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Which researchers found that electrically stimulating certain areas in the brain and brainstem produced cortical activation?

Moruzzi and Magoun

Arousal states appear to be determined by in interaction about the ___________, __________, _________ and ___________.

brainstem, hypothalamus, thalamus, basal forebrain

Dampening of arousal systems with concomitant active inhibition by ______________ systems produces sleep.

thalamo-cortical

Areas maintaining wakefulness include?

oral pontine reticular formation,
midbrain central tegmentum,
posterior hypothalamus

Where are sleep promoting areas located?

midline brainstem,
dorsolateral medullary reticular formation,
anterior hypothalamic preoptic region

What is the "sleep modulating center", with both sleep and waking active sites?

Magnocellular nucleus basalis of Meynert located in the forebrain

The Magnocellular nucleus basalis of Meynert located in the forebrain has projections to ___________ and ______________.

neocortex, midbrain reticular formation

What type of projections are projections from the Magnocellular nucleus basalis of Meynert?

acetylcholine projections

Sleep is a behavioral state that differs from wakefulness by a readily reversible loss of ______________________.

reactivity to event's in one's environment

Sleep is divided into stages based on?

electroencephalography (EEG),
electro-occulogram (EOG),
electromyogram (EMG)

What are the two "light" stages of non REM sleep?

I and II

What are the two "deep" stages of non REM sleep?

III and IV

During Rapid Eye Movement sleep, the EEG resembles?

awake state or NREM stage I

During REM sleep, what happens to EMG activity?

dramatic decrease

Descriptive words for stage I NREM?

I-light, theta, delta (low amplitude) horizontal eye

Descriptive words for stage II NREM?

II-light, theta, delta, sleep spindles, K complexes

Descriptive words for stage III NREM?

III, deep, high amplitude delta (20-50%)

Descriptive words for stage IV NREM?

IV, deep, high amplitude delta (>50%)

Electrical stimulation of _____________________ produces slow wave sleep.

nucleus tractus solitarius (NTS)

Lesions in the nucleus tractus solitarius produces _________________.

cortical desynchronization (waking pattern of EEG)

NTS appears to inhibit more rostrally situated neurons in the ____________________ system.

ascending reticular activating

Direct connections between NTS and major areas of the ____________ system exist.

limbic (anterior thalamus, hypothalamus, amygdala)

Where might lesions produce insomnia?

seritonin rich raphe nucleus

What chemical can produce insomnia by blocking production of serotonin?

Parachlorophenylalanine (a trytophan hydroxylase inhibitor)

Slow wave sleep can be restored in PCPA induced insomnia by administration of _______________.

5 Hydroxytrytophan

How does serotonin appear to modulate sleep?

its effect on other hyponogenic factors in the anterior hypothalamus and suprachiasmatic nucleus

Serotonin is a precursor for what?

melatonin

Melatonin is synthesized and released by the ______ gland.

pineal

Melatonin is synthesized and released by the pineal gland through ___________ activation from the ______________ tract.

sympathetic,
retino-hypothalamic

What effect does prolonged bright light stimulation have on melatonin and sleep?

supresses

________________________ appears to inhibit waking areas in the rostral midbrain and mesopontine reticular core.

Preoptic nucleus of ant. Hypothalamus

Preoptic nucleus of ant. Hypothalamus appears to inhibit waking areas in the _______________ and ___________________________.

rostral midbrain, mesopontine reticular core

Where is prostaglandin D2 highly concentrated?

preoptic nucleus

Prostaglandin inhibition by _____________ can decrease diurnal sleep.

indomethacin

The __________________ may also promote sleep by inhibiting the waking area in the posterior hypothalamus.

anterior hypothalamus

What factors have hynogenic effects by acting on the anterior hypothalamus.

triazolam, 5HTP, muramyl peptides, PGD2

What type of neurons are involved in sleep spindles and delta waves?

GABAergic

Sedatives and hypnotics stimulate __________ receptors and facilitate sleep.

GABA

Sleep spindles are rhythmic cortical waveforms generated by oscillatory activity in ______________ of the thalamus.

nucleus reticularis

Slow waves are generated in ________________ circuits arising in _______________.

neocortical, all cortical layers

An increase in GABAergic anterior hypothalamic preoptic and basal forebrain neurons is associated with _______ sleep.

slow wave

What is cortical EEG doing in REM sleep?

highly desynchronized (similar to waking)

What type of sleep is associated with pontine geniculate occipital spikes?

REM

What phasic events are associated with PGO spikes?

rapid eye movements, changes in respiration, heart rate, muscle twitches, and dreaming

Where do PGO spikes originate from?

