Midterm Flashcards
1
Q
What are the 2 main things that are studied in neurodevelopment?
A
- mechanisms that govern the developmental trajectories of the NS
- alternative pathways underlying pathological outcomes
2
Q
What are some factors that can influence neurodevelopment?
A
Genes and environment (drugs, toxins, stressors)
3
Q
What is neuropsychology?
A
it is the study of brain-behaviour relationships
>assessment of brain function based on behavioural expression
4
Q
What is the main function of neurons?
A
They form the basis of communication within the brain through networks
5
Q
What is the main function of glial cells?
A
they are the “supportive” cells in the NS that help the neurons function
6
Q
What two things are integral to proper function of the brain (like learning and memory)
A
growth and change
7
Q
Important changes on the brain occur when? What can interfere with this?
A
at critical periods
Teratogens that disrupt proper development
8
Q
Neuroplasticity
A
Mechanisms that allow the brain to change and adapt to environmental stimuli
9
Q
What does neuroplasticity allow for?
A
- compensatory mechanisms after an injury
- adaptation to changes
10
Q
Do we have the same amount of neuroplasticity at all ages in life?
A
No
Younger individuals have more plasticity
11
Q
Early embryonic cells become what?
A
Neural progenitors
12
Q
Do neurons and glial cells have different progenitor cells?
A
No, they can stem from the same progenitor cells
13
Q
What genes regulate neurogenesis and gliogenesis?
A
Different genes
14
Q
Do neurons or glial cells usually develop first?
A
Neurons
15
Q
Do we keep generating neurons throughout our lives?
A
No, we have most of our neurons at birth
16
Q
If we do not generate any more neurons after birth, why does our brain get bigger?
A
Because we develop more glia during life
17
Q
Do we need all the neurons we are born with?
A
No, the neurons we do not use get pruned
18
Q
What are the electrical and chemical communicators in the brain
A
Electrical = action poteital Chemical = neurotransmitters
19
Q
Why do some babies who were exposed to alcohol in utero get fetal alcohol syndrome and some do not? (2)
A
- It depends on the stage of development they were exposed
2. Some genes are protective and some genes put you more at risk
20
Q
Embryogenesis:
A
Process by which an embryo develops
21
Q
Inner cell mass develops into what?
A
embryo
22
Q
What does the trophoblast contribute to?
A
the placenta
23
Q
How many days after fertilization does implantation occur?
A
7 days
24
Q
What layer does the nervous system develop from?
A
ectoderm germ layer
25
The neural tube is developed by what time point?
3 weeks
26
What part of the neural tube develops into the brain
the front part
27
What factors can impact the development of the NS
Genetic Factors
Environmental Factors
- toxins, drugs, diet
***often a combination
28
What is the progression of the central dogma? What is a last additional factor?
Genes -- DNA -- mRNA -- Protein
| Post translational modification
29
How are human's brains similar to other animals?
Similar types of neurons, synapses and neurotransmitters
30
How many genes were mapped in the human genome project
30 000
31
What can post-translational modification depend on?
Another protein
32
What happens when a gene that codes for something like BDNF becomes mutated?
It can impair the functioning of other proteins that depend on it for post-translational modification
33
What is a SNP
Single nucleotide polymorphism = there is a different nucleotide at a single location
34
Do SNPs always cause problems?
No, they can be non-consequentical
35
What is "whole genome sequencing"?
It identifies the complete DNA sequence of an organism's genome at a single point in time
36
How many genes were mapped in the human genome project
30 000
37
What can post-translational modification depend on?
Another protein
38
What happens when a gene that codes for something like BDNF becomes mutated?
It can impair the functioning of other proteins that depend on it for post-translational modification
39
What is a SNP
Single nucleotide polymorphism = there is a different nucleotide at a single location
40
Do SNPs always cause problems?
No, they can be non-consequentical
41
What is "whole genome sequencing"?
It identifies the complete DNA sequence of an organism's genome at a single point in time
42
What is RNA-sequencing and what can it be used for?
