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350 Cards in this Set

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Types of glial cells?
Astrocytes, most common, nutrition, deactivated NT's, bb barreir
Oligodendroctyes and Schwann cells (wrap around axons to make myelin sheaths)
Microglia (like macrophages)
the inability to identify and draw items using visual cues, with preservation of other sensory modalities. It represents a failure of transmission of information from the higher visual sensory pathway to the association areas and is caused by bilateral lesions in the visual association areas
Apperceptive visual agnosia is
nability to name or use objects despite the ability to draw them. It is caused by bilateral medial occipitotemporal lesions and can occur along with other visual impairments
Associative visual agnosia
inability to recognize a color despite being able to match it
Color agnosia
inability to name a color despite being able to point to it
Color anomia
complete inability to perceive colo
Central achromatopsia
a failure to acknowledge blindness, possibly owing to interruption of fibers involved in self-assessment
Anton's syndrome
Anton's syndrome causes?
It is seen with bilateral occipital lobe lesions. The most common causes are hypoxic injury, stroke, metabolic encephalopathy, migraine, herniation resulting from mass lesions, trauma, and leukodystrophy.
a triad of optic ataxia (the inability to direct optically guided movements), oculomotor apraxia (inability to direct gaze rapidly), and simultanagnosia (inability to integrate a visual scene to perceive it as a whole).
Balint's syndrome
What lesion causes Balint's syndrome?
Balint's syndrome is seen in bilateral parieto-occipital lesions
agraphia, calculation difficulties (acalculia), right-left disorientation, and finger agnosia

lobe?
name?
Gerstmann syndrome includes agraphia, calculation difficulties (acalculia), right-left disorientation, and finger agnosia. It has been attributed to lesions of the dominant parietal lobe.
The syndrome of word deafness, characterized by intact hearing for voices but an inability to recognize speech, may reflect damage to the
left parietal cortex

This syndrome is thought to result from disconnection of the auditory cortex from Wernicke's area.
auditory sound agnosia, is defined as the inability to recognize nonverbal sounds, such as a horn or a cat's meow, in the presence of intact hearing and speech recognition

lesion?
Researchers consider this syndrome the right hemisphere correlate of pure word deafness.
Unlike the signals of the somatosensory, visual, and auditory systems, olfactory signals do not pass through the
thalamus but project directly to the frontal lobe and the limbic system, especially the pyriform cortex
The sense of taste is believed to discriminate only broad classes of stimuli:
sweet, sour, bitter, and salty
The importance of the corticospinal system becomes immediately evident in strokes, in which ? returns as the cortical influence is ablated and the actions of the brainstem motor systems are released from cortical modulation.
spasticity
What brain structure mediates postural tone?
Basal Ganglia
Basal Ganglia subcomponents?
The four functionally distinct ganglia are the striatum, the pallidum, the substantia nigra, and the subthalamic nucleus
What are components of the corpus striatum
caudate and putamen
Caudate fxn?
The caudate nucleus plays an important role in the modulation of motor acts.
When functioning properly, the caudate nucleus acts as a gatekeeper to allow the motor system to perform only those acts that are goal directed
Anatomical and functional neuroimaging studies have correlated ? activation of the structure? with obsessive–compulsive behavior
Anatomical and functional neuroimaging studies have correlated decreased activation of the caudate with obsessive–compulsive behavior
What happens if caudate dysfxnal?
When it fails to perform its gatekeeper function, extraneous acts are performed as in obsessive–compulsive disorder or in the tic disorders, such as Tourette's disorder.
What is bradykinesia due to?
Overactivity of the striatum owing to lack of dopaminergic inhibition (e.g., in parkinsonian conditions) results in bradykinesia, an inability to initiate movements.
The caudate, in particular, shrinks dramatically in ? disease
The caudate, in particular, shrinks dramatically in Huntington's disease
Describe huntington's
This disorder is characterized by rigidity, on which is gradually superimposed choreiform, or “dancing,” movements.
Psychosis may be a prominent feature of Huntington's disease, and suicide is not uncommon.
Along with mvmt fxn what else does caudate influence?
The caudate is also thought to influence associative, or cognitive, processes.
dystonic posturing and flapping movements of the arms and legs. ... seen in what disease, what structure involved?
The globus pallidus receives input from the corpus striatum and projects fibers to the thalamus. This structure may be severely damaged in Wilson's disease and in carbon monoxide poisoning, which are characterized by dystonic posturing and flapping movements of the arms and legs.
The substantia nigra is named the black substance because the presence of ?causes it to appear black to the naked eye.
The substantia nigra is named the black substance because the presence of melanin pigment causes it to appear black to the naked eye.
substania nigra associated with what disorder
Parkinson's disease
ballistic movements, sudden limb jerks of such velocity that they are compared to projectile movement
Lesion?
subthalamic nucleus
Moreover, ablation of the ? renders intentional movements coarse and tremulous.
cerebellum
The skillful use of the hands is called ?, and deficits in skilled movements are termed ?.
The skillful use of the hands is called praxis, and deficits in skilled movements are termed apraxias.
The three levels of apraxia are ?
The three levels of apraxia are limb-kinetic, ideomotor, and ideational
inability to use the contralateral hand in the presence of preserved strength;
name?
lesion?
Limb-kinetic apraxia is the inability to use the contralateral hand in the presence of preserved strength; it results from isolated lesions in the supplementary motor area, which contains neurons that stimulate functional sequences of neurons in the motor strip
inability to perform an isolated motor act on command, despite preserved comprehension, strength, and spontaneous performance of the same act.

