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72 Cards in this Set
- Front
- Back
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Which of the following helps to stabilize the sleep switch?
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Orexin
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Which of the following are EEG findings characteristic of stage II sleep?
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Theta frequency with sleep spindles
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Which of the following is NOT part of the classical clinical tetrad of narcolepsy?
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Decreased REM latency
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Physical consequences of lack of sleep
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Impaired glucose tolerance Weight gain
Depressed immunity |
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Mental consequences of lack of sleep
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Impaired cognition
Impaired emotional regulation Psychotic symptoms |
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Given all of the negative consequences of sleep deprivation, we must conclude that sleep is not
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is not just a restful time
In no organ is this more obvious than the brain |
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EEGs of sleeping brains demonstrate several well-defined stages that occur in a predictable sequence, which is termed the
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“sleep architecture.”
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Dreaming, particularly the vivid hallucinatory state, is associated with
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the REM stage
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NREM sleep is further divisible into four main stages
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Beta: >12 Hz Alpha: 8-12 Hz Theta: 5-8 Hz Delta: <5 Hz
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Normal wakefulness is characterized by which wave?
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beta range activity
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Calm resting with the eyes closed is characterized by which stage
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alpha range activity
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NREM stage 1
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Very light sleep
Easily arousable EEG is characterized by theta activity |
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NREM stage 2
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Slightly deeper than stage I
Overall rhythm is theta range, but the characteristic features of this stage are sleep spindles and K-complexes (This is like Stage I + sleep spindles and K- complexes) |
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Sleep spindles are
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short bursts of activity
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K complexes are
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small disturbances in sleep
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NREM Sleep stage 3 and 4
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Slow wave sleep
Further deepening of sleep The part of sleep that is perceived as being restorative Characterized by delta waves |
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Problems with sleeping usually affect
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Delta wave which is the delta speed
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Sleepwalking typically last
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10 min
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Sleep walking occurs in children ages
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typically ages 4 to 8), but it is commonly outgrown
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sleep walking occurs in
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deep sleep
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The EEG is indistinguishable from the EEG in
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he waking state
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On average, over an eight-hour night, a person will have
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five REM episodes
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REM Movement Behavior is characterized by
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(most likely to happen late into the night) failure of muscle paralysis during REM phase -- is this more likely to occur early or late in the night?
The actions of the dreamer are motorically enacted Associated with Parkinson's Disease and parkinsons- plus syndromes (not infrequently preceding the usual motor symptoms of these disorders) Symptoms can be controlled with clonazepam |
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sleep walkng occurs in deep sleep which is
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stage 3 and 4
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manifestations of sleep walking happen more during
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during early night (deep sleep_
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Manifestations of REM disorders occur more during
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late into the night
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narcolepsy is
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transitions between the various stages of sleep are disrupted, producing sleep attacks and REM phenomena while awake.
Prevalence is ~1:2,000 Onset in adolescence, with an average 15 year delay in diagnosis. Nighttime sleep is actually quite poor and often highly fragmented. |
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Narcolepsy cardinal symptom
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Excessive daytime sleepiness
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narcolepsy clinical tetrad
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Sleep attacks
Hypnagogic hallucinations Sleep paralysis Cataplexy |
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Narcolepsy can be seen in EEG by
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severely decreased REM latency (typically <5 mintues)
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Hypnagocic hallucinations:
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hallucinations, mostly visual, as person wakes up or fall asleep.
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Sleep paralysis:
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They wake up but still paralyzed so we wake up in the middle of REM.
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Hypnagogic hallucinations+Sleep paralysys may be responsible for some accounts of
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alien abduction
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Cataplexy
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transient loss of muscle tone in response to overwhelming emotion. They fall down due to loss of muscle tone, this is different to sleep paralysis in which people fall down because they fall asleep.
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The main components of sleep control are:
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the body's clock, the sleep switch, and stabilizing mechanisms.
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One important aspect of sleep control is the maintenance of
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wakefulness during daytime hours.
The suprachiasmatic nucleus (SCN) of the anterior hypothalamus acts as the main timekeeper of the brain. |
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Light stimulates production of
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CLOCK and BMAL1.
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Role of CLOCK and BMAL1
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he CLOCK-BMAL1 dimer stimulates production of PER and CRY
PER and CRY dimerize The PER-CRY dimer inhibits production of CLOCK and BMAL1. Takes 24 hours |
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Sleep Switch
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Ventral Pre-Optic Nucleus (VLPO) is sleep-inducing
Ascending neurotransmitter systems are wake- inducing They are mutually inhibitory |
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Orexin supports the
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monoaminergic arousal systems.