REM-ON cells in medial pontine reticular formation and adjacent reticular tegmental nucleus

In animals, REM sleep has been eliminated by placing lesions where?

ventral to locus ceruleus

REM sleep can be induced by cholinergic stimulation of the __________.

pons

REM sleep can be induced by __________ stimulation of the pons.

cholinergic

REM-OFF cells are represented by what cells? (which become silent during REM)

noradrenergic cells of locus ceruleus

___________ is 30% greater in REM sleep.

Rheobase

What is the progressive decrease in muscle tone in REM sleep associated with?

hyperpolarization of moter neurons

What type of sleep does many antidepressants suppress?

REM

What happens in REM behavior disorder?

persistant muscular tone during REM, bursts of excessive limb and body movements,

There is a reduction in body and brain temperature at the onset of sleep. What change is this associated with?

vasodilation

At the onset of sleep, there is reduced thermosensitivity of ______________.

hypothalamic preoptic nucleus

What serves as an endogenous clock influencing both sleep and body temp in a closely coupled fashion?

suprachiasmatic nucleus

How much does brain metabolism decrease in slow-wave sleep?

20-35%

Is inhibition of TSH sleep promoting or sleep inhibiting?

promoting

Is inhibition of cortisol sleep promoting or sleep inhibiting?

promoting

Is stimulation of GH and prolactin sleep promoting or sleep inhibiting?

promoting

Is muramyl peptide sleep promoting or sleep inhibiting?

promoting

Is prolactin sleep promoting or sleep inhibiting?

promoting

Is stimulation of TSH sleep promoting or sleep inhibiting?

inhibiting

Is stimulation of cortisol sleep promoting or sleep inhibiting?

inhibiting

Who is more likely to be obese, those who sleep more than 9 hours or those who sleep less than 6 hours?

less than 6 hours

What are the causes of epilepsy?

trauma, oxygen deprivation, tumors, infections, toxic states

What are precipitating causes of seizure?

strong emotional stimuli, alkolosis (hyperventilation), drugs, fever, loud noises/flashing lights

What terminates a seizure?

neuronal fatique, active inhibition?

What is the incidence of epilepsy?

.5-1% of population (2nd most common neurological disease)

Which type of seizure is associated with Aura, Tonic Phase, Tonic-clonic phase and Post-ictal phase?

Grand Mal

Which type of seizure is associated with "zone-out"?

Petite Mal

What type of seizure is Focal- and symptoms depend on the area of the brain that is involved?

Psychomotor

Which type of seizure "migrates"?

Jacksonian

Which type of seizure is associated with brief muscle jerks and dementia?

myoclonic

Which type of seizure is a "drop" seizure?

atonic

Which type of seizure is a life-threatening and persistant state of seizure?

Status Epilepticus

What is an altered sensation prior to a grand mal seizure called?

aura

What is the tonic phase of a grand mal seizure?

rigid stiffening of body, loss of conciousness

What is the tonic-clonic phase of a grand mal seizure?

strong muscle contraction and convulsions, which are over within minutes

What is the Post-ictal phase of a grand mal seizure?

return to conciousness, may be associated with confusion, stupor, slurred speech, weakness

What drugs are used to treat epilepsy?

phenobarbitol, dilantin, tegratol, depeken (Valproic Acid)

What is a surgical treatment of epilepsy?

excision of epileptic foci

What is a vagal stimulator treatment for?

epilepsy

What is a sensory evoked potential?

change in EEG resulting from stimulation of a sensory pathway

To determine sensory ep, EEG is recorded during?

repetitive natural stimulation (tap on skin or flash of light)

Is schizophrenia characterized by positive or negative symptoms?

negative (loss of function)

What are some of the positive symptoms of schizophrenia?

delusions, hallucinations, disorganized speech, bizarre behavior

What are some of the negative symptoms of schizophrenia?

alogoria, flat affect, anhedonia, avolition, attentional impairment

The positive symptoms of schizophrenia are associated with what area?

mesolimbic- ventral tegmental area to many areas of limbic system (dopaminergic)

The negative symptoms of schizophrenia are associated with what area?

mesocortical- ventral tegmental area to neocortex

What are some anatomical abnormalities associated with schizophrenia?

enlargement of ventricles and prominent sulci due to abnormal brain development

What is the concordance of schizophrenia in monzygotic twins?

40%

What is the concordance of schizophrenia in dizygotic twins?

10%

What is a psychological symptom of L-Dopa?

schizophrenia

What is the definition of "mood"?

sustained emotional state

Melancholia means?

black bile

Who first described unipolar depression in writings in the 5th century BC?

