neuro unit 4 vocab

clinical depression

affects 10% of the population and can last several months

• c = uncontrolled stress (dysregulation of HPA), genetic predisposition expressed via environmental factors

major depressive episode

must meet 5/9 symptoms that are persistent for at least 2 weeks from DSM-V

effects of high cortisol

1. low 5-HT, DA, and NE in synapse (monoamine hypothesis of depression)

   • leads to decreased 5-HT1A, 5-HT2, beta, alpha 2A, and D1

2. low production of BDNF

depression in the brain

1. increased amygdala activity

2. increased activity in frontal lobe

3. thinning of cortex of R hemisphere

4. decreased hippocampal volume

5. decreased blood flow to ares involved in attention

major depressive disorder (MDD)

intense sadness alternates with mania

• congenital

• types:

  • bipolar I

  • bipolar II

  • rapid-cycling

• t = antidepressants + modd stabilizer

postpartum depression

depression after childbirth

• 1/8 women

• c = drop in estrogen/progesterone after childbirth

• lack of treatment causes postpartum psychosis

postpartum psychosis

caused by untreated postpartum depression

• s = hallucinations, delusions, paranoia

seasonal effective disorder (SAD)

seasonal depression

• c = increased 5-HT transporters, increased melatonin

• t = antidepressants + light therapy

monoamine oxidase inhibitor (MAOI)

reduce degradation of 5-HT

• side = hypertension with food/drugs

• hardil

tricyclic antidepressants (TCA)

blocks reuptake of 5-HT, NE, DA

• side = dizzy, hypotension

• elavil

serotonin-specific reuptake inhibitors (SSRI)

reduces 5-HT reuptake by binding to SERT

• side = weight gain, sexual dysfunction

• prozac, zoloft, paxil

serotonin norepinephrine reuptake inhibitors (SNRI)

reduce reuptake of 5-HT and NE

• side = nausea

• effexor

norepinephrine dopamine reuptake inhibitor (NDRI)

reduce reuptake of NE and DA

• side = tremors, dizzy, insomnia

• wellbutrin, zyban

electroconvulsive shock therapy (ECT)

electrical current induces seizure

repetitive transcranial magnetic stimulation (rTMS)

alters cortical electrical activity

deep brain stimulation

implant electrode to stim cingulate cortex

ED50

effective dose in 50% of patients

TD50

toxic dose in 50% of patients

LD50

lethal dose in 50% of patients

anxiety in the brain

• prefrontal cortex shuts down

• anterior cingulate cortex hyperactive

• amygdala enlarges (boosts signal)

GABA in anxiety

decreased → not effective in inhibiting release of NE and 5-HT

NE and 5-HT in anxiety

increased release of NE and 5-HT to synapse (5-HT hypothesis of anxiety)

generalized anxiety disorder (GAD)

persistent anxiety for long time without identification of true source

• t = cognitive behavioral therapy + meds

phobias

intense irrational fears centered in specific thing

• t = exposure and response therapy (ERT)

obsessive compulsive disorder (OCD)

recurrent uncontrolled thoughts (obsessions) cause anxiety and repetitive acts (compulsions)

• c = exposure to strep as a child produces antibodies that attack brain proteins

• t = cognitive behavioral therapy + meds

post-traumatic stress disorder (PTSD)

memories of unpleasant event causes intense anxiety

• s = repeated flashbacks, nightmares, sporadic behaviors

• c = deficit in STM, overactive adrenergic system, small hippocampus, reduced neurogenesis

• t = propanolol

benzodiazapenes (BZD)

binds to GABA → increases binding to GABAA → increase inhibition of 5-HT and NE release

• s = habit forming, drowsy, memory impairment

• valium, xanax, ativan

buspar

5-HT1A agonist

beta-blockers

propanolol

antidepressants

prozac, paxil, effexor

schizophrenia

involves breakdown of relation between thought, emotion, and behavior (split mind)

positive symptoms

not present under normal conditions

positive symptoms of schizo

• psychosis

negative symptoms

should be present under normal conditions

negative symptoms of schizo

1. emotional dysregulation

   • flat effect

   • anhedonia

2. impaired motivation

   • algonia

   • social withdrawal

cognitive symptoms of schizo

1. neurocognitive impairment

risk factors for schizo

• genetic predisposition

  • mutation of DISC1 gene

• environmental factors

  • older paternal age

  • virus in vivo

  • erythroblastosis fetalis

  • hypoxic during birth

  • stress associated with city living and pollution

schizo in the brain

1. hypofrontality hypothesis: decreased blood flow to frontal lobes due to decreased metabolic activity there

2. enlargement of lateral ventricles

NT in schizo

• increased DA

• increased 5-HT

• decreased G

first-generation antipsychotics (FGA)

D2 agonists

• reduce positive symptoms, worsen negative symptoms

• long term use leads to movement disorders

• only used as a last resort

• side = akathisia, dystonia, neuroleptic-induced parkinsonism, tardive dyskinesia (TD)

• chlorpromazine, haloperidol (halodol)

second-generation antipsychotics (SGA)

agonists for D2 and 5-HT2A

• reduces positive and negative symptoms

• side = weight gain, diabetes, heart issues

• risperidone, olansopine, zyprexa, ablify

atypical antipsychotic

NMDA agonist, 5-HT2A antagonist, balances DA levels

• side = sleepy, nausea, dizzy, dry mouth

• caplypta

glutamate hypothesis

dysfunction of G leads to underactivation of G receptors, leading to decreased activity in frontal cortex

brain-derived neurotropic factor (BDNF)

helps in neural connections, prevents neurodegeneration, promotes plasticity

lithium

mood stabilizer

1. reduce NMDA to reduce G activity

2. increase GABAB to increase GABA activity

3. increase BDNF

• side = weight gain, fatigue, kidney damage

depakote

mood stabilizer

• increases GABA activity

dose response curve

graph that shows effective dose of drug

prefrontal cortex function

dampens anxiety under normal conditions

anterior cingulate cortex function

amplifies signals from amygdala under normal conditions

amygdala function

responds to scary stimulation under normal conditions

social cognition

understanding social cues

akathisia

feelings of anxiety, restlessness, pacing, repetitive and purposeless actions

dystonia

involuntary muscle contractions and abnormal postures

neuroleptic-induced parkinsonism

tremor at rest and slowing of limbs

tardive dyskinesia (TD)

irreversible movement disorder, involuntary hyperkinetic movements of face/tongue/limbs/trunk