Upgrade to remove ads
Terms in this set (251)
Chapter 18 - Neurobiology of Schizophrenia, Mood Disorders and Anxietry Disorders -
For each of these three conditions you should know what the suspected causal factors are, how they are expressed clinically, and possible treatment protocols.
What is Schizophrenia?
Schizophrenia is a term coined by Eugene Bleuler in 1911 to describe a collection of illnesses characterized by thought disorders
What Causes Schizophrenia?
1% of population (higher in twins, siblings)
Emerges in young adults
Slightly earlier onset in males than females
Monozygotic twins concordance rate 30% to 50%
Dizygotic twins/siblings concordance rate 15%
May result from neurodevelopmental defects in utero
WHat is the chromomosomes count for schizophrenia?
Loci on chromosomes 18 and 22
Loci on 22 also seen in bipolar
What is the Neuroanatomic alteration for schizophrenias
Enlargement of lateral and third ventricles; widening of frontal cortical fissures and sulci
What are the Neurotransmitter alterations for Schizophrenias
-Brain dopamine pathways altered.
Dopamine receptors blocked by antipsychotics.
-Gamma aminobutyric acid (GABA) is reduced.
-Glutamate (acts on the N-methyl-D-aspartate [NMDA] receptor subtype)
Implicated in learning and memory
Schizophrenia - Clinical manifestations
-Related to alterations in temporal lobe
-Anhedonia, alogia, and avolition
Schizophrenia - Mood Disorders
+Mood refers to a sustained emotional state
+Affective states are brief emotional feelings
-Euphoria, joy, surprise, fear, sadness, etc.
-States such as sadness become prominent
-Neuroanatomic and functional abnormalities
What is the Categories of mood disorders of a Schizophrenic?
-Also called major depression, clinical depression
-25% of people with depression will have a manic episode
What is the Genetic predisposition of a Schizophrenia?
+Twin studies: concordance rates
-40% monozygotic; dizygotic 11%
What is the Neurochemical dysregulation of a Schizophrenic?
-Hypothalamic-pituitary-adrenal system dysregulation
-Hypothalamic-pituitary-thyroid (HPT) system dysregulation
What are the HPT System Dysregulation and Mood?
20% to 30% of persons with unipolar depression have an altered HPT system
Increased CSF levels of thyrotropin-releasing hormone (TRH)
Blunted thyrotropin-stimulating hormone (TSH) response to TRH challenge
Decreased nocturnal rise in TSH
What are all the Treatments for Mood Disorders?
-Is a salt so when sodium gets low it gets dangerous
-Increase neurotransmitter amount in the synapse
-SSRIs , MAOIs
+Combination of both
+ECT alters monoamine systems
-Used when drug therapy is not effective or contraindicated
-Safe enough to use on pregnant women
What are the Antidepressant Treatments?
+Three major classes of antidepressant medications
-Monoamine oxidase inhibitors (MAOIs)
-Diet can lead to hypertensive crisis
+Tricyclic antidepressants (TCAs)
+Selective serotonin reuptake inhibitors (SSRIs)
-Side effects include nausea and sleep disturbances
+All increase monoamine neurotransmitter levels within the synapse
Anxiety Disorders. Described Panic Disorder?
+80% respond to cognitive behavioral therapy (CBT) and/or antidepressant medication
Describe Generalized anxiety disorder
+Excessive and persistent worries for 6 months
+Norepinephrine and serotonin abnormalities
+GABA-BZ receptor alterations
Describe Posttraumatic stress disorder (PTSD
+Exposure to terrifying, life-threatening trauma
+Lifetime prevalence rate 7% to 8%
+Adults: smaller hippocampus, brain structure susceptible to damaging effects of the stress hormone cortisol and excitatory amino acids
+Pediatric: studies reveal generalized effect of trauma on reducing total brain volume
Which of the following BEST describes schizophrenia?
A. Positive personality
B. Negative personality
C. Disruption of thoughts
D. Constant hallucinations
c. Schizophrenia is a collection of illnesses characterized by thought disorders. It is characterized by positive and negative symptoms. A positive personality may be a lay term to describe a happy person. Hallucinations are a component of schizophrenia.
Which of the following is a TRUE statement regarding the epidemiology of schizophrenia?
A. If a mother has twins, both twins will have schizophrenia 100% of the time.
B. Ten percent of the general population will have schizophrenia.
C. It is a simple genetic transmission.
D. Concordance between siblings is 15%.
d. The genetic penetrance is not simple. It can occur in a child with parents who do not have the disease. Monozygotic twins have a concordance rate of 30% to 50%. Siblings and dizygotic twins have a 15% concordance rate. Schizophrenia occurs in approximately 1% of the population.
A schizophrenic woman becomes pregnant. Which of the following is a TRUE statement regarding her offspring?
A. Schizophrenia may result from neurodevelopmental defects.
B. Research does not indicate any environmental involvement in schizophrenia.
C. An early brain effect manifests immediately.
D. There are no suspected alterations in brain structure.
a. There are suspected alterations in brain structure that may result from neurodevelopmental defects. Researchers hypothesize that an early brain defect may remain silent until that part of the brain is used. Researchers also believe that these defects may be environmental in nature and may be the result of viruses, prenatal nutritional deficiencies, perinatal complications, and hypoxia.
Which of the following abnormalities have been documented in schizophrenic brains?