Detects the presence and quantity of RNA in a genome
| > Used to see how much of a protein is being made
43
1. What is CRISPR,
2 How does it work
3. What was it originally created to do?
1. It is a gene editing tool
2. It targets gene activation or repression within a 20-nucleotide target sequence
3. It was created to manipulate animal DNA to make animal models for diseases
44
Genotype:
genes- raw material and blueprints
45
Phenotype
structural and functional expression (like behaviour or physical appearance)
46
Critical Periods:
Specific period during development when external stimuli may help to shape neurodevelopmental processes
47
Complete penetrance
ALL individuals with the gene mutation will show disease symptoms
48
High penetrance
highly likely that individuals with the mutation will show disease symptoms
49
Incomplete penetrance
Some individuals fail to show symptoms even though the mutant genotype is present
50
Most neurodevelopmental disorders have _____ penetrance
| What does this suggest?
Incomplete
| Suggests that it is not only the mutation but other factors like the environment that cause a disease
51
Bidirectionality of environment and gene
Environmental "stimuli" can affect neuronal activity during development
Neuronal activity can influence the expression of many genes
52
How is the gene-environment interaction studied in humans
Twin studies
| Usually twins reared apart
53
What is medical genetics?
The study of inherited factors and mechanisms that influence medical/behavioural outcomes
54
Heredity:
Circumstance where phenotypic trait is passed form parents to children through genetic inheritance
55
What is it called when there is an abnormal chromosome number?
Aneuploidy
56
Karyotype:
Technique that checks the number and appearance of chromosomes
57
What are 3 types of monogenic genetic disorders?
1. Sex-Linked = inheritance related to the sex of the individual (X-linked mutations)
2. Autosomal Dominant = one allele possessed gene mutation, another is normal but the phenotype is still observed
3. Autosomal recessive = both alleles in gene pair are mutated and produce the phenotype
58
What make multifactorial (polygenic) conditions more complicated/
It does not follow the same rules of inheritance and there are variable phenotypes
59
What are 3 factors of mitochondrial disorders?
- "Non-traditional" inheritance (more rare)
- Only a few disorders
- Characterized by alterations in the mitochondrial DNA
60
Expressivity:
variability in clinical severity
61
Penetrance:
Frequency of expression of genotype that results in specific phenotype
62
What are 3 DNA technology/linkage analysis for disorders
1. Condition seen in other family members
2. Gene mapping to ID possible variants/mutations
3. Localize gene to chromosome
63
Linkage analysis:
Searching for genetic code that could allow genetic testing for inheritable conditions
64
Genetic factors operate in the context of what?
Environmental conditions
65
Detrimental environmental exposure when during brain development result in a potential of a greater impact on brain structure and function?
Earlier stages
| > Critical periods
66
Fetal brain is most vulnerable to chemical and infectious agents in the _____ ______ ______
Maternal blood stream
67
What can make some people more prone to the detrimental effects of teratogens?
People who possess a genetic susceptibility
68
Teratogen:
Agent or factor external to the fetus that can cause structural or functional malformations during prenatal development
Ex. Alcohol
69
Why can infection during pregnancy be bad?
They trigger an immune response and the immune factors might alter the neurodevelopment
70
What is an example of an activity that can promote neurogenesis
Exercise
71
If mom has a mental health disorder is it more or less likely for the child to have a mental health disorder?
Higher
72
What are 5 environmental factors that can impact neurodevelopment
1. Intrauterine infections
2. Neurotoxins
3. Heavy metal exposure
4. Stress/diet
5. Maternal mental health
73
How does Zika harm the fetus and what can be the result?
The virus diverts resources away from mechanisms needed to produce neurons and there will be a heightened immune response
>> Microcephaly
74
What exactly can Zika do to neurons
It can either directly kill developing neurons or it can just limit their growth
75
What are the primary (3) effects of prenatal HSV infection
1. lesions appear within 2 weeks of exposure
2. genital inflammation
3. Fever, headache, nausea
76
What are the secondary effects of prenatal HSV infection (4)
1. Psychological effects including depression (for mom)
2. Possible weakening of the BBB
3. Inflammatory mechanisms can result in a pre-term birth
4. Activates inflammatory mechanisms
77
What bacterial infection can be passed from the mother to the child that affects the genitals and eyes?
Chlamydia Trachomatis
78
What 4 issues can happen to pregnant women (and their babies) with clamydia?
