1) HIPPOCAMPUS AND THE MTL

Hippocampus

Hippocampus, Cerebellum, Amygdala

Set 3 - Hippocampus, context, space

Hippocampus, Memory, and Neuroplasticity

Hippocampus & LTP

Wed 10/14 Quiz 18: Brain - Amygdala, Cerebellum, Hippocampus

Memory Systems and Neurobiology: H.M., Hippocampus, and Recognition Tasks

Exam Review Chapters 1, 2, & 3. Chapter 1 The Science of Psychology Behavior: Everything, we do that can be directly observed. Behavioral approach: an approach to psychology emphasizing the scientific study of observable behavioral responses and their environmental determinants. Biological approach: an approach to psychology focusing on the body, especially the brain and nervous system. Case study or case history: an in-depth look at a single individual. Cognitive approach: an approach to psychology emphasizing the mental processes involved in knowing: how we direct our attention, perceive, remember, think, and solve problems. Control group: The participants in an experiment who are as much like the experimental group as possible and who are treated in every way like the experimental group except for a manipulated factor, the independent variable. Correlational research: research that examines the relationships between variables, whose purpose is to examine whether and how two variables change together. Critical thinking: The process of thinking deeply and actively, asking questions, and evaluating the evidence. Dependent variable: The outcome; the factor that can change in an experiment in response to changes in the independent variable. Double-blind experiment: An experimental design in which neither the experimenter nor the participants are aware of which participants are in the experimental group and which are in the control group until the results are calculated. Evolutionary approach: An approach to psychology centered on evolutionary ideas such as adaptation, reproduction, and natural selection as the basis for explaining specific human behaviors. Experiment: A carefully regulated procedure in which the researcher manipulates one or more variables that are believed to influence some other variable. Experimental group: The participants in an experiment who receive the drug or other treatment under study—that is, those who are exposed to the change that the independent variable represents. Functionalism: James’s approach to mental processes, emphasizing the functions and purposes of the mind and behavior in the individual’s adaptation to the environment. Humanistic approach: An approach to psychology emphasizing a person’s positive qualities, the capacity for positive growth, and the freedom to choose any destiny. Hypothesis: A testable prediction that derives logically from a theory. Independent variable: A manipulated experimental factor; the variable that the experimenter changes to see what its effects are. Longitudinal design: A special kind of systematic observation, used by correlational researchers, that involves obtaining measures of the variables of interest in multiple waves over time. Mental processes: The thoughts, feelings, and motives that people experience privately but that cannot be observed directly. Natural selection: Darwin’s principle of an evolutionary process in which organisms that are best adapted to their environment will survive and produce offspring. Naturalistic observation: The observation of behavior in a real-world setting. Placebo: In a drug study, a harmless substance that has no physiological effect, given to participants in a control group so that they are treated identically to the experimental group except for the active agent. Placebo effect: The situation where participants’ expectations, rather than the experimental treatment, produce an experimental outcome. Population: The entire group about which the researcher wants to draw conclusions. Psychoanalysis: techniques involves an analyst unlocking a person's unconscious conflicts by talking with the individual about his or her childhood memories, dreams, thoughts, and feelings. Psychodynamic approach: an approach to psychology emphasizing unconscious thought, the conflict between biological drives (such as the drive for sex) and society’s demands, and early childhood family experiences. Psychology: The scientific study of behavior and mental processes. Sample: The subset of the population chosen by the investigator for study. Sociocultural approach: an approach to psychology that examines the ways in which social and cultural environments influence behavior. Structuralism: Wundt’s approach to discovering the basic elements, or structures, of mental processes. Theory: A broad idea or set of closely related ideas that attempts to explain observations and to make predictions about future observations. Validity: The soundness of the conclusions that a researcher draws from an experiment. In the realm of testing, the extent to which a test measures what it is intended to measure. Variable: Anything that can change. Wilhelm Wundt is most often regarded the "founding father" of modern psychology. He was also the founder of structuralism. William James was the founder of functionalism. J. B. Watson and B. F. Skinner believed that psychology should focus on an organism's visible interactions with the environment—that is, behaviors. Ethical Guidelines developed by the American Psychological Association include: • informed consent. • confidentiality. • deception. • debriefing. Chapter 2 The Brain and Behavior Action potential: The brief wave of positive electrical charge that sweeps down the axon. Adrenal glands: glands at the top of each kidney that are responsible for regulating moods, energy level, and the ability to cope with stress. Amygdala: An almond-shaped structure within the base of the temporal lobe that is involved in the discrimination of objects that are necessary for the organism’s survival, such as appropriate food, mates, and social rivals. Association cortex: Sometimes called association areas, the region of the cerebral cortex that is the site of the highest intellectual functions, such as thinking and problem solving. Autonomic nervous system: The body system that takes messages to and from the body’s internal organs, monitoring such processes as breathing, heart rate, and digestion. Axon The part of the neuron that carries information away from the cell body toward other cells. Basal ganglia Large neuron clusters located above the thalamus and under the cerebral cortex that work with the cerebellum and the cerebral