WEEK 3 Flashcards

1
Q

phospholipid barrier

A

hydrophobic membrane surrounding neurons, allowing the separation of aqueous ions between the extracellular and intracellular spaces. to move ions in and out, there are protein pumps (sodium potassium pumps) and ion channels (sodium channel or potassium channel).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

two types of ion channels

A

1) leak channels: they are open and allow ions to passively flux up and down their concentration gradients

2) gated channels: closed at resting condition but open either due to electricity (voltage-gated channel) or neurotransmission (ligand-gated channel). once open, they allow ions to flux across the membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

resting membrane potential: leak channels

A

negatively charged anions are permanently locked within the cell, making the intracellular space negatively charged. this attracts positive ions, sodium and potassium, towards the extracellular space. while also repelling negatively charged ions like chloride, the extracellular space is positively charged. in response to this charge, more potassium will enter the cell (as there are more potassium leak channels on neurons). some sodium will enter but there are less sodium leak channels.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

resting membrane potential: sodium potassium ATP pump

A

energy-dependent mechanism that helps to maintain the high concentration of potassium in the cell, the low concentration of potassium outside the cell, the high concentration of sodium outside the cell, and the low concentration of sodium inside the cell. it collects 3 sodium ions from inside the cell and pumps them to the extracellular space. in return, 2 potassium ions are pumped into the intracellular space from the extracellular space. this maintains the concentration gradient at resting potential.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

sodium potassium ATP pump: mechanisms

A

1) increases the concentration of sodium in the extracellular space

2) increases the concentration of potassium in the intracellular space

3) the exchange of positively charged ions helps to maintain the net negativity of the intracellular space compared to the extracellular space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

two ionic forces

A

1) electrostatic force: the charge component, the one for the positive ions to go towards the negative ions through the leak channels

2) force of diffusion: they want to move along their concentration gradients from an area of high concentration to an area of low concentration (ex: potassium wanting to leave the cell due to lower concentration in the extracellular space)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

ionic forces and the 3 main ions

A

1) sodium: both electrostatic force and diffusion want to push sodium into the cell - as the cell is negatively charged, and it has a low concentration of sodium. this makes sodium incredibly potentiated, meaning that as soon as a sodium channel opens, it will rush into the cell

2) potassium has divergent forces: electrostatic force attracts it to the negatively charged intracellular space, but the force of diffusion wants it out, since its in lower concentration in the extracellular space.

3) chloride ions shows the opposite to potassium: electrostatic force attracts it to the positively charged extracellular space, but the force of diffusion wants it in the cell, as its concentration is lower in the intracellular space.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

equilibrium potential

A

point for any ion where the net flux across the membrane is 0, because of electrostatic force and force of diffusion being equal to each other. so under resting conditions, these ions would not move across the membrane potential.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

graded potential

A

change in the membrane’s potential around the ion channel, which can be positive or negative. usually caused by the flux of sodium ions into the cell following the opening of a ligand-gated channel on the postsynaptic cell. if it is sodium or potassium it depolarizes the postsynaptic neuron (making it more positively charged towards the AP firing threshold). if it is chloride ions it hyperpolarizes the postsynaptic neuron (making it more negatively charged away from the AP firing threshold).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

AP firing threshold

A

when the graded potential reaches the axon initial segment (AIS) there is a threshold which determines whether a consequent AP will be fired or not: if the graded potential is below the AP threshold, no AP is generated, it decays, and the cell returns to its resting potential. if the graded potential is above the AP threshold, an AP is generated and we get a rapid flux of sodium ions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

spatial summation of excitatory postsynaptic potentials (EPSPs)

A

if a single channel were to respond, that graded potential may not be above the threshold. however, if 3 inputs were to fire simultaneously, their responses would be summed in the cell body, so we have a much larger graded potential which travels to the AIS above the threshold and generates an AP.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

temporal summation of excitatory postsynaptic potentials (EPSPs)

A

if a single input were weak, but was later followed up by a second input, alone neither of them would be able to match the AP threshold. however, if they fired very quickly after the other, their potentials would be summed up on top of each other and potentially lead to the firing of an AP.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

excitatory postsynaptic potential (EPSP)

A

changes that happen in response to the positively charged ions (sodium and potassium) which moves the membrane potential towards the triggering threshold for an AP - depolarization.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

inhibitory postsynaptic potential (IPSP)

A

changes that happen in response to the negatively charged ions (chloride) which moves the membrane potential away from the triggering threshold for an AP - hyperpolarization.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

voltage gated channels (sodium and potassium)

A

1) voltage gated sodium channel: in response to electrical stimulus, the channel will open, and due to both electrostatic and diffusion forces, sodium will rapidly flux into the cell, depolarizing it.

