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SK298 - Brain, the mind & mental health > Week 14 - Biology and treatment of psychosis > Flashcards

Week 14 - Biology and treatment of psychosis Flashcards

1
Q

What are the lateral ventricles and what do they contain?

A

They are spaces in the brain that are filled with CSF

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2
Q

Where is CSF produced and what is its function?

A
  • Produced by the choroid plexus
  • Provides physical protection and physiological maintenance to the brain
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3
Q

What area of the brain shows a difference in size in people with schizophrenia?

A

The lateral ventricles

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4
Q

What type of brain drug could explain the larger lateral ventricles seen in some individuals with schizophrenia?

A

It’s possible that the amount of brain tissue surrounding the lateral ventricles has decreased - the ‘shrinkage’ would then allow more space for the ventricles to fill with CSF

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5
Q

What is the name of the top branch of the lateral ventricles?

A

The anterior horn

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6
Q

What is the name for the bottom branch of the lateral ventricles?

A

The inferior or temporal horn

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7
Q

What change in the ventricles has been noted in some individuals with SSDs?

A

They are found to be enlarged

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8
Q

What information does the amygdala process?

A

Information regarding emotions, learning and memory

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9
Q

What change in the amygdala has been found in some individuals with SSDs?

A

It has been found to be overactive

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10
Q

What is the hippocampus important for?

A

Learning and memory

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11
Q

What changes are noted in the hippocampus in some individuals with SSDs?

A

It may be reduced in size

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12
Q

What type of projcetions does the hippocampus send to the nucleus accumbens?

A

Glutaminergic projections

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13
Q

What does the nucleus accumbens play an important role in?

A

Reward-related learning

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14
Q

What does the ventral palladium play a critical role in?

A

Processing and execution of motivated behaviour

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15
Q

What type are many of the neurons in the ventral palladium?

A

GABAergic

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16
Q

What is meant by the term projection neuron?

A

A neuron whose axon extends from one region or structure of the CNS to another (sometimes distant) region or structure

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17
Q

What are medium spiny neurons (MSNs)?

A

A type of GABAergic inhibitory projection neuron

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18
Q

What type of interneurons and projection neurons are in the amygdala?

A
  • GABAergic interneurons
  • Glutamatergic projection neurons
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19
Q

What effect do the GABAergic interneurons in the amygdala have?

A

They modulate (decrease) glutamatergic projection neuron activity

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20
Q

In SSDs, what is thought to be the the effect that glutamatergic projections from the PFC have on the activity of the GABAergic interneurons of the amygdala?

A

They might fail to properly modulate (increase)

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21
Q

If GABAergic interneurons in the amygdala fail to modulate the glutamatergic projection neurons, what will happen to the glutamatergic projection neurons of the amygdala?

A

They will become overactive

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22
Q

What can happen to the projection from the amygdala to the hippocampus in people with SSDs?

A

It cam become overactive

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23
Q

If the projection from the amygdala to the hippocampus becomes overactive, what can the resulting effect be?

A

It will contribute to damage of GABAergic interneurons in the hippocampus

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24
Q

What is the effect on the hippocampus if its GABAergic interneurons are damaged?

A

It can lead to a reduction in the size of the hippocampus

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25
Q

If GABAergic interneurons in the hippocampus are damaged, what effect can this have on the nucleus accumbens?

A

The excitability of glutamatergic projections to the NAc cannot be controlled

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26
Q

If excitability of glutamatergic projections to the NAc cannot be controlled, what is the effect on the nucleus accumbens?

A

It leads to hyperactivity of the NAc

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27
Q

What is the name of the GABAergic neurons in the nucleus accumbens?

A

Medium spiny neurons (MSNs)

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28
Q

Is the GABAergic pathway of medium spiny neurons which projects from the nucleus accumbens to the ventral palladium inhibitory or excitatory?

A

Inhibitory

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29
Q

In SSDs, is the nucleus accumbens likely to be hypo- or hyperactive?