cortex to control and coordinate voluntary movements. Brain stem The stem like brain area that includes much of the hindbrain (excluding the cerebellum) and the midbrain; connects with the spinal cord at its lower end and then extends upward to encase the reticular formation in the midbrain. Cell body The part of the neuron that contains the nucleus, which directs the manufacture of substances that the neuron needs for growth and maintenance. Central nervous system (CNS): The brain and spinal cord. Cerebral cortex: Part of the forebrain, the outer layer of the brain, responsible for the most complex mental functions, such as thinking and planning. Chromosomes: In the human cell, threadlike structures that come in 23 pairs, one member of each pair originating from each parent, and that contain DNA. Corpus callosum: The large bundle of axons that connects the brain’s two hemispheres, responsible for relaying information between the two sides. Dendrites: Treelike fibers projecting from a neuron, which receive information and orient it toward the neuron’s cell body. Deoxyribonucleic acid (DNA): A complex molecule in the cell’s chromosomes that carries genetic information. Dominant-recessive genes principle: The principle that if one gene of a pair is dominant and one is recessive, the dominant gene overrides the recessive gene. A recessive gene exerts its influence only if both genes of a pair are recessive. Endocrine system: The body system consisting of a set of glands that regulate the activities of certain organs by releasing their chemical products into the bloodstream. Forebrain: The brain’s largest division and its most forward part. Frontal lobes: The portion of the cerebral cortex behind the forehead, involved in personality, intelligence, and the control of voluntary muscles. Genes: The units of hereditary information, consisting of short segments of chromosomes composed of DNA. Genotype: An individual’s genetic heritage; his or her actual genetic material. Glands: Organs or tissues in the body that create chemicals that control many bodily functions. Glial cells: The second of two types of cells in the nervous system; glial cells (also called glia) provide support, nutritional benefits, and other functions and keep neurons running smoothly. Hindbrain: Located at the skull’s rear, the lowest portion of the brain, consisting of the medulla, cerebellum, and pons. Hippocampus: The structure in the limbic system that has a special role in the storage of memories. Hormones: Chemical messengers that are produced by the endocrine glands and carried by the bloodstream to all parts of the body. Hypothalamus: A small forebrain structure, located just below the thalamus, that monitors three pleasurable activities—eating, drinking, and sex—as well as emotion, stress, and reward. Limbic system: A set of subcortical brain structures central to emotion, memory, and reward processing. Midbrain: Located between the hindbrain and forebrain, an area in which many nerve-fiber systems ascend and descend to connect the higher and lower portions of the brain; in particular, the midbrain relays information between the brain and the eyes and ears. Motor cortex: A region in the cerebral cortex, located just behind the frontal lobes, that processes information about voluntary movement. Myelin sheath: A layer of fat cells that encases and insulates most axons. Neocortex: The outermost part of the cerebral cortex, making up 80 percent of the human brain’s cortex. Nervous system: The body’s electrochemical communication circuitry. Neural networks: Networks of nerve cells that integrate sensory input and motor output. Neurons: One of two types of cells in the nervous system; neurons are the nerve cells that handle the information-processing function. Neurotransmitters: Chemical substances that are stored in very tiny sacs within the neuron’s terminal buttons and involved in transmitting information across a synaptic gap to the next neuron. Occipital lobes: Structures located at the back of the head that respond to visual stimuli. Ovaries: Sex-related endocrine glands that produce hormones involved in women’s sexual development and reproduction. Pancreas: A dual-purpose gland under the stomach that performs both digestive and endocrine functions. Parasympathetic nervous system: The part of the autonomic nervous system that calms the body. Parietal lobes: Structures at the top and toward the rear of the head that are involved in registering spatial location, attention, and motor control. Peripheral nervous system (PNS): The network of nerves that connects the brain and spinal cord to other parts of the body. Phenotype: An individual’s observable characteristics. Pituitary gland: A pea-sized gland just beneath the hypothalamus that controls growth and regulates other glands. Plasticity: The brain’s special capacity for change. Prefrontal cortex: an important part of the frontal lobes that is involved in higher cognitive functions such as planning, reasoning, and self-control. Resting potential, The stable, negative charge of an inactive neuron. Reticular formation: A system in the midbrain comprising a diffuse collection of neurons involved in stereotyped patterns of behavior such as walking, sleeping, and turning to attend to a sudden noise. Somatic nervous system: The body system consisting of the sensory nerves, whose function is to convey information from the skin and muscles to the central nervous system about conditions such as pain and temperature, and the motor nerves, whose function is to tell muscles what to do. Somatosensory cortex: A region in the cerebral cortex that processes information about body sensations, located at the front of the parietal lobes. Stem cells: Unique primitive cells that have the capacity to develop into most types of human cells. Stress: The responses of individuals to environmental stressors. Stressors: Circumstances and events that threaten individuals and tax their coping abilities and that cause physiological changes to ready the body to handle the assault of stress. Sympathetic nervous system: The part of the autonomic nervous system that arouses the body to mobilize it for action and thus is involved in the experience of stress. Synapses: Tiny spaces between neurons; the gaps between neurons are referred to as synaptic gaps. Temporal lobes: Structures in the cerebral cortex that are located just above the ears and are involved in hearing, language processing, and memory. Testes: Sex-related endocrine glands in the