2) voltage gated potassium channel: in response to electrical stimulus, the channel will open, and due to diffusion forces, potassium will flux out of the cell, rendering the intracellular space more negative - hyperpolarizing it.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

action potential: phases

A

1) resting membrane potential

2) depolarizing stimuli

3) depolarization reaches the threshold: voltage gated sodium channels open and sodium enters the neuron

4) rapid flux of sodium further depolarizes the neuron

5) sodium channels close 0.5 ms after they open, so no sodium can flux in any longer

6) slower responding potassium channels open and potassium leaves the cell, hyperpolarizing it

7) voltage gated potassium channels close, some potassium enters the cell via leak channels

8) resurrection of the normal resting membrane potential

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

absolute refractory period

A

point at which the sodium channels are inactivated, they can’t flux sodium anymore. this lasts until the resting membrane potential has been restored. no AP can be triggered in that neuron. this has two functions:

1) allows the neuron to control its excitability

2) prevents back propagation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

relative refractory period

A

after the hyperpolarisation phase, where potassium channels render the membrane potential more negative than the resting potential. during this time an AP can be triggered, but because the membrane is below resting potential, it would require a greater input.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

channels’ three functional states

A

1) closed/resting state (sodium + potassium): when the gate is closed and can’t flux ions

2) open/active state (sodium + potassium): when the gate is open and can flux ions

3) inactive/refractory state (only sodium): a ball and chain mechanism has taken up into the pore and physically blocks it. although the gate is open, it is blocked, so no sodium can pass through and the cell can’t fire an AP.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

sodium channel changes during an AP

A

1) resting condition: gate is closed

2) voltage-dependent activation of the gate: gate opens and sodium fluxes into the cell

3) depolarization phase: sodium moves the cell to a more positive state. if it is above the threshold, we get rapid opening of other sodium channels and a huge influx of sodium, with an even larger depolarization phase.

4) 0.5 ms after sodium gates are opened, the ball and chain blocks the gate, preventing further depolarization,

5) potassium channels open, pushing potassium outside the gate, and we have hyperpolarisation of the cell. the ball and chain is removed and the gate closes.

6) the channel is back to its resting condition.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

myelin

A

generated by Schwann cells in the PNS or oligodendrocytes in the CNS. it is an insulating fatty layer that prevents the current from leaking across the environment.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

AP conduction: non-myelinated axons

A

relatively slow process because sequential voltage-gated channels have to respond along the entire length of the axon.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

AP conduction: myelinated axons

A

conduction is called saltatory conduction: the AP jumps from one node of ranvier to another. myelin can really exceed the speed of regular propagation because we don’t have to have sequential activation of ion channels across the entire length of the axon, we get saltatory conduction from one node to the next.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

nodes of ranvier

A

bare uninsulated sections between the oligodendrocytes, exposed to the extracellular space. these are specialized compartments that have a high density of voltage gated channels, making them uniquely excitable.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

synaptic transmission in chemical synapses

A

in response to an incoming AP, the calcium channels on the presynaptic neuron open. calcium floods into the cell and the vesicles move to the membrane via exocytosis, where they fuse with the membrane and are then released into the synaptic cleft. neurotransmitters will then diffuse across the gap and trigger the ligand-gated ion channels on the postsynaptic neuron.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

stimulus-dependent neurotransmitter release

A

the firing mechanism between the presynaptic and postsynaptic cells is stimulus-dependent: the higher the voltage of the current, the more voltage-gated channels open, the higher the release of neurotransmitters, the more APs are triggered.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

neurotransmitter removal: mechanisms

A

1) reuptake of neurotransmitters into the presynaptic cell

2) reuptake of neurotransmitters into supporting glial cells (astrocytes) - super energy efficient recycling