A

Hyperactive

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30
Q

Which type of neurons are found in the ventral tegmental area?

A

Dopamine neurons?

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31
Q

Where do some of the dopaminergic neurons of the ventral tegmental area project to?

A

The nucleus accumbens

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32
Q

Via which pathway do some of the dopaminergic neurons of the ventral tegmental area project to the ventral tegmental area?

A

Via the mesolimbic dopamine pathway

33
Q

Via which pathway do some of the dopaminergic neurons of the ventral tegmental area project to the prefrontal cortex?

A

The mesocortical dopamine pathway

34
Q

In SSDs, hyperactivity of the hippocampus could lead to what type of activity in the mesolimbic and mesocortical dopaminergic pathways?

A

Enhanced

35
Q

Which structures are found to be enlarged in some people with SSDs?

A

The lateral ventricles

36
Q

Which brain structure is reduced in size in some people with SSDs?

A

The hippocampus

37
Q

Which neurotransmitter pathway connects the amygdala with the hippocampus?

A

Glutamatergic

38
Q

Which neurotransmitter is released by the medium spiny neurons located in the nucleus accumbens which project into the ventral palladium?

A

GABA

39
Q

In studies of twins, if one twin has SSD-associated reduction in the size of their hippocampus, is it likely that the other twin will also have a reduction in the volume of their hippocampus?

A

No

40
Q

In people with an SSD, what is the effect on the activity level of neurons in their hippocampus?

A

Activity levels are higher, especially during hallucinations

41
Q

What effect on the density of GABAergic interneurons in the hippocampus has been noted in some people with schizophrenia?

A

A mared reduction in the density

42
Q

What is meant by the term disinhibited?

A

When an excitatory neuron becomes more active because it is no longer inhibited by another neuron

43
Q

In people with SSDs, what are three effects of dysregulated hippocampal function?

A
  • As the hippocampus is vital to the formation of new memories, people with SSDs may have difficulty in remembering words which are presented to them
  • Spatial memory is processed in the hippocampus and so also disrupted in those with SSDs
  • Individuals with SSDs are slower at becoming familiar with, or habituated to, stimuli that are repeatedly shown to them
44
Q

What is meant by the term habituation?

A

The gradual decrease in response to a stimulus that is constantly present or frequently encountered

45
Q

What is the hypothalmic-pituitary-adrenal axis (HPA axis)?

A

A pathway connecting the hypothalamus, pituitary gland and adrenal glands

46
Q

What activates the HPA axis (hypothalamic-pituitary-adrenal axis)?

A

Stress

47
Q

If stress activates the HPA axis (hypothalmic-pituitary-adrenal axis) what hormone is released into the body?

A

Cortisol

48
Q

What is a potential negative consequence of high cortisol levels?

A

Damage to the hippocampus

49
Q

What type of projections does the amygdala send to the hippocampus?

A

Glutamatergic projections

50
Q

In animal experiments, what consequence was found in response to overactivity of the glutamatergic projections from the amygdala to the hippocampus?

A

Damage to GABAergic interneurons in the hippocampus

51
Q

Will the activity of glutamatergic projection neurons from the hippocampus be altered if GABAergic interneurons are damaged in this region?

A

Yes - the hippocampus may become overly excited because the GABAergic neurons can no longer inhibit the glutamatergic neurons

52
Q

How may the brain help alleviate some of the damage to hippocampal GABAergic neurons caused by an overactive amygdala?

A

Certain areas of the PFC send glutamatergic axons to the amygdala which results in inhibition of parts of the amygdala

53
Q

Is overactivity or underactivity of the hippocampus associated with psychosis?

A

Overactivity

54
Q

If you can prevent damage to GABAergic interneurons of the hippocampus by decreasing glutamatergic input from the amygdala to the hippocampus, would this increase or decrease the excitation of the glutamatergic neurons that project from the hippocampus?

