Ch 19- Neurobiology of Schizophrenia, Mood Disorders & Anxiety Disorders
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Questions and Answers

Which factor is LEAST likely to be implicated in the etiology of depression?

  • Genetic predisposition
  • Environmental stressors
  • Neurochemical imbalances
  • Elevated levels of monoamine metabolites in CSF (correct)
  • According to the diagnostic criteria, how many symptoms must be present within a two-week period to diagnose major depression?

  • All nine symptoms must be present
  • At least two, including either depressed mood or loss of interest
  • Five or more, with at least one being either depressed mood or loss of interest of pleasure (correct)
  • At least three, including one of the core symptoms
  • What percentage of weight change in a month is considered a significant symptom of major depression?

  • Greater than 1%
  • Greater than 3%
  • Greater than 5% (correct)
  • Greater than 10%
  • Which neurochemical is NOT directly implicated in the monoamine hypothesis of depression?

    <p>Acetylcholine (D)</p> Signup and view all the answers

    Dysphoric mood is best described as:

    <p>A feeling of dissatisfaction, unease, and unhappiness (D)</p> Signup and view all the answers

    What is the current prevailing understanding of the etiology of mood disorders?

    <p>A complex interplay between genes and environment (D)</p> Signup and view all the answers

    Alterations in which brain region and neurotransmitter receptor have been found in suicide victims?

    <p>Frontal cortex; norepinephrine receptor alterations (A)</p> Signup and view all the answers

    Which specific serotonin receptor subtype shows decreased binding in the frontal, temporal, and limbic cortex of depressed individuals?

    <p>5-HT1A (A)</p> Signup and view all the answers

    Which of the following is a symptom of a manic episode?

    <p>Elevated mood (C)</p> Signup and view all the answers

    What neurotransmitter status is associated with bipolar mania?

    <p>Elevated monoamines (B)</p> Signup and view all the answers

    Which of the following is a common side effect of MAOIs?

    <p>Dry mouth (C)</p> Signup and view all the answers

    What physiological change is noted in individuals with depression?

    <p>Elevated cortisol levels during night (D)</p> Signup and view all the answers

    Which locus is linked to the genetic predisposition of bipolar disorder?

    <p>Chromosome 22 (B), Chromosome 18 (C)</p> Signup and view all the answers

    How do proinflammatory cytokines relate to depression?

    <p>They may trigger chronic elevations in cortisol. (C)</p> Signup and view all the answers

    Which of the following foods can induce hypertensive crisis in MAOI users?

    <p>Aged cheeses (D)</p> Signup and view all the answers

    Which brain regions are linked to structural alterations in depression?

    <p>Frontal lobe and limbic system (A)</p> Signup and view all the answers

    What is one main characteristic of schizophrenia?

    <p>Break in reality or thought disorders (A)</p> Signup and view all the answers

    Which neurotransmitter system is primarily implicated in the pathogenesis of schizophrenia?

    <p>Dopamine (A)</p> Signup and view all the answers

    What structural brain abnormality is commonly associated with schizophrenia?

    <p>Enlargement of lateral and third ventricles (B)</p> Signup and view all the answers

    What role does glutamate play in schizophrenia?

    <p>Under activation of its receptors contributes to the disorder (A)</p> Signup and view all the answers

    Which of the following factors is associated with the risk of developing schizophrenia?

    <p>Maternal viral infections during pregnancy (D)</p> Signup and view all the answers

    What is believed to be the effect of reduced thalamus size in individuals with schizophrenia?

    <p>Disruption in neurotransmission between cortex and sensory areas (A)</p> Signup and view all the answers

    Which enzyme's reduction is associated with impaired cognitive and emotional functions in schizophrenia?

    <p>Glutamic acid decarboxylase (B)</p> Signup and view all the answers

    What percentage of the world’s population is affected by schizophrenia?

    <p>1% (D)</p> Signup and view all the answers

    Which brain area is primarily associated with cognitive problem-solving impairments in adolescents with early onset issues?

    <p>Dorsolateral prefrontal cortex (A)</p> Signup and view all the answers

    What is one of the positive symptoms of schizophrenia linked to excess dopamine?

    <p>Auditory hallucinations (B)</p> Signup and view all the answers

    Which of the following is a negative symptom associated with prefrontal pathologies in schizophrenia?

    <p>Alogia (D)</p> Signup and view all the answers

    Which mood disorder is characterized by chronic and uncontrollable emotional states like sadness?

