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Brain And Behaviour > Lecture 10- Schizophrenia > Flashcards

Lecture 10- Schizophrenia Flashcards

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1
Q

Schizophrenia affects

A

1% of the worlds population

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2
Q

What is schizophrenia known as

A

A break from reality

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3
Q

Three categories of symptoms

A
  • Positive
  • Negative
  • Cognitive
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4
Q

Symptom onset is usually in

A

Early adulthood but can happen earlier or later

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5
Q

Which type of symptoms are the first to emerge

A
  • Negative
  • Then cognitive
  • Then positive
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6
Q

What do positive symptoms include

A
  • Thought disorders
  • Delusions
  • Hallucinations
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7
Q

What are positive symptoms

A

Extra to life (hallucinations)

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8
Q

What do thought disorders contain

A
  • Disorganised, irrational thinking
  • Difficulty arranging thoughts logically
  • Jump from topic to topic
  • Sometimes choose meaningless or rhyming words
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9
Q

Types of delusions

A
  • Persecution, false beliefs of threats
  • Grandeur, power or importance
  • Control, related to persecution, being controlled by others
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10
Q

Most common type of hallucinations

A

-Auditory

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11
Q

What are olfactory hallucinations

A
  • Think they experience something others can’t detect

- Contribute to the delusion that others are trying to kill them

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12
Q

Why are they described as negative symptoms

A

Absence of normal behaviours

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13
Q

Examples of negative symptoms

A
  • Poverty of speech
  • Social withdrawal
  • Lack of initiative
  • Persistence
  • Flattened emotional response
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14
Q

Cognitive symptoms include

A
  • Difficulty in sustaining attention
  • Poor abstract thinking
  • Poor problem solving
  • Low psychomotor speed
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15
Q

All neurocognitive deficits are associated with

A

Frontal lobe hypofunction

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16
Q

Weinberger (1988) suggested that the negative symptoms of schiz are caused primarily by

A

Hypofrontality (decreased activity)

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17
Q

What’s the stroop task

A
  • Incongruent task:
  • Trying to name the colour of the ink not the word (which would be a colour)
  • Schizophrenia patients are slower and less accurate
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18
Q

What’s the Wisconsin card sort task

A
  • Sorting cards and trying to work out the rule
  • Normally there is an increase in blood flow to dIPFC
  • Schizophrenia reduced blood flow there
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19
Q

What are sensory motor gating deficits

A
  • Difficulties screening out irrelevant stimuli

- Schizophrenia seem to not be good at screening

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20
Q

What’s the P50 signal in event related potentials

A
  • 2 auditory stimuli 500ms apart
  • Healthy people have a P50 wave on the 2nd click which is 80% diminished
  • Schizophrenia there is no change in response to 2nd click
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21
Q

Difference in Pre-Pulse Inhibition between normal and schizophrenia

A
  • Weak stimulus precedes a startle compared to just startle
  • Normal response inhibits startle if there’s a initial weak stimulus
  • Schizophrenia no change
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22
Q

What’s smooth pursuit

A

Tracking a moving stimulus

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23
Q

How do normal and schizophrenia differ in smooth persuit

A

Eye movements not as smooth, distracted and catching up with stimulus

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24
Q

Ventricle sizes difference

A
  • Schizophrenia twice as big
  • Reduced brain volume, less grey matter
  • Reduced size in temporal, frontal lobes and hippocampus
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25
Q

While schizophrenia is heritable

A

It is not due to a single dominant or recessive gene

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26
Q

One rare mutation involves the gene

A

DISC1

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27
Q

What is DISC1 involved in

A
  • Regulation of Neurogenesis
  • Neuronal migration
  • Postsynaptic density in excitatory neurons
  • Mitochondria function
28
Q

DISC1 presence increases chance of schizophrenia by a factor of

A

50

29
Q

Children of what fathers are more likely to develop schizophrenia

A
  • Older fathers

- Likely due to mutations in spermatocytes

30
Q

Percentage of developing schizophrenia if both parents are schizophrenic

A

46%

31
Q

Percentage of developing schizophrenia if MZ twin is schizophrenic

A

48%

32
Q

What biological reason might there be for differences in MZ twins

A
  • two organisms form their own placenta before day 4
  • if after day 4 organisms become monochorionic, one placenta
  • monochoronic twins found 60% concordance rate
33
Q