- Reproductive issues
- Blindness for child
- Preterm birth
- Infertility or miscarriage
79
When there is increased inflammation during pregnancy, what is happening in the fetal brain (4)?
- Activated microglia
- activated astrocytes
- maturation arrest or death of oligodendrocytes
- Axonal loss or death of neurons
80
What are the potential phenotypic consequences of increased inflammation in the developing brain (4)
- preterm birth
- motor deficits
- cognitive and behavioural impairment
- psychiatric illness
81
Stress can lead to the release of what?
Cytokines
82
What are the effects of cytokines on the fetus?
Not clear, but it could impact neuronal development
83
Stress reduces what factors in the brain that are important for survival??
BDNF
84
Stress can also increase levels of proteins that are ____ to neurodevelopment
toxic
85
What important function does BDNF do?
It is important for the growth and survival of neurons
86
Neurotoxin:
A chemical/substance that is toxic to neurons (impacts brain development)
87
What are 2 neurotoxins and what do they do?
Tetrodotoxin - inhibits sodium channels (kills all activity dependent mechanisms)
Botulinum Toxin - inhibits ACh at the neuromuscular junction and results in paralysis
88
Why is activity at the neuromuscular junction during development important?
It helps to fine tune muscle activity and proper neuronal development
89
How do pesticides affect neurons?
they damage neurons
90
What is an example of a pesticide that has been linked to Parkinson's
Paraquat
91
What are 4 elements in a proper diet that are very important in facilitating neuronal development?
- Folate
- Choline
- Omega 3 fatty acids
- Water
92
What can happen to the baby if the mom has folic acid deficiencies
Spina Bifida
93
What heavy metal is known to be toxic to neurons and what does it do (3)?
Mercury:
- Delay neuronal development
- Sensory impairment
- reactive with selenium
94
What is the consequence when mercury reacts with selenium?
It will disable selenium form being able to protect neurons from oxidative damage
95
A mother can transfer unbalanced _______ ______ to the fetus
Neurotransmitter processing
96
Children born of mentally ill mothers can more likely to develop which 2 mental illnesses?
Depression and schizophrenia
97
What timeline of the mother smoking can cause harm to the fetus?
Only with prolonged smoking
| If she stops smoking early in pregnancy it does not seem to have as great of an effect
98
What is a potential impact on the baby of the mother smoking
Head size
99
What is the effect of PAHS, an air pollutant, on neurodevelopment
It has a potential neurotoxic effect that could impact neurodevelopmental trajectory
100
What is BPA found in and what are the potiential effects of it?
Plastics
| > Can have neurodevelopmental issues and impact feeding behaviours
101
Paternal exposure:
Anything the father of the baby is exposed to before his partner's pregnancy can cause possible epigenetic effects
102
What can be the impact of paternal alcoholism on the baby
May exhibit hyperactivity and decreased cognitive performance
103
What are the potential epigenetic mechanisms of stress that can impact a child?
Exposure to stress --> Modulation of BDNF signalling --> Changes in synaptic plasticity-->:
1. Vulnerability to anxiety
or
2. Vulnerability to alcohol consumption
104
What are some of the multiple factors on how the environment can affect the brain (5)
- Loss of protein homeostasis
- DNA damage
- Lysosomal dysfunction
- Epigenetic changes
- Immune dysregulation
105
What behavioural signatures that are tested to determine if there is a neurological disorder (4)
- Learning and memory (attention and executive function)
- visual-motor integration
- social behaviour
- motor skills
106
What is ultrasound used for?
To detect structural aspects during embryonic and fetal development
107
Prenatal testing is done especially for what?
High risk pregnancies
108
What is considered a high risk pregnancy?
mother over 35 years
109
What is Integrated Prenatal Screening (IPS)
testing the maternal blood to look for biomarkers from the fetus
110
What is the nuchal translucency test?
It measures the fluid-filled space between the back of the feral neck and the uterine lining
111
What measurement on the nuchal translucency is considered abnormal
More then 3.5mm
112
What do the nuchal translucency correlate with? (4)
- Miscarriage
- Still birth
- Down syndrome
- heart defects and rare genetic disorders
113
Karyotype:
chart of chromosomes
114
What does karyotyping allow for?
allows for the identification of genetic disorders caused by chromosome alterations/abnormalities
115
Aneuploidy:
an abnormal number of chromosomes
116
What is an amniocentesis test?
