False: The amygdala has a complex range of functions centring on emotions, emotionally conditioned behaviour and establishing links between emotional value and memories. It has no role in visuo-spatial function (Sadock & Sadock 2005, p. 1749).

True: Two areas have been implicated in dyslexia:

False: Delayed neuropsychiatric symptoms occur in 10–30% of victims. They include personality changes, cognitive impairment, Parkinsonism, incontinence, dementia, and psychosis. Recovery within one year occurs in 50–75% of cases. Approximately 11% have gross sequelae. The level of consciousness on admission to hospital correlates with neuropsychiatric sequelae (Lishman 1997, p. 552; Mitchell 2004, p. 249).

False: The characteristic spongiform appearance of the brain in CJD is due to vacuolation of glial cells and not due to neuronal loss (Lishman 1997, p. 478).

True: The normal values for CSF are:

False: Metabolic disorders cause EEG abnormalities. Initial changes include slowing of alpha rhythms with diminution in voltage. Later there is progressive slowing and disorganization with runs of theta activity. In metabolic coma, regular high voltage delta activity appears, sometimes bilaterally synchronous and sometimes more random in distribution. In deep coma, the EEG becomes flat and featureless (Lishman 1997, p. 130).

False: 5% of patients with epilepsy commit suicide compared with 1.4% of the general population (Trimble & Schmitz 2002, p. 107).

False: The terms alternative psychosis and forced paradoxical normalization refer to the antagonism between psychosis and seizures or EEG discharges. They are a group of inter-ictal psychoses that appear after spontaneous or, more often, drug-induced disappearance of clinical and subclinical seizure manifestations (Trimble & Schmitz 2002, p. 45).

False: Verbal recall is affected mostly in left frontal lesions.

True: Linkage analysis is a technique which localizes disease genes on chromosomes. It relies on the fact that genes which are close together on a chromosome are more likely to be inherited together. The further apart they are then the more likely that they will be split by recombination during meiosis. The recombination fraction (θ) can be calculated and converted to centimorgans (cM) with a θ value of 0.01 corresponding to 1 cM. For low values of θ this approximates to a distance of around 1000 kb and this relation holds for values of up to around 30 cM.

Where it is difficult to use genes as a known location, other markers such as restriction fragment length polymorphisms (RFLPs) or single nucleotide polymorphisms (SNPs) are used. Linkage analysis was employed to localize the genes for Huntington’s disease and cystic fibrosis.

Association studies look for association between a phenotype and a genetic marker. This may be a specific allele of a candidate gene. Candidate genes are those where variation has a biologically plausible reason to cause the phenotype, e.g. dopamine transporter and schizophrenia. Alternatively, association between known genetic markers and the phenotype may be studied to implicate a chromosomal region (Puri & Tyler 1998, p. 194).

True: Genomics is the study of entire genomes. The genome is the sum total of the genetic material, i.e. DNA within the organism. Transcription of DNA into RNA is the basic mechanism by which cells mediate their growth, function and metabolism.

The transcriptome is the sum total of RNAs transcribed.

The proteome is the collection of translated proteins.

The metabolome or metabonome is the collection of breakdown products of enzymatic activity (Sadock & Sadock 2005, p. 115).

False: The nervous system is a prime target for the HI virus and is affected early in the illness. Abnormalities are found in the CSF in a large proportion of asymptomatic HIV positive individuals (Lishman 1997, p. 319; Mitchell 2004, p. 182).

True: HIV encephalitis typically presents as delirium, but occasionally directly as dementia. Delirium is seen in about 10% of patients who are HIV positive and in 25–50% of hospitalized patients with AIDS. Delirium may be the most common single neuropsychiatric complication in AIDS (Mitchell 2004, p. 186).

True: The CAG repeat size and the age of onset are inversely correlated. However, for a given repeat size, there is a wide range of onset ages. CAG repeat lengths are also associated with the age of onset of psychiatric symptoms (Mitchell 2004, p. 161; Yudofsky & Hales 2002, p. 333).

True: In Huntington’s disease, cognitive dysfunction including intelligence, memory and visuospatial deficits correlates with the degree of atrophy of the caudate nucleus. Moreover, impairments in executive functions correlate more robustly with caudate nucleus atrophy than with frontal atrophy (Yudofsky & Hales 2002, p. 926).

True: The diencephalic structures involved in memory include the mamillary bodies, medial dorsal thalamic nuclei, internal medullary lamina and the mamillothalamic tracts. They support the role of the hippocampi. The hippocampi are involved in explicit (declarative) memory, e.g. memory for facts such as who the Prime Minister is. They are not involved in implicit (procedural) memory, e.g. the non-conscious, automatic performance of previously learned skills such as driving a car.

