Reactive attachment disorder
child is withdrawn, due to neglect, often linked to orphanages etc
Disinhibited social engagement disorder
Interacts with anyone incl strangers (diminished checking back when walking away), due to neglect, links to high risk groups, presents like williams
ASD issues with cognitive, joint attention skills, face processing etc
cog- weak central coherence (difficulty predicting seq of events, understanding big picture, playing pretend), problems initiating joint attention where someone points at something to draw attention to it, get someone to do something eg balloon etc (BEST PREDICTOR OF ASD) -look all over face rather than eye contact -issues w theory of mind/ mind blindness, showing empathy, responsiveness to others (do show attachment to caregivers)
brain growth abnormalities in various structures -increased local connections but decreased distal (pruning issue)
What is the biggest buffer of stress for a kid?
Epigenetics that can be heritable from ACEs (adverse childhood experiences)?
Methylation model histone modification, and telomere shortening (more telomerase in pts with high ACE and premature aging)
Best model for primary care approach to ACEs?
Proactive (better than reactive), screen prenatal patients, screen early adolescents, screen everyone to understand chronic dis risks
PAPEZ CIRCUIT fxn and pathway?
for emotional behavior! (core of limbic system) MACH 1: HC > mammillary body (via fornix) > ant thalamic nucl > cingulate gyrus > HC
YAKOVLEV'S CIRCUIT fxn and path?
discovered later, included basolateral structures for more visceral aspects of emotion (command center for 4 f's) DORSOMEDIAL thal mucl > orbitofrontal cortex (OFC) > temporal pole of amygdala (via uncinated fasc) > HC, connects it to papez's circuit and also transmits signal back to thalamus to begin again
structures of the limbic sys include?
hypothal extends from
lamina terminalis (ant) to mamm bodies (post)
amygdala location and divisions?
medial aspect of temporal pole near uncus (kinda above/in front of HC?)
div into: corticomedial for olfaction, central for autonomic responses, and basolateral for emotional attachments
near/under septum pellucidum of brain, bulges near bottom of ventricles, above hypothal
cingulate gyrus location and divisions
mesocortex near CC (the gyrus on top of it)
anterior portion- drive and emotion
posterior portion- attention, awareness, memo
what structures is the HC formation made of? subdivisions
made of subiculum, dentate gyrus, and HC proper
-divided into 4 sections based on histo: CA1-4 (CA4 more inward into curly part)
what are the "4 different elements of the limbic system"?
the CINGULUM, FORNIX, MAMMILLOTHALAMIC TRACT, and PERFORANT PATHWAY
subcallosal gyrus, cingulate gyrus, HF
HF, septal area, basal forebrin, thalamus, mamm bodies
mammillothalamic tract connects (intuitive)
mamm bodiy, ant nucl of thalamus
perforant pathway fxn and connects
spatial memo path
where are memories stored and where do they travel when recalled?
stored in cortex, and travel to enterohinal cortex then HF
types of memo
declarative- explicit like episodic and semantic
nondeclarative- implicit like skills
and sensory memo
4 stages of memo formation
encoding, storage, retrieval and recogniition
long term potentiation pathway
NMDA rec usu blocked by Mg2+
but stmulation by glutamate will force off Mg ions and allow calc to enter, changes post syn membranes of neurons leading to LTP, incr EPSPs and more connections to other elements in HC (CA1-4)
amygdala affects attachement of emotion (eg see actor and feel good)
septal nucl MAYBE deals w. aggression
cingulate gyrus affects cog and beh, lesions here can reduce drive (abulia), assoc with psych disorders like OCD, tourettes, depr (stim subgenul gyrus may help intractble depr)
hypothal- feeding disorders and aggro, innate
HF- memo formation, smell/olfaction in memo
frontal lobes- modulate emo drive, inhibition
what can lesion to cingulate gyrus do?
produce abulia (reduce drive, since cing gyrus affects cog/beh), and affect psych disorders (but can stim subgenual gyrus to help with depr)
KLUVER-BUCY (monkeys) / PICK'S (humans)
where is lesion/ sx?
lesion to bilat ant temporal lobe
decr aggro, limited fear resp, indiscriminate sexual beh, oral fixtion, distractibility
from alcoholism (thiamine def)
can cause ataxia, confusion, ophthalmoplegia, have to create stories to fill in memo gaps, anterograde memo issues (issues w new memo)
another name for the limbic system?