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Neuro Quiz 4 > Schizophrenia Pathophysiology > Flashcards

Schizophrenia Pathophysiology Flashcards

1
Q

Schizophrenia is:

A

Both disturbed content form and content of thought
Intellectual function is also impaired
- DA hyperactivity!!

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2
Q

Define Positive Symptoms

A 
Delusions
Hallucination
Disorganized speech
Bizarre or disorganized behavior
(antipsych agents - DA antgonists)
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3
Q

Define Negative Symptoms

A

Loss or decline of normal function such as speech, blunting of emotions
Anergy
Loss of sociability
Loss of ability to derive pleasure

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4
Q

Define Cognitive Symptoms

A

Impaired ability to focus
Poor decision making
Impaired working memory

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5
Q

Define Persecutory delusions

A

involving the belief that others are spying on or planning harm to you

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6
Q

Delusions

A

Your thoughts are being broadcast to the world
Thought and feelings are imposed from an outside source
- Speech may be vague or repetitive and rambling
- Internal thoughts

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7
Q

Hallucinations

A

Distinguished from those induced by LSD
Positive symptoms = similar to toxic amphetamine
- Sensory

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8
Q

PCP intoxication =

A

Positive/negative aspects of SCZ

- It is a NMDA receptor antagonists so it blocks DA reuptake and enhance DA release

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9
Q

Schizophrenia Life time risk & age of onset

A

1%

Late teens, early 20s (coincides with maturation of PFC)

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10
Q

Psychosis vs Schizo

A

P: common comorbidity in neuro/psych disorders and externally induced

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11
Q

Schizo + Suicide risk

A

10%

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12
Q

Schizo + Neurodevelopmental Model

A

End stage of abnormal neurodevelopment that occurred many years before the onset
- Genetic and environmental

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13
Q

Infections + Schizo

A

Prenatal (rubella, toxoplasma, HSV, influenza) = increased risk

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14
Q

Famine + Schizo

A

In utero during famine + mood disorders = increased risk

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15
Q

Low birth weight + Schizo

A

Nonspecific RF shows in ADHD, autism, etc too

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16
Q

Urban environment + Schizo

A

Stress, mood/anxiety disorder elevation = increased risk

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17
Q

Childhood trauma + Schizo

A

Phsyical, mental, social trauma
Paternal age, maternal stress, winter birth, obstetrical complication (DM, C-section, etc)
Nutritional deficiencies in folate, Fe or Vit D
ALL = increased risk

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18
Q

Dizygotic twins risk

A

17%

19
Q

Monozygotic twins risk

A

48%

20
Q

Heritability in Schizo

A

0.81

21
Q

DISC1

A

Causative of SCZ
Scaffold protein that organizes and spatially regulates activity of proteins involved in neuronal proliferation, migration, cell signaling, spine regulation and synapse maintenance
- unlike bipolar

22
Q

COMT

A

Clearance of DA in PFC

23
Q

CACNA1c

A

Alpha subunit of voltage-gated Ca channel (also RF for bipolar)

24
Q

TCF4/ITF2

A

transcription factor in brain that interacts with others and plays a role in brain development

25
Q

NRGN

A

Protein kinase in postsynaptic synapse

Binds calmodulin in low Ca and target for thyroid hormone function in brain

26
Q

Copy Number Variants

A

Regions of DNA that are deleted or duplicated resulting in genes that are haploid or polyploid (vary in size)

27
Q

CNV + NRXN1

A

NRXN1 = Neurexin - encodes a cell surface adhesion molecule that is involved in formation and maintenance of synapses
- Some are de novo or private mutations that arrive spontaneously in the pt or parents’ gametes

28
Q

CNV do what?

A

Disrupt genes involved with signaling, synaptic plasticity, and neurodevelopmental processes
- Depend on paternal age

29
Q

Dopamine hypothesis - Nigrostriatal

A

Disrupt in PD

30
Q

Dopamine hypothesis - Tuberoinfundibular

A

DA neuron in the hypothalamus project to the pituitary and inhibit the release of prolactin
- Prolactin levels can measure DA function

31
Q

Dopamine hypothesis - Mesolimbic/mesocortical

A

DA cells in the ventral tegmentum area (VTA) project their axons to limbic system and prefrontal cortex
VTA innervation in nucleus accumbens (NA) is important for imparting reward and reinforcement
NA acts as the “gate” for input from the hippocampus, amygdala, septum, hypothalamus, PFC and inhibitory feedback from PFC

32
Q

DA in the NA

A

Modulate the flow of information esp neuromodulation of PFC networks

33
Q

General accepted deficits:

A

grey matter in PFC and temporal cortex

34
Q

SCZ development?

A

The deficits are seen before first episode but if a second hit comes around the functional maturation time of the PFC it will lead to the full grown disease

35
Q

Cortical atrophy + SCZ

A

If that second hit doesn’t come this atrophy normalizes, SCZ is only seen when a second hit has come

36
Q

Dorsolateral region Function

A

Cognitive functions: working memory, planning, elaboration of thoughts

37
Q

Ventral region function:

A

Conscious regulation of emotions

38
Q

Causes of negative and positive symptoms

A

Hyperactivity of DA in ventral PFC = (+)

Hypofunction of DA in dorsolateral PFC = (-) and cognitive

39
Q

Schizo Patients Show:

A

Enlarged ventricles
Reduced PFC, temporal lobe, and hippocampal volume (not neurodegenerative but excess pruning of synapses cause)
Reduced cerebral blood flow in the front lobes (hypofunction)
Abnormal eye movements (PFC)
Abnormal stimulus induced EEG (diffuse)
Default Mood Network (inward looking) is not easily deactivated by tasks that active externally=directed networks

40
Q

Simple explanation of SCZ

A

Positive symptoms = overactivity of DA in Na and ACC

Negative symptoms = frontal hypofunctionality

41
Q

Why use antipsychotics:

A

serotonergic innervation in PFC inhibits its function and these neurons are hyperactive due to stress which then reduced PFC function

42
Q

Homovanillic acid =

A

DA metabolite so might predict elevated levels in a disease of hyperactive DA

43
Q

Define depolarization blockade

A

Axons become refractory to firing because they become depolarized and unable to reactivate voltage gated channels

44
Q

Inihbit DA in pituitary and striatum =

A 
Increase prolactin (lactation or gynecomastia)
Extrapyramidal motor effects

Neuro Quiz 4 (4 decks)

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