scrotum that produce hormones involved in men’s sexual development and reproduction. Thalamus: The forebrain structure that sits at the top of the brain stem in the brain’s central core and serves as an important relay station. Left Hemisphere • verbal processing, speech, grammar Right Hemisphere • spatial perception • visual recognition • emotion Chapter 3 Sensation and Perception Absolute threshold: The minimum amount of stimulus energy that a person can detect. Apparent movement: The perception that a stationary object is moving. Auditory nerve: The nerve structure that receives information about sound from the hair cells of the inner ear and carries these neural impulses to the brain’s auditory areas. Binding: In the sense of vision, the bringing together and integration of what is processed by different neural pathways or cells. Binocular cues: Depth cues that depend on the combination of the images in the left and right eyes and on the way the two eyes work together. Bottom-up processing: The operation in sensation and perception in which sensory receptors register information about the external environment and send it up to the brain for interpretation. Cones: The receptor cells in the retina that allow for color perception. Convergence: A binocular cue to depth and distance in which the muscle movements in an individual’s two eyes provide information about how deep and/or far away something is. Depth perception: The ability to perceive objects three-dimensionally. Difference threshold: The degree of difference that must exist between two stimuli before the difference is detected. Feature detectors: Neurons in the brain’s visual system that respond to particular features of a stimulus. Figure-ground relationship: The principle by which we organize the perceptual field into stimuli that stand out (figure) and those that are left over (ground). Frequency theory: Theory on how the inner ear registers the frequency of sound, stating that the perception of a sound’s frequency depends on how often the auditory nerve fires. Gestalt psychology A school of thought interested in how people naturally organize their perceptions according to certain patterns. Inner ear: The part of the ear that includes the oval window, cochlea, and basilar membrane and whose function is to convert sound waves into neural impulses and send them to the brain. Kinesthetic senses: Senses that provide information about movement, posture, and orientation. Middle ear: The part of the ear that channels and amplifies sound through the eardrum, hammer, anvil, and stirrup to the inner ear. Monocular cues: Powerful depth cues available from the image in one eye, either the right or the left. Noise: Irrelevant and competing stimuli—not only sounds but also any distracting stimuli for the senses. Olfactory epithelium: The lining of the roof of the nasal cavity, containing a sheet of receptor cells for smell. Opponent-process theory: Theory stating that cells in the visual system respond to complementary pairs of red-green and blue-yellow colors; a given cell might be excited by red and inhibited by green, whereas another cell might be excited by yellow and inhibited by blue. Optic nerve: The structure at the back of the eye, made up of axons of the ganglion cells, that carries visual information to the brain for further processing. Outer ear: The outermost part of the ear, consisting of the pinna and the external auditory canal. Pain: The sensation that warns an individual of damage to the body. Papillae: Rounded bumps above the tongue’s surface that contain the taste buds, the receptors for taste. parallel processing: The simultaneous distribution of information across different neural pathways. Perception: The process of organizing and interpreting sensory information so that it makes sense. perceptual constancy: The recognition that objects are constant and unchanging even though sensory input about them is changing. perceptual set A predisposition or readiness to perceive something in a particular way. place theory: Theory on how the inner ear registers the frequency of sound, stating that each frequency produces vibrations at a particular spot on the basilar membrane. retina The multilayered light-sensitive surface in the eye that records electromagnetic energy and converts it to neural impulses for processing in the brain. Rods: The receptor cells in the retina that are sensitive to light but not very useful for color vision. selective attention: The act of focusing on a specific aspect of experience while ignoring others. semicircular canals: Three fluid-filled circular tubes in the inner ear containing the sensory receptors that detect head motion caused when an individual tilts or moves the head and/or the body. Sensation: The process of receiving stimulus energies from the external environment and transforming those energies into neural energy. sensory adaptation: A change in the responsiveness of the sensory system based on the average level of surrounding stimulation. sensory receptors: Specialized cells that detect stimulus information and transmit it to sensory (afferent) nerves and the brain. signal detection theory: An approach to perception that focuses on decision making about stimuli in the presence of uncertainty. subliminal perception The detection of information below the level of conscious awareness. Thermoreceptors: Sensory nerve endings under the skin that respond to changes in temperature at or near the skin and provide input to keep the body’s temperature at 98.6 degrees Fahrenheit. top-down processing The operation in sensation and perception, launched by cognitive processing at the brain’s higher levels, that allows the organism to sense what is happening and to apply that framework to information from the world. trichromatic theory: Theory stating that color perception is produced by three types of cone receptors in the retina that are particularly sensitive to different, but overlapping, ranges of wavelengths. vestibular sense: Sense that provides information about balance and movement. visual cortex: Located in the occipital lobe, the part of the cerebral cortex involved in vision. volley principle: Principle addressing limitations of the frequency theory of hearing, stating that a cluster of nerve cells can fire neural impulses in rapid succession, producing a volley of impulses. Weber’s law: The principle that two stimuli must differ by a constant minimum percentage (rather than a constant amount) to be perceived as different.