3) degrading of neurotransmitters on the postsynaptic membrane

4) diffusion of neurotransmitters away from the synaptic cleft and taken up into the blood stream

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

the 2s, 3r, 2d system

A

2 s:
- synthesis (presynaptic terminal)
- storage (presynaptic terminal)

3r:
- release (synaptic cleft)
- receptors (postsynaptic terminal)
- reuptake (presynaptic terminal)

2d:
- degradation (presynaptic terminal)
- drugs and disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

glutamate

A

amino acid widely distributed in the CNS, occurring at 70% of all synapses. there is very little glutamate at the PNS. it is the most important excitatory neurotransmitter in the CNS.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

glutamate: synthesis

A

occurs in 2 types of cells:

1) glial cells: oxoglutarate is converted into glutamate by GABA transaminase

2) neurons: glutamine is converted into glutamate via glutaminase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

glutamate: storage

A

stored in vesicles by a protein called the vesicular glutamate transporter (vGluT). to get glutamate in, hydrogen ions are pumped out of the vesicles. high hydrogen content makes vesicles acidic, and is used to pump in glutamate via a proton pump which converts the energy of ATP into higher concentration of hydrogen in the vesicle, which can then be exchanged for neurotransmitters.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

glutamate: release

A

released by the nerve terminal at the axon terminal bouton. they are released in a calcium-dependent process: calcium is required to move and fuse vesicles with the membrane to allow neurotransmitters into the synaptic cleft.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

glutamate: receptors

A

1) ionotropic glutamate receptors (iGluRs): ion channels activated by glutamate, subdivided into NMDARs, AMPARs, and kainaite Rs. they mostly allow in sodium and push out potassium. however, NMDARs also allow in calcium ions.

2) metabotropic glutamate receptors (mGluRs): G-protein coupled receptors that can be subdivided into three groups: mGluR1&5, mGluR2&3, mGluR4&6-8).

34
Q

glutamate: reuptake

A

1) excitatory amino acid transporters (EAATs) take glutamate back into the presynaptic terminal, where it can be repackaged into vesicles and reused.

2) taken up into astrocytes via conversion into glutamine by glutamine synthase. the glutamine is then transported out of the astrocyte and back into the neuron by the glutamine transporter Glnt, which can then be synthesized back into glutamate via glutaminase.

35
Q

glutamate: degradation

A

removed by EAATs to the neuron for recycling or into astrocytes where it is converted to glutamine by glutamine synthase.

36
Q

glutamate: drugs

A
  • ketamine: dissociative anesthetic and channel blocker at the NMDAR
  • memantine: competitive antagonist to the NMDAR
  • perampanel: competitive antagonist to the AMPAR and kainate R
37
Q

glutamate: disease

A
  • some are caused by the recreational use of drugs, which causes addiction and dependency (PCP, ketamine)
  • epilepsy is associated with the glutamatergic system as it controls the excitability of the brain
  • glutamate is critical to all CNS functions.
38
Q

GABA

A

amino acid widely distributed in the CNS, 30% of synapses. there is very little GABA in the PNS. it is the most important inhibitory neurotransmitter in the CNS.

39
Q

GABA: synthesis

A

synthesized from glutamate by an enzyme called glutamic acid decarboxylase (GAD).

40
Q

GABA: storage

A

stored in vesicles by the vesicular GABA transporter (vGABAT). these vesicles also have a proton pump that fill them with hydrogen ions which can then be exchanged for GABA.

41
Q

GABA: release

A

GABA has a calcium-dependent vesicular release which occurs at the axon end terminal bouton.

42
Q

GABA: receptors

A

1) ionotropic receptors (GABA-ARs): ion channel for chloride ions, allowing negative ions into the cell.

2) metabotropic receptors (GABA-BRs): coupled to the G-proteins Gi and Go.

43
Q

GABA: reuptake

A

the transporter protein that moves it back into neurons is the GAT1, the neuronal GABA transporter. the transporter that moves it into astrocytes is GAT3, the glial GABA transporter.

