Neuropsychology Flashcards
What are the two main divisions of the Nervous System?
- Central: brain + spinal cord
- Peripheral: afferent nerves (sensory or receptor nerves) that carry info from sense organs to CNS and efferent nerves (motor/effector nerves) that carry info from CNS to muscles/glands
3 Divisions of the Brain
- Hind brain
- Mid brain
- Fore brain
What are the 5 groups of the spinal cord?
- Cervical
- Thoracic
- Lumbar
- Sacral
- Coccygeal
What are afferent nerves?
AKA Sensory or Receptor nerves
Carry info from sense organs to the CNS
What are efferent nerves?
AKA Motor or Effector nerves
Carry info from CNS to the muscles and glands
What are the two brances of the Peripheral Nervous System?
- Somatic Nervous System
- Autonomic Nervous System
What is the role of the Somatic Nervous System?
Controls action of skeletal muscles
Voluntary movement
Relays signals from the senses
What is the role of the Autonomic Nervous System?
Contains nerves that are around smooth muscles, glands (e.g. all our organs)
Regulates things that are involuntary (e.g. digestion, respiration, heartrate)
What are the 2 Branches of the Autonomic Nervous System?
- Sympathetic NS: mobilizes resources to prepare for threat
- Parasympathetic NS: deactivates the F-F-F response. Active during states of relaxation
What are the 3 parts of a neuron?
- Cell Body: responsible for protein synthesis, contains the nucleus, mitochondria
- Dendrites: short fibers that come out of cell body. Respond to stimulation from other neuros and carry it to cell body
- Axon: carries info away from cell body
What is Conduction?
Other terms: resting potential, depolarization, action potential
The electrochemical process through which info is received and processed within a nerve cell
Resting Potential: inside of cell negatively charged, outside positively charged
Stimulation from other cells can lead to depolarization which triggers an action potential
What is Synaptic Transmission?
The transmission of info from one neuron to another
NT’s released following an action potential, float across to other neurons receptor site
2 processes of synaptic transmission termination
Reuptake & Enzynmatic Degradation
- Reuptake: terminal buttons suck in the excess NT’s and store for future
- Enzymatic Degradation: enzyms around the synapse break down the NT which is then removed as waste
What are the 2 chemical messengers of the nervous system?
- Neurotransmitters
- Hormones
What is a Neuromodulator?
A NT that increases or decreases the sensitive of neurons to the effects of other NT’s
What are Cholingeric Neurons?
Neurons that produce Acetylcholine
Acetylcholine (ACh): what does it do?
Involved in:
* Voluntary movement
* Learning & memory
* Sexual behaviour
* Sleep
Can be inhibitory or excitatory
Degeneration in the hippocampus associated with aging and Alzheimers
Where is Dopamine released in the brain?
Basal ganglia
Limbic system
Frontal lobes
What does Dopamine do?
Make me happy
Movement
Learning
Mood
Reinforcing effects of stimulants, opiates, nicotine
Abnormal levels linked to: depression, schizophrenia, Tourette’s, ADHD, Huntington’s, Parkinson’s
What does Norepinephrine do?
Mood
Dreaming
Learning
Automatic responses
Abrnomal levels: depression, mania, panic disorder
What does Serotonin do?
Regulates anxiety, mood, aggression
Memory
Pain
Sleep
Appetite
Sexuality
Low Levels: depression, aggression, PTSD, PCD, Bulimia
High Levels: Schizophrenia, Autism, Anorexia
What does Gamma-Amino Butyric Acid (GABA) do?
Main inhibitory NT of the CNS
Motor Control
Anxiety regulation
Abnormal levels: sleep, eating, anxiety, seizure disorders, Parkinson’s, Huntington’s
What does Glutamate do?
Excitatory NT in the CNS
Long Term Potentiation (LTP) which is needed for memory formation
High Levels: seizures, stroke, TBI, Alzheimers, Parkinsons, Huntingtons
Also contribute to anxiety disorders, schizophrenia, mood disorders
What are Endorphins?
The natural morphine, but it doesn’t make me puke
Hormones: Thyroxin
Controls metabolism
Low = hypothyroidism
High = hyperthyroidism
* At extreme: Grave’s Disease
Hormones: Insulin
Stimulates uptake of glucose and amino acids
Low = diabetes
Hyperglycemia: high appetite, weight loss, pee lots, thirsty, prone to infection, apathy, kidney problems
High = hypoglycemia (hunger, weakness, headaches, visual disturbance, palpitations, anxiety, depression, confusion)
Hormones: Cortisol
Regulates blood glucose levels
Low = Addison’s disease (weakness, fatigue, low BP, irritability, darkening of skin pigmentation)
High = Cushing’s disease (obesity, hypertension, impaired concentration & memory, depression/anx, low libido)
Hindbrain: 3 parts
Brain stem
1. Medulla Oblongata
2. Pons
3. Cerebellum
Role of Medulla Oblongata
Hindbrain
Controls:
* Breath
* Heart
* BP
* Digestion
Stimulates:
* Coughing
* Swallowing
* Salivating
Damage often fatal
Role of the Pons
Hindbrain
Connects 2 halves of cerebellum
Relays sensory & motor information
Role in: arousal, sleep, respiration
Role of the Cerebellum
Hindbrain
Role in:
* balance
* coordination
* posture
Damage: may cause ataxia (slurred speech, tremors, loss of balance)
What 2 parts make up the midbrain?