PSYCH 202: Intro to the Hippocampus

Plasticity in the Hippocampus

Hippocampus LTD

hippocampal circuits 2

hippocampal circuits 1

Hippocampal memory + LTP

Unit 1: Psychology’s History and Approaches Big Idea: Psychology is the scientific study of behavior and mental processes. This unit asks: Why do people think, feel, and behave the way they do, and how do psychologists study it? 1. Early Schools of Thought Structuralism Focused on breaking conscious experiences into smaller parts. Example: Describing every taste, smell, and feeling while eating pizza. Functionalism Focused on WHY behaviors and thoughts exist. Example: Fear exists because it helps humans survive danger. Connection: Structuralists asked “What are thoughts made of?” Functionalists asked “What purpose do thoughts serve?” 2. Major Psychological Perspectives Biological Perspective Behavior comes from the brain, genetics, and hormones. Example: Depression connected to serotonin levels. Behavioral Perspective Behavior is learned through rewards and punishments. Example: A dog learns tricks because it gets treats. Cognitive Perspective Focuses on thinking, memory, and problem-solving. Example: Why students remember some facts better than others. Humanistic Perspective Humans naturally strive for growth. Example: Trying to achieve goals and improve yourself. Psychodynamic Perspective Unconscious conflicts affect behavior. Example: Getting unusually angry because of hidden stress. Evolutionary Perspective Behaviors developed because they helped survival. Example: Humans naturally fearing dangerous animals. Sociocultural Perspective Behavior is shaped by culture and society. Example: Different cultures have different expectations for personal space. 3. Research Methods Experiment Used to determine cause and effect. Independent Variable What the researcher changes. Dependent Variable What the researcher measures. Example: Studying whether sleep affects test scores. * Amount of sleep = IV * Test score = DV Correlation Shows relationship between variables. Important: Correlation does NOT equal causation. Example: Ice cream sales and drowning both rise during summer. Random Assignment Participants randomly placed into groups. Helps reduce bias. Double-Blind Procedure Neither researchers nor participants know who receives treatment. Prevents expectations from affecting results. BIG AP EXAM CONNECTION The AP exam loves asking: * Which perspective best explains this behavior? * Which research method should be used? * Why doesn’t correlation prove causation? Example: A psychologist studies how rewards affect studying. → Behavioral perspective + experiment Unit 2: Biological Basis of Behavior Big Idea: Your brain, nervous system, hormones, and genetics all shape behavior. The whole unit asks: How do your body and brain create thoughts, emotions, and behavior? 1. Nature vs. Nurture = Who You Are Main Idea: Your behavior comes from BOTH: * Nature = genetics/heredity * Nurture = environment and experiences Example: Someone may inherit anxiety tendencies but stressful experiences can make anxiety stronger. 2. Nervous System Central Nervous System Brain + spinal cord. Peripheral Nervous System Nerves outside the brain and spinal cord. Sympathetic Nervous System Activates during stress. Example: Heart racing before giving a speech. Parasympathetic Nervous System Calms the body afterward. 3. Neurotransmitters Dopamine Reward and pleasure. Example: Social media likes feel rewarding. Serotonin Mood and sleep. Low levels linked to depression. Acetylcholine Movement and memory. Linked to Alzheimer’s disease. GABA Calms nervous system. Low GABA linked to anxiety. 4. Brain Structures Frontal Lobe Decision-making and personality. Occipital Lobe Vision. Temporal Lobe Hearing and memory. Hippocampus Memory formation. Amygdala Fear and aggression. BIG AP EXAM CONNECTION A student panicking before a test: * amygdala activates fear * sympathetic nervous system increases heart rate * adrenaline releases Unit 3: Sensation and Perception Big Idea: Sensation detects information. Perception interprets information. This unit asks: How does the brain create your experience of the world? 1. Sensation Absolute Threshold Smallest amount of stimulation needed to notice something. Example: Hearing a quiet text notification. Difference Threshold Smallest noticeable difference between stimuli. Example: Noticing the TV volume changed. Sensory Adaptation Becoming less aware of constant stimulation. Example: Not noticing your hoodie after wearing it awhile. 2. Vision Rods Help see in dim light. Cones Detect color. Blind Spot Area without receptors. 3. Hearing Frequency Determines pitch. Amplitude Determines loudness. 