Takes up amniotic fluid that contains fetal cells that can be tested
117
What tests can be done after an amniocentesis (5)
- karyotyping
- molecular testing
- PCR
- FISH
- PAPP-A
118
What levels of PAPP-A is associated with down syndrome?
low levels
119
Why don't mons like having an amniocentesis
Because it can result in the loss of the fetus
120
What is Chronic Villus Sampling (CVS)
The collection and examination of fragments of placental tissue (chorionic villi)
121
What are the 5 aspects of multi-method approaches to diagnosis neurodevelopmental disorders
- imaging
- molecular testing
- genetic testing
- psychological testing
- assessment of mental retardation
122
Why is it hard to do clinical assessments during development?
Because a child changes so quickly and there is no "normal" trajectory
123
What behavioural assessments CAN you do with a newborn to assess normal development? (6)
- lack of alertness
- poor quality of sleep
- abnormal cry
- feeding problems or constant drooling
- spastic movement
- abnormal head size
124
What are structural imaging techniques
Ultrasound
CT scan
MRi
125
What are functional imaging techniqies
fMRI
| PET
126
What are standards of normality?
Early developmental assessments that involve age and stage specific testing and "normative reference"
127
What is fragile X syndrome?
Abnormal FMR protein makes astrocytes not properly support the neuron so it has delayed development
128
Cognitive psychology
Study of the effects of brain function on psychological processes
129
Cognitive neuroscience
Molecular and biochemical processes underlying cognitive function
130
Why is there a focus on the development of the adolescent brain over the adult brain?
Because the adolescent brain is still developing a lot
131
What part of the brain do we keep lots of plasticity even as adults? Why?
Hippocampus
| For memory formation
132
The bursts and plateaus of neurodevelopment are correlated with what?
Social and academic changes
133
Some conditions do not become apparent until late adolescence or young adulthood, what makes them apparent?
There are increases multi-tasking demands and higher work load
134
What are the 3 areas of speech assessment
Articulation = pronounce words
Expressive Language = express thoughts coherently
Receptive Language = ability to understand language and follow directions
135
What makes diagnosis in adolescence easier than in infancy
They are able to communicate with language
| There are more concrete developmental milestones for defined characteristics of neurological testing
136
What is new on the DSM 5?
There are treatment strategies suggested
137
Learning disorder:
Neurological condition affecting the brain's ability to receive, process, retain, and respond to information
138
What are some of the areas affected by learning disorders? (6)
```
Reading
Writing
Listening
Speaking
Reasoning
Math
```
139
Are people with learning disabilities unintelligent?
No, they generally have average or above average intelligence
140
Learning disorders are now thought of as on a _____
spectrum
141
Why is it that many people fall under the category of "multiple impairments" for learning disorders?
Because often if there is an abnormality with part of the brain there will be more than one problem
142
Psychosocial manifestations fo a LD (6)
- Attention
- Concentration
- Inference
- Emotional labelling
- Interactional dysfunction
- Social and communicative competence
143
The cause if LD is unknown, but there have been correlations
- Prenatal exposure to drugs, toxins or heavy metals
- Birth complications
- Genetic (run in families)
144
Concordance:
Both twins have disability
145
Discordance:
One twin has the disability
146
Dysregulation of ______ in the brain is thought to be linked to LD, either hyper or hypo
pruning
147
Linkage analysis has found correlations between which two chromosomes and dyslexia
15 and 6
148
Although statistically boys have more LD than girls, why might those stats be wrong?
Difference in how the problem manifests itself in boys and girls:
- Boys act out
- Girls get chatty or quiet
149
what can be the reason that two disorders often occur together? (comorbid)
There is overlap in risk factors and/or genetic susceptibilities
150
there is an increased risk for juvenile delinquency and substance abuse for what disorder
Learning disorder
151
Do people grow out of learning disorders?
