exam 3 neuro

Affective disorder

A mental disorder characterized by dramatic changes or extremes of mood

Major depression

• interferes with your daily life

• Symptoms are severe

• Interfere with your ability to work, sleep, study, eat, and enjoy life

• An episode can occur only once in a persons lifetime, but more often, a person has several episodes

Persistent depressive order

• Depressed mood that lasts for at least 2 years

• A person diagnosed may have episodes of major depression along with periods of less severe symptoms, but symptoms must last for 2 years

Symptoms of major depression (5 or more)

1. Depressed mood

2. Diminished interest or pleasure

3. Change in weight (5% in one month)

4. Change in sleep

5. Psychomotor agitation or retardation

6. Loss of energy

7. Feelings of worthlessness or excessive guilt

8. Trouble concentration

9. Recurrent thoughts of death or dying

Psychotic depression

Severe depression plus some form of psychosis

Postpartum depression

Hormonal and physical changes coupled with the responsibility of caring for a newborn

10-15% of women suffer after giving birth

Seasonal affective disorder (SAD)

Onset during winter months when less natural sunlight

Blue light and antidepressant meds

Melanopsjn has peak absorb and at 470-490 nm

Monoamine hypothesis

Serotonin, dopamine, norepinephrin, epinephrine

Decrease in catecholamines leads to depression

Increase in catecholamines leads to manic episodes

Treatments for major depression

Monoamine oxidase- enzyme that destroys dopamine, serotonin, and norepinephrine in the cytosine. MAO- inhibitors

Selective serotonin reuptake Inhibitors (SSRI) used for treatments of depression, anxiety, ocd

Deep brain stimulation in broadmann 25

Bipolar disorder

Manic episode= overly joyful or overexcited state (at least 3 changes)

Depressive episode= extremely sad or hopeless state ( at least 5 changes)

Hypomanic episode= at least 3 changes but the episode is not severe enough to cause a marked impairment in social or occupational function

Mixed state= both manic and depressive at the same time

Bipolar I Disorder

Manic symptoms or mixed episodes so severe patient needs to be hospitalized

Depressive episodes occurs as well, lasting about 2 weeks

Bipolar II Disorder

Hypomanic episode with no previous manic episodes ( last 4 days)

Depressive episodes occur as well, lasting about 2 weeks

Bipolar Disorder Not Otherwise Specified (BP-NOS)

Symptoms exist but fail to meet BP I or BP II

Cycothalmic disorder

Milder form of BP with milder episodes of Hypomanic as well as depression that lasts more than 2 years

Treatment BP: mood stabilizers

Lithium is a monovalenf cation

• blocks activation of pip2

• Disrupts adenylyl cyclase

• Glycogen synthase kinase

Treatment BP: psychotherapy

• cognitive behavioral therapy

• Family focused therapy

• Social rhythmic therapy

• Psychoeducation

Anxiety disorders

• phobias

• Panic disorder

• Obessive compulsive disorder

• Generalized anxiety disorder

Generalized anxiety disorder

At least 6 months of excessive anxiety and worry that is difficult to control and interferes with normal daily life

Patient can’t control the worry

3 or more of the following:

• Restlessness or feeling on edge

• Easily fatigued

• Difficulty concentrating

• Irritability

• Muscle tension

• Sleep disturbance

Brain regions of interest for phobias

• left dmpfc

• Left acc

• Left insula

• Left amygdala

Brain ROIs for ocd

Increased activity in the ventral anterior cingulare cortex Prefrontal cortex

Increased activity in the orbitofrontal cortex

Decreased activity in the caudate

Increased activity in the cerebellum

Treatments for anxiety disorders

Medication and therapy

SSRIs and other anti depressants

Benzodiazepines

• enhances the effects of gaba

Cognitive behavior therapy

• thought processes can be changes

• Well established

Exposure therapy

positive features of schizophrenia

1. Hallucinations

2. Delusions

3. Thought disorders

4. Movement disorders

Negative features of schizophrenia

1. Loss of interest in everyday activities

2. Appearing to lack emotion

3. Reduced ability to plan or carry out activities

4. Neglect of personal hygiene

5. Social withdrawal

6. Loss of motivation

Cognitive features of schizophrenia

1. Problems with making sense of info

2. Difficulty paying schizophrenia

3. Memory problems

Schizophrenia

2 or more of the following during a month:

• delusions

• Hallucinations

• Disorganized speech

• Grossly disorganized or cationic behavior

• Negative symptoms

Social/ occupational dysfunction

Continuous signs of disturbance for at least 6 months

Symptoms not due to schizoaffective disorder or mood disorder

Symptoms not due to substance use or general medical condition

Schizophrenia: dopamine hypothesis

D2 receptors activated lowers cAMP levels

Schizophrenia: glutamate hypothesis

• pcp and ketamine mimic positive negative and cognitive. These are NMEA receptor antagonists

• Low dose of pcp mimic schizophrenia effects in rodents

• Blocking of nmda receptor by pcp

Treatment for schizophrenia

• typical antipsychotic: dopamine antagonists

• Psychophysical therapy

• Coordinated specialty care(CSC)

Globus pallidus

Substantia nigra

Putamen

Vol

Within the basal ganglion motor loop, there are inhibitory connections originating in which nuclei?