- Reticular Activating System
- Substantia Nigra
Role of the Reticular Activating System
Midbrain
Part of reticular formation (bunch of neurons from spinal cord to midbrain)
Regulates:
* Sleep-wake transition
* Screens incoming sensory info, esp. when sleeping
* Wakes us up if sensory info needs to be attended to (e.g. cat chaos)
Role of the Substantia Nigra
Midbrain
Role in:
* controlling movement
* reward-seeking
* addictive behaviour
Degeneration of dopamine neurons here can lead to Parkinson’s
Forebrain (Subcortical): 4 areas
- Hypothalamus
- Thalamus
- Basal ganglia
- Limbic system
Role of Hypothalamus
Forebrain
Controls ANS and Endocrine via teh pituitary
Role:
* Maintain homeostasis: temperature, metabolism
* Motivated behaviours: drinking, feeding, sex, aggression, maternal behaviour
* Expression of strong emotions, esp. rage, fear, excitement
What are the 2 parts of the Hypothalamus?
Forebrain
Suprachiasmatic Nucleus:
* Regulates circadian rhythm through light/dark cues
Mammillary Bodies:
* Important for memory
* Damage can result in Korsakoff’s Syndrome (antero/retrograde amnesia, confabulation). related to thiamine deficiency as a result of alcoholism
Role of the Thalamus
Forebrain
Central Relay Station
* Relay incoming sensory info to cortex (except for olfaction-it is relayed by LIMBIC)
* Process info between different cortical regions and between cortex & subcortical
* Language, memory, activity
3 parts of the Basal Ganglia
Forebrain
- Caudate nucleus
- Globus pallidus
- Putamen
What brain areas make up the Extrapyramidal Motor System?
Substantia nigra
Cerebellum
Basal Ganglia (caudate nucelus, globus pallidus, putamen)
Role of the Basal Ganglia
Forebrain
Process and relay info needed for control of:
* Voltuntary movement
* Motor expression of emotion
* Sensorimotor learning
Abnormalities:
* Tourette’s
* Huntington’s
* Parkinson’s
* Schizophrenia
* Mood disorders
* OCD
* ADHD
4 parts of the Limbic System
Forebrain
- Amygdala
- Septum
- Cingulate cortex
- Hippocampus
Role of the Amygdala
Forebrain
- Integrates and directs emotional reactions
- Attaches emotion to info it gets from the senses
- Mediates aggressive/defensive behaviour
Damage: lack of fear, struggle reading tones/expressions
Kluver-Bucy Syndrome: low fear & aggression, increased docility, altered diet, psychic blindness, hypersexuality
occurred in monkeys w/ bilateral lesions in amygdala and anterior temporal lobe
Role of the Septum
Forebrain
Inhibits emotionality
Lesions may cause Septal Rage Syndrome (shown in rats)
* Hyperemotionality
* Viciousness
Role of the Cingulate Cortex
Forebrain
Regulates emotional responses and pain perception
Role of the Hippocampus
Forebrain
Role:
* Memory and Learning
* Memory consolidation
Damage:
* Anterograde amnesia
* Degeneration linked to memory loss
What is Contralateral Representation?
Forebrain
Each hemisphere controls the opposite side of the body
Olfactory is the exception.
Lateralization of Function
Each hemisphere dominates for certain behaviours
Left Hemisphere is often responsible for language, logic, positive emotion
Right Hemisphere for spatial relationships, creativity, negative emotion
What happened in studies with split brain patients?