A. Increased reelin in prefrontal cortex
B. Decreased reelin in interneurons containing GABA
C. Decreased glutamic acid decarboxylase
D. Increased reelin in hippocampus
c. There is a documented decrease in reelin, an extracellular matrix protein involved in neuronal migration in the prefrontal cortex and hippocampus. Reelin is concentrated in interneurons that contain GABA, the most widespread inhibitory neurotransmitter in the brain. Glutamic acid decarboxylase is decreased in concentration, and this likely impairs synaptic performance and cognitive function.
Which of the following drugs may actually cause psychosis at high doses?
a/ Drugs that increase dopamine transmission such as levodopa, cocaine, and amphetamine may produce psychosis at high doses. Traditional antipsychotic drugs have a high affinity for dopamine receptors, including chlorpromazine, fluphenazine, and haloperidol, and reduce psychotic states.
Which of the following is a TRUE statement regarding dopamine in relation to schizophrenia?
A. Negative symptoms result from increased dopaminergic transmission.
B. Increased secretion of dopamine may contribute to positive symptoms.
C. It is involved in learning and memory.
D. It is found in increased concentrations in CSF.
b. Increased secretion of dopamine may contribute to positive symptoms. Negative symptoms may result from decreased dopaminergic transmission. Learning and memory are related to glutamic acid. Decreased concentrations of glutamic acid have been found in the CSF of schizophrenic individuals.
Which of the following is NOT one of the three dimensions of schizophrenia?
A. Psychotic symptoms
B. Negative symptoms
C. Disorganized symptoms
D. Neutral symptoms
d. Three dimensions are the current focus for schizophrenia: psychotic symptoms, including hallucinations and delusions; disorganized symptoms, which include thought disorder or inappropriate behavior; and negative symptoms characterized by the absence of something that should be occurring.
A man states he is hearing voices instructing him to steal money from the church. This perception is which of the following?
B. Disorganized speech
C. Disorganized behavior
d. A hallucination is a perception experienced without external stimulation of the sense organs. Sensory hallucinations may involve auditory, tactile, visual, gustatory, and olfactory features. A delusion is a persistent belief contrary to the educational and cultural background of the individual. Disorganized speech and behavior are also positive symptoms of schizophrenia.
An individual suffering from schizophrenia is unable to experience emotions, especially pleasure. Which of the following terms describes this?
c.Anhedonia is the inability to experience emotions, and individuals often report a sense of detachment from the environment. Alogia is the absence of spontaneous speech production for the purpose of answering s or expressing oneself. Avolition is a deficit in spontaneous or goal-directed behavior. Aphasia is the lack of speech.
Which of the following is a TRUE statement regarding a mood disorder?
A. It is a sustained emotional state.
B. It is a disruption of thought.
C. Lifetime prevalence rate for depression is 1%.
D. Two percent of those with major depression develop bipolar disorder.
a. A mood disorder is a sustained emotional state. There is unipolar or major depressive disorder or bipolar (manic-depressive) illness. A disruption of thought is consistent with schizophrenia, not a mood disorder. Lifetime prevalence for depression is 16.2% for the general population. The prevalence of bipolar disorder ranges from 3% to 5% in the general population.
Which of the following is TRUE regarding mood disorders?
A. The hypothalamic-pituitary-adrenal (HPA) system hormones are decreased in a large percentage of individuals with major depression.
B. Depression occurs with deficits in brain norepinephrine.
C. Environmental factors have no role in depression.
D. There is no genetic role in depression.
b. Depression has been noted with deficits in norepinephrine, dopamine, and serotonin. HPA system activity is increased in a large percentage of individuals with major depression. Environmental and genetic factors play large roles in the development of depression.
proposes that the subjective emotions we experience are because of our awareness of our bodily response (autonomic arousal)
stimulus --> response --> subjective emotion
suggests that we consciously interpret a situation and this results in the feelings of emotion
Problem: body has same reaction to multiple emotions
stimulus --> conscious feeling --> autonomic arousal
asserts that bodily response provides only the raw materials of emotion, and it is a process of cognitive appraisal of this bodily response that results in the feeling of subjective emotion
stimulus --> autonomic arousal --> appraisal --> conscious feeling
what all structures directly surrounding the brainstem were initially labeled
role: give us learned fear. Enables to acquire a fear to something that is aversive
a collection of bizarre behaviors that occur following a bilateral temporal lobectomy; one such symptom is a flat emotional affect and decreased fear response.
removal of temporal lobes
- remove ventral stream; can't perceive objects very well
- oral fixation to explore the object (compensation)
- anterograde amnesia
- with emotion: lose emotional reactions to things they should fear. No physiological responses to them.
ventromedial prefrontal cortex
plays an important role in the control of emotional behavior and in modulating emotional response
the smallest speech units and are distinct sounds; the stimulus of speech
approximate number of morphemes in English language
96% left hemisphere lateralized
70% left hemisphere lateralized
the Wada procedure
allows the lateralization of language to be examined prior to surgical interventions
a region of frontal cortex located just anterior to primary motor cortex; a speech production area, necessary for the generation of fluent speech; this plans what the motor mvmts should be and generates the signals to send to M1
a region of temporal cortex posterior to primary auditory cortex and parabelt areas; speech comprehension area, necessary for understanding and generating meaningful speech; putting it together/grouping the info together into what we know as language
a bundle of fibers (axons) connecting Wernicke's area with Broca's area; bi-directional line of communication;
plays a role in transforming visual information (written word) into verbal information; link to the visual system
speak a word: mimic back.
