Lecture 6
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43 terms
Terms | Definitions |
|---|---|
 What are the 4 types of signaling pathologies? | Neurodegeneration, Schizophrenia, Mood/Affective disorders, Anxiety disorders |
| What are the the positive and negative symptoms of schizophrenia | Positive: dissociative thinking, hallucinations, delusions, paranoia Negative: Diminished affect, impoverished speech, lack of motivation, social avoidance |
| What brain structure abnormalities are associated with schizophrenia? | Enlarged ventricles, cellular disarray, hypofrontality, and loss of gray matter |
| What do ECT and TMS stand for and what do they do? | Electroconvulsive therapy and Transcranial magnetic stimulation. They essentially cause a seizure in the brain, leading to compensatory GABA increase, increased DA, NE, 5HT activity, increased neural growth factor release, and stress hormone release. Among other things, used to treat schizophrenia. Causes memory deficits and may depend on electrode placement. |
| What is the dopamine hypothesis? | Schizophrenia is caused by either presynaptic or postsynaptic hyperfunctioning of dopamine, specifically on the D2 receptor. |
| What is some support for the dopamine hypothesis? | 1. The dopamine suppressing effects of schizophrenia treatment reserpine and chlorpromazine. 2. Amphetamine psychosis 3. Highly effective treatment haloperidol only has affinity for D2 receptors |
| What are some problems with the dopamine hypothesis | 1. Not all patients respond to drug treatment 2. Drugs are not specific 3. Time of drug action which is rapid compared with the onset of relief, which takes weeks 4. Full spectrum of symptoms not resolved |
| What are the types of affective disorders? | Depression and Bipolar disorder |
| What is some evidence for a biochemical mechanism for depression? | 1. MAOIs and other drugs that affect 5HT, NE, and DA systems treat depression 2. High levels of stress hormones/stress hormone dysregulation are associated with depression 3. 5HT system components are alter in depressed/suicidal people: suicide victims have low 5HT, a variant of 5HT1A receptor is associated with higher depression risk, manipulation of 5HT1B receptor can lead to depressed mice |
| What are the three types of antidepressants? | MAOIs, tricyclics, S(x)RIs (SSRIs and SNRIs) All upregulate monoamines |
| What does MAOI stand for and what do they do? | Monoamine oxidase inhibitors block the degradation of dopamine, serotonin, and norepinephrine |
| What do tricyclics do? | Primarily block serotonin and norepinephrine reuptake, with no effect on dopamine. They also act on a number of G-Protein coupled recepters and act as sodium and calcium channel blockers Lead to some additional therapeutic effects compared to MAOIs and SSRIs, but also more side effects |
| What do S(x)RI's do? | Selectively block uptake, and can specifically target different transporters Have fewer side effects but take 6-8 weeks to take effect |
| What are the 4 types of bipolar disorder? | Type I, Type II, Bipolar-Not-Otherwise-Specified, Cyclothymia |
| Characterize Type I Bipolar disorder. | Manic or mixed episodes ≥ 7 days, or manic symptoms requiring hospitalization and depression typically ≥ 2 weeks |
| Characterize Type II Bipolar disorder. | Full depression plus hypomania (Manic-like symptoms ≥ 4 days) |
| Characterize Bipolar-NOS. | Symptoms do not meet diagnostic criteria for either bipolar I or II, but are clearly out of the person's normal range of behavior (e.g. the symptoms may not last long enough, may have too few symptoms) |
| Characterize cyclothymia. | Hypomania + mild depression for ≥ 2 years |
| What is rapid cycling? | Four or more episodes of mania or depression in one year, can occur with any of the Bipolar types, but Type II is most common |
| What brain structure abnormalities are associated with bipolar disorder? | Enlarged ventricles 'white matter hyperintensities' Structural changes (Uncertain) (Smaller amygdala, Smaller hippocampus, frontal cortex abnormalities) |
| What is kindling theory? | 1. Repetition of stressful events that individually would not cause a manic or depressive episode can trigger an episode 2. Over time, the threshold for the trigger lowers 3. Eventually, a trigger is unnecessary - episodes will spontaneously kick off |
| What are the challenges with treating bipolar disorder? | Two opposing symptoms, Timing of phase onset is unpredictable, Compliance is low (because mania is fun) |