Info in left visual field, people couldn’t verbally ID object or pick it out with right hand, but could with left hand
4 Lobes of the Cerebral Cortex
Forebrain
- Frontal Lobe
- Parietal Lobe
- Occipital Lobe
- Temporal Lobe
Role of the Frontal Lobe
- Motor behaviour
- Expressive language
- Higher-level cognitive functions
4 Areas of the Frontal Lobe
Forebrain
- Primary motor cortex
- Premotor cortex
- Broca’s area
- Prefrontal cortex
Role of the Primary Motor Cortex
Part of the Pyramidal Motor System (pathway of neurons from motor cortex to brain stem and spinal cord. Mediates intricate movement, and speed/strength of movement)
Role in the control of voluntary movement
Lesions may produce weakness, paralysis, apraxia
Role of Premotor Cortex
Forebrain
Location: anterior to primary motor cortex
Active during motor actions, or when observing people do motor actions
Role of Broca’s Area
Forebrain
A primary language area, within the left frontal lobe
Broca’s Aphasia: deficits in production of written and spoken language
* slow, simple speech
* difficulty repeating phrases
* anomia
Role of the Prefrontal Cortex
Forebrain
High order cog functions:
* planning
* judgement
* problem solving
* memory (WM & prospective memory)
* regulate emotion & motor responses
Damage:
* Dorsolateral Prefrontal Area: ‘Dysexecutive syndrome’ (impaired problem solving, planning, abstract thinking, highly distracticle, apathetic)
* Medial Frontal:” pseudodepression
* Pseudopsychopathy
Temporal Lobe: 2 main roles
- Auditory input
- Long-term memory
2 areas of the Temporal Lobe
- Auditory Cortex
- Wernicke’s area
Role of Auditory Cortex
Temporal Lobe
Mediation of auditory input
Damage:
* auditory agnosia (can’t distinguish sound)
* auditory hallucinations
Role of Wernicke’s Area
Temporal Lobe
Location: left temporal lobe
Role: language comprehension
Damage:
* Wernicke’s Aphasia: trouble understanding language. they produce fluent speech but it is nonsensical. Anomia, difficulty w/ repetition
What is Conduction Aphasia? What causes it?
Temporal Lobe
What? comprehends language and speaks fluently, but has anomia and difficulties repeating what has been heard
Cause: lesions in the arcuate fasciculus (connects Broca and Wernickes)
What may cause deja vu?
Temporal lobe
Electrical stimulation of certain parts of the right temporal lobe
Medial Temporal Lobe and Memory
H.M. example
Tumors here may affect verbal or nonverbal memory
H.M had a bilateral medial temporal lobectomy to treat epilepsy
ST memory and pre-surgery memory were intact
Couldn’t acquire new information, or recall info retained shortly before the surgery
Parietal Lobe & the Somatosensory Cortex Role
-
Role:
* process somatosensory input and integrates it w/ other info
Parietal Lobe Damage: 3 types of Somatosensory Agnosia
Somatosensory Agnosia:
* tactile agnosia: can’t ID objects by touch
* asomatognosia: can’t recognize own body parts
* anosognosia: can’t recognize own symptoms
Parietal Lobe Damage: Contralateral Neglect
Loss of knowledge of or interest in one side of the body or things in the environment
Location: right parietal lobe
Parietal Lobe Damage: 3 types of Apraxia
Apraxia
* can’t do purposeful movement.
* Ideomotor Apraxia: can’t carry out request to do an action, but can do it spontaneously
* Constructional Apraxia: can’t draw or copy simple figures or arrange blocks in pattern
Parietal Lobe Damage: Gerstmann’s Syndrome
Cause: lesions in left hemisphere
Impact:
* Agraphia: difficulties w/ writing
* Acalculia: difficulties w/ math
* Finger agnosia: can’t recognize our fingers
* Left-right disorientation
Occiptal Lobe & the Visual Cortex
Role: process visual info
Damage:
* Total damage = complete blindness
* Less extensive = blind spots, after-images, loss of depth perception, alexia (can’t recognize printed words), visual agnosia (can’t recognize familiar objects)
What is Prosopagnosia and what causes it?
Occipital Lobe
What? inability to recognize familiar faces
Cause: damage that affects junction of occipital/temporal/parietal lobes
What are the 3 Components of Emotions?
Physiological Foundations of Behaviour
- Autonomic arousal
- Feelings
- Behaviour
Ekman’s 6 Primary Emotions
Physiological Foundations
- Happiness
- Sadness
- Fear
- Anger
- Disgust
- Surprise
Papez’s role in the study of emotions
Physiological foundations
One of the first to research brain mechanisms underlying emotions
Neural circuit that mediates experience and expression of emotions
Circuit = hippocampus, mammillary bodies, anterior thalamic nuclei of thalamus, cingulate gyrus
Ended up being more involved w/ memory than emotion
3 Brain areas involved in emotion
Physiological foundations
- Hypothalamus: physical expression of emotion through ANS and pituitary
- Amygdala: attach emotional content to memory, esp. fear & anxiety, mediate aggression, recognize fear in others
- Cerebral Cortex: left linked to positive emotions; damage = depression, anxiety. Right linked to negative emotions; damage = indifference
James-Lange Theory of Emotion
Physiological Foundations
Emotions happen when an autonomic response occurs to stimuli, which is then interpreted as an emotion
e.g. I’m trembling, so I must be scared.