    <p>Unipolar depression (A)</p> Signup and view all the answers

    What role does Reelin play in the brain?

    <p>Involved in neuronal migration and synaptic function (B)</p> Signup and view all the answers

    What structural change is commonly associated with cognitive impairments in patients with schizophrenia?

    <p>Cerebral ventricular changes (D)</p> Signup and view all the answers

    Which neurotransmitter alterations are related to depression symptoms?

    <p>Decreased norepinephrine and serotonin (B)</p> Signup and view all the answers

    Which cognitive function is predominantly impaired in individuals with dorsal prefrontal cortex changes?

    <p>Goal-oriented activity initiation (B)</p> Signup and view all the answers

    What is a primary characteristic of generalized anxiety disorder (GAD)?

    <p>Persistent, excessive worrying about various life events (A)</p> Signup and view all the answers

    What is commonly associated with major depression concerning the HPA axis?

    <p>Chronic activation and elevated glucocorticoids (C)</p> Signup and view all the answers

    What percentage of individuals may find relief from depressive symptoms through ECT?

    <p>50% to 80% (C)</p> Signup and view all the answers

    Which brain structures are associated with emotional and cognitive functions that ECT may increase in volume?

    <p>Hippocampus and amygdala (D)</p> Signup and view all the answers

    Which cytokines are known to be increased due to psychosocial stress in individuals with depression?

    <p>Interleukin-1α and IL-6 (D)</p> Signup and view all the answers

    Which of the following is NOT a factor for using ECT?

    <p>Mild depressive symptoms (C)</p> Signup and view all the answers

    What brain region has been reported to have reduced volume in individuals with depression?

    <p>Frontal lobe (D)</p> Signup and view all the answers

    In terms of neurogenesis, what has been identified in animal models of stress-induced depression?

    <p>Reduction in new hippocampal neurons (D)</p> Signup and view all the answers

    What type of treatment is considered first-line for alleviating symptoms of GAD?

    <p>Norepinephrine reuptake inhibitors and SSRIs (A)</p> Signup and view all the answers

    Which of the following abnormalities is associated with generalized anxiety disorder?

    <p>Decreased serotonin levels in CSF (A)</p> Signup and view all the answers

    What percentage of individuals with major depressive disorder may show alterations in the hypothalamic-pituitary-thyroid system?

    <p>20% to 30% (C)</p> Signup and view all the answers

    What neurobiological changes may occur after ECT treatment?

    <p>Neurogenesis and increased hippocampal volume (A)</p> Signup and view all the answers

    Bipolar I disorder is characterized by which of the following features?

    <p>Manic episodes and at least one major depressive episode (D)</p> Signup and view all the answers

    Which area of the brain showed elevated activity associated with anticipatory anxiety in GAD?

    <p>Cingulate cortex (B)</p> Signup and view all the answers

    Which hormone's levels are blunted in response to TRH challenge in some individuals with MDD?

    <p>Thyroid-stimulating hormone (TSH) (D)</p> Signup and view all the answers

    What effect does chronic depression have on cortisol levels?

    <p>Cortisol levels remain chronically elevated (A)</p> Signup and view all the answers

    Flashcards

    Symptoms of a manic episode

    Characteristics such as elevated mood, irritability, and decreased sleep.

    Monoamine hypothesis of depression

    Suggests depression is linked to reduced brain monoamines like norepinephrine and serotonin.

    Cortisol in depression

    Persistent high cortisol can lead to immunosuppression and trigger depression.

    Altered brain structures in depression

    Structural changes include reduced volumes in the frontal lobe and limbic system.

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    Cytokines and depression

    Pro-inflammatory cytokines can increase and compound symptoms of depression.

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    Side effects of MAOIs

    Common side effects include sedation, insomnia, and dry mouth, plus risk of hypertensive crisis.

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    Bipolar vs. Depression

    Bipolar has elevated neurotransmission while depression has reduced levels.

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    Risk factors for MDD

    Includes stress, genetic predisposition, and serotonin dysfunction.

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    Schizophrenia

    A mental disorder characterized by thought disorders and a disconnect between cognitive and emotional functions.

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    Heritable disorder

    A disorder influenced by genetic factors, not strictly determined by them.

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    Glutamate receptors

    Neurotransmitter receptors involved in cognition, whose underactivation is linked to schizophrenia.