No, adolescent LD generally will persist into adulthood
152
What are the co-morbidities of LD? (4)
- Depression
- Aggressive behaviour
- Social incompetence
- Emotional problems
153
What is the neurological underpinning to a learning disorder
The improper development of the cortex
154
Cognitive impairment is almost always associates with what
a learning disability
155
What gene has been linked with learning disability
SHANK3
156
What percentage of people have some form or dyslexia?
~1 in 5
157
People with dyslexia can read, it just takes what?
More time and more cognitive resources
158
Dyslexia is not a visual disorder but rather a _____ disorder
Language
159
What type of spelling is common in people with dyslexia
Phonetic spelling
160
The lateral (Sylvian) fissure is important for ______ processing
Language
161
What are the functions of the lateral fissure
Receiving both auditory and visual information
| Wernicke's area
162
Evolutionarily, why are learning disabilities associated with reading not speaking
Because our brains are automatically designed to make speech sounds, not to read
163
What can you do to mitigate the symptoms of a LD
Reading
| > A skill that can be strengthened through practice
164
What is a key feature of all the fetal alcohol spectrum disorders?
Brain damage
165
Which FASD is the most severe?
Fetal alcohol syndrome
166
What is the prevalence of FASD
24-48/1000
167
Why is alcohol so dangerous to a fetus?
Because it crosses the placental barrier
168
What are the 3 principles of teratology?
1. Results in abnormal development
2. Time of exposure (most risk in 1st trimester)
3. Dose and duration of exposure (unknown)
169
FAS is known as a _______ condition
Teratogenic
170
What are the major criteria for FAS diagnosis (3)`
- Prenatal and/or post natal growth deficiencies
- 3 cardinal facial features
- CNS abnormalities
171
What are the 3 cardinal facial features of FAS
Small eyes
Smooth philtrum (cupid's bow)
Thin upper lip
172
Is FASD heritable?
No
173
What 2 types of drinking increase the risk that a baby will have FASD
binge drinking
| drinking during the first trimester
174
What are 3 distinct brain characteristics of FASD
Microcephaly
Thin corpus callosum
Abnormal cerebellum
175
What is the critical period for most damaging effect of alcohol on the structure/function of the brain?
3-12 weeks gestation
176
People with FASD have a predisposition to what?
Addictive behaviour
177
What are 3 cognitive disabilities of FASD
- Learning disorders and general mental retardation
- Attention deficits
- Reasoning and problem solving issues
178
Behavioural symptoms of FASD (6)
- Attention deficit
- hyperactivity
- Memory loss
- Conduct issues
- Cognitive deficits
- Learning disabilities
179
What receptor does alcohol (ethanol) stimulate
GABA
180
GABA-A receptor:
Ionotropic
| Gates Cl channel
181
GABA-B receptor:
Metabotropic
| Gates K+ channels
182
Which of the GABA receptors does ethanol bind to?
GABA-A
183
What happens when ethanol binds to the GABA-A receptor
It increases the time that the Na channel is open, so more sodium comes in and an action potential is more likely
184
4 cormorbidities of FASD
- Anxiety and mood disorders (depression)
- ADHD
- Addiction
- Suicide
185
Is there a cure for FASD
There is no cure, the damage is permanent
| >Focus on prevention
186
What are the treatments/interventions for FASD
- Optimize environmental environment
- Limit alcohol consumption
- Give parents strategies to deal with kid
- Social support
187
What is a limit to animal research on FASD
Animals metabolize alcohol differently than humans
188
What is resveratrol
An antioxidant that is found in red wine
189
Is having a single drink during pregnancy ok?
It can have just as much of an effect as binge drinking, so don't risk it
190
What is an issue with retrospective studies on FASD
Moms likely do not want to admit how much they drank while pregnant because they know it is bad
191
What are the different binding sites on the GABA A receptor (5)
```
GABA
Alcohol
Benzodiazepine
Barbiturates
Steroids
```
192
Most of the etiology of ADHD is speculative and extrapolated based on what?
based on treatments that work
193
What were the 3 early criterion for attention
1. Central feature of awareness, what we choose to focus on
2. Effortful
3. Motivated by a goal `
194
Executive function requires what 3 things?
- Sustained mental effort
- self regulation
- planning and execution
195
What are the 2 symptoms of ADHD?