Cannon-Bard Theory of Emotion
Physiological Foundations
Stimulus triggers thalamus to engage SNS and cerebral cortex
Arousal and emotional experience occur together
Thinks all emotions have same physiological response
Schacter & Singer’s Cognitive Arousal Theory
Physiological Foundations
Emotion is a combo of physical arousal and cognitive attributions for the arousal
Physical sensations similar for most emotions
What part of the brain starts puberty?
The hypothalamus-pituitary-gonadal axis (HPG)
Genetic, but affected by diet, health, climate, etc.
What 4 parts of the brain shows sexual dimorphism?
- The corpus callosum
- Amygdala
- Hippocampus
- Cerebellum
HRT for Cisgender People?! WHY?
To reduce the effects of menopause (e.g. osteoporosis, heart disease, all the other great stuff)
Increase sex drive (T given to both men and women for this purpose)
Describe Stage 1 Sleep
- Transitional stage
- fast alpha waves replaced by slower theta waves
- Drowsy, muscles relax, heart slows
Describe Stage 2 Sleep
- Starts in a few minutes
- Theta waves w/ sporadic sleep spindles and K-Complexes (bursts of higher activity)
- Moderately light sleep
Describe Stage 3 Sleep
- Transition stage
- large & slow delta waves appear
Describe Stage 4 Sleep
- Large, slow delta waves
- Deep breath, slowed heart, low BP
- Deep sleep
Describe REM Sleep
Deep sleep, but brain waves are similar to stage 1/2
Breath and heart similar to awake
AKA Paradoxical Sleep
Dreams here are more vivid and easily remembered
What happens to sleep as we age?
We sleep less
Less time spent in REM and in Stages 3/4
We start to wake more throughout the night
May shift to earlier bed time, earlier wake time
What happens in REM Deprivation?
Alters sleep patterns
Anxiety, irritability
Impair cog functioning
Effects go away once allowed to sleep
A REM rebound occurs once asleep
Hippocampus Role in Memory
Memory consolidation (ST to LT)
Consolidation happens during sleep
Amygdala Role in Memory
Forms emotional memories by linking emotions to stimuli and events
Prefrontal Cortex Role in Memory
Working Memory
Prospective Memory: remember something in the future
Temporal Lobes Role in Memory
Storage of LT declarative memory
Long Term Potentiation Role in Memory
High-frequency stim of neurons increases sensitivity and structure of dendrites
These changes may underlie memory formation
Proteins Role in Memory
ST memory = modification of preexisting proteins
LT memory = synthesis of new proteins
Meds that block the synthesis of protein or RNA prevent formation of LT memory
What is Sensation?
receipt of info by sensory receptors and the translation of that info into nerve impulses that get sent to the brain
What is Perception?
The process of becoming aware of and interpreting what has been sensed
Vision: What are rods?
A photoreceptor that are adapted for low levels of light
See in black, white, grey
Location: periphery of retina
Vision: What are cones?
Photoreceptors specialized for detecting colour, visual acuity, function best in bright light
Location: clustered around centre of retina (fovea)
What is the stimulus pathway from the photoreceptors to the optic nerve?
Photoreceptors –> Bipolar Cells –> Ganglion Cells
Axoms of the Ganglion Cells form the optic nerve
Young-Hemholtz Trichromatic Theory of Colour Vision
There’s 3 types of color receptions that respond to a primary colour
What are the colours?! red, blue, green
applies only to 1st level of processing @ retina
Hering’s Opponent-Process Theory of Colour Vision
3 types of opponent-process cells (stimulated by 1-inhibited by another)
1. red-green
2. yellow-blue
3. white-black
Patterns of stimulation produce colours
Explains why we see after images
Applies to 2nd level of processing (retina to visual cortex)
What causes colour blindness?
Genetic: anomaly on X chromosome
Injury/Disease
Most common is red-green colour blindness
What is the Auditory Pathway?
Sound wave enters –> auditory canal –> ear drum –> ossicles –> oval window –> cochlea –> hair cells (auditory receptors) –> transformed to neural activity –> auditory nerve –> thalamus –> auditory cortex
Components of Sound: What is Loudness?
Intensity
Amplitude of sound waves
Measures in decibels
Pain threshold is 120db
Components of Sound: What is Pitch?
Frequency of sound waves
Measured in cycles per second (Hertz)
Human range: 20-20,000 Hz
Components of Sound: What is Timbre?
Tonal quality of sound, related to the sound waves complexity
Makes it possible to distinguish between two sounds that have same loudness and pitch
Pain: What is one of its distinguishing features?
It is not caused by a single type of stimulus, but a variety
What affects pain sensitivity?
