14. Fear & anxiety 2

Question 1

What is Kulvery-Bucy syndrome? (Fear/anxiety 2 B&B)

Answer 1

• A disorder produced when both right and left medial temporal lobes malfunction
• No fear response
• Hypersexuality

Question 2

What is a lack of fear response associated with? (Fear/anxiety 2 B&B)

Answer 2

Removal of the amygdala

Question 3

Patient SM had what and what did it result from? (Fear/anxiety 2 B&B)

Answer 3

• Bilateral amygdala lesions

- Formed from Urback-Wiethe disease

Question 4

How many separate nuclei does the amygdala contain in the temporal lobes? (Fear/anxiety 2 B&B)

Answer 4

22

Question 5

What is seen during public speaking? (Fear/anxiety 2 B&B)

Answer 5

• Increase in amygdala activation

- Leading to social anxiety disorder

Question 6

What does the amygdala contain? (Fear/anxiety 2 B&B)

Answer 6

A high number of BZ binding sites

Question 7

What does an injection of BZ into rats amygdala cause? (Fear/anxiety 2 B&B)

Answer 7

Anxiolytic effect (reducing anxiety)

Question 8

What are the cognitive and somatic symptoms to a fear response? (Fear/anxiety 2 B&B)

Answer 8

• Cognitive = anxious thoughts

- Somatic = elevated heart rate

Question 9

What is the process once a fearful stimuli is recognised? (Fear/anxiety 2 B&B)

Answer 9

• Stress response
• Sensory information channeled to the amygdala
• Amygdala excites the locus coeruleus and hypothalamus
• Acute stress response (HPA axis)

Question 10

What is the acute stress response on the HPA axis? (Fear/anxiety 2 B&B)

Answer 10

• Hypothalamus releases corticotropin releasing hormone
• Pituitary glad releases adrenocorticotrophic hormone
• Adrenal cortex releases cortisol and adrenaline
• Locus coeruleus releases noradrenaline
• Flight or flight response produced

Question 11

What are the effects of the sympathetic nervous system activation? (Fear/anxiety 2 B&B)

Answer 11

• Noradrenergic systems
• Increased heart rate/BP
• Inhibited digestion

Question 12

What are the effects of the central nervous system activation? (Fear/anxiety 2 B&B)

Answer 12

• Serotonergic systems
• Narrowing attention
• Cortical activation

Question 13

How is the hippocampus related to anxiety? (Fear/anxiety 2 B&B)

Answer 13

• Anxiolytic effect (anxiety reducing)

- Provides contextual information on stimuli that help condition fear

Question 14

How is anxiety formed in relation to the hippocampus? (Fear/anxiety 2 B&B)

Answer 14

• Glucocorticoid receptors activated

- Ca2+ entry

Question 15

What are the two impacts that can cause anxiety in relation to the hippocampus? (Fear/anxiety 2 B&B)

Answer 15

• Diminished hippocampus activity

- Loss of feedback to the amygdala

Question 16

Where are noradrenergic projections sent from the locus coeruleus? (Fear/anxiety 2 B&B)

Answer 16

• Cerebellum
• Hippocampus
• Neo-cortext
• Thalamus

Question 17

How is the locus coreuleus activated? (Fear/anxiety 2 B&B)

Answer 17

• Events that are essential for survival
• Increased firing of LC
• Increased arousal/attention

Question 18

What is a noradrenergic projection? (Fear/anxiety 2 B&B)

Answer 18

Neurons that induce anxiety related behaviours

Question 19

Where are serotonergic projections sent from the raphe nuclei? (Fear/anxiety 2 B&B)

Answer 19

• Striatum
• Nucleus accumbens
• Frontal cortex
• Hippocampus

Question 20

What are BZ’s used for? (Fear/anxiety 2 B&B)

Answer 20

• Generalised anxiety disorders

- Panic disorders

Question 21

What are SSRI’s used for? (Fear/anxiety 2 B&B)

Answer 21

• Obsessive compulsive disorders
• Personality disorders
• Post traumatic stress disorder

Question 22

What is buspirone used for? (Fear/anxiety 2 B&B)

Answer 22

Generalised anxiety disorder