Anxiety Disorders and Autism Spectrum Disorder Flashcards
When is the amygdala most active during presentation of phobias?
Before the patient is shown the phobia
Dendritic spine number in ASD patients overtime
Rises above normal in childhood and stays that way through adulthood
What can carbon dioxide cause?
Panic attacks
How do PTSD patients end up with a smaller hippocampus?
They may be born with it and it shrinks more with stressful situations
Have meds to treat core behavior issues been effective in ASD treatment
No
When does anxiety become a problem?
When it is in control; we cant control it
What happens with the HPA axis in anxiety?
The amygdala sends a stronger response (ends up eventually causing more cort)
Hippocampus of PTSD patients
Much smaller
How can a panic attack be stopped?
Trying to slow things down and regain control
What does research not support in ASD diets?
gluten and casein free diets not supported
Development of PTSD pathway
Stress sensitivity, over consolidation of fear, generalization of fear cues, impaired extinction of fear memories
What do smaller hippocampi of PTSD patients cause?
Impaired negative feedback from hippocampus to HPA axis which leads to excessive cort release
Stress response just from your thoughts
Anxiety
How early can ASD be diagnosed? More in boys or girls?
As early as 18 months. Boys 4 times more likely
Minicolumn differences in ASD patients
Minicolumns are much more dense in ASD patients
Meds approved for self-injurious behavior in ASD
Antipsychotics
Sources of genetic mutations in ASD
77% unknown
15% Mendelian disorders/mutations
5% rare and de novo mutations
3% chromosome abnormalities
Medications other than GABA-A agonists used to treat anxiety
Beta blockers (epinephrine/NE antagonist) and antidepressants (SSRIs)
Sudden onset of very strong intense fear of discomfort, strong sympathetic nervous system arousal, hyperventilation
Panic attack
These genes regulate brain development and synaptic changes and are likely related to ASD
Candidate genes
4 major specific phobia categories
Natural environment, animals, mutilation/medical treatments, situations
Parts of the brain with structural abnormalities in ASD
Cerebellum, amygdala, hippocampus
Strong negative emotion and physiological sensations from the anticipation of threat
Anxiety disorders
VR exposure therapy, MDMA assisted therapy, psychotherapy
PTSD treatments
Does the GABA-A receptor depolarize or hyperpolarize?
Hyperpolarize. Allows Cl- in
What do benzodiazepines increase at the GABA-A receptor? IMPORTANT
Increase frequency of opening Cl- channel
What could inappropriate levels of GABA inhibition cause?
A person to overreact to a perceived threat
Region of amygdala that receives inputs?
Lateral nucleus
Where are abnormalities seen in anxiety disorders?
Pathways connecting brainstem, amygdala, and related subcortical structures and decision making areas of frontal lobes, HPA axis, and NE, 5HT, and GABA NT systems
How is ASD treated not with meds?
Intensive, early childhood learning experiences provided during most of the childs waking hours
There are lower levels of this NT in ASD
Oxytocin
Could be a risk factor for PTSD, a result, or both
Lower gray matter volume
Generalization and how its related to PTSD
PTSD patients show fear in response to stimuli similar to the one that first caused the PTSD
Stimulation of locus coeruleus (NE) causes this
Panic attack
Abnormal versions of this glial cell are in ASD patients
Abnormal microglia
This is more active in ASD
Default mode network (DMN)
Repeated panic attacks followed by at least one month of worrying about another panic attack
Panic disorder
Uncontrolled chronic worry, catastrophizing, physical symptoms create anxiety spiral
Generalized anxiety disorder
What happens in generalized anxiety disorder?
Hypoactivity, reduced inhibition of the amygdala which then overexcites the HPA axis and sympathetic nervous system
Do ASD brains have more or less lateralization?
More (more symmetry)
How has autism prevalence risen over the last 40 years and why?
It has gone way up due to rise in incidence in general and relaxation of diagnostic criteria
Dysfunctions of this can be seen in ASD patients (debated)
Dysfunctions in mirror system function (debated)
How can postnatal factors influence gut microbiota and thus ASD
Child delivery method, feeding method (breast/formula), use of pre/probiotic supplements and/or antibiotics
What happens in the body during a panic attack that is counterproductive?
The body does things that won’t help you calm down like hyperventilating (trying to breathe more)
Normal response to genuine danger
Fear
Has a high comorbidity with anxiety disorder or other mood disorders
Panic disorder
Drugs that reduce anxiety
Anxiolytics
Associated with agoraphobia
Panic disorder
2 core symptoms of ASD
Social communication deficits and repetitive behaviors
Childhood brain development in ASD and what does this cause/what causes this?
Brain development is abnormally accelerated through early childhood, producing first brain enlargement, followed by a period of deceleration. High neurotrophic levels and excess CSF
What do barbiturates increase at the GABA-A receptor? IMPORTANT
Increase duration of opening Cl- channel
What do relatives of ASD patients show and what does this help show?
Elevated levels of autistic traits. ASD is linked to genetics
Severe emotional disturbance after experiencing or witnessing severely stressful event
PTSD
Do patients with ASD show more or less autophagy?
Less. They have less pruning and end up with more dendrites
Higher levels of this NT are seen in ASD patents and it is due to ___
Elevated 5HT levels. Due to impaired 5HT reuptake
Concordance rate of ASD
76-88%
IV administration of sodium lactate (respiratory stimulant) causes what?
Panic attacks in individuals prone to them but not controls
Region of amygdala that sends outputs?
Central nucleus
These types of medications are specific to treating anxiety (IMPORTANT)
GABA-A agonists (benzodiazepines, barbiturates, alchohol)
This area has lower volume in PTSD patients
Anterior cingulate cortex
Classical conditioning and how it relates to the amygdala and specific phobias?
Strong stimulus becomes paired with weak stimulus that causes stronger input to lateral nucleus of amygdala which creates stronger outputs from the central nucleus of the amygdala which creates stronger signals to the periaqueductal gray region of midbrain
How do ASD symptoms vary?
All ASD patients have different combinations of symptoms (no combination is better or worse)
What does risperidone do in ASD?
Provides some therapeutic benefit (5HT antagonist)
What altered network communications are seen in ASD patients?
Signals are sent broken up, like a dashed line, and not outright, like a solid line
Marked and persistent fear that is excessive or unreasonable cued by presence or anticipation of specific object or situation
Phobia
Symptoms include recurring dreams, flashbacks, hyper-arousal and avoidance of stimuli associated with trauma (respond to more cues overtime), and high levels of vigilance and an impairment in daily functioning
PTSD
Causes can include perinatal complications, inc parental age, exposure to infection and nutritional factors, maternal use of antidepressants, gut microbiota
ASD
Observed brain differences in ASD patients
unusual patterns of activation and weak connections across many areas. Brain development is abnormally accelerated through early childhood, producing first brain enlargement, followed by a period of deceleration