- Past experience with pain (more past exp = more sensitive)
- Expectations of pain relief
- Anxiety/depression
- BPD/ASD/etc
Gate Control Theory of Pain
**2 types of nerve fibres: **
-large myelinated fibres
-Small, unmyelinated fibres
Activation of large inhibits transmission of pain by small fibres
How to activate? massage, temperature therapy, etc.
What is Neuropathic Pain?
Caused by nervous system trauma, surgery, disease, drugs
E.G. Phantom Limb Pain: thought to be caused by damage to central/peripheral NS
Treatment: anti-depressants, opioids, anticonvulsants, topical analgesics, transcutaneous nerve stimulation (TENS)
What is Synesthesia?
An involuntary perceptual condition in which stim of one sensory mode elicits a sensation in another mode
Types:
-Grapheme Synesthesia: numbers/letters are associated with a colour
What causes Synesthesia?
Cytowic (1993) said the limbic system
Others say increased connectivity of neural connections between associated regions
Genetic, sensory deprivation, drug use, brain damage
What is Psychophysics?
Study of the relationship between magnitude of physical stimuli and psychological sensations
Psychophysics: Fechner’s 2 Thresholds
Absolute Threshold & Difference Threshold
- Absolute Threshold: weakest stimuli that a person can detect . Its the intensity at which a stimulus is detected 50% of the time by people
- Difference Threshold: AKA Just Noticeable Difference. Smallest physical difference between two stimuli that is recognized as a difference (e.g. with a 10lbs weight, you don’t notice a difference between 8 lbs or 12lbs. JND is 2lbs)
Psychophysics: Weber’s Law
The just noticeable difference for any stimulus increases in size in direct proportion to the magnitude of the stimulus
Psychophysics: Fecher’s Law
There’s a logarithmic relationship between psychological sensation and magnitude of physical stimulus
Intensity of internal sensation increases arithmetically as the stimulus increases
Psychophysics: Steven’s Power Law
There’s an exponential relationship between psychological sensation and magnitude of a physical stimulus, and it varies between stimuli
Method of Magnitude Estimation: participants rated intensity value to different stimuli. It showed that the perception varied based on type of stimuli.
E.g. doubling intensity of a light may double perception of its brightness, but doubling the temp of a room more than doubles the perception of heat
What are Neurological Disorders? Give 5 examples.
Disorders of the nervous system
1. stoke
2. TBI
3. motor disorders
4. seizures
5. headaches
What are the 2 types of brain imaging techniques?
- Structural techniques
- Functional techniques
Structural Brain Imagining Techniques
ID structural changes
Types:
CT/CAT (computerized axial tomography) scan: xray
MRI: magnetic & radio waves
Show cross sections of brain
Functional Brain Imaging Techniques
Brain structure and activity
Types:
1. PET (positron emission tomography): radioactive injection. Map NT’s and find dysfunction
2.* SPECT* (single photon emission computed tomography): like PET, but lower resolution
3. fMRI: shows brain activity based on blood oxygenation
What are the 2 types of stroke?
- Ischemic: artery is blocked
- Hemorrhagic: blood vessel in brain ruptures or leaks
What are the risk factors of stroke?
- Hypertension
- Athersclerosis
- Atrial fibrillation
- Diabetes
- Cigarettes
- Age/Gender/Race
Symptoms of a Middle Cerebral Artery Stroke
Most common one
Contralateral hemiplegia & hemiparesis (face + arm)
Contralateral visual field loss
Aphasia
May not notice some symptoms
Symptoms of Anterior Cerebral Artery Stroke
Contralateral hemiplegia (leg)
Impaired judgment and insight
Personality change
Incontinence
Symptoms of Posterior Cerebral Artery Stroke
Cortical blindness
Visual agnosia
Language impairment
Memory loss
2 types of TBI
- Open Head Injury: symptoms focal to area affected, resolves quickly, rare to lose consciousness
- Closed Head Injury: more wide spread damage, often lose consciousness. Often has emotional, behavioural, physical, cognitive symptoms
What 3 measures are often used for TBI?
- Glasgow Coma Scale
- Duration of Post Traumatic Amnesia
- Duration of Loss of Consciousness
All rated as mild/moderate/severe
What is Postconcussional Syndrome?