44
Q

GABA: degradation

A

occurs by an enzyme called GABA transaminase mostly in glial cells. oxoglutarate is converted to glutamate and GABA is converted to an inactive compound, succinic semialdehyde.

45
Q

GABA: drugs

A

1) not used clinically:
- muscimol: agonist which activates the GABA-AR
- bicuculine: competitive antagonist for GABA-AR
- picrotoxin: GABA-AR channel blocker

2) clinically-useful for GABA-A:
- benzodiazepines, ethanol, general anesthetics

3) GABA-BR drugs:
- baclofen: agonist
- saclofen: competitive antagonist

  • tiagabine: interferes with GABA reuptake by blocking GAT1.
  • vigabatrine: blocks GABA transaminase (degradation)
46
Q

GABA: disease

A
  • barbiturates act on GABA-ARs
  • epilepsy, anxiety, and insomnia
  • GABA has a major function in the CNS, associated with the brain’s inhibitory actions
47
Q

dopamine (DA)

A

monoamine located in specific areas in the CNS, more restricted distribution.

  • nigrostriatal pathway is dopaminergic, associated with Parkinson’s
  • mesocortical pathway is dopaminergic, associated with schizophrenia
48
Q

DA: synthesis

A

3 step process:

1) tyrosine is taken in by the diet

2) it is converted to DOPA through a rate limiting enzyme called tyrosine hydroxylase

3) DOPA is converted to DA by dopa decarboxylase

49
Q

DA: storage

A

stored in vesicles by two types of vesicular monoamine transporters, VMAT1 and VMAT2. these can be cell type specific: some dopaminergic neurons have VMAT1 and others VMAT2.

50
Q

DA: release

A

calcium-dependent vesicular release which occurs mainly at the axon terminal bouton. BUT DA can also be released in an “en passant” manner, where small release sites are located all the way down the axon.

51
Q

DA: receptors

A

one type: GPCRS. they can be subdivided into D1-like receptors (coupled to G5) or D2-like receptors (coupled to Go or Gi).

52
Q

DA: reuptake

A

reuptaken into the neuron by a dopamine active transporter (DAT), co-transported with one chloride ion and two sodium ions.

53
Q

DA: degradation

A

end-product: homovanillic acid.

1) dopamine is converted by monoamine oxidase (MAO) to dihydroxyphenylacetic acid by catechol-o-mthyltransferase (COMT)

2) dopamine is converted into 3-methoxydopamine by COMT, then by MAO to homovanillic acid.

54
Q

DA: drugs

A

1) levodopa: treats Parkinson’s, increases DA synthesis and is a precursor

2) for storage: reserpine, methamphetamine - blocking the vesicular transporter

3) for release: amantadine

4) for receptors:
- full agonists: dopamine, apomorphine, bromocriptine
- competitive antagonists: haloperidol, chlorpromazine (clinically used)

5) for reuptake: cocaine, bupropion, methylphenidate (Ritalin)

6) for degradation:
- MAO inhibitors: phenelzine, selegiline
- COMT inhibitors: entacapone, tolcapone

55
Q

DA: disease

A
  • cocaine, amphetamines, and bromocriptine (fungal grain contamination) interfere with the dopaminergic system
  • Parkinsons’, schizophrenia, hormonal disturbances, and drug dependence
  • DA is involved in motor control and pituitary control, may be involved in reward systems and thought.
56
Q

5-HT (serotonin)

A

monoamine with a restricted distribution (raphe nuclei). found in the enteric nervous system (80% platelets).

57
Q

5-HT: synthesis

A

3 steps:

1) tryptophan is taken in by diet

2) tryptophan hydroxylate is the rate limiting enzyme which converts it to 5-hydroxytryptophan

3) DOPA decarboxylase then converts it to 5-HRT

58
Q

5-HT: storage

A

VMAT1 and VMAT2 transport it into the vesicles, requiring hydrogen ions to be pumped out in exchange.

59
Q

5-HT: release

A

calcium-dependent release mainly on the axon terminal bouton. BUT it can also be co-released with neuropeptides, such as somatostatin and substance P.

