Neuropsychology Exam 3

SDSU Philip Holocomb

three components of emotion

behavioral, experimental, physiological

James Lange theory of emotion

proposes that emotions arise after physiological arousal, (stimulus triggers a body response (like a racing heart), and the brain interprets that physical reaction as a specific emotion (fear, joy))

behavioral

facial expressions (pPaul Eman), body language, language are all aspects that reflect how humans are a social species

Experiential

2 aspects: subjective quality (Emotions happen to us), Cognitive (how do you interpret the behavioral, physiological & subjective experiences, Emotional regulation)

Physiological

Change in the autonomic nervous system (heart rate, respiration rate, sweating) to prepare us to respond to our changing environment.

Cannon-Baird 

Physiological response follows the “feeling”, Heart pounds after we feel afraid

Schachter and Singer - Two Factor Theory

proposes that experiencing an emotion involves two key components:

first, a general physiological arousal (like a racing heart or sweating) then a cognitive appraisal or label that interprets the reason for that arousal, leading to the specific emotion felt (e.g., fear, excitement, anger)

beta blockers

medications that block the effects of adrenaline (epinephrine), slowing your heart rate and lowering blood pressure by relaxing blood vessels, making it easier for the heart to pump (Blocks physiological response, People report feeling less fearful)

stage fright & beta blockers

Beta-blockers can be used for stage fright by a doctor's prescription to manage the physical symptoms of performance anxiety, such as a pounding heart or trembling, by blocking the effects of adrenaline

amygdala

Made up of several sub-nuclei (Central nucleus, Lateral nucleus, Basal),

Removal of any results in tameness, Stimulation results in fear response  (Startle, Avoidance)

orbito-frontal cortex

Evidence suggests it has to do with translating the personal consequences of behavior (Patients with OF damage can verbalize consequences, but are less likely to use this information)

circadian rhythm

A pattern of cyclical body activities lasting about 24 hours (Physical, behavioral, and internal biological changes)

what controls circadian rhythms?

2 influences: environmental/sun & Internal clock ( “endogenous oscillator”, runs “free” in the absence of an external synchronizer For ex: if you put someone in a room with no windows and no lights)

What are Circadian Rhythms for?

pacemaker of daily activity; Arousal level, Metabolism, Hormonal activity

 EEG (electroencephalogram)

noninvasive test that records the brain's electrical activity using electrodes placed on the scalp, creating wavy lines (brainwaves)

(to diagnose and monitor conditions like epilepsy, sleep disorders, comas, head injuries, or dementia, by detecting abnormal patterns or changes in brainwave frequencies and amplitudes.)

the 4 eeg types

Alpha, beta, theta, delta

Beta waves

13-20 Hz, wide awake

Alpha waves

 8-12 Hz

theta waves

4-7 Hz

delta waves

1-4 Hz most difficult to wake someone up

Sleep spindles

12-14 Hz

Sleep Stages defined by EEG

Stage 1 from wide awake (beta) to alpha

Stage 2 from alpha to theta

Stage 3 has both theta and some delta (see spindles in this stage)

Stage 4 mostly delta (slow wave sleep, most difficult to wake someone up)

5 REM sleep - paradoxical sleep

• Stages 1-4 are NON-REM

slow wave sleep

stage 4 mostly delta waves, most difficult to wake up, NREM occurs here

REM

paradoxical sleep (called paradoxical bc the EEG thinks you’re awake so it’s a paradox), most people woken up during REM report dreaming (REM also associated w paralysis of body)

what is dreaming

Periods of cortical activity during sleep, associated with images, ideas, & emotions

(May (or may not) be remembered after waking, More likely to remember if awakened during REM)

dyssomnia

category of sleep problems characterized by a direct problem with the sleep process itself

(types of dyssomnia = Hypersomnia & Insomnia)

parasomnia

category of disorders that involve unwanted events or experiences that occur during transitions (From wakefulness to sleep, between stages of sleep, while waking up)

