Week 4.2: Cognition in mood disorders Flashcards
This refers to difficulties with mental abilities such as thinking, knowing, remembering, judging, and problem-solving.
Cognitive Impairment
The complex network of neurons and their connections in the brain that work together to process information.
Brain Circuitry
The process by which the information in a gene’s DNA is transferred to messenger RNA (mRNA) for protein production.
Gene Transcription
What are the different cognitive domains?
Attention: The ability to focus on specific stimuli or tasks.
Learning and Memory: The processes involved in acquiring new information and recalling it.
Speed of Processing: How quickly one can understand and respond to information.
The process of evaluating a person’s cognitive functions, such as memory, attention, and problem-solving skills.
Cognitive Assessment
This involves self-reported measures where individuals rate their own cognitive abilities, often using rating scales or questionnaires.
Subjective Assessment
This involves standardized tests administered by clinicians to measure cognitive abilities.
Objective Assessment
Assessments made by healthcare professionals through interviews or observing a person’s behavior.
Clinician Ratings
Quick assessments done by healthcare professionals to evaluate cognitive function. Two common tests are:
Mini Mental State Examination (MMSE): A brief 30-point questionnaire used to screen for cognitive impairment.
Montreal Cognitive Assessment (MoCA): A 30-point test designed to detect mild cognitive impairment.
Cognitive Function Bedside Tests
Significant and noticeable cognitive deficits, often seen in conditions like dementia or neurodegenerative disorders.
Gross Cognitive Impairments
Tools where individuals rate their own cognitive abilities by answering questions about their experiences.
These questionnaires are valuable because they capture the individual’s subjective experience of their cognitive abilities, providing insight into how they perceive their cognitive function.
Self-Rated Cognitive Questionnaires
A cognitive test where individuals match symbols with corresponding digits as quickly as possible. It measures speed of processing. The score is the number of correct symbols matched within 90 seconds, with a maximum score of 93.
Digit Symbol Substitution Test (DSST)
A test to assess immediate and delayed recall. The administrator reads a list of words, and the individual repeats back as many words as they can remember. There is also a delayed recall component where the individual is asked to recall the words after some time.
Rey Auditory Verbal Learning Test (RAVLT)
Higher-order cognitive processes that include planning, decision-making, problem-solving, and task flexibility. Often impaired in mood disorders.
Executive Function
A test to assess executive function. The individual connects circles in an ascending pattern, alternating between numbers and letters (e.g., 1-A, 2-B, 3-C). The time taken to complete the task is recorded, with higher times indicating greater impairment.
Trail-Making Test, Part B (TMT-B)
Cognitive processes that are influenced by emotions and involve emotional processing. It includes how we respond to negative feedback and is important in mood disorders because it can affect antidepressant response and overall mood.
Hot Cognition
Cognitive processes that are more logical and emotion-independent. It involves executive functions like attention, perception, and psychomotor functions (coordination of movement).
Cold Cognition
A brain region associated with hot cognition and emotional processing. It has connections to the amygdala, which is involved in processing emotions.
Ventral Medial Prefrontal Cortex (vmPFC)
A brain region associated with cold cognition and non-emotional cognitive functions. It is involved in logical thinking, sensory processing, and motor functions, and has connections to areas like the basal ganglia and parietal cortex.
Dorsal Lateral Prefrontal Cortex (dlPFC)
Brain pathways involved in motivation and reward. Dysfunction in these pathways can lead to reduced decision-making capacity and loss of reward sensitivity.
Mesolimbic-Cortical Circuitry
What is depression’s link to dysfunction in the brain’s motivational pathways?
People with depression may have trouble making decisions, especially under pressure, and may not respond to rewards as they typically would.
Difficulties in functioning in social and work environments due to cognitive deficits.
Psychosocial Impairment
Treatments involving medications that can help reduce or manage cognitive deficits.
Pharmacological Interventions
Non-medication-based treatments, such as cognitive-behavioral therapy (CBT), that aim to improve cognitive function and coping strategies.
Behavioral Interventions
Techniques that directly stimulate or modulate brain activity, such as transcranial magnetic stimulation (TMS) or electroconvulsive therapy (ECT).
Neuromodulatory Interventions
Factors that might influence the results of a study, making it difficult to determine the true effect of the variable being studied.
Examples include medication effects, previous head injuries, and other health conditions.
Confounding Variables
Drugs that affect a person’s mental state, often used to treat psychiatric disorders.
Psychotropic Medications
Another term for major depressive disorder (MDD), characterized by persistent low mood and other symptoms.
Unipolar Depression
A period during which the symptoms of depression are reduced or disappear.
Remission
Symptoms that remain even after the major depressive episode has resolved.
Residual or Persisting Symptoms
The return of symptoms after a period of improvement.
Relapse
Waking up in the middle of the night and having difficulty falling back asleep.
Mild-Nocturnal Insomnia
A mental health condition characterized by extreme mood swings, including manic (high) and depressive (low) episodes. Previously known as manic-depressive illness
Bipolar Disorder (BD)
A severe mental disorder characterized by distortions in thinking, perception, emotions, language, sense of self, and behavior.
Previously known as dementia praecox.
Schizophrenia
Is a normal, tranquil mental state or mood.
Euthymia
Is there a difference in cognitive impairments of patients with schizophrenia from those with bipolar disorder?
