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?
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
How is cysteine transported across the BBB?
ACS system (also transports alanine and serine along with A system)
Which system of transporting amino acids across the BBB may limit accumulation of -NT glycine in cord and +NT glutamate in the brain?
A system
What changes L-Dopa into dihydroxyphenylacetic acid?
DOPA Decarboxylase and monoamine oxidase
What enzyme detoxifies glutathione-bound compounds and vasoactive leukotrienes?
delta-glutamyl transpeptidase
Cerebral Spinal Fluid is secreted by?
Choroid Plexus
How much CSF is secreted by the Choroid Plexus each day?
500ml
What is the total volume of CSF?
150 ml
How often is CSF turned over?
3 times per day
CSF has less __________________________ (secretory products) than plasma.
less protein, glucose, K+, Ca++, Mg++, pH
CSF has more ___________________ (secretory products) than plasma.
Cl-, osmolarity, Na+
How is the constant external environment for neurons and glia maintained?
CSF communicates with brain ISF
What are the functions of CSF?
Communicates with brain ISF, removal of potentially harmful brain metabolites, mechanical cushion, reduces weight of brain, transport of peptides to distant sites, pH affects both ventilation and blood flow
What serves as the one-way valve to allow CSF to flow into the blood and not allow blood to flow into the CSF?
arachnoidal villi
Obstruction of flow of the CSF causes?
hydrocephalus
What is the normal CSF pressure?
10 mmHg
What usually causes noncommunicating hydrocephalus?
blockage of the aqueduct of Sylvius from a congenital defect or tumor
What usually causes communicating hydrocephalus?
blockage of fluid flow into subarachnoid space around basal regions of the brain or blockage of arcachnoidal villi