortical atrophy
Cortical atrophy is probably the type of atrophy best studied and more delimited. This condition is characterized by affecting the upper structures of the Encephalon And causes, mainly cognitive symptoms.
Regions involved
As its name suggests, cortical atrophy is characterized by affecting the cerebral cortex. This region of the brain can be divided into four large lobes:
- Frontal lobe : Is located in the frontal region of the skull. It is the largest structure of the cortex and is responsible for performing functions such as planning, the development of abstract thinking and the development of behavior.
- Parietal lobe : Is the second largest lobe of the cortex. It is located in the upper part of the skull and is responsible for integrating and giving meaning to sensitive information.
- Occipital lobe : It is the smallest lobe of the cortex, it is located in the back and it mainly realizes the transmission of the visual information.
- Temporal lobe : It is located in the lower region of the skull and plays a major role in the development of memory and thinking.
Main symptoms
The main symptoms of cortical atrophy are related to Cognitive functions , Since these are mainly regulated by the cerebral cortex. In this sense, the most important manifestations are:
- Deterioration of memory.
- Dysfunction of language.
- Decreased attention and concentration.
- Disorientation.
- Impairment of executive functions.
- Behavioral and personality changes (when the frontal lobe is affected)
Related diseases
The main disease that can cause cerebral atrophy is Alzheimer's, since this pathology affects the temporal lobe causing a strong deterioration in memory.
Other pathologies such as Pick's disease (Affecting the frontal lobe) or Lewy Body Dementia can also lead to this type of atrophy.
Subcortical atrophy
Subcortical atrophy, unlike cortical atrophy, is characterized by not causing deterioration of cognitive functions. This type of atrophy affects the lower regions of the brain and originates other manifestations.
Regions involved
Subcortical atrophy can affect a large number of structures in the brain, although the most typical are the thalamus and Hypothalamus .
He midbrain , he cerebellum , The protuberance or the Medulla bulb Are other regions that can deteriorate in this type of atrophy.
Main symptoms
The symptoms of subcortical atrophy can be divided into three major groups:
- Psychological alterations: atrophy originated in the thalamus or hypothalamus can generate depression, motivational deficits or Anxiety disorders .
- Alterations in movement: the most typical symptoms of subcortical atrophy have to do with movement. Pathologies such as multiple sclerosis or Parkinson's generate difficulties in the coordination of movement and muscular tension.
- Physical alterations: Atrophy in the more subcortical regions of the brain (brain stem) can cause symptoms such as: alterations in the cardiovascular system, decreased muscle tone, or violations of metabolic and thermoregulation processes.
Related diseases
Pathologies that can cause subcortical atrophy are much more numerous than those that cause cortical atrophy. The most prevalent are: Parkinson's disease, Huntington's disease , Multiple sclerosis, encephalitis And acquired immunodeficiency syndrome.
References
- Jodar, M (Ed) et al (2014). Neuropsychology. Barcelona, UOC Editorial.
- Javier Tirapu Ustárroz et al. (2012). Neuropsychology of the prefrontal cortex and executive functions. Editorial Viguer.
- Lapuente, R. (2010). Neuropsychology. Madrid, Plaza edition.
- Junqué, C. I Barroso, J (2009). Neuropsychology. Madrid, Ed. Synthesis.
- Bryan Kolb, Ian Q. Whishaw (2006): Human Neuropsychology. Editorial Panamericana Médica, Barcelona.
- Jódar, M (ed). (2005). Language and memory disorders. Editorial UOC.