When a TBI results in prolonged symptoms such as:
* dizziness
* headaches
* memory impairment
* fatigue
* emotional instability
Could meet DSM-5 for Major/Mild Neurocognitive Disorder
Huntington’s Disease: Symptom Progression
Initial Symptoms:
* Depression
* Anxiety
* Mania
* Emotional lability
Middle Symptoms:
* Forgetfulness
* Personality changes
* Motor symptoms (clumsiness, fidgetting, incoordination)
Later Symptoms:
* Athetosis: slow, writhing movement
* Chorea: involuntary movement of face, limbs, trunk
* Disarthria: struggle articulating words
* Dysphagia: difficulty swallowing
* Immobility
* Mild/Major neurocog
Age of Onset: 30-50
Huntington’s Disease: Causes
Genetics:
* autosomal dominant gene
Brain:
* smaller basal ganglia
* abnormal cortex
* reduced metabolic brain activity
Neurotransmitter:
* Glutamate
* ACh
* GABA
* Dopamine
Parkinson’s: Symptoms
Tremor:
* first symptom
* “Pill rolling” hand movement
Rigidity:
* neck, arms, legs
* ‘Cogwheel Rigidity’ = tremor + rigid = jerky movement
Postural Instability:
* unsteadiness
* Stooped posture
Bradykinesia:
* difficulty initiating/completing movements
* Face: blank mask
Parkinson’s: Cause
Loss of dopamine producing cells in the substantia nigra
Basal ganglia, thalamus and cortex then affected
Symptoms of a Simple Partial Seizure
No loss of consciousness
Uncontrollable movements
Sensory (hallucinations, paresthesias)
Autonomic (nausea, sweating)
Symptoms of a Complex Partial Seizure
Start with aura
Alteration in consciousness
Automatisms: involuntary complex movements
Most often originating in lobes of cerebral cortex, esp. temporal
Generalized Seizures: Tonic Clonic
AKA grand mal
Symptoms:
* altered consciousness
* Tonic (stiffening of body) followed by clonic (jerky movement of arms and legs)
* Once conscious, may be depressed, irritable, confused, have amnesia
Generalized Seizures: Absence Seizures
AKA petit mal
Symptoms:
* brief loss of consciousness
* Vacant stare
Migraine: causes
Low serotonin that leads to constriction of blood vessels
But really, they don’t know
Migraine: Treatment
Medication:
* NSAIDs
* Ergotamine
* Sumatriptan
* SSRI
* Beta-blockers
Other:
* thermal biofeedback
* autogenic training
Tension Headaches: Causes
Usually muscle tension
Serotonin may be involved
Cluster Headaches: Treatment
Medication:
* sumatriptan
* lidocaine
Other:
* oxygen therapy
Sinus Headaches: Causes and Treatment
Causes:
* Sinusitis
Treatment:
* Antihistamines
* Decongestants
* Antibiotics
* Corticosteroids
Quantitative Genetic Methods: what does it look at?
calculates the net impact of genetic and environmental variables on specific traits
Molecular Genetic Methods: what does it look at?
Used to ID what genes are responsible for specific traits
What effect does an Agonist have?
Psychopharmacology
Produce similar effects as do neurotransmitters
What effect does an Inverse Agonist have?
Psychopharmacology
Produce effects opposite to those of a neurotransmitter
What effect does an Antagonist have?
Psychopharmacology
Produce no activity on their own; they reduce/block the effects of a NT or agonist
What are the effects of race/ethnicity on psychoactive drugs?
Psychopharmacology
Asians and African Americans may metabolize some isoenzymes slower than White peoples
This leads to increased sensitivity to the therapeutic and side effects of meds
What are the 5 types of antidepressants?
Psychopharmacology
- Tricyclic (TCA’s)
- SSRI’s
- Monoamine Oxidate Inhibitor (MAOIs)
- Serotonin-Norepinephrine Reuptake Inhibitors (SNRI)
- Norepinephrine-dopamine Reuptake Inhibitors (NDRI’s)
Tricyclic Antidepressant: how does it work? Name 3
Psychopharmacology
How? block reuptake of norepinephrine and serotonin
Common Ones:
1. Imipramine (Tofranil)
2. Clomipramine (Anafranil)
3. Amitriptyline (Elavil)
Tricyclic Antidepressants: 8 Uses
Psychopharmacology
- MDD w/ hopelessness and anhedonia
- Relieve physicals symptoms: appetite, sleep, energy
- Dysthymic Disorder
- Panic attack
- Agoraphobia
- OCD (clomipramine)
- Enuresis (imipramine)
- Chronic pain
Tricyclic’s: Side Effects
Psychopharmacology
- Anticholinergic: dry mouth, constipation, urinary retention, blurred vission
- Gastrointestinal
- Impaired sexual functioning
- Drowsiness
- Weight gain
- Confusion/memory impairment
Less common:
* tachycardia
* arrhythmia
* Orthostatic hypotension
Very toxic in overdose
SSRI’s: How do they work? Name 3
Psychopharmacology
Work? increase the availability of serotonin at synapses
Common Ones:
1. Fluoxetine (prozac)
2. Sertraline (Zoloft)
3. Paroxetine (Paxil)
SSRI: Uses
- MDD
- Dysthymic disorder
- OCD
- Panic disorder
- Social phobia
- Binge eating
- Premature ejaculation
SSRI’s: Side Effects
Psychopharmacology
Common:
* Nausea
* Loss of appetite
* Impaired sex functioning
* Dizziness
* Agitation
* Headaches