- must get auditory in A1
- then fed in Wernicke's; access to how that sound has some meaning in language
- spits that info into Broca's via the arc. fasc.
- Broca's uses the info to plan out what needs to be done to produce sound and feeds that into M1
- can comprehend speech relatively well but have severe deficits producing fluent speech
- causes issues with the production of language
- type of speech they generate has meaning that underlies it, but the problem is generating speech output in an appropriate way
- speak fluently but their speech is meaningless and they have severe problems with comprehending speech
- speech output is fine, but the semantic access is cut off; a fluent (flowing) aphasia but doesn't make sense
- results from damage to the arcuate fasciculus but Broca's and Wernicke's areas remain intact
- can generate and comprehend speech with few difficulties
- have deficits repeating words
Transcortical Sensory Aphasia
- results from damage to the angular gyrus
- are able to repeat words spoken to them BUT cannot comprehend the meaning of those words
seizures that begin within a cortical focus and begin to spread but remain within a relatively localized brain area; these have a limit to how far they can go
seizures that often begin within a cortical focus and then spread generally throughout the brain; these will keep spreading across cortex
(absence) seizures that are generalized seizures that persist for very short periods (~30 sec) and result in periods of impaired consciousness (characterized by periods of staring).
(tonic-clonic) seizures that are generalized seizures that result in convulsions
diseases of central and peripheral nervous system
• Structural, electrical, and biochemical abnormalities
• Distinct from psychological disorders which are abnormalities of thought, feeling or behavior
the branch of medicine that deals with these disorders of the nervous system
a period of sudden, excessive, and synchronous activity of cerebral neural tissue
When excit. goes out of control, or some activity that should have been contained or localized, this runs wild and the excitation spreads throughout the brain
Traumatic brain injury
occurs when an external force damages neural tissue, shears axons, or ruptures blood vessels
permanent brain damage (and associated loss of function) caused by a disturbance in blood supply to the brain
occurs when there is an interruption to the blood supply due to an obstruction of blood flow
interruption of blood supply through a clot or collection of debris that gathers in a place; loss of blood to an area that causes tissue to die off
occurs when a blood vessel ruptures, seeping out blood which puts pressure on surrounding tissue and damages it
a blood clot
a piece of material that dislodges from one location and then blocks an artery elsewhere
Occurs elsewhere in the body and flows through until it gets stuck; can happen due to infection or a thrombus somewhere that can break into pieces that can cause compounding damage
Constraint-induced movement therapy
requiring the patient to put their good limb in a sling, preventing them from using the good arm while forcing them to use the disabled limb. This aids in the occurrence of processes of neuroplasticity in motor cortex by releasing the stroke- affected hemisphere from inhibition by the healthy hemisphere
a mass of cells in the central nervous system with uncontrollable growth and serving no useful function
originates from cells of the meninges (dura and arachnoid mater); the pressure on the surrounding cells kills them
originates from hormone secreting cells of pituitary gland; tumors close to hind brain structures are a little bit more dangerous than those elsewhere in cerebral cortes. If one here presses on or suppresses the medula, it can result in death, even if benign
originate from neural glial cells
- Ependymal cells
a degenerative disorder in which the dopaminergic cells of the substantia nigra degenerate, resulting in tremor, slowed movement, and instability
Deep brain stimulation
developing as a treatment for a variety of extreme mental disorders and neuro conditions. Implant of an electrode somewhere in the brain that can be controlled externally to compensate for whatever deficit is present there. Electrode set to stimulate that area with a certain frequency continuously.
Electrodes implanted in the subgenual ACC have shown promise in alleviating extreme treatment resistant depression
a hereditary condition that results in a degeneration of the caudate and putamen (striatum) of the basal ganglia
Symptoms: involuntary jerking or writhing movements (chorea)
a degenerative neural disorder characterized by severe dementia
This is a degeneration of cells across the cortex. Severe loss of cortical volume and circuits. Some areas are more susceptible, particularly of the frontal and temporal lobes, hippocampus, locus coeruleus, and raphe nuclei
a decline in cognition, perception, memory, and language; have quite good memory for the past, even confusions with past mixing with present, but have quite a deficit building new memories. Not as much retrograde as it is anterograde
deposits of protein (β- amyloid), degenerated neurites, and glia
Stunts the activity of neurons and eventually leads to their death.
degenerating neurons with an accumulation of intracellular tau-protein; don't allow for development of synapses. Causes cognitive decline in Alz.