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so orexin tends to favor waking up, in narcolepsy the patient is
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orexin defficient possibly due to autoimmune response.
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site of integration of sleep signals
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Dorsomedial nucleus of the hypothalamus (DMH)
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DMH perceives inputs from
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SCN and prjects to VLPO. Allows factors other than light levels to affect sleep induction.
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True or False: Improved concentra/on in response to s/mulants is a diagnos/c criterion of ADHD.
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False, someone without ADHD would concentrate better
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Working memory is associated with which Brodmann’s area?
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46
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People who grow out of ADHD, according to Rapoport, may show which of the following changes?
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Normalized thickness of the gray ma.er of the right parietal lobe
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What is “a.en/on”?
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The ability to focus on and to select informa/on from the internal and external milieus
• A common metaphor is that a.en/on is the brain’s spotlight |
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AAttention is not unitary concept it has 2 basic distinctions
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Type of a.en/on – orien/ng, altering, execu/ve – Posterior vs. Anterior
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Attention alerting types of attention
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Maintenance of alertness. Allows for further processing. Decreased reac/on /mes but also decreased accuracy.
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Attention Orienting
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Focuses on certain pieces of informa/on at the expense of others. Can be bo.om-‐up or top-‐down.
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Attention Executive
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Voluntary control over a.en/onal processes.
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Attention has 2 networks
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Posterior and Anterior
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Posterior Network
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More involuntary
– Involves: • Superior colliculus • Pulvinar • Posterior parietal lobe |
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Anterior network
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More voluntary
– Involves: • SMA • Basal ganglia • Prefrontal cortex (Dorsal Lateral cortex and Anterior Cingulate Cortex) – Regulates the posterior networks |
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Top down mechanism are those that
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we control the response to the stimuli
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Bottom up mechanism
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stimulus orient us without our control like how the prof yelled good morning to get our attention
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Cognition is regulated the same way motor activity is regulated. The posterior network gathers info as to what to pay attention, and the anterior network can
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override stimulus and redirect attention by regulating the posterior network
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Working memory
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Really a misnomer, as this is not actually a kind of memory at all.
• This is the scratch pad of the brain • Decays with /me and vulnerable to distrac/on • A classic test of this is the digit span |
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Working memory
• Appears to be correlated to Brodmann’s area |
46
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the popula/on of delay neurons appear to be par/cularly connected to
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working memory
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Which NTs are involved in working memory
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dopamine and norepinephrine
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What are execu/ve func/ons?
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What does a CEO (in theory, anyway) do?
• Allocates resources, determines priori/es, creates plans of ac/on, etc. • These are examples of execu/ve func/ons: higher-‐order cogni/ve func/ons that regulate and help control other cogni/ve func/ons • An essen/al component of execu/ve func/ons is working memory |
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A.en/on-‐Deficit/Hyperac/vity Disorder is about
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76%
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Attention-‐Deficit/Hyperac/vity Disorder characteristics
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Volumes are decreased throughout the brain
• Neocor/cal development is delayed • Only about 10-‐15% con/nue to meet full criteria as adults; Rapoport’s study suggests that their right parietal lobes might show normalized thickness of the gray ma.er. |
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Is response to stimulants, a diagnostic of ADHD?
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nO. Likely, the poor a.en/on is due to under-‐ s/mula/on.
• Of course, too much of these medica/ons will over-‐s/mulate and cause problems with focus (pharmacological doses are different from recrea/onal doses) |
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The a.en/onal network in each hemisphere focuses on the other half of the world
• This is true for the external environment and for the self • Interes/ngly, the a.en/onal systems on the lek side is commonly dominant and is able to provide |
attetion to both sides.
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What happens when we take out the left sided attentional networks?
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Neglect syndromes, like patients who suffer a stroke on a test they draw maybe half of a watch but also they would not recognize half of their own body.
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neglect syndromes pertain to
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Perceptions – line cancellation task
Conceptons – clock drawings, the Rialto – Self – somatoparaphrenia, asomatagnosia |
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Delirium
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Also known as the acute confusional state
• Delirium is a case of acute brain failure • Characterized by: – Waxing and waning level of consciousness – A.en/onal deficits. Brain is so ill it causes moments of lucidness and crazyness back and forth |
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disorienation is not a criteria to diagnose delirium, but
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digit pan is
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What NTs is involved in Delirium?
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Acetylcholine systems
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Medications that impact several neurotransmitter systems can be deliriogenic:
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Antmuscarinic – GABAergic
– Opioidergic |