60
Q

5-HT: receptors

A

1) ionotropic receptor (5HT3): only 5-HT receptor that is a ligand-gated ion channel. tallows sodium and calcium into the cell and pushes potassium out.

2) metabotropic receptors: at least 6 families (5-HT1, 2, 4, 5, 6, 7) subdivided by what G-proteins they couple to.

61
Q

5-HT: reuptake

A

reuptaken by a serotonin transporter (SERT). chloride and 2 sodium ions are co-transported to get it back to the presynaptic derm.

62
Q

5-HT: degradation

A

converted by MAO into 5-hydroxyindolealdehyde, and then the second enzyme, aldehyde hydrogenase, converts it into 5-hydroxyindoleacetic acid (5-HIAA).

63
Q

5-HT: drugs

A

1) for synthesis: p-chlorophenylalanine and L-tryptophan (precursor)

2) for receptors:
- full agonist: 5HT, sumtriptan
- partial agonist: bluspirone

3) for reuptake: SSRI (citalopram), TCAs (imipramine), amphetamine (MDMA)

4) for degradation: MAOI (phenelzine)

64
Q

5-HT: disease

A
  • amphetamines and derivatives (MDMA), LSD, mescaline, and psilocybin (magic mushrooms)
  • depression, anxiety, hallucinations
  • serotonin is important in mood, sleep/wake cycle, and appetite
65
Q

neurotransmission

A

process by which info encoded in the form of an AP is communicated from one neuron to another within a given pathway, and ultimately, a neuronal network. electrical info is received at the presynaptic terminal, then converted into chemical info through electrically stimulated neurotransmitter release which is driven by calcium influx into the presynaptic terminal. the released neurotransmitters bind to receptors, which become activated, which activate second messenger pathways like ionic flux. this converts the chemical info back into electrical info in the shape of APs.

66
Q

neurotransmitter regulation

A

1) release is controlled from the presynaptic terminal by auto receptors

2) receptors can be increased or decreased

3) degradation happens either through the synaptic cleft or the uptake by an enzyme into glial cells.

4) synthesis and storage are regulated by enzymes in the presynaptic terminal

67
Q

schizophrenia: positive symptoms

A

additional features that are not ordinarily present.

  • delusions: 90% of patients
  • hallucinations: generally auditory and critical voices (70% of patients). may also be visual, or related to smell, taste, or touch
  • thought disorder: disordered speech, like rapid changes of subject, use of invented words, inappropriate emotional responses to other people
68
Q

schizophrenia: negative symptoms

A

loss or reduction in normal function.

  • alogia: reduced speech
  • affective flattening
  • avolition: diminished ability to begin and sustain activity (related to motivation)
  • anhedonia
  • associality: social withdrawal
69
Q

schizophrenia: cognitive symptoms

A

specific impairments in certain cognitive domains that affect the person’s life and work.

  • working memory
  • spatial memory
  • ability to pay attention
  • executive functions (planning + decision-making)
70
Q

four schizophrenia life courses

A

group 1: single episode of psychosis with no impairment (22% of patients)

group 2: several episodes of psychosis (relapse-remit) with no or minimal impairment (35% of patients)

group 3: repeated episodes of psychosis without full recovery, impairment following first episode (8% of patients)

group 4: repeated episodes of psychosis which increase in severity and are associated with no recovery or return to normality (35% of patients)

71
Q

schizophrenia: risk factors

A

1) environmental:
- obstetric complications
- exposure to infection or inflammation either in utero or in early post-natal life
- exposure to social stress (childhood trauma)
- drug use (cannabis)

2) genetic:
- highly heritable
- rare variants of large effect (DISC1 gene, Nrxn1 deletion)
- common variants of small effect (polygenic score)

these determine clinical outcome and symptom severity.

72
Q

DA pathways in the brain

A

1) nigrostriatal pathway: critical for the control of movement, projects from the substantia nigra to the striatum

2) mesolimbic and mesocortical pathways: project from the ventral tegmental area to the nucleus accumbens, amygdala, hippocampus, mesolimbic pathway, PFC, mesocortical pathway. involved in both limbic and cognitive functions such as memory, motivation, emotional response, reward, desire, and addiction.