an autoimmune disorder in which the immune system attacks myelin sheaths resulting in demyelinated axon tracts and deposits of cellular debris (sclerotic plaques)
a behavioral or psychological condition or syndrome that causes significant distress, disability, disturbed functioning, or increased risk of harm or pain to one's self or others
a mental disorder characterized by a loss of contact with reality; fragmentation and disruption of thought, perception, mood, and movement; delusions; hallucinations; and disordered memory
• Reduced expression of emotion
• Poverty of speech
• Memory impairment
• Deficits in goal-directed
• Disorganized Speech
• Grossly disorganized speech
• Catatonic behavior
decreased prefrontal activity, is found in schizophrenic patients; accounts for the negative symptoms of schizophrenia
The Dopamine Hypothesis
The positive symptoms of schizophrenia have been linked to over-activity of the mesocorticolimbic dopamine system (diffuse modulatory projections from the ventral tegmental area)
a class of disorders marked by emotional disturbances of varied kinds that may spill over to disrupt physical, perceptual, social, and thought processes
Overactivity of the subgenual portion of the anterior cingulate cortex has been associated with major depression
lift depression by affecting the action of the neurotransmitters norepinephrine and serotonin
Drug used to control mood in patients with major
depression and bipolar disorders
- Can bring patients out of current manic episodes
- Can prevent future manic episodes
The intentional induction of a seizure by an electric current applied to one or both cerebral hemispheres; alleviates the symptoms of severe depression
a group of disorders characterized by irrational or inappropriate expressions of fear
negatively emotionally salient stimulus results in a fear response; the changes in the circuitry of these fear responses has a sustained activity in that circuit and a sustained bodily response
a coordinated reaction to that stimulus
• Avoidance behavior
• Increased arousal
• Activation of the sympathetic division of the ANS
• Adrenal release of the hormone cortisol
the collective name for the hypothalamus, pituitary gland, and adrenal gland -- mediates the stress response
Components feeding into hypo can start to activate this circuit. Release of cortisol will go into brain and go into hippo, which if there's too much will not do its job and get out of whack. Compounding effect
medications that reduce anxiety
(such as Valium) increase GABA activity by binding to a site on the GABAA receptor. Binding this site increases the effectiveness of GABA
Posttraumatic Stress Disorder
PTSD; syndrome characterized by prolonged physiological arousal symptoms related to recurring memories and dreams linked to a traumatic event and continuing for months or years after the event.
Traumatic events that may trigger PTSD include:
- violent personal assauls
- natural or human-caused disasters
- military combat
The 3 components of mind lllustrated by Freud
1. Primitive functions, including "instinctual drives" such as sex and aggression are located in the part of the ind that Freud thought to be operating on an unconscious level and called the id.
2. The rational part of the mind he called the ego. Much of the ego's activity Freud also believed to be unconscious, although experience (to him, our perceptions of the world) is conscious.
3. The superego aspect of the mind acts to repress the id and to mediate the ongoing interaction between the ago and the id.
Dorsal frontal cortex is:
self-conscious thought; SUPEREGO
Ventral frontal cortex regulates:
Limbic system and brainstem regulate:
instincts and drives; ID
Posterior cortex generates:
sensory representations of the world; EGO
unconscious primitive functions and instinctual drives
preconscious and rational part of the mind; some unconscious and some conscious (like our perceptions)
acts to repress the id and to mediate the ongoing interactions between the ego and id
movement within neuroscience and psychoanalysis to combine the insights of both to yield a unified understanding of mind and brain.
Neurologists treat ___ disorders, such as:
organic; Parkinson's disease and stroke.
Psychiatrists treat ___ disorders, such as:
behavioral; schizophrenia and depression
The causes of brian abnormalities in neurological disorders
1. genetic errors (like Huntington's disease)
2. progressive cell death resulting from a variety of neurodegenerative causes (Parkinson's or Alzheimer's disease)
3. rapid cell death (stroke or traumatic brain injury)
4. loss of neural connections (multiple sclerosis)
In contrast to organic-neurological disorders, far ___ is known about the neurobiological causes of behavioral-psychiatric disorders.
A single brain abnormality can cause a behavioral disorder, explaining everything about the disorder and its treatment. T or F
Cause: Genetic error. Disorder:
Cause: Hormonal anomaly. Disorder:
Cause: Developmental anomaly. Disorder:
Cause: Infection. Disorder:
Cause: Injury. Disorder:
traumatic brain injury
Cause: Toxins. Disorder:
Cause: Poor nutrition. Disorder:
Cause: Stress. Disorder:
Cause: Negative experience. Disorder:
developmental delays among Romanian orphans
behavioral disorder caused by elevated levels of the amino acid phenylalanine in the blood and resulting from a defect in the gene for the enzyme phenylalanine hydroxylase; the major symptom is severe mental retardation. This is one of those disorders where a single brain abnormality can cause a behavioral disorder explaining everything about the disorder and its treatment.
Behavioral symptoms give few clues to specific:
neurochemical or nueurostructural causes.
There is yet no clear demonstration of a single receptor system with a specific relation to a specific ___.
Loss of dopamine is related to:
the muscle rigidity and dyskinesia seen in Parkinson's disease.
Nigrostriatial Dopamine Pathways
axons of neurons in the midbrain substantia nigra project to the basal ganglia, supplying dopamine to maintain normal motor behavior, Loss of dopamine is related to the muscle rigidity and dyskinesia seen in Parkinson's patients.
Only when the loss of dopamine neurons exceeds ___ do investigators see clinical signs of Parkinson's disease.
The brain's plasticity is ___; when diseases progress slowly, the brain has a large capacity for ___.
Even if a patient has actual neuropathology, such as lesions in the nervous system, determining the cause of a:
behavioral disorder may still be difficult. The same goes for if you have symptoms of brain trauma, but no signs of damage on an MRI scan because the pathology may be super subtle (a drop in dendritic-spine density)
The fact that a drug reduces symptoms does not necessarily mean that:
it is acting on a key biochemical aspect of the pathology; aspirin can get rid of a headache, but that does not mean that the headache is caused by the receptors in which aspirin acts.
Caution of believing that cures to behavioral diseases has been found by treating animals is especially important for:
How many people in the US suffer a diagnosable mental disorder in a given year, and how many in their lifetime?
year = 1/4
lifetime = 1/2
What is the leading cause of disability after age 15?
behavioral and neurological disorders
the study of the distribution and causes of diseases in human populations
We categorize psychiatric disorders by 3 types:
disorders of psychoses, mood, and affect
Abbreviation for Diagnostic and Statistical Manual of Mental Disorders, the American Psychiatric Association's classification system for psychiatric disorders.
