Schizophrenia Flashcards
abnormal behaviours that have been gained such as hallucinations (typically auditory), delusions (paranoia), and thought disorder (all together called psychosis)
positive symtoms
normal functions that have been lost such as blunted emotional responses, poverty of speech, social withdrawal, anhedonia, lack of insight, and cognitive deficits
negative symptoms
At least ___ or ____ core symptoms: ____, ____ or _____ _____ must be present for diagnosis of schizophrenia. These symptoms are also present in other conditions that need to be ruled out before schizophrenia is diagnosed. Other symptoms include lack of ____ into the illness, delusions of _____, and ______.
1,3 , hallucinations, delusions, disorganized speech, insight, reference, suspiciousness
_____% of the population suffer from schizophrenia at any given time. Onset is typically after ____ (18 years). In men, it typically does not onset after ______. A small number of women develop symptoms after _____ (45+ years)
1, puberty, 30, menopause
The cognitive abnormalities are ____ dramatic than the psychotic symptoms. However, these deficits may be a ___- component of the disorder. Cognitive functioning is the #1 predictor of ____ _____ ____. Better cognitive functioning has a better _______. The severity of ____ symptoms are not related to the severity of cognitive deficits.
less, core, long term outcome, prognosis, psychotic
The 7 primary domains of cognition that are affected are: speed of ____, _____ ___, ____ learning/memory, ____ cognition, _____/vigilance, ______/problem solving, _____ learning/memory.
processing, working memory, visual, social, attention, reasoning, verbal
many functions mediated by the _____ such as ____ attention, working memory, behavioural _____, and ____ are impaired in schizophrenia. Brain activation studies show that those with schizophrenia show _____ ____ in PFC activity when performing the ____ _____ _____ in comparison to their discordant identical twin controls. Other brain regions were activated ____ in both groups, showing they they do not show as dramatic of disruption in function in other ____ regions
PFC, selective, flexibility, planning, minimal increase, wisconsin card sort, similarly, cortical
a test of cognitive flexibility critically dependent on the PFC
wisconsin cart sort
The odds of developing SZ increases if one has a _______ that has SZ. The highest concordance is in _____ twins, or if both parents are schizophrenic (_____). _______ _____ also indicate that there is a heritability component. Thus, there is a strong genetic component to the disease, but ____ ____ are not the only cause. ____ of genes or different _____ of alterations may be linked to SZ. In particular, the ____ gene mutation has been linked to risk for schizophrenia. This gene encodes for proteins essential in _____ _____. Various polymorphisms are also associated with impaired ____ _____
relative, identical, 50%, adoption studies, altered genes, dozens, combinations, DISC1, neural development, cognitive functioning
_____ during development are another major contributing factor to the emergence of SZ. There is a higher occurrence of _____ complications with SZ vs the general population, such as ___ ___ during pregnancy, _____ birth or low ____ ____, and ____/_____ stressors during pregnancy. Early developmental insults lead to ____ ____ in adulthood.
perturbations, perinatal, poor nutrition, premature, birth weight, physical, immune, brain abnormalities
Stressor later in life (after puberty) can ____ the onset of SZ. Genetics increase ____ to stressors by the mother or child, either in ____ or later in life. Some people may have a genetic ____ to acquiring the disease, but certain types of stressors over development need to trigger it.
trigger, sensitivity, utero, susceptibility
Some behaviours in early _____ signal potential risk for SZ, such as _____ and ____, reduced responsiveness to ____ ____, difficult _____, and poor _______ performance.
infancy, apathy, passivity, verbal commands, temperament, sensorimotor
During adolescence, (a period of significant brain development), excessive _____ pruning can result in a loss of _____ ______ matter
synaptic, cortical grey
Some schizophrenics have enlarged ____ due to smaller ____ and other ____ lobe regions. Closer inspections reveals _____ of hippocampal neurons is altered. Most brain changes observed in SZ aren’t correlated with the _____ _____ ____ or _____ _____. It is not brain damage per se, but changes in _____ ______ that occur during early development that can disrupt how brain regions ______ information.
