neurobiology of mental health

Question 1

what are ‘stress’ risk factors of schizophrenia?

Answer 1

• hypoxia in utero
• perinatal injury or trauma
• migration
• canabi use

Question 2

what are genetic predisposing factors of schizophrenia?

Answer 2

• COMT
• • dysbindin 1
• NRG1
• they are polygenic and have partial penetrance

Question 3

what are positive sx of schizophrenia?

Answer 3

Voices,

delusions

thought insertion/withdraal/broadcast

Question 4

what are negative sx of schizophrenia?

Answer 4

Neglect,

isolation,

lack of emotional expression

avolition

Question 5

what are cognitive sx of schizophrenia?

Answer 5

Reduced concentration and attention

reduced executive functioning (ability to plan complex tasks)

Question 6

what is the precursor to dopamine?

Answer 6

tyrosine

Question 7

what typeof receptor is the dopamine receptor?

Answer 7

g coupled

Question 8

what does dopamine do?

Answer 8

Executive functions
 Motor control 
Motivation 
Reward 
Lactation- inhibits prolactin so stops lactation  
Nausea

Question 9

which ares of the brain is dopamine evolved in?

Answer 9

• mesolimbic
• nigrostraital
• mesocortical
• tuberoinfundibulnar

Question 10

what happens to the dopamine pathways in schizophrenia?

Answer 10

• too much dopamine in the mesolimbic pathway responsible for the positive sx
• too little dopamine in the mesocortical pathway- responsible for the negative sx

Question 11

what sx are typical antipsychotics good at addressing?

Answer 11

Typical antipsychotics are D2 receptor antagonists.
This means they block the effect of dopamine at the level of the synapse.
Therefore most effective at addressing +ve symptoms

Question 12

what is the effect of typicalantipsychotics on the tuberinfundibulary pathway?

Answer 12

Dopamine has inhibitory effect on prolactin release.
Reduced dopamine by D2 antipsychotics therefore causes
Hyperprolactinaemia

Question 13

what are the effects of atypical antipsychotics?

Answer 13

5HT2 antagonists

• clozapine
• quitiepine
• respiridone
• olanzapine

Question 14

what are neuroanatomical changes that occur in schizophrenia?

Answer 14

• enlarged ventricles
• reduced grey matter volume
• decreased gyrification
• loss of symmetry of planum temporale- associated with auditory processing

Question 15

what are some organic causes of schizophrenia?

Answer 15

• NMDA receptor autoimmune encephalitis
• temporal lobe epilepsy
• huntingtons
• Wilson disease
• Parkinson’s disease

Question 16

what sign should you look for for wilson’s disease?

Answer 16

kayer Fleischer ring in eyes

Question 17

what causes wilsons disease?

Answer 17

• autosomal recessive disease affecting ATP7B gene

leads to copper deposition in brain and liver

Question 18

what is the triad for autism?

Answer 18

• limited repertoire
• reduced social interaction
• reduced communication

Question 19

what are 2 practical ways that autism can be tested?

Answer 19

• sally anne test to show theory of mind hypothesis of lacking in empathy
• nano test to show over systemisation

Question 20

what have functional scan shoed about autism?

Answer 20

• hypoactive fusiform gyrus in response tp faces - may be y they can’t recognise emotion in others

Question 21

what is the triad for ADHD?

Answer 21

• Attention difficulties
• Impulsivity
• Hyperactivity

Question 22

where do individuals have deficits in ADHD?

Answer 22

deficit in executive functioning (planning)

and delayed rewards (delay aversion)

Question 23

Where does executive function come from?

Answer 23

frontal lobe.

Question 24

what areas of the brain are involved in delayed aversion?

Answer 24

amygdala and frontal lobe.

Question 25

which neurotransmitters are abnormal in ADHD patients?

Answer 25

dopamine and noradrenaline

Question 26

what does FMRI show in ADHD patients?

Answer 26

If someone with ADHD knows a delay is coming, we can see over activation of the prefrontal cortex and amygdala.

Question 27

what medications are given for ADHD

Answer 27

Noradrenaline and Dopamine Reuptake inhibitors. Methylphenidate (Ritalin)

Question 28

what brain changes are observed in bipolar?

Answer 28

Loss of prefrontal cortex mass and progressive hypoactivation Sustained hyperactivity of amygdala and increasing volume size

Question 29

what are the 3 main sx of depression?

Answer 29

Low mood Anhedonia Tiredness

Question 30

what are supplementary sx of depression?

Answer 30

Cognitive (hopelessness, helplessness, worthlessness, guilt, poor concentration, poor attention, lack of motivation) Somatic (early morning waking, loss of appetite, weight loss, libido) Motor symptoms (slow motor movements – “Motor Retardation”)

Question 31

what is evidence of the involvement of serotonin in depression?

Answer 31

Dietary depletion of tryptophan (precursor for serotonin) can cause relapse of depression Reserpine – An antihypertensive that causes rapid depletion of serotonin in the synaptic cleft classically causes depression Selective Serotonin Reuptake Inhibitors (SSRIs) work by blocking the reuptake of serotonin in to the pre-synaptic neuron

Question 32

where does serotonin project from?

Answer 32

raphe nucleus

Question 33

where does noradrenaline project from?

Answer 33

Locus Coreleus to innervate the limbic system and frontal lobe

Question 34

which drugs inhibit rey-take of noradrenaline and serotonin?

Answer 34

Venlafaxine, Duloxetine

Question 35

how cab stress relate to anxiety?

Answer 35

Chronic stress exposure with prolonged raised cortisol is closely associated with anxiety disorders

Question 36

which area of brain shrinks in PTSD?

Answer 36

hippocampus

Question 37

what is the cascade of events in PTSD?

Answer 37

Trigger (e.g. smell) Hippocampus recalls fragment of memory (e.g. image) Amygdala reacts to memory (“flashback”) Pre-frontal cortex unable to rationalise the situation. Unable to recognise person is safe Person attempts to avoid or escape