Dysfunctions
Brain Addiction
Alzheimers disease
A.D.H.D attention deficit
hyperactivity disorder
Autism
Bipolar disorder
Cerebral Palsy
Depression
Dyslexia
Eating disorders
Epilepsy
Huntingtons disease
Korsakoffs psychosis
Lou Gehrigs disease
lateral sclerosis
Multiple Sclerosis
Muscular dystrophy
O.C.D. obsessive
compulsive disorder
Parkinsons disease
P.T.S.D. post traumatic
stress disorder
Schizophrenia
Stress
Tourettes syndrome
Brain Dysfunctions: Functional disorders
Symptoms of mental disorders
deficient or inappropriate social behavior
illogical, incoherent or obsessional thoughts
inappropriate emotional behaviors
depression, mania, anxiety
delusions and hallucinations
Brain Dysfunctions: Psychotic disorders
Schizophrenia
disordered thought
Major affective disorders (bipolar/depression)
disordered feelings or emotions
Brain Dysfunctions: Schizophrenia
What is the incidence?
Is schizophrenia inherited
What are the behavioral manifestations?
Do we know about neural involvement?
Brain Dysfunctions: Schizophrenia
Can the genes be
isolated? About 5-7
genes involved
Double hit theory genetic susceptibility
but then you
need an
environmental trigger
(pre- or postnatal).
The Toll of Brain Disorders
From Haley, 1959:
A: Do you work at the air base
B: You know what I think of work. Im 33 in June do you mind?
A: June?
B: 33 years old in June. This stuff goes out the window after I live
this, uh - leave this hospital. So I cant get my vocal cords back. So
I lay off cigarettes. Im in a spatial condition, from outer space myself
A: Im a real spaceship from across.
B: A lot of people talk that way, like crazy, but Believe It or Not,
by Ripley, take it or leave it--alone--its in the Examiner, its in the
comic section, Believe It or Not, by Ripley, Robert E. Ripley,
Believe it or not, but we dont have to believe anything, unless I feel
like it. Every little rosette--- too much alone.
A: Yea, it could be possible
B: Im a civilian seaman.
A: Could be possible. I take my bath in the ocean.
B: Bathing stinks. You know why? Cause you cant quit when you
Brain Dysfunctions: Schizophrenia Symptoms
Residual or negative symptoms
withdrawal, neglect & lack of affect
Positive symptoms
delusions, persecution-aliens are after you
hallucinations (auditory), hear voices talking to
you,
Brain Dysfunctions: Schizophrenia Memory
Deficits in working memory
Wisconsin Card
Sorting Task
Stroop Test
GREEN
RED
RED
BLUE
RED
BLUE
GREEN
Identical Genes, Different Fates
Brain Dysfunctions: Schizophrenia Brain
Ventricles are enlarged in affected twin
Increased thalamic size
Some people show changes in prefrontal
cortex and hippocampus
Decreased cerebellar activity
Brain Dysfunctions: Schizophrenia Treatment
One of the major hurdles in treating
schizophrenics is that they stop taking their
medication when they feel well.
Medication and behavioral support.
Thorazine - chlorpromazine
blocks dopamine and controls psychosis but
results in Parkinsons like symptoms
LSD, cocaine effect dopamine and serotonin
systems, but differ in their effects from
symptoms of schizophrenia
Brain Dysfunctions: Schizophrenia Treatment
Anti-psychotic compounds
Reserpine naturally occurring from
Snakeroot. Traditionally used to medicate
psychiatric disordered in India.
Side effects motor stiffness, Parkinson like
symptoms
Brain Dysfunctions: Schizophrenia Treatment
Dopamine hypothesis
The older neuroleptics (chlorpromazine,
reserpine) bind to postsynaptic dopamine
receptors, D1 and D2.
Haloperidol another very strong antipsychotic drug, binds the D2 type dopamine
postsynaptic receptors.