What is used for looking for indicators of behavioral disorders?
brain imaging like MRI and PET, but these may be problematic because many behavioral disorders display similar abnormalities.
show a remarkable loss of gray matter in the cerebral cortex of children with schizo (usually found between ages 13-18)
The long-term prospects for curing organic or behavioral disorders on the macro level depend on:
the ability to treat structural and biochemical abnormalities at the micro level.
Organic abnormalities include:
genetic disorders (hintington's), developmental disorders (autism), infectious diseases (meningitis), nervous system injuries (brain or spinal-cord trauma) and degenerative dementias (alzheimer's).
Biochemical abnormalities include:
disordered proteins in cell-membrane channels, low or high numbers of neuro-receptors, and low or high numbers of molecules.
Challenges to diagnosis of behavioral and non-behavioral disorders
people are seldom objective observers of their own behavior or that of a loved one, we tend to be selective in noticing and reporting symptoms, dianosing non-behavioral disorders is lessd ependent on subjective observations than on objective experimental methods, and physicians, psychiatrists, psychologists, and counselors will all approach from a different bias and use different tests thus maybe getting a different answer.
Multiple receptor systems serve many different functions, like GABA:
GABA affects nearly 30% of the synapses in the brain, which is why benzos relieve aniety yet have side effects as well. An exception is the nigrostriatial dopaminergic system and its close relation to Parkinson's disease.
Treatments for disorders fall into 4 general categories
surgery either damages some dysfunctional area of the brain or stimulates dysfunctional areas with electrodes. Neurosurgical treatment of Parkinson's employs both tactics.
Deep brain stimulation (DBS)
form of neurosurgical treatment, where electrodes are implanted in the brain to stimulate a targeted area with a low-voltage electrical current so patient can facilitate own behavior. This is been used to treat depression, but if taken off of it, patients relapse.
used to use insulin to lower blood sugar to produce seizures in depression patients. Was replaced by electroconvulsive therapy (ECT) but that's not used much today because it leads to memory loss, large convulsions that are dangerous, BUT it can help parkinson's by increasing production of synapses to enhance function of putamen.
Newest technique of electrophysiological treatments
trans-cranial magnetic stimulation (TMS) which uses magnets rather than electrical stimulation to treat depression. It can help with auditory hallucinations, but not in schizo patients. It has uncertain results on anxiety patients.
Why doesn't TMS (trans-cranial magnetic stimulation) work to reduce auditory hallucinations in schizo patients?
because their brain is less plastic and has less memory capacity so it has less of a likelihood to reform
non-invasive manipulation of the brain; two events led to this revolution: development of neuroleptics as a treatment for schizo stemmed from a drug used to pre-medicate sr=urgical patients and a new class of anti anxiety drugs were invented (the anxiolytics like Valium)
Pharmacological treatment for parkinson's patients
L-dopa; led to the idea that drugs might be "magic bullets"
Pharmacological treatment for depression
Behavioral disorders ___be reduced to a single chemical abnormality. Can or cannot?
Schizo patients who take neuroleptics are:
having a positive effect on the mesolimbic dopamine system, but also has a long term effect on the nigrostriatal dopaminergic system that controls movements
an inability to stop the tongue from moving; motor side effect of neuroleptic drugs
non-invasive manipulation of experience, focus on key environmental factors that influence how a person acts. As behavior changes in response to these treatments, the brain is affected as well.
Treatment of generalized anxiety disorders
caused by chronic stress; not simply a problem of abnormal brain activity, but also a problem of experiential and social factors that fundamentally alter the perception of the world.
Two general ways to change behavior
behavioral therapies and cognitive therapies
treatment that applies learning principles, such as conditioning, to eliminate unwanted behaviors. includes systematic desensitization; by altering our behavior we alter the brain and vise versa.
slowly exposed to your fear by therapist
psychotherapy based on perspective that thoughts, and thus the treatment of emotional disorders, requires changing maladaptive patterns of thinking.
talking therapy derived from Freudian psychoanalysis and other psychological interventions.
Real-time fMRI (rtfMRI)
behavior modification technique where, to change their behavior, individuals learn to control their own patterns of brain activity.
Virtual reality (VR) therapy
patients placed into a virtual 3-d world can experience sights, sounds, and even smells that mimic situations related to the behavioral disorder.
Traumatic Brain Injury
a common result of head impacts with other objects. Cerebral trauma is the most common in people under 40 and age and sex are 2 of the most important factors. Children and elderly more likely to suffer head injury from falls.
People with concussions suffer diffuse loss of:
Symptoms and outcome of brain trauma (TBI)
can cause scared tissue which causes later epileptic seizures. Loss of blood brief but mitochondrial disruption lasts for up to weeks. TBI accompanied by loss of consciousness.
2 kinds of behavioral effects result from TBI:
impairment of the specific functions mediated by the cortex at the coup (site of impact) lesion and more generalized impairments from wide spread trauma throughout the brain
Can MRI and CT often show TBI caused abnormalities?
blood trapped in brain
Who is most effected by a TBI?
Magnetic resonance spectroscopy (MRS)
modification of MRI that can identify changes in specific markers of neuronal function, like n-acetylaspartate (NAA)
a marker idendified by the MRS; the second most abundant amino acid in the human brain. People with TBI show remarkable decrease in NAA decreasing with severity, and it can help in monitoring response to therapy.