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    Dopaminergic neurotransmission

    Neurotransmission involving dopamine, which is reduced in schizophrenia, particularly affecting negative symptoms.

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    Lateral and third ventricles

    Brain structures that may enlarge in individuals with schizophrenia, associated with cognitive impairments.

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    Thalamus reduction

    A decrease in thalamus size that may impact communication between brain areas.

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    Maternal infections

    Illnesses during pregnancy that can lead to neurodevelopmental defects in the fetus, increasing schizophrenia risk.

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    Temporal lobe alterations

    Changes in the temporal lobe that may contribute to positive symptoms in schizophrenia.

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    MAOIs

    Monoamine oxidase inhibitors, a type of antidepressant with significant side effects.

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    ECT

    Electroconvulsive therapy, a treatment for severe depression producing brain changes.

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    ECT effectiveness

    ECT alleviates depressive symptoms in 50% to 80% of patients.

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    Hippocampal volume

    Volume of the hippocampus related to mood and emotion may increase after ECT.

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    Generalized Anxiety Disorder (GAD)

    Characterized by excessive, persistent worrying about various life events.

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    Neurotransmitter deficiencies in GAD

    GAD is linked to reduced norepinephrine and serotonin systems.

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    Cingulate cortex activity

    Heightened activity in this area is associated with anticipatory anxiety in GAD.

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    Treatment for GAD

    First-line treatments include norepinephrine reuptake inhibitors and SSRIs.

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    Cortical gray matter loss

    Progressive decrease in cortical gray matter in adolescents due to early onset disorders.

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    Dorsolateral prefrontal cortex

    Brain area linked to goal-directed and cognitive problem-solving behaviors that shows functional alterations.

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    Reelin protein

    Extracellular matrix protein critical for neuronal migration and synaptic function that is reduced in certain disorders.

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    Positive symptoms of schizophrenia

    Symptoms linked to excess dopamine, including delusions and hallucinations.

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    Negative symptoms of schizophrenia

    Symptoms linked to prefrontal pathologies such as lack of speech and pleasure.

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    Mood disorders

    Emotional states like sadness or mania that become chronic and are uncontrollable.

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    Unipolar depression

    Major or clinical depression characterized by persistent sad mood without manic episodes.

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    Bipolar disorder

    Mood disorder characterized by alternating episodes of mania and depression.

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    Major Depression

    A mood disorder characterized by persistent sadness, loss of interest in activities, and various physical symptoms over at least two weeks.

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    Symptoms of Depression

    Five or more symptoms including depressed mood, significant weight changes, insomnia, and feelings of worthlessness.

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    Genetic Predisposition

    The genetic component that makes individuals more susceptible to mood disorders when paired with environmental stressors.

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    Neurochemical Dysregulation

    An imbalance of neurotransmitters like norepinephrine, dopamine, and serotonin contributing to depression.

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    Monoamine Hypothesis

    The theory suggesting that a deficiency in monoamines (norepinephrine, serotonin, dopamine) is a key factor in depression.

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    Neuroanatomic Abnormalities

    Changes in brain structures and functions, such as receptor alterations linked to depression and suicide.

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    Serotonin 5-HT1A Receptor

    A specific serotonin receptor subtype whose binding is reduced in depressed individuals.

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    Psychomotor Agitation

    An increase in physical movement or restlessness often seen in depressed individuals.

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    Frontal Lobe Volume in Depression

    Depressed individuals often show reduced frontal lobe volume.

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    Temporal Lobe Volume Changes

    Bipolar illness is linked to decreased or asymmetric temporal lobe volume.

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    HPA System Activation

    Chronic stress activates the HPA system, leading to elevated glucocorticoids in depression.

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    Proinflammatory Cytokines

    Stress increases cytokines like IL-1α and TNF-α, affecting brain signaling.

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    Neurogenesis in the Hippocampus

    Depression is associated with reduced neurogenesis in the hippocampus.

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    BDNF in Depression

    Low levels of brain-derived neurotrophic factor (BDNF) are found in stress-induced depression.

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    Hypothalamic-Pituitary-Thyroid (HPT) System

    20-30% of MDD patients show alterations in the HPT system.