Schizophrenia: Cognitive impairments are broad and linked to developmental issues, affecting multiple cognitive domains from an early stage.
Bipolar Disorder: Cognitive impairments are more episodic, related to mood episodes, but can persist over time. There is significant variation in cognitive performance among individuals with bipolar disorder.
It suggests cognitive deficits are present before the onset of the illness and are linked to abnormal brain development.
Neurodevelopmental Model of Cognitive Impairment
A model of cognitive impairment that suggests cognitive deficits begin at the onset of the illness and worsen with each episode.
Neuroprogressive Model of Cognitive Impairmaint
Studies that observe a population at a single point in time, providing a snapshot of the current state.
Cross-Sectional Studies
Studies that follow the same individuals over a period of time, allowing researchers to observe changes and developments.
Longitudinal Studies
What are the cognitive subgroups in bipolar disorder?
Intact: Individuals with no significant cognitive impairments.
Selective Deficits: Individuals with impairments in specific cognitive areas.
Global Deficits: Individuals with widespread cognitive impairments.
What is the impact of mood episodes on cognition?
Mood episodes can affect cognition due to a combination of medication effects, environmental factors, and abnormal metabolic processes in the brain.
These processes occur against a background of vulnerability to mental health conditions, influenced by genetics, childhood trauma, and stress.
What are the possible causes of cognitive impairments for individuals with mood disorders?
Illness-Related Impairments: Cognitive impairments that are directly related to the mood disorder.
Secondary Causes: Impairments that may be due to medication, comorbid conditions, unhealthy lifestyle, or organic brain illnesses like dementia.
The presence of one or more additional conditions co-occurring with a primary condition.
Co-morbidity
Physical disorders that affect brain function, such as dementia.
Organic Brain Illness
A substance that blocks the action of hormones.
Hormonal Antagonist
A drug that mimics the action of dopamine, a neurotransmitter.
Dopamine Agonist
A class of antidepressants that increase the levels of serotonin and norepinephrine in the brain.
Serotonin-Norepinephrine Reuptake Inhibitor (SNRI)
A substance that improves cognitive function, particularly executive functions, memory, creativity, or motivation.
Cognitive Enhancer
Improvement in patients receiving a placebo due to their belief in the treatment.
Placebo Response
The ability of a substance to improve cognitive function.
Pro-Cognitive Effects
The improvement in cognitive functions happens regardless of changes in mood.
Mood-Independent
What is the impact of stress on prefrontal networks?
Stress weakens the networks in the prefrontal cortex, which is crucial for regulating thought, action, and emotion
The part of the brain responsible for higher-order functions like decision-making, problem-solving, and regulating emotions.
Pre-frontal Cortex (PFC)
A brain region involved in processing emotions, particularly fear and stress.
Amygdala
A group of structures linked to controlling movement and habitual behaviors.
Basal Ganglia
The part of the nervous system that controls involuntary actions like heart rate and digestion.
Autonomic Nervous System
Behaviors where we automatically react without thinking things through.
Reflexive or Habitual Behaviors
These are older parts of the brain that handle basic survival functions. Under stress, these circuits take over, leading to more instinctual and less rational responses.
Primitive Brain Circuits
Type: Hormonal antagonist.
Benefit: Used primarily for its effects on the hormonal system, with some evidence suggesting cognitive benefits in mood disorders.
Mifepristone
Type: Antidepressant.
Benefit: Shown to improve cognitive function in patients with major depressive disorder (MDD) by enhancing cognitive abilities such as memory and executive function
Vortioxetine
Type: Dopamine agonist.
Benefit: Used in Parkinson’s disease, it has shown potential cognitive benefits due to its action on dopamine pathways
Pramipexole
Type: Antidepressant (Serotonin-Norepinephrine Reuptake Inhibitor - SNRI).
Benefit: While primarily used to treat depression and anxiety, it has some evidence suggesting cognitive benefits
Duloxetine
Type: Antipsychotic.
Benefit: Used in the treatment of bipolar disorder and schizophrenia, with some evidence of cognitive benefits
Lurasidone
Type: Stimulates red blood cell formation.
Benefit: Known for its use in treating anemia, it has also shown potential cognitive benefits in mood disorders
Erythropoietin
Type: Cognitive enhancer.
Benefit: Recognized for its ability to enhance cognitive function in healthy individuals and may have similar benefits in people with mood disorders
Modafinil
A condition caused by high levels of cortisol (a stress hormone).
Cushing’s Disorder
A drug that blocks the effects of glucocorticoids, which are stress hormones.
Glucocorticoid Receptor Antagonist
A drug that blocks the effects of progesterone, a hormone involved in pregnancy.
Progesterone Receptor Antagonist
The ability to protect nerve cells from damage or degeneration.
Neuroprotective
Refers to the support and growth of neurons (nerve cells) in the brain.
Neurotrophic factors are proteins that help neurons survive, grow, and maintain their functions. They play a crucial role in the development, maintenance, and repair of the nervous system.
Neurotrophic
A psychoeducative strategy aimed at improving everyday functioning in patients with mental health disorders. It combines education about cognitive dysfunctions with practical techniques to enhance daily life skills
Functional Remediation
Thinking about thinking.
Metacognition
Traditionally used for mood stabilization, it may also have neuroprotective and cognitive benefits.
Lithium
Therapeutic approaches to enhance cognitive abilities and daily functioning.
Cognitive Remediation