Recovery from traumatic brain injury
little doubt that the bulk of cognitive recovery occurs in the first 6-9 months, while the recovery of memory functions is somewhat slower than recovery of general intelligence. Final level of memory performance is slower than for other cognitive functions. There is not much of a chance for the recovery of social skills or normal personality, which often show significant change.
Is quality of life reduced after TBI?
yes, and this reduction is chronic
Can you recover your social skills or normal personality after TBI?
not much of a chance of it
People with brainstem damage in a TBI:
have a poorer cognitive outcome, and a poorer outcome is probably true of people with initial dysphasias or hemipareses as well.
sets of a sequence of damage that progresses even if the blood flow is restored. Results in a lack of blood, called ischemia, followed by a cascade of cellular events that wreak the real damage.
lack of blood from a stroke
Effects of stroke
changes begin in the ionic balance of the affected regions, including changes in pH and in the properties of the cell membrane. Results in a form of neural shock, diaschisis, that leads to a temporary loss of neural function in areas both adjacent to an injury and in regions that are distant in the nervous system.
a form of neural shock that happens in a stroke; leads to temporary loss of neural functions in area adjacent to an injury and in regions that are distant in the nervous system.
Neurological cascade of events happening during a stroke
Changes begin in ionic balance of affected regions, from release of massive amount of glutamate and prolonged opening of calcium channels, which then allow toxic levels of calcium to enter cell, producing both direct toxic effects and also instigating various second-messenger pathways that can prove harmful to the neurons. mRNA is stimulated, altering the production of proteins in the neurons. Next, brain tissues become inflamed and swollen, threatening the integrity of cells that may be far removed from the stroke site. Energy crises as mitochondria reduce their production of ATP ro produce cerebral energy, and finally results in a form of neural shock called diaschisis. Metabolic rate decreases by about 25% across the whole hemisphere.
Treatments for stroke
ideal is to restore blood flow before the cascade of events begins; one clot-burster is tissue plasminogen activator (t-Pa) which must be administered within 3 hours to be effective. Neuroprotectants might help, and patients with small gray matter loss can benefit from pharmacological interventions (domaniergic, noradrenergic, etc) but this does NOT work for white matter loss. TMS and direct cortical stimulation can work if the person has good residual motor control.
can be used to try and block the cascade of events in a stroke, but is not very helpful because specific targets are relatively unknown
If there is dead tissue from a stroke, the way to treat this is:
by doing treatments that facilitate plastic change (speech therapy or physical therapy), although these are no 100% effective and it is not sure at what time duration would be best.
treatment for stroke victim; ex: slinging intact sling for multiple hours a day and forcing patients to only use impaired limb
Direct Cortical Stimulation or trans-cranial magnetic stimulation (TMS) in combo with behavioral therapy can be used as a treatment for:
stroke victims, if they have good residual motor control.
person suffers recurrent seizures that register on an EEG and are associated with disturbances of consciousness; seizures are a common character. Epileptic disorders widely vary in their intervals, from minutes to hours to weeks or years
How many people suffer a seizure in their lifetime and how many suffer multiple?
1 in 20 suffer one; 1 in 200 suffer multiple.
Epileptic seizures are classified as symptomatic seizures:
identified with a specific cause, such as infection, trauma, tumor, vascular malformation, toxic chemicals, very high fever, or other neurological disorders.
Seizures are idiopathic if:
they appear spontaneously and in the absence of other diseases of the central nervous system.
The brain is most epileptic when it is:
inactive and the patient is sitting still
3 symptoms within the variety of epileptic episodes
1. an aura, or warning, of impending seizure may take the form of a sensation - an odor or a noise - or it may simply be a "feeling" that the seizure is going to occur.
2. loss of consciousness ranges from complete collapse in some people to simply staring off into space in others. Period of lost consciousness is often accompanied my amnesia, including forgetting the seizure itself.
3. Seizures commonly have a motor component, but as noted, the movement characteristics vary considerably. Some people shake, other exhibit automatic movements like rubbing hands or chewing.
begins locally (at a focus) and then spreads out to adjacent areas. Originates from the point in the neocortex representing the region of the body where the movement is first seen.
Jacksonian focal seizures
ex: attack starting with jerking finger, then to more jerking fingers, then to jerking hand, and so on
Complex partial seizures
originate in the temporal lobe and somewhat less frequently in the frontal lobe; characterized by 1. subjective experiences (forced repetitive thoughts, alterations in mood, deja vu, etc.) before attack 2. Automatisms (repetitive stereotyped movements like lip smacking or undoing buttons during attack 3. postural changes, like when they assume a catatonic or frozen posture doing attack
repetitive stereotyped movements like lip smacking, chewing, or activities like undoing buttons during a complex partial seizure
lack focal onset and occur on both sides of the body
Grand mal seizure
characterized by loss of consciousness and stereotyped motor activity. Patients go through 3 stages: 1. tonic stage (body stiffens and breathing stops) 2. clonic stage (there is rhythmic shaking) 3. post seizure postictal depression (patient is confused). 50% preceded by an aura and shows EEG action across multiple lobes
Treatment of epilepsy
anticonvulsive drugs, which are anesthetic agents given in low doses without alcohol (diphenylhydantoin, phenobarbital, ect.) that inhibit discharge of abnormal neurons by stabilizing the neuronal membrane, especially in inhibitory neurons. Surgery can also be used to remove the focus of abnormal functioning in patients with focal seizures, and most patients show full recovery from this with no seizures.
myelin is damaged, and the functions of neurons whose axons it encases are disrupted. Characterized by loss of myelin in motor tracts but also sensory nerves; myelin and sometimes axons are destroyed. MRI allows affected areas to be indentified. Remissions and relapses are a main feature. Paraplegia (the classic feature of MS) may eventually confine the affected person to bed.