Hippocrates

Untreated unipolar depression typically lasts how long?

4-12 months

What condition is characterized by pervasive unpleasant mood that is present most of the day, along with at least three other symptoms (such as decreased sex drive, guilt, thoughts about dying/suicide, etc)?

Unipolar Depression

What is the term for inability to experience pleasure?

anhedonia

When are symptoms of unipolar depression symptoms usually worse?

in the mornings

What are some subtypes of unipolar depression?

(endogenous)melacholic, reactive

What is the incidence of unipolar depression?

5% or 8 mil in US

Bipolar is similar to unipolar with the addition of?

mania

Which disorder has an elevated or irritable mood which lasts at least a week?

bipolar

Overactivity, reckless involvements, and social intrusiveness are all symptoms of?

mania- bipolar

What is the concordance of general depression among monozygotic twins?

50%

The incidence of suicide in biologic relatives of depressed adoptees is _________ than biologic relatives of normal adoptees.

6-10 times higher

What treatment for depression has an effectiveness rate of about 90%?

Electroconvulsive therapy

How effective are drugs at treating depression?

70%

What are some examples of drugs for the treatment of depression?

MAO inhibitors, tricyclic, specific serotonin, uptake blockers, lithium salts

What receptors are changed in ECT therapy?

aminergic

MAO inhibitors decrease breakdown of ______________.

biogenic amines (norepinephrine and serotonin)

MAO inhibitors have a lag time of __________, and it takes __________ for full effect.

lag- 1 to 3 weeks
full effect- 4-6 weeks

Tricyclic compounds work how?

biogenic amine uptake blockers

What is the response rate for tricyclic compounds in the treatment of depression?

70% response rate

Trycyclic compounds have a lag time of __________, and it takes __________ for full effect.

lag- 1 to 3 weeks
full effect- 4-6 weeks

How does fluoxetine (Prozac) work?

specifically block the re-uptake of serotonin

Lithium Salts are effective at terminating ______________.

manic episodes

How do Lithium salts work?

inhibit neuronal signal transduction systems

What has a similar effect of lithium salts?

omega 3 fatty acids

What is a "key feature" of anxiety disorders?

frequent occurance of symptoms of fear

Excessive anxiety is _______.

maladaptive

What are the subjective manifestations of anxiety?

heightened sense of awareness, deep fear of impending disaster and death

What is the average age of onset for panic attacks?

late 20s

Infusion of sodium lactate into blood and inhalation of CO2 can trigger?

panic attacks

What are the drug treatments for anxiety?

benzodiazepines (valium, librium)

How do drugs for the treatment of anxiety work?

enhance activity of GABA receptor (opens Cl- channel, increasing Cl- influx, hyperpolarizing cell)

In US ____% of population older than 65 show mild to severe mental impairment.

11

After the age of 75, there is a __% increase in dementia per year.

2

What is the most common form of dementia?

alzheimers

What are some general changes on CT or MRI associated with Alzheimer's Disease?

thining of cortical gyri, enlarged ventricles

What genes may be involved in Alzheimers?

primarily C21, can be C1, C14, C19

What are the neuronal features of Alzheimers?

extracellular plaques containing amyloid, neurofibrillary tangles

Where are amyloid plaques concentrated in Alzheimers?

neocortex, hippocampus

Neuronal cell loss in the hippocampus and nucleus basalis of Meynert indicates?

Alzheimer's

Decreased neuropeptides in alzheimers include?

somastatin, NPY, corticotrophin RF, Substance P, VIP

What is the normal cerebral blood flow?

50-65 ml/100 gms/min

Cerebral blood flow represents about ____% of resting cardiac output.

15

Most strokes (75%) are what type?

occlusive

What percent of strokes are hemorrhagic?

25%

Most substances that must cross the BBB are not _______ soluble and use specific carrier mediated transport systems.

lipid

What does the brain use for energy?

glucose

How does glucose gain entrance across the BBB?

GLUT 1

Is glut 1 energy dependent?

no

Where in the brain is there no BBB?

posterior pituitary and circumventricular organs (secretory areas)

Leaky areas of the brain (with no BBB) are isolated from the rest of the brain by ___________________ which prevent free exchange with CSF.

specialized ependymal cells (tancytes)

How is leucine and valine transported across the BBB?

energy and Na dependent L system (for large neutral AA with branched or ring side chains)

How is alanine and serine transported across the BBB?

Energy and Na dependent A system (for neutral AA with short linear or polar sidechains) OR ACS system

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