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SK298 - Brain, the mind & mental health > Week 9 - The neurobiology and management of ADHD > Flashcards

Week 9 - The neurobiology and management of ADHD Flashcards

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1
Q

What are the two main types of symptom in ADHD?

A

Symptoms that relate to attention and imulsivity/hyperactivity

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2
Q

As well as impairment in executive functions, what else do people with ADHD show impairments in?

A
  • Selective attention
  • Sustained attention
  • Response precision
  • Temporal information processing
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3
Q

What are the two main processses which can drive selective attention?

A
  • Endogenous attention
  • Exogenous attention
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4
Q

What is meant by the term selective attention?

A

The ability to process one stimulus in the presence of another potentially distracting stimuli

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5
Q

What are the two ways which selective attention may be driven?

A
  • Exogenous (bottom-up)
  • Endogenous (top-down)
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6
Q

What is exogenous attention driven by?

A

Sensory stimuli

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7
Q

What is endogenous attention driven by?

A

Internal goals or desires such as hunger

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8
Q

Where in the brain does the endogenous attention circuit begin?

A

The prefrontal cortex

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9
Q

Where in the brain does exogenous attention begin?

A

The sensory areas

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10
Q

Which type of attention is driven by a sensory stimuli such as a flash of light?

A

Exogenous attention

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11
Q

What is the key difference between exogenous and endogenous attention in terms of where the brain circuits begin?

A

Exogenous attention begins in sensory areas such as the visual cortex whereas endogenous attention begins in the prefrontal cortex

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12
Q

What does the superior calliculus play a role in?

A
  • Receiving and processing sensory information
  • Receiving projections from and sending projections to midbrain regions
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13
Q

Dysfunction in the superior calliculus may result in what difficulties?

A

Filtering the appropriate sensory stimuli from an otherwise overwhelming environment

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14
Q

What effect to the prefrontal cortex is noted in people with ADHD?

A

A reduction in volume

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15
Q

What is meant by myelination?

A

The process by which axons of neurons are coated in a fatty insulating substance called myelin

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16
Q

What is the purpose of myelination?

A

To speed up the conduction of action potentials

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17
Q

What abnormality to white matter has been noted in patients with ADHD?

A

A reduction in myelin

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18
Q

Which neurotransmitter is thought to be the most important for exogenous attention?

A

Acetylcholine

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19
Q

Which neurotransmitter is thought to be important for endogenous attention?

A

Dopamine

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20
Q

Name the three monoamine neurotransmitters

A
  • Dopamine
  • Serotonin
  • Noradrenalin
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21
Q

What are the three principal dopaminergic pathways?

A
  • Mesolimbic
  • Mesocortical
  • Nigrostriatal
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22
Q

As well as ADHD, what other conditions are dopaminergic pathways of interest regarding?

A
  • Addictions
  • Psychosis
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23
Q

What is the nucleus accumbens involved in?

A

Motivation

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24
Q

What is the nucleus accumbens of particular interest in the study of?

A

Addiction

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25
Q

Abnormalities within the serotonergic pathways are thought to be the basis of which condition?

A

Depression

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26
Q

What do serotonergic neurons play roles in?

A
  • Sleep walking
  • Emotions
  • Moods
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27
Q

What is the hippocampus involved in?

A
  • Learning
  • Memory
  • Emotion
  • Mood
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28
Q

What are noradrenergic pathways most notably involved in?

A
  • Arousal
  • Reaction to stimuli
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29
Q

What are neurons that synthesise, store and release acetylcholine known as?

A

Cholinergic

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30
Q

What are cholinergic pathways involved in?

A
  • Cognition
  • Learning
  • Memory
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31
Q

Cholinergic function is of particular interest with regards to the study of which condition?

A

Dementia

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32
Q

Where is the pons located?

A

The brain stem

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33
Q

Cognitive flexibility involves which 5 areas of the brain?

A
  • Ventral tegmental area
  • Prefrontal cortex
  • Basal forebrain
  • Amygdala
  • Parietal cortex
34
Q

Working memory involves which 3 areas of the brain?

A
  • Ventral tegmental area
  • Prefrontal cortex
  • Locus coeruleus
35
Q

Response inhibition involves which 3 areas of the brain?

A
  • Basal ganglia
  • Raphe nuclei
  • Prefrontal cortex
36
Q

Neurotransmitter is released from vesicles in the axon terminal into what?

A

The synaptic cleft

37
Q

What does the neurotransmitter cross the synaptic cleft and bind to?

A

Receptors on the cell membrane of the postsynaptic neuron

38
Q

Action potentials travel to the axon terminal in the what?

A

Presynaptic neuron

39
Q

What are the methods by which neurotransmitter can be removed from the synapse?

A
  • Reuptake
  • Enzymatic degradation
  • Diffusion
40
Q

What does the gene which has been linked with ADHD code for?

A

The dopamine transporter

41
Q

What are the names of the two genes which have been linked with ADHD?