Safer in overdose
Combined with other meds may cause Serotonin Syndrome
Monoamine Oxidase Inhibitors (MAOI’s): How do they work? Name 2
Psychopharmacology
How? block an enzyme that breaks down norepinephrine & serotonin
Common Ones:
1. Phenelzine (Nardil)
2. Tranylcypromine (Parnate)
MAOI’s: Uses
Psychopharmacology
Atypical depression (increased appetite, hypersomnia, RSD, reactivity, hypochondriasis)
Depression that hasn’t responded to other meds
MAOI’s: Side Effects
Psychopharmacology
Common:
* dry mouth
* anti-cholinergic
* nausea
* weight gain
* dizziness
* insomnia
* tremoe
* Tachycardia
* Impaired sex functioning
Overdose:
* Seizures
* Coma
* Cardiac arrest
Combined with other drugs/food containing tyramine can cause Hypertensive Crisis
Serotonin-Norepinephrine Reuptake Inhibitors (SNRI’s): Name 3
- Venlafaxine (Effexor)
- Duloxetine (Cymbalta)
- Desvenlafaxine (Pristiq)
SNRI’s: Side Effects
Psychopharmacology
- Sleep disturbance
- nausea
- gastrointestinal
- sex dysfunction
- headache
- high BP
SNRI’s: Uses
Psychopharmacology
- MDD
- GAD
- SAD
- Panic Disorder
Norepinephrine-Dopamine Reuptake Inhibitors (NDRI’s): Name 1
Psychopharmacology
- Buproprion: Wellbutrin, Zyban
Lithium: 2 main types, 4 sub
Psychopharmacology
Lithium carbonate:
1. Eskalith
2. Lithonat
3. Duralith
Lithium citrate:
1. Cibalith
Lithium: Side Effects
Psychopharmacology
Common:
* nausea
* diarrhea
* metallic taste
* weight gain
* hand tremor
* fatigue
* mild cog impairment
Anti-Seizure Drugs: what are they used for? Name 2
Psychopharmacology
- Cabamazepine (Tegretol)
- Valproic acid (Depakote)
Used to treat mania and mania w/ rapid cycling
Anti-Seizure Drugs: Side Effects
Psychopharmacology
- Vomiting
- Lethargy
- Tremor
- Ataxia
- Visual disturbances
Monitor closely for liver failure, low white blood cell count, anemia
Traditional Antipsychotics: how do they work? Name 3
Psychopharmacology
How? block dopamine receptors
Common ones:
1. Phenothiazines: clorpromazine (Thorazine), thioridazine (Mellaril)
2. Butyrophenones: haloperidol (Haldol)
Traditional Antipsychotics: Uses?
Psychopharmacology
- Schizophrenia (only work on + symptoms)
- Psychosis
- Tourette’s
- Acute mania
Traditional Antipsychotics: Side Effects
Anticholinergic
Extrapyramidal
Neuroleptic malignant syndrome
Anticholinergic:
* Dry mouth
* Urinary retention
* Blurred vision
* Tachycardia
* Gastric distress
* Sex dysfunction
Extrapyramidal:
* Parkinsonism
* Dystonia (muscle contraction, involuntary movement)
* Akathisia
* Tardive dyskinesia
Neuroleptic malignant syndrome: life threatening. ridity muscle, fever, unstable blood pressure, cog disturbances, autonomic dysfunction
Sedatives/Hypnotics/Anxiolytics: 2 types
Psychopharmacology
- Benzodiazapines
- Barbituates
Benzodiazapines: how do they work? Name 5
Psychopharmacology
How? enhance GABA
Common ones:
1. Diazepam (valium)
2. Alprazolam (xanax)
3. clonazepam (klonapin)
4. Lorazepam (ativan)
5. Triazolam (Halcion)
Benzos: uses
Psychopharmacology
Anxiety
Insomnia
Muscle spasms
Seizures
Moderate/severe alcohol withdrawal
Benzos: Side Effects
Psychopharmacology
Common:
* Drowsiness/sedation
* Ataxia
* Incoordination
* Anterograde amnesia
* Reduced concentration
* Anticholinergic
* Sex dysfunction
Very addictive
Severe withdrawal
Fatal mized with other CNS depressants
Barbituates: how do they work? Name 3
Psychopharmacology
How? affect GABA in reticular activating system, medulla, parts of cortex
Common ones:
1. thiopental (pentothal)
2. amobarbital (amytal)
3. secobarbital (seconal)
Barbituates: Uses
Psychopharmacology
General anesthetic
Manage agitated patients
ST insomnia treatment
Used to be for anxiety
Barbituates: Side Effects
Psychopharmacology
Common:
* Drowsiness
* Dizziness
* Confusion
* Ataxia
* Cog impairment
* Paradoxical excitement
Very addictive
Withdrawal: seizures, delirium, death
Too much fatally suppresses breathing
Azaspirones (sedative): how do they work? name 1
Psychopharmacology
How? affects dopamine, norepinephrine, serotonin
Med: Buspirone (BuSpar)
Azaspirones: Side Effects
Psychopharmacology
Common:
* Dizziness
* Light headedness
* Nausea
* Headache
Doesn’t have strong sedative effect
Seems to be less addictive
Narcotic-Analgesics: how do they work? Name 3 main types
Psychopharmacology
How? mimic the bodies natural analgesics (endorphins, enkephalins)
Types:
1. Natural opioids: opium, morphine, codeine
2. Synthetic opioids
3. Semi-synthetic opioids: heroin, methadone, oxycodone (Percodan, OxyContin), hydrocodone (Vicodin), meperidine (Demerol)
Narcotic-Analgesics: Side Effects
Psychopharmacology
Common:
* Dry mouth
* Nausea
* Pupil constriction
* Hypotension
* Cough suppression
* Sex dysfunction
* Respiratory depression
Overdose: decreased pulse, convulsions, coma, death
Chronic Use: dependence, tolerance, withdrawal.