A

Decrease

55
Q

Excitatory glutamatergic neurons of the hippocampus are thought to be over- or underactive in people with an SSD?

A

Overactive

56
Q

Excessive excitation of the glutamatergic neurons of the hippocampus may have what indirect effect?

A

Exaggerated dopamine neurotransmission in the brain

57
Q

Which region in the brain has cell bodies of dopaminergic neurons which send projections to the nucleus accumbens and the prefrontal cortex?

A

Ventral tegmental area

58
Q

As well as receiving dopamine input from the ventral tegmental area, what other input does the nucleus accumbens receive?

A

Glutamate input from the hippocampus

59
Q

Would glutamate release from the hippocampus increase or inhibit the activity of neurons in the nucleus accumbens?

A

Increase, as glutamate is an excitatory neurotransmitter

60
Q

What is the name for the GABAergic neurons in the nucleus accumbens which receive dopamine and glutamate input?

A

Medium spiny neurons

61
Q

Where do the medium spiny neurons in the nucleus accumbens project to?

A

The ventral pallidum

62
Q

Would the GABAergic neurons of the nucleus accumbens known as medium spiny neurons excite or inhibit the neurons of the ventral pallidum?

A

Inhibit, as GABA is an inhibitory neurotransmitter

63
Q

If active neurons of the ventral pallidum are active and thus inhibiting the ventral tegmental area, what impact might there be on dopamine release in the nucleus accumbens and prefrontal cortex?

A

Inhibiting the dopamine neurons may reduce dopamine release in the target regions

64
Q

In SSDs the hippocampus may be overactive. How might this affect dopamine release in the nucleus accumbens and the prefrontal cortex?

A

If dopamine neurons in the ventral tegmental area are disinhibited they are more likely to be active and release dopamine in the nucleus accumbens and prefrontal cortex

65
Q

In people with SSDs, what effect may amphetamine have?

A

As it increases dopamine neurotransmission, it may induce symptoms of psychosis

66
Q

What and when was the first antipsychotic drug to be discovered?

A
  • Chlorpromazine
  • 1950s
67
Q

What was chlorpromazine originally developed for?

A

To reduce pre-operative anxiety

68
Q

How are D1 and D2 receptors similar?

A

They both metabotropic receptors that bind dopamine in the brain

69
Q

How are D1 and D2 receptors different?

A
  • D1 receptors are located on the postsynaptic membrane and are considered stimulatory
  • D2 receptors are located on both the postsynaptic and presynaptic membranes and are considered inhibitory
70
Q

How would a drug function if it is considered to be an agonist at D2 receptors?

A

The drug would bind to the receptors and prevent dopamine from binding and having its usual physiological effects

71
Q

What are first-generation antipsychotics most effective at doing?

A

Eliminating (or at least reducing) positive symptoms of psychosis such as hallucinations and delusions

72
Q

What are second-generation antipsychotics most effective at doing?

A

They may decrease positive, negative and cognitive symptoms of SSDs

73
Q

What was the original second-line antipsychotic drug?

A

Clozapine

74
Q

Is clozapine or chlorpromazine more effective at reducing aspects of psychosis?

A

Clozapine

75
Q

As well as targetting D2 receptors, how else does clozapine work?

A

It can decrease dopamine function in mesolimbic areas such as the nucleus accumbens, while increasing dopamine transmisison in the prefrontal cortex

76
Q

What effect may clozapine have on D1 receptors in the prefrontal cortex?

A

It may be an agonist

77
Q

What is the effect on the neuron when dopamine binds to D1 receptors?

A

It has a stimulatory effect on the neuron

78
Q

What theory underlies CBT?

A

It focuses on a person’s goals and what is currently impacting their life and considers that how a person thinks can influence feelings and behaviour

79
Q

In individuals with schizophrenia, what effect may exercise have in the brain?

A

It may increase hippocampal size

SK298 - Brain, the mind & mental health (19 decks)

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