ventricles, hippocampus, temporal, organization, time since onset, symptom duration, neural organization, process
The ______ _____ ___ neurons of schizophrenics have reduced number of ______, which reduces _____ power of these cells and leads to _____ failures. Schizophrenia is also associated with ______ (reduced PFC function) as a characteristic ____ symptom. Schizophrenics also have reduced markers for _____ ____ in the ______ and other regions such as the hippocampus. These neurons serve as a major _____ ___ for these areas and in schizophrenics this can lead to a ____ cortex, reducing information ____ and impairing functioning of these regions
prefrontal cortex pyramidal, dendrites, processing, connectivity, hypofrontality, negative, GABAergic interneurons, PFC, information filter, noisy, filtering
In the 1950s, _____ was found to antipsychotic. This medication also caused ____ symptoms in healthy individuals. Brains of Parkinson’s patients was found to be depleted of ______. In 1960s, drugs that increased dopamine release such as ____ could induce psychotic symptoms. Antipsychotics were also found to block ____ ____. In the 1970s, dopamine receptor _____ were discovered, and the antipsychotic _____ of a drug was correlated with binding to ______ ______ (not D1). This led to the dopamine hypothesis of schizophrenia.
chloropromazine, parkinsons, dopamine, amphetamine, dopamine receptors, subtypes, potency, D2 receptors,
The theory that schizophrenia is caused by an abnormal increase in dopamine transmission, leading to overstimulation of D2 receptors
dopamine hypothesis
Support for the dopamine hypothesis includes that all drugs that are effective in treating ____ block ___ receptors to some degree.
psychosis, D2
Study found that giving ____ to schizophrenics vs controls showed greater ____ release in the ____ in schizophrenics. A greater effect was correlated with more ____ symptoms. Thus dopamine release is ____ in schizophrenia
amphetamine, dopamine, striatum, positive, hypersensitive
DA neurons show increased activity to ____ _____ / _____ stimuli. This increase in activity (and dopamine release in the striatum from the ____) may serve as a signal the brain uses to determine what’s important or _______. A hyperactive DA system may ____ normally irrelevant stimuli as important and impair filtering of irrelevant stimuli. This leads to _______ _____ ______ that may contribute to delusions. ____ medications are thought to reduce this by reducing DA activity.
highly salient, novel, VTA, relevant, tag, aberrant salience attribution, antipsychotic
Often schizophrenics still report hearing the _____ when they’re on medication, but they no longer ___ them. Antipsychotic drugs only effectively treat psychosis, often negative symptoms are ____ as well treated by these drugs
voices, bother, not
The idea that different symptoms of schizophrenia are driven by excessive mesolimbic DA function (positive function) combined with reduced prefrontal DA function (negative/cognitive symptoms)
dopamine imbalance hypothesis
Postmortem and recent imaging studies have found evidence of reduced ____ ____ transmission in schizophrenia. Drugs that increase PFC dopamine release (e.g. ______), can improve _____ functions mediated by the PFC in schizophrenic patients
PFC DA, amphetamine, cognitive
Dopamine ____ and ___ receptors can have different effects depending on the circumstance . Depletion of prefrontal dopamine in monkeys decreases in ____ _____ as much as ablation of the PFC in the ___ ___ task. In other words, the monkeys do poorly even with the shortest _____. _____ and ____ depletion had no effect. People with schizophrenia are also impaired on tasks of working memory even on trials with the shortest delay.
D1, D2, working memory, delayed response, delay, NE, 5-HT
Rats trained on a ____ ____ task are trained to turn to the ____ arm in a ___ maze. This is a measure of ____ memory. A ____ ____ only injected into the PFC reduces performance, as well as a ______ ______. Normal performance is in the ___ zone of DA signalling. Thus there is an inverted ___ shaped relationship between DA and cognitive performance.
delayed alternation, opposite, T, working, D1 antagonist, D1 agonist, optimal, U
PFC D1 but not ____ receptors mediate working memory. Animals were first trained in a ____ maze, where 4 arms were blocked and 4 arms were ____ with food. Rats are just trained to find the food. Then, there is a delay period of _____ minutes, and in the test phase, all arms are open, but only previously _____ arms are baited with food. Blocking ___ receptors impairs performance on the task, but blocking ____ receptors in the PFC does not impair performance. Similar effects are seen with _____
D2, radial, baited, 30, blocked, D1, D2, primates
Overstimulating D1 receptors with a D1 _____ impairs performance in ____ ___ tasks, normally. However, when extending the delay between the training and test phase to ____ hours, control animals make ______ errors than on shorter delay (ie. lower _____). Stimulating D1 receptors in this case ______ performance (beneficial effect). Thus D1 receptor stimulation can improve ______ cognitive functioning
agonist, working memory, 12, more, baseline, increases, suboptimal