Psychostimulants: how do they work? Name 3 main prescription types
Psychopharmacology
How? mimic norepinephrine & dopamine
Common Ones:
1. Methylphenidate: ritalin, concerta
2. Pemoline: cylert
3. Amphetamine-dextroamphetamine: adderall
Psychostimulants: uses
Psychopharmacology
ADHD
Narcolepsy
They decrease motor activity & impulsiveness
Psychostimulants: side effects
Psychopharmacology
Common:
1. Insomnia
2. Decreased appetite
3. Weight loss
4. Stomachaches
5. Dysphoric mood
May worsen tics
Kids may have a drug holiday
Norepinephrine Reuptake Inhibitor (NRIs)
How do they work?
Uses
Side Effects
How? block reuptake of norepinephrine
Med: atomoxetine (strattera)
Use: non-stim drug for ADHD
Side Effects:
* Decreased appetite
* dizziness
* fatigue
* irritability
* sexual dysfunction
* menstrual cramps
* may increase SI in kids and teens
Beta-Blockers: how do they work? Name 1
Psychopharmacology
How? inhibit SNS by blocking beta-adrenergic receptors. Slow HR and lower BP
Med: propranolol (Inderal)
Beta-Blockers: Uses
Psychopharmacology
- Hypertension
- Cardiac arrythmias
- Migraine
- Essential tremor
- Physical symptoms of anxiety
Beta-Blockers: Side Effects
Psychopharmacology
Common:
* brachycardia
* hypotension
* sex dysfunction
* fatigue
* nausea
* vision changes
* dizziness
* depression
Abrupt withdrawal:
* headache
* tremors
* confusion
* hypertension
* arrhythmia
Anti-Alcohol Drugs
2 common ones
How do they work?
Side effects
Meds:
1. Disulfiram (Antabuse)
2. Naltrexone (ReVia, Vivitrol)
How?
No. 1 causes nausea, vomit, shortness of breath, tachycardia when taken with booze
No. 2 reduces pleasurable effects of booze and cravings for it
Side effects:
* No.1: drowsy, rash, headache, restless, impotence, blood dyscrasias, metallic/garlic taste. Overdose may be fatal
* No 2.: stomach pain, nausea, vomit, fatigue, headache, joint/muscle pain, liver damage
Cognition Enhancer
Name 4
How do they work?
Psychopharmacology
How? inhibit breakdown of acetylcholine
Meds:
1. Tacrine Hydrochloride (Cognex)
2. Donepezil hydrochloride (Aricept)
3. Rivastigmine (Exelon)
4. Galantamine (Razadyne)
Cognition Enhancer
Side effects
Uses
Psychopharmacology
Uses:
* slow down memory loss & other cog impairments in Alzheimers
* Donepezil: approved for mild/mod/severe Alzheimers
* Others approved only for mild/moderate
Side Effects:
* Diarrhea
* Nausea
* Loss of appetite
* Weight loss
* Stomach pain
* Tacrine Hydrochloride can cause liver failure; rarely prescribed
Practical Clinical Trials
What are they?
How to formulate them? (5 steps)
Psychopharmacology
Focus: effectiveness of intervention in typical community settings
Formulation:
1. Hypothesis about clinical concern
2. Objective/measurable goals that capture clinical significance
3. Randomized design
4. Selection criterion
5. Large sample size
3 types of genetic screening methods
C;B;M
Psychopharmacology
- Cytogenetic: examine chromosomal abnormalities
- Biochemical: examine proteins instead of gene
- Molecular: directly analyze DNA sequence