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BioMed Season Finale Part 1 > CNS Disorders - Schizophrenia > Flashcards

CNS Disorders - Schizophrenia Flashcards

1
Q

what are the positive symptoms of schizophrenia

A

hallucination - mainly auditory
though disorder
stereotyped behaviours

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2
Q

what are the negative symptoms of schizophrenia

A

poverty of affect
temporal disorientation
cognitive impairment

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3
Q

what is the evidence for a genetic cause of schizophrenia

A

high concordance in monozygotic twins of 48%

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4
Q

what are potential psychosocial causes of schizophrenia

A

adolescent onset
stress
emotionally charged home environment
blunted cortisol responses

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5
Q

what is the evidence to suggest that schizophrenia is not caused by structural brain damage

A

CAT/MRI scans show ventricular enlargement and decreased volume of temporal lobe
but no gliosis - so not neurodegenerative

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6
Q

what are the cytoarchitectural abnormalities in a schizophrenic patient

A

decreased number of small neurones in superficial layer
increased number of large neurones in deeper layers

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7
Q

what is the evidence for viral infection being a cause for schizophrenia

A

higher incidence of patients born in winter/spring
exposure of mother to virus during second trimester increases child’s risk to schizophrenia

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8
Q

what are the sites of brain dysfunction during auditory hallucinations

A

decreased size of temporal lobes and enlarged ventricles

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9
Q

in normal brains the left side of the brain has increased activity during verbal tasks - how is this affected by schizophrenia

A

this lateralisation is disrupted
dysfunction of dominant cerebral hemishpere

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10
Q

what does diffusor tensor imaging of schizophrenia show

A

hypo-functionality of dorsal-lateral pre-frontal cortex

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11
Q

what is the site of anti-psychotics and is also a brain dysfunction in schizophrenia

A

basal ganglia

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12
Q

what is the dopamine hypothesis for symptoms of schizophrenia and what is the evidence for this

A

due to excess dopamine neurotransmission in the mesolimbic and mesocortical regions
no consistent evidence for this hypothesis

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13
Q

chronic treatment of antipsychotics to rats was done to anaesthetise and record DA activity in rats, where specifically where they measuring DA activity

A

substantia nigra - SN
ventral tegmental area - VTA

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14
Q

before any antipsychotic treatment outline the activity of VTA neurones compared to SN

A

VTA neurone activity is greater than SN neurone activity

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15
Q

how did acute antipsychotic treatment affect the rats

A

increase in mesolimbic activity of VTA neurones
no change in mesocortical neurone activity

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16
Q

how did chronic antipsychotic treatment affect the rats

A

mesolimbic VTA neurones become silent
still no change in mesocortical neurone activity

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17
Q

so how does the study treating rats with antipsychotics explain the delayed onset effect of antipsychotics - chlorpromazine

A

blocks autoreceptor feedback which increases pre-synaptic activity - release of dopamine
but after a while this causes a depolarizing block in the neurone

18
Q

what is the effect of DA releasing neurones entering depolarizing block in the mesolimbic region

A

since there is no change in neurone activity in the mesocortical neurones from antipsychotic treatment - there is a relative increase in DA activity in the mesocortical region

19
Q

what are the typical antipsychotics

A

phenothiazines
thioxanthenes
butyrophenones

20
Q

what are the common side-effects of typical antipsychotics

A

weight gain
sedation
postural hypotension
atropine-like side-effects
hyperprolactinaemia

21
Q

what is the weight gain and sedation side-effects from antipsychotic use caused by

A

blockade of histamine receptors - antihistamines

22
Q

what is the postural hypotension side-effect from antipsychotic use caused by

A

blockade of alpha-adrenoceptors

23
Q

what is the hyperprolactinaemia side-effect of antipsychotic use caused by

A

blockade of D2 receptors

24
Q

what is a rare but lethal side-effect of antipsychotics

A

neuroleptic malignant syndrome

25
Q

why can antipsychotics produce Parkinson’s like syndrome

A

blocks dopamine receptors in the substantia nigra - which is involved in extra-parameter motor control

26
Q

what is a chronic disorder associated with antipsychotic use

A

Tardive dyskinesia

27
Q

what are the features of Tardive dyskinesia

A

purposeless, repetitive movement
irreversible

28
Q

what are the potential causes for Tardive dyskinesia

A

dopamine receptor super-sensitivity hypothesis
neuroleptic toxicity hypothesis
GABA hypothesis

29
Q

what are the advantages of clozapine and its major flaw

A

produces less sedation
lower incidence of movement disorders
treats negative symptoms

lethal anaemia - agranulocytosis

30
Q

what are the effects of clozapine on different receptors

A

dopamine D4 antagonist
5HT-2A antagonist
alpha-1 adrenoceptor antagonist
muscarinic receptor antagonist

31
Q

what is the genetic basis for the pathophysiology of schizophrenia

A

cortical dysfunction

32
Q

what are the genes implicated in schizophrenia

A

DISC-1
neuregulin
catechol-o-methyltransferase

33
Q

what are the features of Velocardio Facial Syndrome (VCFS)

A

deletion of 1.5-3 Mb in chromosome 22
increased incidence of psychiatric disorders including schizophrenia

34
Q

what mutation in which chromosome has a higher incidence in schizophrenic patients

A

deletion in chromosome 22

35
Q

function of catechol-o-methyltransferase (COMT)

A

metabolic enzyme for dopamine

36
Q

what are the features of DSIC-1

A

increased expression during neuronal development
expressed in cortical neurones
interacts with several proteins

37
Q

how does DISC-1 control neuronal proliferation

A

signals through GS3KB

38
Q

what is Lissenencephaly

A

disease that effects the gyrie formation of the brain
smooth brain

39
Q

what is the significance of the link of DISC-1 mutations and lissencephaly

A

puts DISC-1 as a risk factor for schizophrenia in a pathway that controls neural development

40
Q

what is neuregulin

A

a growth factor that interacts with receptors to regulate neuronal differentiation and migration

41
Q

why may neuregulin be a risk factor for schizophrenia

A

reducing the function of glutamate receptors - NMDA receptors that regulate mesocortical dopaminergic pathways

42
Q
A

BioMed Season Finale Part 1 (13 decks)

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