Stimulants -- Amphetamines
Increase HR, BP, BR
Decrease appetite
Inability to sleep
Sweating, dry mouth
muscle twitching
Major effects
Decreased fatigue
Increased confidence
Increased alertness
Restlessness, irritation
Apprehension, distrust
Behavioral stereotypy
Hallucinations
Psychosis
Brain Dysfunctions: Schizophrenia Treatment
Amphetamine psychosis is similar to
schizophrenia
paranoia
delusions
auditory hallucinations
chlorpromazine also blocks amphetamine
psychosis
Brain Dysfunctions: Schizophrenia Treatment
Atypical antipsychotics
Clozapine
atypical antipsychotic,approved USA 1990
doesnt have the Parkinsons side-effects
also improves negative symptoms, attention,
cognitive ability, thinking
blocks dopamine D1 & D4 receptor & serotonin
5HT2A receptor
side effects, weight gain, white cell decrease
Brain Dysfunctions
Addiction
Alzheimers disease
A.D.H.D deficit
hyperactivity attention disorder
Autism
Bipolar disorder
Cerebral Palsy
Depression
Dyslexia
Eating disorders
Epilepsy
Huntingtons disease
Korsakoffs psychosis
Lou Gehrigs disease
lateral sclerosis
Multiple Sclerosis
Muscular dystrophy
O.C.D. obsessive
compulsive disorder
Parkinsons disease
P.T.S.D. post traumatic
stress disorder
Schizophrenia
Stress
Tourettes syndrome
Brain Dysfunctions: Psychotic disorders
Schizophrenia
disordered thought
Major affective disorders (bipolar/depression)
disordered feelings or emotions
Brain Dysfunctions: Depression
What is the incidence?
Is depression/bipolar inherited
What are the behavioral manifestations?
Do we know about neural involvement?
The Toll of Brain Disorders
Brain Dysfunctions: Depression Incidence
Affective or mood disorder
reactive depression
endogenous depression
bipolar disorder, equal incidence in male and
females
unipolar depression, 2-3 times higher incidence
in females
Amish do not show this difference, is it because the
males mask depression by alcohol?
Brain Dysfunctions: Depression Types
Bipolar - depression and mania
Rapid cycling with a period of hours or days.
Slow with a period of weeks/months
euphoria or mania, can get delusions
often seen in teens and young adults
Unipolar - depression without mania
more prevalent in people over 40
Brain Dysfunctions: Depression Inheritance
Higher for monozygotic (identical) twins
than for dizygotic (fraternal) twins.
Higher rates in biological rather than
adoptive parents
Brain Dysfunctions: Depression Symptoms
Major depression
Feel sad and helpless every day for weeks at
a time. People with major depression have
little energy, feel worthless, contemplate
suicide, have trouble sleeping, cannot
concentrate, get little pleasure from sex or
food, in many cases can hardly even
imagine being happy again.
Brain Dysfunctions: Depression Brain Serotonin
~80% suicides are depressed, also show a
decrease in the level of serotonin and high
levels of cortisol
~85% patients with Cushings syndrome
have episodes of depression, increased
ACTH, increased cortisol
Parkinsons patients are often depressed
lower levels of serotonin
Brain Dysfunctions: Depression Brain Serotonin
Box 4-1
Brain Dysfunctions: Depression population studies
A fishy tale
Strong correlation between low levels of
fish eating and depression.
Brain Dysfunctions: Depression Treatment
drugs for depression that alter
transmission at serotonergic
synapses
Tricyclics
imipramine prevents presynaptic uptake
MAOIs monoamine oxidase inhibitors
blocks the inactivation of transmitter
SSRIs selective serotonin reuptake
inhibitors (Prozac)
prevents serotonin reuptake
Atypical
Brain Dysfunctions: Depression Treatment
Psychotherapy
ECT - electroconvulsive therapy
changes levels of dopamine and serotonin
The HypothalamicPituitaryAdrenal Axis in Depression
Brain Dysfunctions: Depression Treatment
Psychotherapy
ECT - electroconvulsive therapy
Sleep patterns
depressed people enter REM earlier
body temperature
Brain Dysfunctions: Depression Treatment
Sleep patterns
takes time to fall asleep
depressed people enter REM earlier,
less stage 3-4 sleep
body temperature
Brain Dysfunctions: Depression & Sleep
Normal sleep pattern has regular periodic REM and
Non-REM sleep episodes
Sleep and Depression
Sleep and Depression
Brain Dysfunctions: Depression Treatment
Psychotherapy
ECT - electroconvulsive therapy
Sleep patterns
depressed people enter REM earlier
deprivation of REM sleep in depressed
patients can be antidepressant
MAO inhibitors can reduce REM sleep
Brain Dysfunctions: Bipolar Disorder Treatment
Lithium
Blocks the manic and depressive phases of
bipolar disorder
Cade took the urine of manic patients and
mixed it with Lithium to form a soluble
solution. He fed it to guinea pigs to find out if
they would become manic. In the control group
he used the lithium without the urine - both
groups were calm. He thought that the lithium
was calming the guinea pigs -- but actually at
the doses he used they were probably feeling
sick.
Brain Dysfunctions: Bipolar Disorder Treatment
Cade thought the lithium was calming and
went on to try it in manic patients in the
1950s, where it alleviated the depressive
symptoms. These results were ignored until
1960s when it was found that lithium is
profoundly effective in both the phases of
bipolar disorder.
There is little understanding of how it works
but it is the choice long-term treatment for
many patients.