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Psychiatry > Neurobiology of Psychosis > Flashcards

Neurobiology of Psychosis Flashcards

1
Q

What is the % heritability of psychosis?

A

78%

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2
Q

What is the lifetime risk of Schizophrenia if your parents/MZ twin display it?

A

Parents and MZ twin: 45%

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3
Q

By how much is the risk of schizophrenia increased by childhood viral infection?

A

50%

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4
Q

What will you see on imaging in patients with a poor schizophrenic prognosis?

A

Reduced frontal lobe volume
Reduced frontal lobe grey matter
Enlarged lateral ventricle volume

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5
Q

What are the key features of grey matter abnormalities in schizophrenia?

A

Schizophrenia associated with widely distributed GM abnormalities
Abnormalities are present early in illness and likely pre-morbidly
Grey matter reductions due to reduced arborisation and not neuron loss
Grey matter reductions likely progressive in the initial years of illness

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6
Q

What is found in diffusion tensor imaging in schizophrenic patients?

A 
Fractional anisotrophy (healthy white matter tracts decreased)
Mean diffusivity (less health WM tracts) increased
But increased FA correlates with psychotic symptom severity
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7
Q

What is the neurodevelopment model in schizophrenia?

A

Environmental risk factors act in utero
Children who later develop schizophrenia have identifiable impaired behaviour, motor and intellectual development from infancy
Ventricular enlargement is present at diagnosis and is non-progressive
Disruption of normal cerebral cortical cytoarchitecture - in entorhinal cortex
No gliosis

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8
Q

Schizophrenia is related to the overactivity of what pathways?

A

Dopamine

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9
Q

What does the D1 receptor family do (D1 and D5)?

A

Stimulate cAMP

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10
Q

What does the D2 receptor family do (D2,3 and D4)?

A

Inhibit adenylyl cyclase
Inhibit voltage-activated Ca2+ channels
Open K+ channels

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11
Q

What is the agonist of D2?

A

Bromocriptine

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12
Q

What is the antagonist of D2?

A

Raclopride

Haloperidol

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13
Q

What is the agonist of D3?

A

Quinpirole

7OH-DPAT

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14
Q

What is the antagonist of D3?

A

Raclopride

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15
Q

What is the antagonist of D4?

A

Clozapine

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16
Q

Within what brain regions is D1 located?

A

Neostriatum
Cerebral cortex
Olfactory tubercle
Nucleus accumbens

17
Q

Within what brain regions is D2 located?

A

Neostriatum
Olfactory tubercle
Nucleus accumbens

18
Q

Within what brain regions is D3 located?

A

Nucleus accumbens

Island of Calleja

19
Q

Within what brain regions is D4 located?

A

Midbrain

Amygdala

20
Q

Within what brain regions is D5 located?

A

Hippocampus

Hypothalamus

21
Q

Where are D1 and D2 both located in?

A

Limbic and striatal areas. Other subtypes small number but more discrete distribution

22
Q

What does subcortical dopamine hyperactivity lead to?

A

Psychosis

23
Q

What does mesocortical dopamine hypoactivity lead to?

A

Negative and cognitive symptoms

24
Q

What proteins cause the brain pathology in schizophrenia?

A

Neuregulin
Dysbindin
DISC-1

25
Q

What is neuregulin?

A

A signalling protein that mediates cell-cell interactions and plays critical roles in the growth and development of multiple organ systems

26
Q

What is dysbindin essential for?

A

Adaptive neural plasticity

27
Q

What is DISC-1 involved in?

A

Neurite outgrowth and cortical development through its interaction with other proteins

28
Q

What are the typical antipsychotics?

A 
Chlorpromazine
Thioridazine
Fluphenazine
Haloperidol
Zuclopentixol
29
Q

What defines an atypical antipsychotic?

A

Less likely to induce Extra-Pyramidal side-effects
High 5-HT2A to D2 ratio
Better efficacy against negative symptoms
Effective in patients unresponsive to typical drugs

30
Q

What are the atypical psychotics?

A 
Olanzapine
Risperidone
Quetiapine
Clozapine
Aripiprazole
Amisulpride
31
Q

What do psychotomimetic drugs with high affinity for 5-HT2 receptors cause?

A

Hallucinations and thought disturbance- leads to evidence of reduced receptor binding in people at risk of schizophrenia

32
Q

What is a severe adverse effect of clozapine?

A

Agranulocytosis

33
Q

When should an FBC be carried out in patients on clozapine?

A

Weekly for first 6 months
Fortnightly for next 6
Every 4 weeks thereafter
For 1 month after clozapine cessation

Psychiatry (29 decks)

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