Behavioral Science - Genetics in Psychiatry - Thomas L. Schwartz Flashcards
T/F – Genetics of most hereditary disorders (70 % inheritance) can be mapped to specific genes
False.
require hundreds of mutated genes to produce spectrum of clinical symptoms that would cause someone to meet diagnostic criteria for specific disorder
High or low genetic heritability? ADHD? Depression? Anxiety? Schizophenia?
ADHD? - HIGH
Depression - LOW
Anxiety - LOW
Schizophenia - HIGH
Epistasis describes ___
the effect of one gene being dependent on the presence of one or more ‘modifier genes’
What are epigenetics? Does it involve changes in DNA?
describes change in gene expression due to environmental influences, NOT change DNA
Nigrostriatal dopamine pathway:
Originates ___ projects to ____
Controls ___
Originates at substantia nigra
Projects to striatum/basal ganglia
Controls motor function and movement
Mesolimbic dopamine pathway:
Originates ___ projects to ____
Controls ___
Originates at VTA of midbrain
Projects to nucleus accumbens
Controls reward and perception of pleasurable sensations, delusions and hallucinations of psychosis
Mesocortical dopamine pathway:
Originates ___ projects to ____
Controls ___
Originates at VTA of midbrain
Projects to DLPFC or VMPFC
Controls executive functions
VTA > DLPFC Controls cognitive symptoms of schizo
VTA > VMPFC controls affective symptoms of schizo
Tuberoinfundibular dopamine pathway:
Originates ___ projects to ____
Controls ___
Originates at hypothalamus
Projects to anterior pituitary
Controls prolactin secretion
Tuberoinfandibular DA pathway
hypofunction?
hyperfunction?
hypofunction? hyperprolactinemia
hyperfunction? hypoprolactinemia
Mesolimbic dopamine pathway:
hypofunction?
hyperfunction?
hypofunction? amotivation, apathy
hyperfunction? addiction, hallucinations
Nigrostriatal dopamine pathway:
hypofunction?
hyperfunction?
hypofunction? dyskinetic movement, parkinsonism
hyperfunction? dyskinetic movement
Mesocortical dopamine pathway:
hypofunction?
hyperfunction?
hypofunction? inattention
hyperfunction? hypervigilance, insomnia
Which dopamine pathways are involved in schizophrenia? Which are hypoactive which are hyperactive?
Mesolimbic - hyperactive
Mesocortical - hypoactive
What could a mutation in COMT cause?
Schizophrenia ** if paired with other mutations
COMT is catachol-O-methyl transferase > degrades DA mutation usually generates high levels of DA
What are 4 genes involved in dopamine pathways that could lead to schizophrenia symptoms if many mutations occur?
COMT
Tyrosine hydroxylase
D2R (dopamine receptor 2 - sometimes called DAR2)
D3R
What does DISC1 do?
Mutation of DISC1 is associated with what disease?
What is the MAO
DISC1 normally facilitates neurogenesis, cell migration, differentiation, synaptogenesiss and selective pruning of synapses
schizophrenia
epistatic mutation - multiple other downstream genes are affected
What are 2 genes that DISC1 mutation can affect?
ErbB4, NRG
Mutation of DISC1 is associated with what disease?
What is the MAO
schizophrenia
epistatic mutation - multiple other downstream genes are affected
T/F it is possible to have normal dopamine levels and still have schizophrenia
True
Can be due to disrupted neurodevelopment that doesn’t affect dopamine
characteristic brain activity patterns on fMRI associated with gene activation/deactivation/mutation
endophenotype
What is one plausible explanations for mesocortical hypoactivity and mesolimbic hyperactivity?
dysfunctional PFC results in loss of top down control of limbic DA release
Hyperactive mesolimbic system is associated with mutations in which genes?
D2R, Tyrosine hydroxylase, MAOs
Hypoactive mesocortical system is associated with mutations in which genes?
COMT and D3R
What are 2 genes involved in ADHD
D4R, D5R
If enough ADHD associated mutations occur what could occur?
schizophrenia symptoms
5 gene mutations involved in ADHD?
DRD1 (DRD = DAR = D1R) DRD2 DRD4 DAT1 DISC1 (also schizo)
In ADHD what brain regions are affected? Hyper vs Hypo active?
Anterior cingulate cortex and mesocortical pathway is hypoactive
other cortical regions (e.g. insula) not associated with vigilance and concentration are hyperactive - (inefficient compensation)
what two genes are implicated in mesocortical and anterior cingulate hypofunction in ADHD?
DRD4 DRD5
In Depression which pathways/brain regions are involved
mesocortical system is primarily involved
DLPFC is hypoactive
VMPFC between right and left hemispheres (emotional processing areas) are hyperactive
limbic regions are also hyperactive
What genes are involved in major depressive disorder?
DAT, DRD4, COMT
could result in schizo if too many mutations develop
In major depressive disorder - hypoactivity in DLPFC is linked to _____
Hyperactivity in VMPCF and limbic areas are linked to ____
Poor DA tone
Serotonin mutations
Inheritance of which 3 genes might contribute to hypoactivity of the DLPFC / disfunction of the mesocortical pathway in major depressive disorder?