2 types of parasomnia

1) NREM (during SWS) Brain exits from SWS & is caught in between sleep and wakefulness, (more common in children)

ex: Night walking, night terrors, Confusional arousal

2) REM, Muscle atonia is absent, Individual acts out dreams

(More common in older adults (esp dementia))

symptoms of parasomnia

unwanted events or experiences may include abnormal movements or behaviors, abnormal emotions, perceptions or dreams

movements/behaviors may be complex and appear purposeful to others (Patient remains asleep & usually has no memory for the events)

circadian rhythm sleep disorder

when internal biological rhythms fall out of sync with the external world _____ can develop; disruptions include jet lag, shift work, certain neuropsychiatric disorders

narcolepsy

Periods of excessive daytime sleepiness, brief involuntary sleep episodes

(Sometimes resulting from strong emotions, normal pattern of sleep stages is disrupted)

apnea (2 types)

Obstructive, caused by blockage of upper airway - reduction in blood oxygen

Central, problem in the brain stem respiratory area that regulates breathing

sleep walking

occurring during non-REM (NREM) & Stage 3 sleep (slow-wave sleep), involving behaviors like walking while still asleep (often early in the night)

It’s linked to genetics, sleep deprivation, stress, and certain meds, where the brain is partly awake and partly asleep, requiring gentle intervention if needed

(occurs in NREM, kids in SWS, and in older adults it can occur in REM)

night terrors

happen during deep non-REM (NREM) sleep, involving sudden fear, screaming, thrashing, and amnesia of the event, unlike nightmares (REM sleep, remembered)

typically occurs stage 3-4, roughly 90 minutes after falling asleep

confusional state

a more profound deficit of consciousness, including disorientation and difficulty following commands

schizophrenia

a serious mental disorder characterized by disordered thoughts, delusions, hallucinations, and other bizarre behaviors

(types of symptoms: Cognitive: delusions & hallucinations, Incoherence in language: thought disorder, Emotional: blunted/flat affect)

hallucinations

false sensory perceptions (seeing, hearing, smelling, tasting, feeling things not present);

(often linked to brain abnormalities, common in schizophrenia)

delusions

fixed, false beliefs resistant to contradictory evidence,

(often seen in psychotic disorders like schizophrenia or organic conditions (brain injury, dementia, substance use))

positive symptoms (of schizophrenia)

Hallucinations, Delusions, Thought disorder

negative symptoms (of schizophrenia)

Flat affect, lack of speech, anhedonia (inability to experience pleasure), social withdrawal

Anhedonia

inability to experience pleasure

dopamine hypothesis (theory of what causes schizophrenia, why?)

Overactive dopamine system, too many dopamine receptors (too much dopamine released)

neuroleptics

are effective treatment for positive symptoms of schizophrenia, work by blocking dopamine action

(effects on striatum results in side effects like Tardive dyskinesia—movement disorder associated with too many DA receptors)

diathesis-stress model

explains mental disorders as an interaction between an individual's diathesis (a biological/genetic predisposition) and stress (environmental triggers like major life events)

(Underlying predisposition (genetic), stress (environment) triggers the onset of the disorder)

mania

involves extreme mood shifts (highs/lows) with symptoms like euphoria, irritability, decreased sleep, racing thoughts, distractibility, and excessive activity

bipolar depression

refers to the cognitive and brain-based deficits (like impaired attention, memory, executive function) seen during depressive episodes in bipolar disorder, characterized by severe sadness, hopelessness, and low energy, stemming from altered brain structure (e.g., prefrontal cortex, amygdala) and function, impacting mood regulation and daily life.

cyclothymia

a chronic mood disorder characterized by fluctuating periods of hypomanic symptoms (elevated or irritable mood, increased energy) and depressive symptoms

major depressive disorder symptoms (aka unipolar depression)

Most typical symptoms:

• Low mood which pervades all aspects of life

• Inability to experience pleasure in previously enjoyable activities

• “Ruminating” over certain thoughts and feelings of worthlessness

• Inappropriate guilt or regret

• Helplessness or hopelessness

reactive depression (non-clincial)

“Normal depression”, a response to life events, usually passes in relatively short time

biogenic amine hypothesis

postulates that mood disorders, particularly depression and mania, result from alterations in the concentrations of certain neurotransmitters (biogenic amines) in the brain. 

serotonin

a key neurotransmitter linked to mood regulation, happiness, sleep, appetite, and focus

(Prozac blocks the reuptake of serotonin)

SSRIs (Selective Serotonin Reuptake Inhibitors)

antidepressants that work by blocking the reabsorption (reuptake) of serotonin into the neuron that released it, leaving more serotonin in the synapse (gap between brain cells) to improve mood, reduce anxiety, and treat conditions like depression and OCD, by making the neurotransmitter more available for communication