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    Study Notes

    Schizophrenia

    • Schizophrenia is a disorder characterized by a break in reality with a splitting of the cognitive and emotional sides of personality.
    • It affects 1% of the world's population.
    • It is likely caused by multiple genes on different chromosomes, and is not a single-gene disorder.
    • The disorder is related to genetic predisposition and prenatal/perinatal factors.
    • Brain abnormalities in schizophrenia are thought to originate during prenatal cell proliferation and migration.

    Neurochemical and Neuroanatomical Alterations

    • Reduced glutamate receptor activity may contribute to schizophrenia.
    • Reduced GABA biosynthesis enzyme (glutamic acid decarboxylase) activity may be related to impaired cognitive/emotional functions.
    • Reduced dopaminergic neurotransmission in the mesocortical dopamine pathway may result in negative symptoms and cognitive changes.
    • Excitatory neurotransmitter glutamate and its actions on NMDA receptors may be a factor
    • Enlargement of the lateral and third ventricles, and widening of the frontocortical fissures and sulci are often observed in individuals with schizophrenia.
    • Temporal lobe areas, such as the amygdala, hippocampus, and parahippocampal gyrus, show reduction in size.

    Temporal Lobe Alterations

    • Temporal lobe reductions may contribute to positive symptoms.
    • Brain studies in adolescents with early onset schizophrenia show progressive loss of cortical gray matter in the temporal lobes, somatosensory, and motor cortices and dorsolateral cortex.
    • The progressive loss in frontal lobe volume correlates with increased negative symptoms and reduced cognitive functioning.
    • Functional alterations in the dorsolateral prefrontal cortex (reduced blood flow and metabolism) may impair goal-directed cognitive problem-solving.
    • Reduced levels of reelin, an extracellular matrix protein involved in neuronal migration and synaptic function, are observed.

    Mood Disorders

    • Mood disorders are conditions characterized by emotional states, such as sadness or mania, that become chronic and uncontrollable.
    • Alterations in the hypothalamic-pituitary-adrenal (HPA) system, serotonin, norepinephrine, and dopamine are related to symptoms of depression.
    • Unipolar depression, also known as major depression, and bipolar disorder are two major classifications of mood disorders.
    • Genetic, environmental, neurochemical, and neuroendocrine factors contribute to the pathogenesis and/or etiology of depression.
    • Major depressive disorder is a mood disorder featuring a dysphoric mood and frequent insomnia, loss of appetite and body weight, reduced interest in pleasurable activities, and interpersonal relationship difficulties.

    Depression and HPA System

    • Chronic activation of the hypothalamic-pituitary-adrenal (HPA) system and elevated glucocorticoid secretion are observed in major depression.
    • Antidepressant drugs that help normalize HPA hormone secretion often yield a good clinical response.
    • Stress-related activation of the immune system increases the secretion of proinflammatory cytokines, which influences HPA hormone and monoamine metabolism and promotes chronic cortisol elevations.
    • Reduced neurogenesis and decreased BDNF levels in the hippocampus have been implicated in stress-induced depression.

    Bipolar Disorder

    • Bipolar I disorder includes manic episodes and at least one major depressive episode.
    • Bipolar II disorder features recurrent major depressive episodes with one or more hypomanic episodes.
    • Elevated mood, irritable mood, inflated self-esteem are symptoms of manic episodes.

    Generalized Anxiety Disorder (GAD)

    • GAD is characterized by excessive and persistent worrying, lasting at least 6 months, along with at least three of six major symptoms.
    • Underlying defects in norepinephrine and serotonin systems may play a role in GAD.
    • Reduction in a2-adrenergic receptor binding and serotonin levels in the cerebrospinal fluid (CSF) are observed.
    • Reduced platelet benzodiazepine binding in the left temporal hemisphere is also observed.

    Panic Disorder

    • Panic disorder is characterized by intense autonomic arousal and multiple disabling panic attacks, often involving symptoms like rapid heart rate, shortness of breath, and chest discomfort.
    • The disorder features concerns about future panic attacks, and symptoms can last from minutes to an hour.
    • Heightened sensitivity in the amygdala and neural circuit activation in the temporal lobe and brainstem are implicated in panic symptoms.
    • Decreased GABA-benzodiazepine receptor binding in brain regions like the hippocampus, insula and prefrontal cortex may contribute to panic disorder.

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    Description

    This quiz explores the characteristics of schizophrenia, including its prevalence and genetic factors. Additionally, it examines neurochemical and neuroanatomical changes associated with the disorder, highlighting neurotransmitter activities and related brain abnormalities.

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