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Brain and Behaviour > Schizophrenia > Flashcards

Schizophrenia Flashcards

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1
Q

Eugen Bleuler is associated with what?

A

Terming the condition

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2
Q

What are the three categories of symptoms?

A
  1. Negative
  2. Cognitive
  3. Positive
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3
Q

Name the three types of positive symptoms

A

Hallucinations, delusions and thought disorders

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4
Q

How are negative symptoms defined?

A

Absence of normal behaviours

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5
Q

Give 2 examples of negative symptoms

A

Speech poverty, anhedonia, flattened emotional response, lack of initiative, persistence, social withdrawal

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6
Q

What cognitive symptoms are there?

A

Lower performance on IQ tests, planning and info processing deficits, working mem deficits, sensory-motor gating and anti-saccade task deficits, poor oculomotor function

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7
Q

What area of the frontal lobe specifically causes dysfunction?

A

Dorso-lateral PFC

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8
Q

What are the 2 tests that patients are slower at?

A

Stroop test and wisconsin card sort task

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9
Q

What are sensory motor gating deficits?

A

Difficulty screening out irrelevant stimuli

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10
Q

The event related potential that occurs approx 50 ms after the presentation of a stimulus is called what?

A

P50 wave

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11
Q

In the P50 signal task what % of the wave is diminished to the second click in healthy vs schiz ppts?

A

H = 80%, S = no change

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12
Q

What type of eye movements do patients show in the oculomotor task?

A

Catch up saccades

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13
Q

Who found that ventricle size of patients was more than twice as big as that of normal control subjects?

A

Weinburger and Wyatt, 82

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14
Q

There was less grey matter in what three brain regions? (82- Weinburger and Wyatt study)

A

Temporal, frontal and hippocampus

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15
Q

What gene is involved in the regulation of neurogenesis, neuronal migration, postsynaptic density and mitochondria function?

A

DISC1 gene

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16
Q

The presence of the DISC1 gene increases the chance o schizophrenia by a factor of what?

A

50

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17
Q

The DISC1 gene also increases the incidence of 2 other conditions, what are these?

A

Bipolar and autism

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18
Q

How does paternal age affect incidence rates?

A

After puberty they rapidly dividing (every 16 days), mutations in the spermatocytes which are the cells that produce sperm

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19
Q

What is a dichorionic MZ twin?

A

When the blastocyst division occurs before day 4 of development

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20
Q

What is the physical difference between di and monochorionic twins?

A

Di do not share a placenta

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21
Q

David and Phelps found the concordance rate for di versus monochorionic twins was what %?

A

D = 32%
M = 60%

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22
Q

What are examples of early events that cause schiz in the early model?

A

Infections, nutritional deficiencies

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23
Q

What early evidence suggests deviations in brain development? (Walker et al)

A

Children with schiz showed more negative affect in their facial expressions, and more abnormal movements

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24
Q

What study did Schiffman et al 2004 do?

A

Videotaped children eating lunch, blind raters found that the children who later developed schizophrenia displayed less sociability and less psychomotor function

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25
Q

Name the three models of schiz

A

Early model, late development model and two-hit model

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26
Q

What neurotransmitter hypothesis explains schiz?

A

Dopamine hypothesis

27
Q

Overactivity in what area causes the positive symptoms and underactivity in what area causes the negative and cognitive symptoms?

A

Mesolimbic and mesocoritcal

28
Q

What do these drugs: amphetamines, cocaine, methylphenidate and L-DOPA show about the DA hypothesis?

A

They are all dopamine agonists, and they all produce symptoms that resemble the positive symptoms of schiz

29
Q

What type of drugs block dopamine receptors and alleviate symptoms?

A

Antipsychotics

30
Q

Who discovered the drug chlorpromazine as the first antipsychotic?

A

Henri Laborit

31
Q

What type of DA receptors do these antagonists block?

A

D2 type family

32
Q

If a drug has low affinity what does this mean?

A

It binds loosly to the receptor and therefore a higher dose is needed

33
Q

What radioactive tracer is used in SPECT studies?

A

Iodobenzamine (IBZM)

34
Q

What is a reversible ligand?

A

It will compete with DA for binding to that receptor

35
Q

What did Dargham et al, 1998 measure in their study?