4. Perception Gestalt Principles The brain organizes pieces into meaningful wholes. Example: Seeing a complete logo even with missing parts. Depth Perception Ability to see distance in 3D. Example: Catching a volleyball. Perceptual Set Expectations affect perception. Example: Misreading a word because you expected something else. BIG AP EXAM CONNECTION The exam often gives optical illusions or perception scenarios. Example: A person stops noticing a strong smell after 10 minutes. → sensory adaptation Unit 4: Learning Big Idea: Behavior changes because of experience. This unit asks: How do humans and animals learn behaviors? 1. Classical Conditioning Learning through association. Pavlov’s Dogs Dogs learned to associate a bell with food. Unconditioned Stimulus Naturally causes response. Conditioned Stimulus Previously neutral stimulus causing learned response. Example: Feeling hungry when hearing the microwave beep. 2. Operant Conditioning Learning through rewards and punishments. Positive Reinforcement Adding something good to increase behavior. Example: Getting money for good grades. Negative Reinforcement Removing something unpleasant. Example: Seatbelt alarm stopping. Punishment Decreases behavior. 3. Observational Learning Learning by watching others. Example: Kids copying influencers online. BIG AP EXAM CONNECTION The AP exam loves reinforcement examples. Example: A student studies harder after praise from parents. → positive reinforcement Unit 5: Cognitive Psychology Big Idea: Humans think, remember, solve problems, and use language. This unit asks: How does the mind process information? 1. Memory Process Encoding Getting information into memory. Storage Keeping information over time. Retrieval Getting information back. 2. Types of Memory Sensory Memory Very brief memory. Short-Term Memory Temporary limited storage. Long-Term Memory Relatively permanent storage. Working Memory Actively using information. Example: Doing math in your head. 3. Forgetting Proactive Interference Old information disrupts new information. Retroactive Interference New information disrupts old information. Example: Forgetting old password after learning a new one. 4. Problem Solving Algorithm Step-by-step method. Heuristic Mental shortcut. Confirmation Bias Looking for information supporting beliefs. Example: Only reading opinions you already agree with. BIG AP EXAM CONNECTION A student mixes up Spanish vocabulary from last year with current vocabulary. → proactive interference Unit 6: Developmental Psychology Big Idea: Humans develop physically, mentally, and socially across life. This unit asks: How do people change from infancy through adulthood? 1. Piaget’s Cognitive Development Sensorimotor Stage Babies learn through senses and actions. Object Permanence Understanding objects still exist when hidden. Example: Babies searching for hidden toys. Preoperational Stage Children use language but think egocentrically. Egocentrism Difficulty understanding another perspective. Example: A child assuming everyone sees exactly what they see. Concrete Operational Stage Logical thinking develops. Formal Operational Stage Abstract thinking develops. Example: Thinking about hypothetical situations. 2. Attachment Strong emotional bond with caregivers. Secure Attachment Healthy trust and comfort. 3. Parenting Styles Authoritative Strict but supportive. Usually healthiest. Authoritarian Strict with little warmth. Permissive Warm but few rules. BIG AP EXAM CONNECTION A teenager exploring identity and future goals. → Erikson’s identity vs role confusion stage Unit 7: Motivation, Emotion, and Personality Big Idea: Motivation drives behavior, emotions affect actions, and personality shapes how people interact. 1. Motivation Drive-Reduction Theory People act to reduce discomfort. Example: Eating when hungry. Maslow’s Hierarchy Basic needs come before higher goals. Example: Someone struggling financially may focus on survival before self-esteem. 2. Emotion Theories James-Lange Theory Physical response first. Example: Heart races THEN fear is felt. Cannon-Bard Theory Emotion and physical response happen together. Schachter Two-Factor Theory Emotion depends on physical arousal plus interpretation. 3. Personality Trait Theory Personality made of stable characteristics. Big Five Traits * openness * conscientiousness * extraversion * agreeableness * neuroticism BIG AP EXAM CONNECTION A student interpreting sweaty palms before a game as excitement. → Schachter two-factor theory Unit 8: Clinical Psychology Big Idea: Psychological disorders affect thoughts, emotions, and behaviors. This unit asks: How are disorders identified and treated? 1. Anxiety Disorders Generalized Anxiety Disorder Constant excessive worry. Phobias Irrational fears. OCD Obsessions and compulsions. 2. Mood Disorders Major Depressive Disorder Persistent sadness and loss of interest. Bipolar Disorder Extreme mood swings. 3. Schizophrenia Disordered thinking and perception. Hallucinations False sensory experiences. Delusions False beliefs. 4

