Lecture 20 - Cognitive Disorders (Schizophrenia)

Question 1

list the three major diagnostic criteria for schizophrenia

Answer 1

• episode lasts for at least six months
• at least one month of active symptoms
• often associated with anhedonia (inability to experience joy)

Question 2

what are positive symptoms of schizophrenia?

Answer 2

add an abnormal stimulus (hallucinations, delusions, illogical changes in behaviour/thought)

Question 3

what are negative symptoms of schizophrenia?

Answer 3

take away a normal stimulus (lack of motivation/interest, blunted emotion (anhedonia), reduced speech, diminished social interaction)

Question 4

what are cognitive symptoms of schizophrenia?

Answer 4

reduced ability to process and use information

Question 5

what is the prevelance rate of schizophrenia?

Answer 5

0.5-1.0% across the world

Question 6

what is the incidence rate of schizophrenia?

Answer 6

1/10 000 per year

Question 7

why is the incidence rate of schizophrenia lower than the prevalence rate?

Answer 7

because schizophrenia tends to be chronic

Question 8

what is the peak age of onset for schizophrenia for men and women?

Answer 8

• 15-25 for men
• 25-35 for women

Question 9

what is the usual treatment for schizophrenia?

Answer 9

drug therapy (wide range of antipsychotics)

Question 10

what are the two main avenues of research for the neuropathology of scizophrenia?

Answer 10

• neurotransmitter imbalance
• neurodegeneration

Question 11

is there a genetic component to schizophrenia?

Answer 11

there is evidence from family and twin studies, but no genetic markers yet

Question 12

having a first degree family member with schizophrenia increases your risk of developing schizophrenia by:

Answer 12

10x

Question 13

go review slide 626

Answer 13

there is simply no way to write that all down

Question 14

a gene strongly associated with schizophrenia and other neuropsychiatric disorders that regulates the birth of new neurons in the adult brain

Answer 14

the “distrupted in schizoprhenia 1” (DISC1) gene

Question 15

the identification of the DISC1 gene supports a controversial theory linking diseases such as schizophrenia and depression to:

Answer 15

neurogenesis (and provides new potential treatments of psychiatric conditions)

Question 16

what does DISC1 do?

Answer 16

regulates neuronal progenitor proliferation via modulation of GSK3beta/beta-catenin signaling

Question 17

suppression of DISC1 expression reduces _____, leading to _____

Answer 17

neural progenitor proliferation, premature cell cycle exit and differentiation

Question 18

proteins involved in cell adhesion

Answer 18

catenins

Question 19

GSK3beta is a:

Answer 19

kinase

Question 20

typical antipsychotics are dopamine receptor antagonists at:

Answer 20

D2-like receptors (D2/3/4)

Question 21

give two examples of typical antipsychotics

Answer 21

haldol (haliperidol) and largactil (chlorprozamine)

Question 22

list the unwanted side effects of typical antipsychotics

Answer 22

dystonia (causes muscle contractions), Parkinsonism, and tardive dyskinesia

Question 23

list three examples of atypical antipsychotics

Answer 23

• clozaril (clozapine)
• risperdal (risperidone)
• zyprexa (olanzepine)

Question 24

why were atypical antipsychotics developed?

Answer 24

to have less unwanted side effects

Question 25

atypical drugs are potent antagonists at the:

Answer 25

5-HT receptors (particularly 5-HT2)

Question 26

true or false: balance between 5-HT and dopamine receptor antagonism is suggested as a therapeutic mechanism of action for atypical antipsychotics

Answer 26

true

Question 27

list the major components of the mesocorticolimbic dopamine pathway

Answer 27

the ventral tegmental area (VTA) projects to the nucleus accumbens septi (NAS) and the prefrontal cortex (PFC)

Question 28

increases in dopamine activity in the mesolimbic pathway (VTA --> NAS) cause:

Answer 28

positive symptoms of schizophrenia

Question 29

dopamine hypoactivity in the mesocortical pathway (VTA --> PFC) causes:

Answer 29

negative and cognitive symptoms of schizophrenia

Question 30

list the major projections of 5-HT in the brain

Answer 30

from the dorsal and median raphe nuclei to the septum, hippocampus, VTA, NAS, and cortex

Question 31

where are the major serotonin producing cells found?

Answer 31

the raphe nuclei

Question 32

mesencephalic serotonin neurons project to the:

Answer 32

thalamus, basal ganglia, and cortex (see 636)

Question 33

schizophrenia is conceptualized as a _____ disorder

Answer 33

brain connectome

Question 34

schizophrenia can emerge as early as:

Answer 34

late childhood and adolescence

Question 35

see slide 638

Answer 35

seems important but i don't really know how to break it down

Question 36

studies of regional pathways in early onset schizophrenia highlight disruptions in the:

Answer 36

triple resting state networks (frontoparietal, salience, and default mode) and the cerebello-thalamo-cortical pathway in both functional and structural networks

Question 37

- gray matter volume pruning - enhanced strucutral and functional connectivity - improved structural connectome efficiency - differentiated modules in the functional connectome during late childhood and adolescence these are all characteristics of:

Answer 37

typical neurodevelopment

Question 38

- excessive gray matter volume decline - cortical thinning - reduced information processing efficiency in the structural brain network - dysregulated maturation of the functional brain network these are all chracteristics of:

Answer 38

early onset schizophrenia neurodevelopment

Question 39

common functional connectome disruptions of default mode regions were found in:

Answer 39

early and adult onset patients

Question 40

individuals with schizophrenia with negative symptoms exhibit deficits similar to patients with:

Answer 40

damage to the dorsolateral frontal cortex

Question 41

true or false: schizophrenia is typically a chronic progressive illness

Answer 41

true

Question 42

is it possible that schizophrenia is a complex set of disorders, and not simply one entity?

Answer 42

yes

Question 43

although drug therapy can decrease the expression of symptoms, the course of schizophrenia tends to follow a:

Answer 43

downward spiral