3) tuberoinfundibulnar pathway: projects from the A8 dopaminergic nucleus via the hypothalamus to the pituitary gland. involved in hormonal regulation and secretion of the hormone prolactin.

73
Q

DA hypothesis of schizophrenia

A

1) an increase in dopaminergic neurotransmission in the mesolimbic pathway leads to abnormally high levels of dopamine in the nucleus accumbens and the striatum, which underly the positive symptoms of schizophrenia

2) a decrease of dopaminergic neurotransmission in the mesocortical pathway leads to lower levels than normal of dopamine in the PFC, which underlies the negative and cognitive symptoms of schizophrenia

74
Q

Carlsson & Lindquist (1963): chlorpromazine

A

chlorpromazine reduced the positive schizophrenia symptoms. antipsychotic drugs increased the amount of dopamine metabolites in the cerebral spinal fluid of patients. this may be something to do with the brain compensating for the blockage of a dopamine receptor.

75
Q

amphetamines and schizophrenia: PET studies

A

experiments on healthy people who were given amphetamines showed that when amphetamine is given, DA release is stimulated, and patients showed positive schizophrenia symptoms, such as hallucinations. when schizophrenic patients were given amphetamines, their symptoms became much worse.
CONCLUSION: increasing DA transmission induces schizophrenia symptoms, developing the DA theory.

76
Q

18F-DOPA, neuroimaging, and the DA theory of schizophrenia

A

experiments show that schizophrenic patients have a higher uptake value of 18F-DOPA (dye that visualizes the rate of DA synthesis capacity) in the striatum compared to controls. this increase in DA synthesis capacity positively correlated with the severity of patient positive symptoms.
CONCLUSION: most robust evidence for DA dysfunction in schizophrenia, localized in the mesolimbic pathway

77
Q

antipsychotics and D2Rs

A

the efficacy of antipsychotics is closely related to the potency or affinity with which they bind to the D2 receptor. an exception is clozapine, which has a low affinity for D2R but is the most effective. 60-80% of D2Rs must be blocked for the maximum therapeutic effect. if you pass the 80% threshold, positive schizophrenia symptoms improve, but movement disorder side effects show up. this reflects the action of antipsychotics in D2Rs in other dopaminergic pathways, such as the nigrostriatal pathway responsible for the control of movement.

78
Q

drug therapeutic window

A

range of doses in which positive effects are seen without adverse side effects. for antipsychotics it is quite narrow.

79
Q

stress-diathesis model: excess dopamine in schizophrenia

A

the individual inherits several genes that encode for abnormal proteins, leading to defective dopamine function in the mesolimbic pathway, rendering the pathway hyperactive, and leading to the positive symptoms.
however, multiple schizophrenia patients do not respond to antipsychotics, suggesting that DA hyperactivity is just one of the causes.

80
Q

treatment resistance in schizophrenia: PET studies

A

responders have an increased capacity to produce DA, a higher DA synthesis capacity in the striatum. they have normal levels of glutamate in the frontal cortex. non-responders do not show an elevation in DA synthesis capacity and are indistinguishable to healthy controls. however, they have higher amounts of cortical glutamate in the frontal cortex.
CONCLUSIONS:
1) defective glutamate transmission may have something to do with it

2) there may be 2 subtypes of schizophrenia, one based on DA and one not.

81
Q

other neurotransmitters and schizophrenia

A
  • atypical antipsychotics have a dual action on DA and serotonin
  • dopamine, glutamate, and GABA interact and regulate each other
  • glutamatergic cortical projection neurons become overactive due to a reduction in the activity of GABA interneurons. this overactivity drives activation of the mesolimbic pathway, leading to higher levels of DA in the striatum and nucleus accumbens, leading to positive symptoms. imbalances in glutamate and GABA systems therefore give rise to DA imbalance. this is supported by drug trials (ketamine), notably some that block N-methyl-D-aspartate receptors, which lead to excess glutamate, which causes the manifestation of positive symptoms in healthy individuals and exacerbate symptoms in schizophrenia patients.