| How is bipolar disorder treated? | Use a combination of treatments: Mood stabilizer + a secondary treatment that in some cases changes modality with the mood phase |
| What are the 4 types of mood stabilizer? | Lithium, Anticonvulsants, Atypical Antipsychotics, Psychotherapy |
| How does lithium treat bipolar disorder? | Appears to alter the function of some second messenger systems and may have subtle effects on ion balance |
| How do anticonvulsants treat bipolar disorder? | Inhibit rapid, uncontrolled firing of excitatory neurons |
| How do atypical antipsychotics treat bipolar disorder? | Act as serotonin and dopamine antagonists |
| What are the different types of anxiety disorders? | Generalized Anxiety Disorder (GAD), Panic disorders, OCD, Phobia, PTSD |
| What are some general characteristics of anxiety disorders? | They are associated with temporal lobe abnormalities and the sympathetic nervous system is activated during episodes |
| How is GAD diagnosed and what are the associated nervous system abnormalities? | Generalized Anxiety Disorder is diagnosed when a person worries excessively for a period longer than 6 months. Serotonergic projections to the prefrontal cortex, basal ganglia, and limbic areas are less active and there is general hyperactivity of many other circuits in the brain |
| What are the different treatments for GAD? | Cognitive Behavioral Therapy (CBT), Group Therapy, Antidepressants (S(x)RIs, Tricyclics), Benzodiazepines (and other GABA agonists) |
| What is panic disorder? | Panic disorder is an anxiety disorder and is characterized by unexpected and repeated episodes of intense fear. Attacks may last from minutes to hours. |
| What are the different treatments for panic disorder? | Antidepressants, Anxiolytics, Cognitive Behavioral Therapy, Induction therapy |
| What is induction therapy? | Exercises that mimic the most frightening symptoms of a panic attack, but to a lesser extent, done 3-5 times a day. |
| What are the two hallmarks of Obsessive Compulsive disorder? | Obsessions: recurrent, unwanted thoughts Compulsions: repetitive behaviors to combat obsessions |
| What are the different treatments for OCD? | CBT (specifically Exposure Response Prevention) and medication (S(x)RIs, Benzodiazepines, Atypical Antipsychotics) |
| What is post traumatic stress syndrome? | Characterized by memory abnormalities pertaining to the trauma, flashbacks, short-term memory deficits. May actually be a memory extinction failure (NMDA receptors in the hippocampus?). The stress system is also involved. |
| What are the symptoms and treatments for PTSD? | Symptoms: Repeated "reliving" of the event, which disturbs day-to-day activity, Avoidance, and Arousal Treatment: CBT/Psychotherapy, Eye Movement Desensitization and Reprocessing therapy (EMDR), SSRI, tricyclics, low dose atypical antipsychotics |
| What is the rationale behind EMDR? | When a traumatic or distressing experience occurs, it may overwhelm usual ways of coping and the memory of the event is inadequately processed; the memory is dysfunctionally stored in an isolated memory network. An unprocessed memory of a traumatic event can retain high levels of sensory and emotional intensity, even though many years may have passed. EMDR is theoretically a way to give a non emotional component to these unprocessed memories and allow for complete processing |
| What is Tourette's Syndrome? | Characterized by vocal and motor tics that wax and wane, it can be progressive, but isn't always so |
| What are the structural abnormalities associated with Tourette's? | Alterations in the thalamus, basal ganglia, and frontal cortex of the brain with gray matter reductions in some places and white matter in others as well as (uncertain) dopamine supersensitivity. There appears to be some dysfunction in communication between the cortex/prefrontal cortex and some of the deeper structures (basal ganglia) |
| What are the different Tourette's syndrome treatments? | CBT/Psychotherapy, Typical and atypical antipsychotics, Antihypertensives that target adrenergic receptors (norepinephrine), Antidepressants, Deep Brain Stimulation |
| What are the drawbacks of Deep Brain Stimulation? | Requires brain surgery Placement is difficult and must be precise May not work for everyone Technology can fail |
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