Navigation and the Hippocampus Lecture Review

Hippocampal ripples and memory consolidation during sleep

TEMA 2: ESQUIZOFRENIA Los trastornos del espectro de la esquizofrenia y otros trastornos psicóticos son la esquizofrenia, otros trastornos psicóticos y el trastorno esquizotípico (de la personalidad). Se definen por anomalías en uno o más de los siguientes cinco dominios: delirios, alucinaciones, pensamiento (discurso) desorganizado, comportamiento motor muy desorganizado o anómalo (incluida la catatonía) y síntomas negativos (expresión emotiva disminuida, abulia, anhedonia, alogia, asocialidad). Generalidades ● La esquizofrenia es el trastorno psicótico más frecuente que afecta a 1 de cada 100 personas a lo largo de la vida. ● Se considera multicausal, con la interacción entre diversos genes y el entorno, índice de heredabilidad del 50-80 % ● Uso de sustancias psicoactivas, particularmente cannabis, incrementa el riesgo de desarrollarla. ● Usualmente, inicia en la adolescencia (usualmente antes de los 25 años) ● Involucrado diversos sistemas de neurotransmisores, mecanismos asociados a neuroinflamación, estrés oxidativo y segundos mensajeros. Historia "esquizofrenia" proviene del griego y fue acuñada en 1908 por el psiquiatra suizo Eugen Bleuler. Está formada por los términos "schizein" que significa "separar" y "phren" que se traduce como "mente" o "alma". Epidemiología ● Tiene la misma prevalencia tanto en hombres como en mujeres. ● Las personas que consumen gran cantidad de cannabis presentan riesgo 6 veces más elevado de sufrir esquizofrenia. Etiología ● Factores genéticos ● Factores biológicos: 1. DOPAMINA: plantea que este trastorno tiene su origen en una actividad dopaminérgica excesiva, la teoría se elaboró a partir de eficacia y la potencia de muchos antipsicóticos (es decir, los antagonistas del receptor de la dopamina) y las sustancias que aumentan la actividad dopaminérgica (en concreto, la cocaína y las anfetaminas) son psicomiméticas. 2. SEROTONINA: Las hipótesis actuales plantean que el exceso de serotonina es la causa de los síntomas tanto positivos como negativos de la esquizofrenia. La fuerte actividad antagonista de la serotonina de la clozapina y otros antipsicóticos de segunda generación lo confirman. 3. NORADRENALINA: La anhedonia en la esquizofrenia se podría explicar por el deterioro neuronal selectivo dentro del sistema neural de refuerzo de la noradrenalina. 4. GABA: algunos pacientes con esquizofrenia presentan una pérdida de neuronas gabaérgicas en el hipocampo y la pérdida de neuronas gabaérgicas inhibidoras podría provocar la hiperactividad de las neuronas dopaminérgicas. 5. GLUTAMATO: Las hipótesis propuestas sobre el glutamato son la hiperactividad, la hipoactividad y la neurotoxicidad que provoca. 6. ACETILCOLINA Y NICOTINA: la reducción de los receptores muscarínicos y nicotínicos en los núcleos caudado-putamen, el hipocampo y ciertas regiones de la corteza prefrontal. Estos receptores desempeñan un papel en la regulación de los sistemas neurotransmisores implicados en la cognición, que se ve afectada en la esquizofrenia. 7. NEUROPÉPTIDOS: Los neuropéptidos, como la sustancia P y la neurotensina, se localizan con los neurotransmisores catecolamina e indolamina, e influyen en la acción de estos. Tipos de Esquizofrenia 1. Tipo paranoide ● Se caracteriza por la presencia de uno o más delirios, especialmente de persecución o grandeza, y alucinaciones auditivas frecuentes. ● Se presenta en edades mas avanzadas, mantienen cierto grado de funcionamiento social ● Pueden parecer nerviosas, desconfiadas o reservadas, hostiles o agresivas. 2. Tipo desorganizado ● Manifiesta por un comportamiento regresivo, primitivo, desorganizado y desinhibido. ● Pensamiento muy alterado, escaso contacto con la realidad, aspecto descuidado, y respuestas afectivas inadecuadas. ● Antes de los 25 años de edad ● Suelen reír sin motivo aparente, sonríen de manera burlona, hacen muecas 3. Tipo catatónico ● Alteraciones motoras importantes como estupor, rigidez, negativismo, posturas extrañas, mutismo o estados de excitación ● presentan movimientos repetitivos, manierismos y flexibilidad cérea ● pueden alternar rápidamente entre agitación y parálisis ● Durante la fase de excitación catatónica, puede requerirse atención médica urgente para evitar autolesiones o daño a otros. ● Alteraciones motoras importantes como estupor, rigidez, negativismo, posturas extrañas, mutismo o estados de excitación catatónica. 4. Tipo Indiferenciado ● Útil para describir casos mixtos o atípicos. ● Paciente presenta síntomas claros de esquizofrenia, pero no encaja del todo en ninguno de los subtipos anteriores. 5. Tipo residual ● Persisten signos como retraimiento social, afecto embotado, pensamiento ilógico, comportamientos extraños y una leve desorganización del pensamiento. ● Se refiere a pacientes que han tenido episodios esquizofrénicos previos, pero que actualmente no presentan síntomas activos intensos. Otros subtipos 1. Bouffée délirante: aparición de síntomas psicóticos de menos de 3 meses. El 40% evolucionan a esquizofrenia. Se asemeja al trastorno esquizofreniforme. 