Amyotrophic lateral sclerosis

What does als stand for

Substantia nigra

Dopaminergic neurons comprise which nucleus in the motor loop

Repeated head trauma

Which of the following is/ are not a factor in developing ms

L-dopa

What would be the best pharmacological treatment for someone with Parkinson’s disease?

Hippocampus

What part of the brain is the gateway for the formation of new long term declarative memories

D2 dopamine receptors

Which of the following is not a key player in the pathology of Alzheimer’s disease

Knowing how to swim

Which of the following is the best example of a non declarative memory

Temporal lobe enlarges

Which of the following is not a pathology of Alzheimer’s disease

Long term potentiation

What is the name for the molecular process by which synapses are strengthened over time by repeated use or paired stimuli

Having an excessive fear of a specific object circumstance or situation

Which of the following is not a requirement for being clinically diagnosed with panic disorder

Manic episodes

Which of the following is not a symptom of major depression

Acetylcholinesterase inhibitors

Which of the following is not a treatment for bad

Manic episodes

What is the difference between someone suffering from major depression and someone suffering from bad

Hyperactivity

What is the major difference between adhd and add

Social interaction and social communication

Repetitive behaviors and restricted interests

Autism spectrum disorder is a developmental disorder defined by qualitative impairments in two realms by the age of 3 years. Identify the 2 realms

Fragile X syndrome

What is the most wide spread single gene cause of autism spectrum disorder

Stress

What is something common to most if not all anxiety disorders

Early interventional behavioral therapy

What is treatment for autism spectrum disorder

Parkinson’s disease

A degenerative neurological disorder that affects the motor system

Cause of Parkinson’s disease

Death of da secreting neurons in the Substantia nigra

Symptoms of Parkinson’s disease

Resting tremor, loss of voluntary movement control, muscular rigidity, slowness of movement, shuffling gait, postural instability

Electrode placed in globus pallidus or subthalamic nucleus

For Parkinson’s tremors not pharmacological

Multiple sclerosis

An immune mediated and neurodegenerative disease that attacks the myelin sheath (specific target unknown)

Cause of ms

Immune system attacks the oligodendrocytes of the CNS and destroy the Myelin sheath surrounding the myelinated axons of the CNS

Symptoms of ms

Numbness or weakness in one or more limbs

partial or complete loss of vision usually one eye at a time often with pain during eye movement

Double vision

Tingling/pain in parts of body

Tremor, lack of coordination

Fatigue and dizziness

NeuroDegeneration in ms

t lymphocytes (and B lymphocytes) cross the BBB attack Myelin

Inflammation drives the liberation of free iron from intracellular stores

Damages both dna and mitochondria

As Myelin is damaged, More axon is exposed re-distributing the ion channels (compensatory mechanism)

This redistribution and unregulation drives influx of more cations, which causes excitotoxicity

Treatments for ms

Block the auto immune response (B cells)

• ocrelizumab

Facilitate the protection and regeneration of oligodendrocytes

Rehab

Deep brain stimulation

• electrode is placed in thalamus

ALS

Degenerative neurological disorder that causes the death of both upper and lower motor neurons In the motor cortex of the brain, the brain stem and the spinal cord. This disrupts voluntary movements and muscle power

Symptoms of als

Spasticity, exaggerated stretch reflexes, progressive weakness, atrophy and finally paralysis

Treatment als

Riluzole. Blocks voltage gated sodium channels and may function as an nmda receptor antagonist

• death usually occurs 2-6 yrs after disease onset due to failure of respiratory muscles

Dopamine

What nt receptor is most likely associated with schizophrenia

Hallucinations

What symptom of schizophrenia would be considered a positive feature

Deep brain stimulation

Which of the following would not be a treatment for schizophrenia

Declarative memory

Encoded in medial temporal lobe (hippocampus)

Facts, events

Non-declarative memory

Encoded in other areas of the brain

Procedural unconscious

Retrograde amnesia

Loss of memory for events before the accident

Cortex

Anterograde amnesia

Loss of memory for events after the accident

Hippocampus