A
  • SLC6A3
  • DRD4
42
Q

If more dopamine transporters are available, what impact will there be on removal of dopamine from the synapse?

A

It will be removed from the synapse more effectively, meaning it has less chance to bind to receptors

43
Q

What does DRD4 code for?

A

A specific type of dopamine receptor

44
Q

If the receptor is less sensitive to dopamine, what would that mean for the postsynaptic neuron effect of dopamine binding to these receptors?

A

The usual effect of dopamine on the postsynaptic neuron would be subdued

45
Q

What does the SLC6CA3 protein create?

A

A transporter which is more efficient at removing dopamine from the synapse, which reduces the amount available to bind to receptors

46
Q

What does the DRD4 protein create?

A

Receptors with reduced sensitivity to dopamine

47
Q

What is one of the biggest indicators that ADHD may have a dopaminergic basis?

A

The fact that medication used to treat it primarily targets this neurotransmitter

48
Q

What is meant by the term descriptive statistics?

A

Data that describe or summarise features of a data set, such as the mean and standard deviation

49
Q

What is meant by the term standard deviation?

A

The spread of data around the mean value

50
Q

What is meant by the term inferential statistics?

A

Results of data or statistical analysis that allow inferences/predictions to be made from sets of data

51
Q

What is a P value?

A

The probability that the difference between two data sets has arisen by chance alone

52
Q

If a P value is close to zero, what does that mean?

A

It is less likely that the difference between two sets of data has arisen by chance (ie it is more likely that there is a genuine difference between the two groups)

53
Q

To determine whether there is a statistically significant difference between two data sets, P values are compared with a cut-off value known as what?

A

The a value (alpha value)

54
Q

What is an a (alpha) value?

A

The level of the P value is taken to denote statistical significance

55
Q

What a value is usually used with regards to P values?

A

0.05

56
Q

What is meant by the term parent training?

A

A type of training that aims to provide parents or carers with techniques for managing the behaviour of children

57
Q

What ages of children is the Incredible Years parent programme suitable for?

A

From birth to 12 years

58
Q

What are the key aims of the Incredible Years programme?

A

To support parents in developing child-centered behaviours such as play, following the child’s lead, and to ensure that parents reinforce positive behaviours in their children

59
Q

What is meant by the term between-participants design?

A

An experimental design in which different groups of participants are used for each condition

60
Q

What is meant by the term within-participants design?

A

An experimental design in which the same group of participants is used in both experimental and control conditions

61
Q

What is meant by the term experimental condition?

A

The condition in which the suspected causal variable is present

62
Q

What is meant by the term control condition?

A

The condition from which the suspected causal variable is absent

63
Q

What is meant by the term order effects?

A

An effect on an experimental outcome measure that arises from the order in which participants are tested

64
Q

What four factors are thought to compromise conditions including ADHD?

A
  • Emotional or affective reactions
  • Psychological symptoms
  • Thoughts or cognitions
  • Behaviours
65
Q

In ADHD management, what does CBT focus on?

A
  • Establishing structures and routines
  • Establishing clear rules and expectations for key settings (eg work/school/home)
  • Social skills with peers
  • Problem solving
  • Active listening skills
  • Dealing with and expressing feelings
66
Q

What is meant by the term psychostimulant drugs?

A

A class of drugs that typically increase activity of the central nervous system

67
Q

When were psychostimulant drugs first discovered?

A

The 1930s

68
Q

Which neurotransmitters fall into the category of monoamines?

A
  • Dopamine
  • Noradrenaline
  • Serotonin
69
Q

What is the role of the neurotransmitter transporter?

A

The transporter is normally responsible for removing neurotransmitter from the synapse

70
Q

How does methylphenidate work?

A

By blocking the transporter (reuptake channel)

71
Q

What effects does dopamine have at the synapse?

A
  • Blocking transporters (uptake channels)
  • Displacing dopamine from vesicles in the presynaptic neuron, which can then be transported into the synapse
72
Q

What percentage of people discontinue treatment with long-acting ADHD drugs?

A

19%

73
Q

What percentage of people discontinue treatment with short-acting ADHD drugs?

A

38%

74
Q

What is the only non-stimulant drug treatment for ADHD currently available?

A

Atomoxetine

75
Q

What role does the superior calliculus have in the brain?

A

It is part of the circuitry involved in selective attention and processing sensory information

76
Q

What is synaptophysin?

A

A protein which aids release of neurotransmitter by interacting with synaptic vesicles

77
Q

Where in the brain is the superior calliculus found?

A

The midbrain

78
Q

Aside from blocking reuptake channels, what other effect does amphetamine have at the synapse?

A

It can displace dopamine from the vesicles within the presynaptic neuron, which can then be transported into the synapse

79
Q

Methylphenidate and amphetamine both have what kind of effect on dopaminergic activity within the brain?

A

They increase it

80
Q
A

SK298 - Brain, the mind & mental health (19 decks)

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