2. Esquizofrenia latente: Describía casos con síntomas leves o atípicos que no cumplían los criterios actuales, hoy se diagnosticarían con trastornos límite, esquizoides o esquizotípicos. 3. Esquizofrenia Oniroide: está completamente absorto en sus alucinaciones y se desconecta del entorno. Suele incluir desorientación y perplejidad. 4. Parafrenia: sinónimo de esquizofrenia paranoide poco útil en la práctica clínica moderna. 5. Esquizofrenia Seudoneurótico: inicialmente presentan ansiedad, fobias u obsesiones, pero que luego desarrollan psicosis o trastornos del pensamiento. Ahora se le llama trastorno limite 6. Trastorno delirante simple: pérdida gradual de motivación, iniciativa e interés social, sin alucinaciones o delirios persistentes. 7. Trastorno depresivo psicótico: Ocurre cuando, tras un episodio agudo de esquizofrenia, el paciente entra en un estado depresivo. 8. Esquizofrenia de inicio temprano: Aparece durante la infancia y suele confundirse inicialmente con autismo o discapacidad intelectual. 9. Esquizofrenia de Inicio tardío: principalmente en mujeres mayores de 45 años. Sintomas paranoides, mejor pronostico Criterios diagnosticos A. Dos o más de los siguientes síntomas, cada uno debe estar presente durante una parte significativa del tiempo durante un periodo de un mes (o menos si se trató con éxito). Al menos uno debe ser del 1, 2 o 3: 1. Delirios 2. Alucinaciones 3. Discurso desorganizado (p. ej., incoherencia) 4. Comportamiento muy desorganizado o catatónico 5. Síntomas negativos (disminución de expresión emocional o abulia) B. El funcionamiento en uno o más ámbitos principales (trabajo, relaciones interpersonales, autocuidado) ha estado claramente por debajo del nivel previo desde el inicio del trastorno. En niños o adolescentes: fracaso para alcanzar el nivel esperado en relaciones interpersonales, académicas o laborales. C. Los síntomas persisten por al menos seis meses, incluyendo al menos un mes de síntomas del criterio A (fase activa). Este periodo puede incluir síntomas prodrómicos o residuales. D. Se han descartado trastornos esquizoafectivo, depresivo o bipolar con características psicóticas porque: ● No han ocurrido episodios mayores del estado de ánimo concurrentes con los síntomas de fase activa ● Si han ocurrido, han estado presentes solo por una minoría del tiempo total de la enfermedad activa y residual. E. El trastorno no es atribuible a los efectos fisiológicos de una sustancia o a otra afección médica. F. Si hay antecedentes de trastorno del espectro autista o trastorno de la comunicación en la infancia, solo se puede hacer diagnóstico adicional de esquizofrenia si hay delirios o alucinaciones notables, además de los otros síntomas requeridos, por al menos un mes. Especificar el tipo de episodio y curso (si aplica): Tipo de episodio Descripción ● Primer episodio, actualmente en episodio agudo Primera manifestación que cumple criterios sintomáticos, diagnósticos y de tiempo. ● Primer episodio, actualmente en remisión parcial Se mantiene mejoría tras episodio anterior, pero persisten algunos síntomas. ● Primer episodio, actualmente en remisión total No hay síntomas activos tras episodio anterior. ● Episodios múltiples, actualmente en episodio agudo Nuevo episodio después de un periodo mínimo de remisión. ● Episodios múltiples, actualmente en remisión parcial tras múltiples episodios previos. ● Episodios múltiples, actualmente en remisión total Remisión completa tras múltiples episodios. ● Continuo, Síntomas cumplen los criterios diagnósticos durante la mayor parte del tiempo. ● No especificado, No se especifica el patrón del curso. Especificar la gravedad actual: La gravedad debe clasificarse evaluando cuantitativamente cinco síntomas principales de psicosis: ● Ideas delirantes ● Alucinaciones ● Discurso desorganizado ● Comportamiento psicomotor anormal ● Síntomas negativos Cada síntoma debe calificarse en una escala de 0 a 4: ● 0: Ausente ● 4: Grave Cuadro clínico ● Durante la adolescencia, pueden carecer de relaciones cercanas o haber evitado las citas ● Es común que los pacientes hayan mostrado desde la infancia una personalidad esquizoide o esquizotípica ● También pueden surgir intereses inusuales por temas abstractos, religiosos o esotéricos ● Los síntomas y signos premórbidos de la esquizofrenia aparecen antes de la fase prodrómica cefalea, mialgia, fatiga, problemas digestivos ● Alteraciones motoras y cuidado personal: Rigidez, torpeza motora, ropa inadecuada, tics, ecopraxia ● Catatonia y signos asociados: Mutismo, negativismo, obediencia automatica, manerismos, aveces flexibilidad cerea ● Trastornos del pensamiento: contenido y forma ● Trastornos del proceso del pensamiento en esquizofrenia ● Fuga de Ideas ● Bloqueo del pensamiento ● Déficit de atención ● Pobreza de contenido ● Dificultad para abstraer ● Perseveración y asociaciones raras (ecolalia, fonéticas) ● Circunstancialidad ● Ideas de control o difusión del pensamiento Comorbilidad somática 1. Signos neurológicos: ● Disdiadococinesia: dificultad para hacer movimientos rápidos y alternados. ● Estereognosia alterada: dificultad para reconocer objetos solo con el tacto ● Reflejos primitivos (como el de prensión) presentes en adultos. ● Disminución de la destreza motora. 