1. Faulty attention
| 2. Hyperactivity and impulsivity
196
Which symptom of ADHD is more prevalent in females?
Inattention
197
What 2 things are required for a diagnosis of ADHD?
1. Inattention and/or hyperactivity and impulsivity
| 2. Skill impairment
198
People with the inattentive subtype of ADHA have difficulty attending to ______ and _____ tasks
repetitive and effortful
199
What is the performance vs skill paradigm in ADHD
People with ADHD have all of the necessary skills, they cannot access the skill at that time
200
Inattention in ADHD
Inability to inhibit need to perform a more interesting task
201
Impulsivity in ADHD
Do not think before they act and have issues weighing the consequences of their actions
202
Over-arousal in ADHD
Lack of inhibition, restless, and emotionally reactive
203
Difficulty with gratification in ADHD
They required frequent, immediate, and predictable rewards. They are not good at waiting for long term goals
204
Emotions and locus of control in ADHD
Have rapid ups and downs and blame behaviour on others
205
Where are the delays in brain maturation in people with ADHD
- Basal ganglia
- PFC
- Cerebellum
206
What role does the abnormal PFC play in ADHD (5)
Difficulty with:
- attention
- spatial working memory
- short term memory
- planning and organization
- language skills
207
What role does the abnormal cerebellum play in ADHD
response inhibition and motor coordination
208
Brain structure abnormalities in ADHD (4)
- Smaller right PFC
- Delayed maturation of PFC
- Smaller cerebellum
- Abnormal structure and function of basal ganglia
209
What role does the basal ganglia play in ADHD
improper self-regulation of emotions
210
What 3 NT are possibly affected in ADHD
Dopamine
Norepinephrine
Serotonin
211
What is the role of dopamine in ADHD
Reward/motivation and pleasure seeking behaviours
212
What role does norepinephrine play in ADHD
Emotional and behavioural regulation
213
Dopamine can be converted into what?
Norepinephrine
214
What converts dopamine into norepinephrine
Dopamine-bata-hydroxylase
215
An imbalance in dopamine can lead to an imbalance of what?
Norepinephrine
216
Norepinephrine is related to fight or flight, how could this be impacted in ADHD
Thought that it might play a role in the hyperactivity
217
It has been shown that what reward pathway is impaired in ADHD
Mesolimbic Dopamine system
218
what brain structures are involved in the mesolimbic dopamine system?
Ventral tegmental area
Nucleus accumbens
PFC
219
How could stimulants help ADHD
It will allow for more dopamine in the mesolimbic dopamine system and potentially decrease hyperactivity
220
4 genes that have been linked to impulsive behaviour
DAT1 (dopamine transporter)
DRD2 (dopamine receptor)
MAO-A (monoamine oxidase-A)
5HTT (serotonin transporter)
221
High levels of manganese in the hair of ADHD ppl has been correlated with:
soy-based infant formulas
222
What is the hypothesis of manganese and ADHD
It can accumulate in the brain and has been correlated with the loss of dopamine in the mesolimbic dopamine system
223
What are 4 other prenatal environmental risk factors for ADHD
alcohol
cocaine
lead
smoking
224
If the mom or child has any of these 4 disorders it could be a risk factor for ADHD
- Hyperthyroidism
- Encephalitis
- radiation from cancer
- TBI
225
3 co-morbid factors with ADHD
1. Speech and language problems
2. Poor academic performance
3. Learning disability
226
Do symptoms of ADHD carry into adulthood?
Most do carry into adulthood but some diminish
227
What is the multi-pronged approach to ADHD treatment
- medical
- behavioural
- environmental (limit drug use)
228
Stimulant drugs for ADHD affect which 2 NT
dopamine and norepinephrine
229
2 chemical compound names for stimulant drugs
Methylphenidate
| Dextroamphetamine
230
What are 3 common names for methylphenidate
Ritalin
Cincerta
Metadate
231
What is the common name for dextroamphetamine
Adderall
232
Which of the stimulant drugs is more effective and why?
Adderall
| Allows for more dopamine by blocking reuptake
233
What is the non-stimulant alternative for an ADHD drug? What NT does it target?