Do more women or men have MS?
women outnumber men 2:1
How many people are affected with MS?
50 in 100,000, so one of the most common structural diseases of the nervous system
MS is possibly a ___ disorder.
genomes or organisms so similar that the immune system may mistake its own body for a foreign body and attack it. Many microbial protein sequences are homologous with structures found in myelin.
neurodegenerative disorder; acquired and persistent syndrome of intellectual impairment characterized by memory and other cognitive deficits and impairment in social and occupational functioning.
DSM defines two essential diagnostic features of dementia:
1. loss of memory and other cognitive deficits and 2. impairment in social and occupational functioning
a heterogeneous group of disorders with diverse etiologies, including diseases of the vascular (most prevalent) or endocrine systems, inflammation, nutritional deficiency, and toxic conditions. Most significant risk factors are chronic hypertension, obesity, sedentary lifestyle, smoking, and diabetes.
have a degree of genetic transmission. Parkinson's and Alzheimer's are examples. Both are primarily intrinsic to the nervous system and tend to affect certain neural systems selectively.
related to the degeneration of the substantia nigra and to the loss of dopamine produced here and released in the striatum. Important source of insight to the role of brainstem nucleus and its control of movement.
Parkinson's general symptoms and symptom pace
vary among people (same cells degenerated but symptoms not the same in every sufferer). Symptoms resemble changes in motor activity that takes place with age; often begin with tremor in one hand and stiffness in distal parts of limbs. Eventually, movements become slower and face becomes mask like with loss of blinking and loss of emotional expression. Body become stooped, speech slow, difficulty swallowing leads to drooling. Takes about 10-20 years before symptoms cause incapacity. Symptoms are on again off again. Remission is incident based (man jumping out of wheel chair to save drowner). 4 major ones: tremor, rigidity, loss of spontaneous movement, and disturbance of posture.
the 4 major Parkinson's symptoms
3. loss of spontaneous movement (akinesia)
4. disturbance of posture
Positive Parkinson's symptoms
symptoms that add on a symptom (allowing you to do something else, even if it's negative) not something that takes away (like taking away your ability to walk). Includes: tremor at rest, muscular rigidity, cogwheel rigidity, involuntary movements, and oculogyric crisis.
Parkinson's: Tremor at rest
positive symptom; consists of alternating movements of the limbs when they are at rest; these movements stop during voluntary movements or during sleep. (pill rolling look between fingers)
Parkinson's: Muscular rigidity
positive symptom; increased muscle tone in both extensor and flexor muscles.
Parkinson's: Cogwheel rigidity
positive symptom; moving in slow motion feel
Parkinson's: Involuntary movements
positive symptom; small movements or changes in posture, referred to as akathesia.
Parkinson's: Oculogyric crisis
positive symptom; involuntary turns of the head and eyes to one side which lasts for periods of minutes to hours.
Negative symptoms of Parkinson's
symptoms that take away something you had (like taking away you ability to walk). Includes: disorders of posture, disorders of fixation, disorders of equilibrium, disorder of righting, disorder of locomotion, festination, speech disturbances, and akinesia.
Parkinson's: Disorder of fixation
negative symptom; presents as an inability or difficult in maintaining a part of the body in its normal position in relation to other parts (standing person may gradually fall to their knees)
Parkinson's: Disorders of equilibrium
negative symptom; create difficulties in standing or even sitting insupported
Parkinson's: Disorder of righting
negative symptom; person has difficulty in achieving a standing position from a supine position (can't roll over)
Parkinson's: Disorders of locomotion
negative symptom; difficulty initiating stepping, so shuffle with wide base. On beginning to walk, patients show festination, in which they take faster and faster steps and end up running forward.
in Parkinson's, where the patients begin to walk and then take faster and faster steps and end up running forward.
Parkinson's: Speech disturbances
negative symptom; absence of prosody (rhythm and pitch) in speakers voice
negative symptom; blankness of facial expression or lack of blinking. Difficulty making repetitive movements.
Cognitive symptoms of Parkinson's
cognitive symptoms can mirror motor symptoms, impoverishment of feeling, libido, motive, and attention. Thinking is slowed so it takes a while to process conversations (confused with dementia).
Causes of Parkinson's
loss of cells in the substantia nigra - may be due to disease, such as encephalitis or syphilis, or to drugs such as MPTP. Idiopathic causes may include environmental pollutants, insecticides, and herbicides.
Treating Parkinson's Disease
treatment is directed towards support and comfort so is symptomatic. Early therapy helps them to keep their heads up and live more productive lives for longer. Pharmacology aims to increase whatever dopamine systems remain and to suppress the activity in structures that show heightened activity in the absence of adequate dopamine action. Some drug treatments that stimulate dopamine receptors result in increased sexuality and compulsive gambling. Surgery can help positive symptoms.