In Korsakoff’s syndrome, anterograde memory is most severely affected. New learning is impaired. Disturbance of time sense and confabulation occur. Immediate memory span is well preserved, and beyond a variable retrograde gap remote memories are well preserved. Implicit (procedural) memory is well preserved. They can learn to mirror write even though they do not remember having been asked to perform the task before (Lishman 1997, p. 30; Mitchell 2004, p. 234).

True: Fatigue in multiple sclerosis is caused by the direct effects of multiple sclerosis itself and by depression in approximately equal measure. Fatigue can be episodic or persistent in a third of multiple sclerosis patients. The fatigue is central rather than peripheral in origin (Feinstein 1999, p. 30; Mitchell 2004, p. 144).

True: [¹²³I]Iomazenil and [¹²⁵I]Iomazenil are specific ligands for benzodiazepine receptors. They are used to study benzodiazepine receptors and epileptic foci.

False: The planum temporale or the temporal plane is located in the superior part of the temporal lobe near the auditory cortex. It is the upper surface of the Wernicke’s area. It is associated with language function (Fitzgerald 1996, p. 11; Sadock & Sadock 2005, p. 15).

False: Although not fully lateralized, neglect phenomena and visuospatial deficits are more common with right hemisphere lesions (by implication left hemiplegia) (Gelder et al 2006, p. 324; Hodges 1994, p. 73).

False: Sleep is divided into REM sleep and non-REM sleep. NREM sleep is itself divided into stages 1–4. Sleep progesses through stages 1–4 and then enters REM sleep. NREM and REM sleep then alternate through the night in 90–110-minute cycles. In successive cycles the amount of NREM sleep decreases and the amount of REM sleep increases. The proportion of stages of sleep in a healthy young adult are: stage 1 = 5%; stage 2 = 25–50%; stage 3 = 20–25%; stage 4 = 20–25%; REM = 25%. Stage 1 is at the beginning of sleep, stages 3 & 4 predominate in the first third and REM in the last third of sleep (Fear 2004, p. 327; Sadock & Sadock 2005, p. 282).

True: Sleep apnoea is cessation of breathing for 10 seconds or more. It is caused by airway obstruction, central changes in ventilatory control, metabolic factors or heart failure. It may be accompanied by oxygen desaturation and cardiac arrhythmias (Yudofsky & Hales 2002, p. 713).

Features of obstructive sleep apnoea include excessive daytime sleepiness, loud snoring with frequent awakenings, awakening with choking and/or gasping for breath, morning dry mouth and witnessed apnoea.

Predisposing factors include male gender, middle age, obesity, micrognathia or retrognathia and nasal pharyngeal abnormalities, hypothyroidism and acromegaly.

Other features and co-morbidities include sleep choking, morning headaches, nocturnal sweating, sleepwalking, sleep talking, nocturia, enuresis, impotence, memory impairment, impaired quality of life, depression, hearing loss, automatic behaviour, hypertension, polycythemia, and right-sided heart failure (Yudofsky & Hales 2002, p. 713).

True: The superior oblique muscle is supplied by the fourth cranial nerve, the trochlear. Paralysis of this nerve results in an inability to see inwards and downwards. Isolated nerve damage can occur as a result of closed head injury. Alternatively, the muscle can be directly affected in dysthyroid eye disease or myasthenia. Patients may complain of diplopia when looking downwards – for instance going down stairs. In contrast, in third nerve lesions the affected eye looks down and out due to unopposed actions of lateral rectus and superior oblique, as well as showing ptosis and pupillary dilatation (Lindsay & Bone 2004, p. 145).

True: Hypothyroidism is associated with low voltage, decreased alpha activity and generalized beta activity (Stern & Engel 2004, p. 98).

True: White matter lesions (WMLs) are conventionally divided into those around the ventricular system, i.e. periventricular lesions or PVLs and those elsewhere, i.e. deep white matter lesions, DWMLs or leukoaraiosis. Severe DWMLs and large PVLs may be associated with neurological dysfunction. PVLs may be more common in Alzheimer’s disease than in elderly controls or depressed patients. Large PVLs are related to cognitive impairment and gait abnormalities. Small PVLs are probably clinically insignificant. The association of both periventricular and subcortical WMLs with subjective memory complaints and mild cognitive impairment has been replicated (Mitchell 2004, p. 45; Sadock & Sadock 2005, p. 3619).