Atomoxetine
| Norepinephrine
234
Why would you choose a non-stimulant ADHD drug?
Because it does not contain amphetamine so it is less damaging to the developing brain and it is not addictive
235
Aggressive behaviour
characterized by verbal or physical attack that could be a "protective" response or may destructive toward the self and others
236
Impaired cognitive function in aggression
May leas to incorrect perception of danger or offence
237
Impaired escape or avoidance in aggression
Behaviours likely causes by high levels of anxiety and impaired stress response
238
Impulsivity and aggression
Can be a precursor to aggressive behaviours
| Can be frustration at inability to express one's self
239
Delayed neurodevelopment in aggression
aggression may be an altered mechanism for communicating emotions *especially in delays with cognitive and communication areas
240
Significant life trauma or maltreatment and aggression
May lead to aggressive behaviours
241
Low threshold for anger
associated with impairment in emotional regulation
242
6 potential causes of aggressive behaviour
1. Impaired cog function
2. Impaired escape or avoidance
3. Impulsivity
4. Delayed neurodevelopment
5 Trauma or maltreatment
6. Low anger threshold
243
2 categories of aggressive behaviours
Proactive and reactive
244
Proactive aggression
Seeking out to do harm to a specific person
245
Reactive aggression
A response to perceived harm, slight or violation
246
Aggressive behaviour is characteristic of what neurological conditions (7)
```
depression
bioplar disorder
TBI
PTSD
Alzheimer's
Dementia
Down syndrome
ADHD
```
247
How is aggressive behaviour treated?
Treating the specific individual characteristics by identifying the underlying the "primary symptoms"
248
5 symptoms of aggressive behaviour
```
Impulsivity
Emotional instability
Anxious
Cognitive disorganization
Predatory aggressive behaviour
```
249
2 major types of aggressive disorders
```
Oppositional defiant disorder (ODD)
Conduct disorder (CD)
```
250
What is the current focus in research on aggression
Studying adolescents and identifying precursors through longitudinal studies
251
What are the risk factors that can be identified at an early age for aggressive behaviour
Difficult infant/temperamental
Negative parenting behaviour
>>both together
252
Where is an ____ and ____ difference in the prevalence rates
age and gender
253
What are 2 potential prenatal risk factors to aggressive behaviour
Smoking and other drug use during pregnancy
254
Brain inhibition is linked to 4 executive functions
- working memory
- self regulation
- internalization
- reconstruction
255
What area of the brain processes much of the executive functions in aggressive behaviour
Prefrontal cortex fronto-striatal region (part of the basal ganglia)
256
4 brain regions implicated in aggression
Ventro-medial PFC
Orbitofrontal cortex
Nucleus accubmens
Amygdaya
257
Ventromedia PFC in aggression
Delay of gratification
258
Orbitofrontal cortex in aggression. Is it larger or smaller?
restrain impulsive aggression
| > larger
259
Nucleus accubmens in aggression
Reward and reinforcement
260
Amygdala in aggression. Is it larger or smaller?
Emotional memories used for decision making
| >Smaller
261
Which NT plays the biggest role in aggression
serotonin
| >central role in impulsivity
262
Serotinin interacts with what 4 NT in aggression
Norepinephrine (irritability)
Dopamine (reward)
Glutamate (excitation)
GABA (inhibition)
263
Is it the amount of serotonin that is important in aggression?
No, it is its balance with other NT
264
Mice lacking which serotonin receptor exhibited increased impulsivity and aggression
5-HT1B
265
4 neurodevelopmental predispositions to aggressive behaviour
- Genetic influence
- Prenatal exposure to high levels of testosterone (males)
- Childhood trauma or stress
- intrauterine exposure to smoke
266
What is the hypothesis of MAO and aggression. Why?
Inhibition of brain MAO during fetal brain development is a risk factor for aggression. Leads to excess dopamine in the synapse and the brain gets used to the excess excitation and seeks it out
267
vasopressin in aggression
it is involved in the stress response and seems to be more of it in aggressive males
268
Long term exposure to cortisol _______ serotonin in the limbic system. What does this impact?