Obsessive-compulsive disorder (OCD)

a mental disorder characterized by the presence of obsessions and/or compulsions

(obsessions: unwanted, recurrent, and persistent thoughts, images, or urges that cause significant anxiety or distress)

(compulsions: repetitive behaviors or mental acts an individual feels driven to perform in response to an obsession to reduce anxiety)

generalized anxiety disorder (GAD)

a psychological disorder characterized by excessive, uncontrollable, and persistent worry about a variety of everyday things (e.g., work, health, finances) that occurs more days than not for at least six months.

panic disorder

an anxiety disorder characterized by recurrent, unexpected panic attacks followed by at least 1 month of persistent concern about having another attack or significant changes in behavior to avoid future attacks

PTSD

a severe mental health condition that can develop after exposure to a traumatic event involving actual or threatened death, serious injury, or sexual violence.

traumatic brain injury

TBI most common form of brain injury under the age of 40, sport activities account for 20% of TBI,

chronic traumatic Encephalopathy (CTE)

Neurodegenerative disease caused by repeated head injuries, symptoms include problems in 3 areas: behavioral, mood, thinking

(form of dementia, symptoms typically don’t begin until yrs after injuries)

epilepsy

Brain disorder characterized by seizures, seizures are recurrent, 4-10/100 people

(2 types: Symptomatic seizures (Seizures identified with a specific cause (TBI)), Idiopathic seizures (Appear spontaneously))

focal seizures (aka partial)

Begins in one lace (a focus point) and spreads

generalized seizures

Bilaterally symmetrical - two subtypes: grand mal & petit mal

grand mal (aka tonic-clonic)

• Tonic stage (10-20 seconds)— Stiffening phase (tense all muscles)

• Clonic stage (1-3 min) — Convulsion phase (rhythmic, jerking muscle contractions)

• Postictal Phase (min-hours) — tired, sleepy, confused, sore, headache, no memory for seizure

petit mal (absence seizure)

Loss of awareness, no motor activity, except blinking or eye rolling, or turning the head, stare into space - stop speaking

anticonvulsant drugs

drugs commonly used to treat epilepsy;

(Dilantin, phenobarbital, Carbamazepine (carbatrol, tegretol, others))

classic migraine

Begins with Aura that lasts for 20-40 min, cccurs as a result of vasoconstriction, usually in the occipital cortex

parkinson’s disease (PD)

Progressive CNS disorder that primarily affects movement and motor system. Symptoms start gradually

(Early symptoms: Shaking (tremor), rigidity, slowness of movement, difficulty with walking)

(Late symptoms: Further movement problems and dementia)

causes of PD

Motor symptoms result from the death of cells in the substantia nigra, likely environmental & genetic

(15% have a 1st degree relative, aprox 60,000 new cases/year in the US)

substantia nigra

a midbrain structure in the basal ganglia crucial for movement control, reward, and motivation, producing the neurotransmitter dopamine, which is vital for smooth motor function; its degeneration causes Parkinson's disease.

dementia

A syndrome with progressive impairments in memory, thinking, behavior. Negatively impacts a person’s ability to function and carry out everyday activities.

Alzheimer’s disease

Chronic neurodegenerative disease that starts slowly and worsens over time, early symptom is difficulty remembering recent events

(advanced symptoms include: worsening memory language problems, disorientation, mood swings, loss of motivation, not managing self-care)

(The cause of 60-70% of dementia, 6.5 million people in US are affected)

mild cognitive impairment

a stage between normal aging and dementia, characterized by noticeable memory/thinking problems (like forgetting appointments) that are more than typical but don't interfere with daily independence

tau hypothesis

Tau protein abnormalities initiate the disease cascade, Tau protein begins to pair with other threads of Tau

(Form neurofibrillary tangles inside nerve cells, Microtubules disintegrate, destroys structure of the cell’s cytoskeleton, Collapses the neuron’s transport system)

(No treatment/drugs, memory clinics are standard care in advanced cases)

amyloid hypothesis

Extracellular amyloid beta (AB) deposits fundamental cause of Alz disease

(Location of the gene for the amyloid precursor protein (APP) on chromosome 21, almost universally exhibit at least the earliest symptoms of AD by 40)

macroscopic brain development

whole brain development (Morphogenesis) 2 periods: prenatal & postnatal period

microscopic brain developement

Development of neurons

 (Four stages

1) Proliferation – cell division by mitosis (nerve cells rapidly dividing)