Surgery and Parkinson's disease
to surgically help positive symptoms: lesion the internal part of the globus pallidis will reduce rigidity and tremor. Hyperactivity of these neurons can be reduced by stimulating them with deep brain stimulation. Permanent electrode placed on adjacent subthalamic nucleus could help too.
What would be a good treatment to consider for Parkinson's that isn't done yet?
to figure out how to transplant dopamine producing stem cells into the basal ganglia (cells can also come from retinal endothelial cells that can be harvested from neonatal tissue)
Alzheimer's disease is ___ % of all dementias.
What is the cause of Alzheimer's? What are the risk factors?
unknown!! The risk factors are: presence of Apoe4 gene, below average IQ, poor education, and TBI are risk factors for it; people are better able to compensate for cell death if they don't fit these criteria.
Main neuroanatomical change in Alzheimer's and second neuroanatomical change
1. emergence of neuritic (amyloid) plaques, chiefly in the cerebral cortex; plaques can be found in non-dementia patients as well.
2. neurofibrillary tangles-paired helical (spiral) filaments found in both the cerebral cortex and hippocampus are another neuroanatomical change (the posterior half of hippocampus affected more than anterior half; found in patients with down syndrome, parkinson's and other dementias.
Cortex shrinking in Alzheimer's
looses as much as 1/3 of volume, visual and sensory-motor cortex are spared. Frontal lobes less affected than the posterior cortex, and the posterior parietal, inferior temporal cortex, and limbic cortex are the areas most affected. Limbic is severely affected with leads to memory loss. There's also a change of neurotransmitters in remaining cells (acetylcholine, noradrenaline, dopamine, and serotonin reduced, and NMDA and AMPA receptors for glutamate reduced as well)
Are Parkinson's and Alzheimer's aspects of one disease?
both have loss of cells in substantia nigra. Both also have the lewy body: circular fibrous structure that forms within the cytoplasm of neurons and is thought to correspond to abnormal neurofilament metabolism. Found in both of these disorders, but it is a characteristic of Parkinson's.
Age-related cognitive loss
aging associated with declines in perceptual functions, especially vision, hearing, and olfaction, and declining motor, cognitive, and executive(planning) functions as well. Age correlated with decrease in white matter due to myelin loss. Reduction of neurogenesis in hippocampus with age. Exercise can help to improve brain's capacity for neural plasticity via increased neurogenesis, gliogenesis, and trophic factor support. Exercise of the brain helps as well.
Obesity and hypertension are related to:
decreased cortical thickness in frontal lobe
How many people have behavioral disorder?
50% of population
person loses contact with reality, experiencing irrational ideas and distorted perceptions. Schizophrenia is the most common and best understood.
Diagnosing Schizophrenia in the DSM
DSM lists 6 diagnostic symptoms of schizophrenia: 1. Delusions 2. Hallucinations (distorted perceptions such as hearing voices) 3. Disorganized speech (incoherent statements or senselessly rhyming talk) 4. Disorganized behavior or excessive agitation 5. The opposite extreme: catatonic behavior 6. Negative symptoms, such as blunted emotions or loss of interest and drive, all characterized by the absence of some normal response. These criteria are subjective.
Type I schizophrenia
is characterized predominantly by positive symptoms that manifest behavioral excesses, such as hallucinations and agitated movements. Likely due to dopaminergic dysfunction. Associated with acute onset, good prognosis, and a favorable response to neuroleptics.
Type II schizophrenia
characterized by negative symptoms that entail behavioral deficits. Associated with chronic affliction, poor prognosis, poor response to neuroleptics, cognitive impairments, enlarged ventricles, and cortical atrophy (in the frontal cortex).
Some patients of schizophrenia can show combos of both type I and type II. T or F
Neuroanatomical correlates of schizophrenia
people with auditory hallucination founds to have abnormalities in the auditory regions of the temporal lobe and in Broca's area. Structural abnormalities in Wenicke's area among patients with thought disorders. Large ventricles and thinner cortex int he medial temporal regions. Low blood flow in dorsal lateral prefrontal cortex and deficits in executive functions.
Neurochemical correlates of schizophrenia
ventral tegmental dopamine system affected. Drugs that increase dopamine can show symptoms of schizophrenia (amphetamines). Decrease in dopamine and dopamine receptors. Decrease in glutamate and increased glutamate receptors. Decrease in GABA and increased GABA-binding sites. Hippocampal neurons are disorganized.
disordered mental state characterized by excessive euphoria.
mania to depression
Monoamine systems, in norephinephrine and serotonin systems, have roles in ___.
Neurobiology of depression
antidepressants act on signaling pathways, specifically cAMP in the postsynaptic cell. Brain derived neurotrophic factor is down regulated by stress and up regulated by antidepressant meds. Lowering of neurotransmitters is not the only reason for depression.
hypothalamic-pituitay-adrenal circuit that controls the production and release of hormones related to stress.
Cognitive-behavioral therapy (CBT)
problem focused, action oriented, structured, treatment for eliminating dysfunctional thoughts and maladaptive behaviors.
Is misbehavior always bad?
people with frontal and temporal damage acquired music or art talents. Loss of function in some brain areas leads to new function in other areas.
brain function enhancement by pharmacological physiological, or surgical manipulation. Has major moral and ethical issues surrounding it.
Sets with similar terms
Abnormal Psych 3 Exam
AP Psychology Ch. 16
AP Psychology Ch. 16
Other sets by this creator
Rhythm Strips & EKG Practice
Other Quizlet sets
Big Idea questions Heimlier history
Scientific Inquiry Test