2. Exploración ocular: ● Aumento en la frecuencja del parpadeo ● Alteración del seguimiento ocular 3. Lenguaje y alteraciones cognitivas: ● dificultad para percibir la entonación y ritmo del lenguaje Solo el 10% al 20% de los pacientes que ingresan e inician tratamiento mejoran a los 5 a 10 años. Mas del 50% tienen mal pronóstico. Tratamiento Efectos secundarios: extrapiramidales (acatisia, distonías, discinesia tardía), sedación, hipotensión ortostática, hiperprolactinemia (galactorrea, amenorrea, osteoporosis,) supresión de la GnRH (disminución de líbido), sindrome metabolico. Aportes del Dr: Contacto social: aislados, poco sociales, no tienen pareja. Paciente no puede seguir con sus estudios No es curable, es una enfermedad del pensamiento. Pensamiento se estudia: Forma, contenido, control, Robo o inserción de pensamiento solo se da en esta patología Ideas comunes en esquizofrenia ● Ideas delirantes de grandeza en esquizofrenia paranoide ● Ideas de vigilancia o persecución ● Brujería ● Ideas de Contaminación de la comida o que los están envenenando Episodio psicótico agudo polimorfo con o sin síntomas de esquizofrenia: regala todo su dinero, su ropa, no duerme ● Enfermedades del pensamiento: todo lo que tenga que ver con esquizofrenia ● Enfermedades afectivas: depresión y trastorno bipolar Fumar marihuana acerca a padecer esquizofrenia, ya que estimula a la sobreproducción de dopamina, la cual es la misma causa de esquizofrenia ● Acatisia: trastorno del movimiento que se caracteriza por una sensación de inquietud interna y la necesidad incontrolable de moverse, especialmente en las extremidades inferiores. ● Discinesia tardía: movimientos motores provocado por el uso crónico de antipsicóticos, sobretodo los típicos. Normalmente son movimientos orofaciales Antipsicóticos atípicos producen resistencia a la insulina, aumento de peso. La nicotina les ayuda a calmarse. Un enfermo mental difícilmente ataca. Presentan miedo, se esconden Extrapiramidalismo tiene que ver con la vía Nigroestriada: acatasia, discinesia tardia ● Episodio psicótico agudo de 1-30 días con o sin síntomas de esquizofrenia ● Episodio psicótico mayor al mes: Episodio esquizofreniforme Criterio A: 1 mes con ideas delirantes o comportamiento psicótico, con tratamiento menor a 1 mes ● Características de psicosis: Ideas delirantes, alucinaciones auditivas, comportamiento desorganizado y lenguaje desorganizado ● Delirium: alucinaciones visuales, complicacion metabólica donde el paciente tiene trastornos de o Alucinaciones visuales o Alteraciones del estado de conciencia ● Alucinaciones auditivas completas. Voces que hablan entre sí sobre los comportamientos de la persona, son patognomónicas de esquizofrenia ● Alucinaciones auditivas incompletas son patognomónicas de los trastornos afectivos ● Catatonia: escuchan, entienden bien, pero no hay mimética ni habla. ● Catatonia agitada: Hiperactividad motora, es muy rara. ● Esquizofreniforme siempre termina en esquizofrenia ● Esquizofrenia paranoide: debuta a los 25-28 años Tratamiento 1. Antipsicóticos típicos: desde 1950 desde la clorpromazina, decanoato de flufenazina Decanoato de flufenazina: inyectable, es de depósito y se utiliza cuando el paciente es inconsistente con el medicamento. Se utiliza cada 15 días o 1 cada mes, ampolla de 25 mg. Tiene muchos efectos secundarios extrapiramidales: parkinsonismo, sialorrea, torción cervical. Se acompaña de diperideno (2mg al día) ya que hace efecto contrario en vía nigroestriada (en esta vía estan los ganglios basales) o Haloperidol: ampolla 5mg en 1ml, tambien hay en tableta 5mg. o Clorpromazina: 5 ml Dañan mucho la vía nigroestriada pero no tienen daños metabólicos como aumento de peso 2. Antispsicoticos atipicos Dañan menos la vía nigriestriada, pero si hacen que aumente de peso, resistencia a la insulina, diabetes Ningún ansiolitico o antipsicótico se retira de espontáneamente, se van rebajando manualmente En esquizofrenia puedo usar de 5-10 mg de haloperidol en las noches y decanoato de flufenazina debe estar acompañado de Aquineton (biperideno) 2mg diario ( en la mañana). Alergil no funciona 3. Benzodiacepinas: • Prozapina, olanzapina, quetiapina, risperidona: Producen sueño • Flurazidona, olanzapina, pariperidona, quetiapina, olanzapina hay en Honduras. Risperidona ya no • Hiperprolactinemia: prozapina ( Este aumenta apetito) • Para aumento de apetito: Quetiapina ( da mucho sueño), entonces olanzapina • Medicamento que bloquea potentemente al H1 es la Clozapina, por lo que da más sueño • Medicamento que daña más a 5HT2A y 5HT2C es Olanzapina, por lo que está contraindicado en pacientes obesos

Comparative Anatomical Evaluation of Hippocampal Sclerosis in Mesial Temporal Epilepsy