A

Dopamine displacement after treatment with amphetamines

36
Q

The study showed that patients with schiz had higher levels of displacement. What does this mean in terms of dopamine?

A

That they were releasing more dopamine in response to amphetamine compared to controls

37
Q

The study also showed that higher displacement correlated with what type of symptoms?

A

Positive symptoms

38
Q

Long-term treatment with typical antipsychotic drugs leads to what sort of symptoms?

A

Those resembling Parkinsons - slowness in movement, lack of facial expression and general weakness

39
Q

What happens to patients with tardive dyskinesia?

A

They are unable to stop moving

40
Q

Name 2 differences between A-typical and typical antiphsychotics.

A
  1. A-typ improves both positive and negative symptoms
  2. A-typ have lower affinity and therefore don’t produce the parkinsonian side-effects
41
Q

Name the first a-typical antipsychotic

A

Clozapine

42
Q

Give positives and negatives of clozapine

A

P = reduces suicide rate
N = side neffects such as weight gain, sedation, tachycardia

43
Q

What role do NMDA receptors have during early development?

A

Neural migration, survival, pruning, plasticity and apoptosis

44
Q

What is the glutamate hypo-functioning hypothesis and what does it explain?

A

NMDA hypofunction on GABA-ergic interneurons in the PFC
Explains treatment resistant symptoms, why the onset is early adulthood and why the disorder is associated with structural change

45
Q

Blocking the NMDA receptor has what affect?

A

Leads to the excessive release of glutamate

46
Q

PCP and ketamine are examples of what type of drug?

A

NMDA antagonists

47
Q

What do glutamate agonists do to symptoms of schiz?

A

Improves both positive and negative symptoms

48
Q

Describe the task used in the Jentsch 1997 study

A

Monkeys were given PCP for 2 weeks and tested a week later on a task that involved reaching around a barrier for a piece of food

49
Q

What does it mean if an NMDA receptor is hypoactive

A

The activity of the NMDA receptor is inhibited

50
Q

What were the results of the Jentsch 1997 study?

A

Performance on the task depends on the function of the PFC, whether animals had lesions here, and control monkeys performed well but depended on PCP treatment

51
Q

What causes the lack of inhibition of glutamate?

A

Hypofunctioning NMDA receptors at the GABA ergic interneuron in the prefrontal cortex, disinhibits the GABA ergic interneuron, which leads to increased glutamate release

52
Q

What does increased glutamate lead to?

A

Over excitation into the mesolimbic system (VTA) which causes the release of dopamine

53
Q

In the mesocortical system, how are dopamine levels low?

A

Increased glutamate caused by the hypo-functioning NMDA receptor, leads to high excitation at the additional GABA receptor in the PFC, which leads to high levels of inhibition and lower dopamine release

54
Q

What is the role of microglial cells and what is different in patients?

A

The brains immune cells and they are hyperactive

55
Q

What have animal studies shown about pro-inflammatory agents and schiz symptoms?

A

They increase symptoms

56
Q

GWAS studies showed what genes are involved in the heritability of schiz?

A

DRD2, GLU receptor subunits

57
Q

Where is the most significant association found and what region of genes does it include?

A

Chromosome 6 which includes a region of genes involved in acquired immunity - MHC

58
Q

What does it mean if a microglia is amoeboid?

A

It has swollen up and is releasing chemicals

59
Q

What other role does microglia have in early brain development?

A

Neuronal cell death and survival, synaptogenesis and pruning

60
Q

How might early infection lead to schiz according to the microglial theory?

A

Early infection primes the microglia, which may interact with the developing cells in the nervous system, leading to rearrangements of the sympathetic circuitry

61
Q

How does oestrogen play a protective role?

A

17B-estradiol is the mos potent form, the second peak of onset for women may be linked to the decrease in oestrogen following menopause

62
Q

Name the environmental factors that are related to spread of disease and infection

A

Season of birth, population density and viral epidemics

63
Q

What are the other environmental factors that increase schiz?

A

Vitamin D deficiencies, substance abuse and prenatal malnutrition

64
Q

What factors would affect vitamin D levels?

A

Urban areas, those in more extreme latitudes, and those with more melanin

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