‘Early’ neurodevelopmemtal model

A
  • Events in early life cause deviations from norm

- Infections, nutritional deficiency support this theory

34
Q

Evidence suggesting abnormal brain development

A

-Blind raters found that children with later schizophrenia development were less social

35
Q

Late neurodevelopmental model

A

Schizophrenia may result from an abnormality when synaptic pruning occurs

36
Q

Two hit model

A
  • Early developmental insults may lead to dysfunction of specific neural networks
  • Adolescence has excessive synaptic pruning
37
Q

How does cannabis use relate to schizophrenia

A

In adolescence it can cause 6x risk

38
Q

Dopamine (DA) hypothesis

A
  • Schizophrenia is due to abnormalities in DA functioning
  • Overactivity of DA, Results in positive symptoms
  • Underactivity in DA, results in negative and cognitive symptoms
39
Q

What does the DA pathway look like in positive symptoms

A

-Excess levels of DA in the mesolymbic pathway

40
Q

What does the DA pathway look like in negative, cognitive symptoms

A

Lower levels of DA in the prefrontal cortex

41
Q

DA agonist produce symptoms that resemble

A

Positive symptoms of schizophrenia

42
Q

Drugs that mimic positive DA symptoms

A
  • Amphetamine
  • Cocaine
  • L-DOPA
  • Methylphenidate
43
Q

Positive symptoms can be alleviated with

A
  • Antipsychotic drugs

- CPZ, DA antagonist

44
Q

Typical antipsychotics target

A

Block D2 receptors

45
Q

What percentage of patients do not respond to typical antipsychotics

A

20-30%

46
Q

Long term treatment of typical antipsychotics leads to symptoms resembling

A
  • Parkinson’s disease
  • Lack of facial expression, slowness in movement
  • Help with positive not really negative symptoms
47
Q

Atypical antipsychotics work in

A

Treatment resistant patients

48
Q

Atypical antipsychotics do not have

A
  • Parkinson’s side effects
  • Have a lower affinity for the D2 receptors
  • Improve negative and positive symptoms of schizophrenia
49
Q

Clozapine

A
  • First atypical antipsychotic drug
  • Lower affinity for D2, higher affinity for other DA receptors
  • Not widely used
  • Reduces suicide rates
50
Q

Problem with DA hypothesis

A
  • Only explains part of schizophrenia

- Atypical antipsychotics are better yet they target dopamine less

51
Q

Nearly 50% of the neurons in the brain are believed to use

A

Glutamate as their neurotransmitter

52
Q

NDMA receptors are connected to

A

Schizophrenia when NMDA hypofunction

53
Q

NMDA receptors are a critical component of

A

Developmental processes

E.g. neural plasticity, neural pruning of cortical connections

54
Q

Glutamate agonist seem to improve

A

Both positive and negative symptoms of schizophrenia

55
Q

Negative and cognitive symptoms produced by ketamine and PCP caused by

A

Decrease in the metabolic activity of the frontal lobes

56
Q

Positive symptoms associated with NMDA receptors that

A

Are hypofunctional in the prefrontal cortex

57
Q

Glutamate hypothesis in relation to the dopamine hypothesis with positive symptoms

A

In healthy brains GABA neuron will inhibit the glutamatergic neuron, allowing normal level of dopamine release

58
Q

Disinhibited glutamate results in

A

Higher levels of dopamine

59
Q

Hypo-functioning NMDA Receptors theory accounts for

A

Both excess DA release in the mesolymbic DA system as well as reduced release of DA in the prefrontal cortex

60
Q

People who are at risk of schizophrenia’s brain immune cells are

A

Hyperactive

61
Q

Antibiotics that reduce microglial activation cause

A

Symptoms to be reversed

62
Q

Most significant association of chromosome with schizophrenia is

A

Chromosome 6 with a region of the genes involved in acquired immunity

63
Q

Microglia

A
  • Survey the brain for pathogens
  • Identification of a threat causes them to become activated
  • Involved in neuronal cell death, synaptic pruning
64
Q

Microglial activation is not

A

Instantaneous

65
Q

In women there is

A

A 2nd peak onset of schizophrenia at age 45-50 yrs (menopause)

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