COMT, DAR4, DAT
dysfunctional VTA is responsible for hypoactivity of DLPFC (ventral tegmental area of the midbrain –> origin of mesocortical DA pathway)
What is the precursor to serotonin?
tryptophan
True or false, the 5HT pump can also pump in tryptophan
False - serotonin and tryptophan pumps are distinct
Put these in sequence: TRY-OH, serotonin, VMAT2, AAADC, tryptophan, 5HTP
What pathway is this?
Tryptophan>TRY-OH>5HTP>AAADC>5HT (serotonin)>VMAT2
Serotonin synthesis:
Tryptophan is pumped into cell via tryptophan specific transporter then converted to 5HTP by tryptophan hydroxylase (TRY-OH; aka TPH), which is then converted to serotonin/5HT by AAADC and packaged in vesicles by vesicle monoamine transferase 2 (VMAT2)
T/F serotonin can be brought back into the serotenergic axon terminal via SERT
true
SERT = serotonin reuptake transporter
T/F low levels of intracellular serotonin/5HT can be broken down by MAO-A
False - HIGH (not low) levels of intracellular serotonin can be broken down by MAO-B (not A)
T/F extracellular serotonin can be broken down by COMT
False - this beaks down DA
Extracellular serotonin can be broken down by ___?
MAO A and/or MAO B
T/F serotonergic projections originate in the locus cereleous?
False - Serotonin projections originate in the Raphe Nucleus
T/F serotonin projections are both ascending (into the brain) and descending (down the spinal cord)?
True - NE projections from LC do the same
What do the descending serotonin pathways do?
regulate pain (descending inhibitory system)
Hyperfunctioning lymbic serotonin pathways cause these symptoms: 1 2 3 4
Panic
Worry
Obsession
Depression
T/F hyperfunctioning lymbic pathways have high levels of SE
False - may have poor serotonin acitvity
What are 3 commonly mutated genes involved in the serotonin Genetics of MDD/Anxiety/Eating Disorder/BPDO?
5-HT2A 102 T/C
5-HTTLPR promoter
TPH (tryptophan hydroxylase)
5-HTTLPR promoter regulates the expression of the 5-HTTLPR gene. What does the 5-HTTLPR gene code for?
SERT
In depression/anxiety the cingulate cortex and amygdala are hypoactive of hyperactive? What NT is throught to be responsible
Hyperactive
Poor serotonin tone
in anxiety and depression the mesolimbic system is hyper of hypoactive?
hyperactive - also the medial frontal cortex
Which serotenergic gene mutations cause hyperactivity of the mesolimbic system and medial frontal cortex in anxiety/depression?
5HT2R, 5HTTLRP, TPH
Serotonin 2 receptor, CERT, tyrosine hydroxylase
5HT2R, 5HTTLRP, TPH mutations in axiety and depression result in increased or decreased firing and reactivity of the Raphe nucleus?
Increased reactivity and firing - don’t really understand this.. less serortonin reaches the
Put these in order: NE, Tyrosine, VMAT2, DOPA, DDC, TOH, DBH, DA
Tyrosine> (TOH) tyrosine hydroxylase>DOPA>(DDC) dopamine decarboxylase>DA>(DBH) dopamine beta hydroxylase>NE>VMAT2
Hyperfunctioning lymbic NE pathways cause these symptoms:
1
2
3
Panic
worry
arousal
NE might be too high! (opposite of serotonin)
Hypofunctioning corticofrontal NE pathways cause these symptoms:
1
2
ADHD
Depression
What does hypofunctioning of DA NE pathways cause
loss of possitive emotion/affect
depressed mood; loss of happiness, interest, or pleasure; loss of energy or enthusiasm; decreased alertness; and decreased self-confidence are associated with hypofunctioning of which NT systems? Increase in negative affect or loss of positive affect?
DA + NE hypofunction
Loss of positive affect
depressed mood, guilt, disgust, fear, anxiety, hostility, irritability, and loneliness
associated with hypofunctioning of which NT systems? Increase in negative affect or loss of positive affect?
SE (sometimes NE)
Increase in negative affect
What symptoms are associated with an decrease in positive affect?
depressed mood; loss of happiness, interest, or pleasure; loss of energy or enthusiasm; decreased alertness; and decreased self-confidence
What symptoms are associated with an increase in positive affect?
depressed mood, guilt, disgust, fear, anxiety, hostility, irritability, and loneliness
Do PTSD patients have increased or decreased negative or positive affect?
Increased negative affect
What is the difference between Met vs Val alleles of COMT?
Met-COMT = low function/monoamine degradation so high NE/DA = increased NE/DA and anxiety in limbic areas
VAL–COMT = high function = low NE/DA in cortex (in depression VAL allele of COMT could explain low concentration of NE and symptoms of low energy.poor concentration)
X inactivation of MAO results in what?
two copies of MAO expressed - Faster degradation of monoamines and lower levels available to cortex = depression in females
ADHD is associated with what mutation? How does this affect neurotransmitter levels? What brain regions are affected? Hypo or hyper active?
COMT Val allele results in increased monoamine breakdown (so less NT) depriving the frontal cortex and cigulate cortex making them hypoactive