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Neuro Quiz 3 > Pathophysiology of Unipolar Depression > Flashcards

Pathophysiology of Unipolar Depression Flashcards

1
Q

Bipolar defined

A

Drastic mood swings from extreme highs to extreme lows

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2
Q

Depression defined

A

Disorder of inner emotions
Affective disorder or mood disorder
Inappropriate exaggeration of mood

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3
Q

Major depression occurs when:

A

Sadness, grief and other negative emotions interfere with the ability to function in everyday normal life

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4
Q

S&S of Major Depression

A

Persistent sad, anxious, or empty mood
Loss of interest or pleasure in normal activities
Restlessness, excessive crying
Feelings of guilt, worhtlessness, helplessness, hopelessness
Disruptiono f sleep patterns
Changes in appetite and weight
Decreased energy, fatigue, feeling run down
Thoughts of death or suicide
Difficulty concentrating
Headache, digestive problems, chronic pain
Stop caring for themselves

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5
Q

MDD involves

A

Cognitive
Behavioral
Social disruption

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6
Q

Risk Factors for Depression

A 
FH
Stress
Rural
Unemployment
Drug side effects
Ethnicity/Culture
Early Childhood Trauma
Alcohol
Divorced/separated/alone
Illness
Sex/gender
Age (mid-20s)
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7
Q

Triggers + Depression

A

Results from underlying medical conditions, from drug treatments and from stress
Combination of genetic, psychological and environmental factors

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8
Q

Comorbidities + Depression

A

Associated with others (hypothyroidism, nutritional deficiences, neurological/psychiatric disorders

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9
Q

Psychotic Depression Defined

A

The condition also presents with psychotic behaviors such as hallucination and disturbed sense of reality

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10
Q

Define Dysthymia depression

A

Less severe, less disabling
Shows a prolong time course
Predisposes you to MDD

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11
Q

Define Seasonal Affective Disorder

A

Winter = depressed
Spring = remission
Light therapy might be an option

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12
Q

Sleep + Depression

A

Sleep deprivation can result in mood elevation but the depression return after a night of recovery sleep

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13
Q

Define Postpartum depression

A

Depression following delivery

Substantial hormone and physical changes + mental stress of having a baby

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14
Q

Depression is what type of disorder?

A

Heterogeneous

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15
Q

Risk ratio for 1st degree family members is:

A

2-3

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16
Q

Monoxygotic twins vs dizygotic twins

A

54% vs 19%

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17
Q

Heritability number is?

A

.35, which means 65% of the time the phenotypic effects are due to environment and random events

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18
Q

Define Common Variant hypothesis

A

Polygenic disorder and the genes involved are common alleles with a low risk ration

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19
Q

5HT involvement?

A

A polymorphism was IDed in the promotoer of SERT that is a 44 bp insertion/deletion –> short allele produce less SERT
S/S homozygotes are at greater risk of developing MDD
- Primarily in ppl with rough childhood

20
Q

Trp ydroxylase 2 (TPH2) involvement?

A

Hypomorphic allele in the enzyme that catalyzes the rate-limiting step in 5HT synthesis in the brain

21
Q

Brain-derived Neuronotrophic Factor (BDNF)

A

Regulates synaptic plasticity and neuronal survival/differentiation
Reduced by stress
Missense mutation affects synthesis and stability
- Typically in bipolar

22
Q

Define Monoamine Hypothesis

A

Depression is due to serotonergic and noradrenergic hypofunctions

23
Q

Monamine hypothesis explained

A

NE: attention and vigilance, hunger and satiety
5HT: eating behaviors, sleep libido, body temp, melatonin conversion (low 5HT = aggression and impulsive behaviors)

24
Q

Diffuse Neuromodulatory Systems

A

NT just send their signals down neurons

25
Q

The fact that it takes so long for antidepressant drug to work means:

A

Gene changes must be involved /changes in gene regulation alter the pattern of receptors and ion channels in the affected neurons
Could also mean there is a structural change

26
Q

What regions of the brain are involved in the disruption of inner emotions?

A

Limbic system and prefrontal cortex

27
Q

Prefrontal cortex and limbic system are a part of?

A

Part of the Default Mode Network (active during times of engagement)

28
Q

Prefrontal cortex function

A

Planning, motivation and working memory
“elaboration of thoughts” which includes ability to predict and plan for the future, analyze consequences of planned actions
Control over steroeotyped actions

29
Q

Disfunction in the Prefrontal cortex leads to?

A 
Inability to solve complex problems
Lack of motivation
Lack of focus
Impulsivity
Inappropriate social interactions
30
Q

Limbic System Function

A

Interconnected structures that function together in emotion and behavior
Includes: hypothalamus, amygdala, hippocampus, accumbens, cingulate cortex

31
Q

Hypothalamus Function

A

Regulates autonomic function, endocrine function, basic behaviors (eating/sleeping)
Activation of PS: pleasure/warm fuzzy
Activation of S: anxiety, fear, anger
Controls display of emotional behavior

32
Q

Dexamethasone Suppression Test used

A

Test hypothalamic function in MDD

33
Q

Treatment with Dexamethasone leads to

A

Reduced ACTH and cortisol levels

34
Q

50% of pts have

A

Elevated cortisol levels

35
Q

Amygdala Function

A 
Inner emotions (joy, anger, hope, fear, anxiety)
Receives input from PFC and applies emotions to cortical info
36
Q

Hippocampus function

A

Memory consolidation

Positional memory, timing mechanisms, inhibitiono f hypothalamic function

37
Q

Accumbens function

A

“Reward center” which is activated by DA neurons

Responds to novelty and applies positive reinforcements to thoughts and actions

38
Q

Cingulate Cortex Function

A

Emotional awareness

39
Q

How does the limbic system function together?

A

Cingulate gyrus receives sensory info from thalamus, PFC and association cortex
Then sends axons to the hippocampal formation
Hippocampus innervates cortical regions and hypothalamus
- Link outcomes to memory, motivation and behavioral responses

40
Q

Pathology + Depression

A

Reduced volume of hippocampus and areas in PFC

41
Q

Atrophy + Depression

A

None is seen although one study shows dendritic spine reduction

42
Q

Depression + Dentate Gyrus

A

Neurogenesis occurs here and is important for hippocampal function to form new memories

43
Q

Elevated cortisol levels can cause:

A

Hippocampal atrophy (Cushing’s disease) and impaired hippocampal neurogenesis

44
Q

Exercise + Antidepressant + Depression

A

Enhances neurogenesis and elevate BDNF levels (important regulator of hippocampal function)

45
Q

Ketamine + Depression

A

Antidepressant
Rapid effects
Dissociative analgesic and psychotomimetic action
Supposed to rapidly reverese dendritic atrophy with BDNF

Neuro Quiz 3 (3 decks)

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