2) migration 

3) Aggregation (process of neurons climbing)

4) Differentiation ( cells become adult cells & different ones))

zygotic stage

days 0-14 stage

embryonic stage

14 days to 9 weeks

Gastrulation – cells migrate to the interior of the embryo

• Endoderm, Mesoderm, Ectoderm

• Organogenesis

  • Neurulation –folding process, ectoderm gives rise to the nervous system, starts during the 3rd week

fetal stage

9 weeks to 40 weeks

prenatal

9 months/40 weeks of pregnancy

Includes: Zygotic stage (0-14 stage), Embryonic stage (14 days to 9 weeks), Fetal stage (9 weeks to 40 weeks)

postnatal

Neonate (birth to 1 month), Infant (1 month to 1 year) , Childhood (1 yr to 10 yrs), Adolescence (11 to 18yrs)

endoderm

Digestive tract, liver

mesoderm

Skeletal muscle, the skeleton, dermis of the skin, connective tissue, urogenital system, heart, & blood

ectoderm

outermost layer, includes: CNS, nerves, pigment cells, the epidermis, hair & mammary glands

neurulation

forming the neural tube from the neural plate, typically in primary (folding) and secondary (cavitation) phases, leading to the CNS

stages within primary neurulation (anterior CNS) are 1) Neural Plate Formation (ectoderm thickens), 2) Shaping/Folding (groove & folds form via cell convergence/hinges), and 3) Closure/Fusion (folds meet, form tube, neural crest cells separate).

neural tube

The anterior end of the neural tube has 3 parts: Forebrain, Midbrain, Hindbrain

teratogens

are environmental agents (drugs, chemicals, infections, radiation) causing birth defects, leading to physical, cognitive, or behavioral issues like lower IQ, learning disabilities, or Fetal Alcohol Spectrum Disorders (FASD)

proliferation

Stem cells become active, cell division/mitosis occurs, produces new daughter cells (one will attach one will migrate away)

migration

2nd stage of development of neurons, immature neurons use the long, bipolar processes of radial glial cells as a "monorail" or a scaffold to guide their movement radially through the developing brain layers.

aggregation

3rd stage of neuron development, process of neurons climbing

differentiation

4th stage of neuron development, cells become adult cells & different ones

pluripotent stem cell

Cells that can differentiate into any type of cell in the body (from the three germ layers: ectoderm, endoderm, or mesoderm), but not extra-embryonic tissue.

radial glial cells

crucial embryonic neural stem cells that act as temporary scaffolds, guiding newborn neurons from the ventricular zone (where they are born) along their fibers to form the cerebral cortex, essentially creating the brain's layers from inside out.

neural epigenesis (aka epigenetics)

refers to how your environment and experiences change how your genes work, influencing brain development and behavior without altering the DNA code itself

ADHD (Attentional deficit/hyperactivity disorder)

Marked by an ongoing pattern of inattention and/or hyperactivity that interferes with daily functioning

3 core symptoms: inattention, hyperactivity, impulsivity

conduct disorder

Highly impulsive behavior that features: aggression towards people and/or animals, destruction of property, deceitfulness, serious disregard for rules and social norms

(Onset before age 10, far more prevalent in males (4-12x))

Autism Spectrum Disorder

characterized by a lack or altered social interaction, verbal and nonverbal communication problems, restrictive/repetitive behavior

(onset within the first 3 years of life)

(may include significatn cognitive/intellectual deficits)

comorbidity

the simultaneous presence of two or more disorders or conditions in the same individual

Specific language impairment (SLI) & developmental language disorder (DLD)

• Usually diagnosed in young children

  • 2-4 years (delayed language)

  • Spoken language comprehension and/or production problems

• Various hypotheses of the nature of the problem in DLD

  • Suggested there may be more than one disorder or subtype

• Tallal hypothesis/subtype

  • Rapid auditory processing (RAP) deficit

developmental dyslexia

Difficulty learning to read, w/o other significant cognitive deficits, onset around 1st grade

Boder subtypes (of dyslexia)

• Dysidedic (10%ish) visual problems, Dysphonetic (~80%) language system/phonological awareness, Combined (~10%) – double deficit