Suppresses
| Major impact of emotional stability and impulsivity
269
There is an ________ relationship between serotonin and aggressive behaviour
Inverse
270
Activating the 5TH1A receptor _______ aggression
decreases
271
Vasopressin (which has been linked to aggressive behaviour) is dependent on what hormone?
Testosterone
272
There is high levels of vasopressin and testosterone in what brain area. What does this do?
Lateral septum
| Plays a key role in emotional process and stress response
273
What are the treatment strategies for aggression
CBT
| Medication
274
What is the medical interventions for aggression focused on
Targeting the underlying symptoms, like impulsivity
275
What drugs can be used to treat aggression
Stimulants
Antipsychotics
Mood stabilizers
276
What is Tourette's Syndrome?
Neurological condition characterized by repetitive, involuntary movements and vocalizations called tics
277
When is onset for Tourette's
Early childhood or adolescence (2-15 y/o)
278
Do motor or vocal tics typically appear first
Motor
279
Sometimes the motor tics go un-noticed until when?
Until the vocal tics set in
280
Categorization of Tourette's tics
Simple and complex
281
Simple tics
Involves a few muscles or simple sounds
282
Complex tics
Involves multiple groups of muscles
| >Orchestrated in bouts of muscle contractions or is manifested as single words or complete sentences
283
Examples of simple motor tics
- eye blinking
- jerking of the neck
- shrugging of shoulders
- face grimacing
- coughing
284
Examples of complex motor tics
- grooming behaviours
- facial gestures
- jumping, stomping of feet
- smelling objects
285
Examples of simple vocal tics
- Clearing of throat
- Sniffing
- Grunting
- Barking
286
Examples of complex vocal tics
Repetition of words or phrases out of context
- Coprolalia
- Palilalia
- Echolalia
287
Coporalia
Use of obscenities (rare)
288
Parilalia
Repetition of one's own sounds or words
289
Echolalia
Repetition of recently heard words, sounds, or phrases
290
Do complex tics always develop
No, some people just have simple tics
291
What is a misconception of Tourettes that can make diagnosis hard
Misconception that Tourette's is often associated with coporalia, so it can lead to people not going for diagnosis
292
What are the core features of TS (3)
Multiple motor tics
One or more vocal tics
Motor and vocal tics may appear separately or simultaneously
293
Diagnostics criteria of TS
- Tics must be seen many times a day for a year
- Tics must be present for 3 months straight
- Tics impair aspects of social and emotional well being
294
Are people aware of the tics before they happen in TS
Most have a premonition they will happen but some do not
295
TS movements are described as "_______" but _______
Purposeful but unwanted
296
What is more concrete proof that TS tics are involuntary
They can happen during sleep
297
MRI of TS patients show what
A generally normal brain
298
What brain abnormality has been seen in TS. It is more prevalent in who?
Corpus callosum
| Males
299
There is hypoperfusion in what brain areas in TS
Basal ganglia
Orbitofrontal cortex
Temporal lobe
300
There is decrease activity in what 2 brain regions in TS
Cortex and striatum
301
Is the cause of TS known
No
302
People with parents with TS are ____ more likely to get it too
3 times
303
What are the candidate genes implicated in TS
```
Dopamine receptors (DRD1, 2, 4, 5)
Dopamine transporters
```
304
Environmental risk factors of TS (5)
- Infection in childhood
- Low birth weight
- First trimester sickness
- Smoking during pregnancy
- Labour more that 24 hours (possible hypoxia)
305
PANDAS and TS
Hypothesis that the immunological response to anti-streptococcal antibodies target neuron in the basal ganglia
306
What cortical pathway has been associated with TS
Cortirostriatal-Thalamocortical pathway
307
What size of caudate nucleus is associated with tics
smaller
308
What pharmacological treatment involvng dopamine has shown some success in treating TS. What drug is used
Blocking dopamine receptors has been shown to reduce tics
>Haloperidol
309
What are SSRIs used for in treating TS
Treating comorbid impulsivity, obsession and compulsions, anxiety
310
What are 2 alternative methods of treating TS
- Fish oil supplements
| - Deep brain stimulation of basal ganglia
311
Behavioural therapy can be combined with what pharmacological therapy to treat TS
- Antipsychotics
Risperidone
- Stimulants