name lesoin
Ideomotor apraxia

Conditions in two separate areas can produce this apraxia. Disconnection of the language comprehension area, Wernicke's area, from the motor regions causes an inability to follow spoken commands, and

lesions to the left premotor area may impair the actual motor program as it is generated by the higher-order motor neurons.
A lesion in? can also cause an isolated ideomotor apraxia in the left hand.
This program is transmitted across the corpus callosum to the right premotor area, which directs the movements of the left hand.
A lesion in this callosal projection can also cause an isolated ideomotor apraxia in the left hand.
occurs when the individual components of a sequence of skilled acts can be performed in isolation, but the entire series cannot be organized and executed as a whole.

For example, the sequence of opening an envelope, removing the letter, unfolding it, and placing it on the table cannot be performed in order, even though the individual acts can be performed in isolation.

name
lesion
Ideational apraxia

The representation of the concept of a motor sequence may involve several areas, specifically the left parietal cortex, but it likely also relies on the sequencing and executive functions of the prefrontal cortex. This apraxia is a typical finding of diffuse cortical degeneration, such as Alzheimer's disease.
What activates sympathetic system in terms of drugs?
The sympathetic system is highly activated by sympathomimetic drugs, such as amphetamine and cocaine, and may also be activated by

withdrawal from sedating drugs such as alcohol, benzodiazepines, and opioids.
The brain center that drives the autonomic motor system is the ?
The brain center that drives the autonomic motor system is the hypothalamus,
What does hypothalamus control?
The brain center that drives the autonomic motor system is the hypothalamus, which houses a set of paired nuclei that appear to control appetite, rage, temperature, blood pressure, perspiration, and sexual drive.
For example, lesions to the ?, the satiety center, produce a voracious appetite and rage
ventromedial nucleus of hypothalamus
In contrast, lesions to the ?, the hunger center, produce a profound loss of appetite
upper region of the lateral nucleus
hypothalamus
Peripheral nervous system spinal cord arc response system (e.g. to painful stimulus): graded or all-or-none
local
all-or-none
Three core brain areas, like Brodmann areas?
1. The brainstem and the thalamic reticular activating system provide arousal and set up attention
2. the posterior cortex integrates perceptions and generates language
3. at the highest level, the frontal cortex generates programs and executes plans like an orchestra conductor
Brain lateralization ... primary senses more left, right, or bilateral?
The primary sensory cortices for touch, vision, hearing, smell, and taste are represented bilaterally and the first level of abstraction for these modalities is also usually represented bilaterally.
face recognition

more left, right, or bilateral?
localized to the left inferior temporal cortex
cortical processing of olfaction?

more left, right, or bilateral?
in the right frontal lobe.
Prosody, the emotional and affective components of language, or “body language,” appears to be localized in a mirror set of brain units in the ?
right hemisphere
Describe function of: frontal lobes
Frontal lobes
Voluntary movement
Language production (left)
Motor prosody (right)
Comportment
Executive function
Motivation
Describe function of: temporal lobes
Temporal lobes
Audition
Language comprehension (left)
Sensory prosody (right)
Memory
Emotion
Describe function of: parietal lobes
Parietal lobes
Tactile sensation
Visuospatial function (right)
Reading (left)
Calculation (left)
Describe function of: occipital lobes
Occipital lobes
Vision
Visual perception
localize: voluntary movement
front lobes
language production
left frontal lobe
motor prosody
right frontal lobe
comportment
frontal lobes
executive fxn
frontal lobes
motivation
frontal lobes
audtion
temporal lobes
language comprehension
left temporal lobes
sensory prosody
right temporal lobe
memory
temporal lobes
emotion
temporal lobes
tactile sensation
parietal lobes
visuospatial function
right parietal lobe
calculation
left parietal lobe
vision
occipital lobe
visual perception
occipital lobe
Lesion? Fluent spontaneous speech but poor comprehension?
Wernicke's aphasia or transcortical sensory (in tcs can do repetition)
Lesion? Poor sponataneous speech but good auditory comprehension?
Broca's (or transcortical motor ... but can do repetition in transcortical motor)
3 levels of language comprehension?
1. phonological
2. lexical
3. semantic
in phonological processing, individual sounds, such as vowels or consonants, are recognized in the

Phonological processing improves if
inferior gyrus of the frontal lobes.

lip reading is allowed, if speech is slowed, or if contextual clues are provided.
? processing matches the phonological input with recognized words or sounds in the individual's memory.
location?
lexical

Lexical processing determines whether a sound is a word or not. Recent evidence has localized lexical processing to the left temporal lobe, where the representations of lexical data are organized according to semantic category.
? processing connects the words to their meaning.
semantic processing connects the words to their meaning.
retain the ability to repeat words in the absence of an ability to understand or spontaneously generate speech.

possible lesion?
Persons with an isolated defect in semantic processing

Semantic processing activates the middle and superior gyri of the left temporal lobe, whereas the representation of the conceptual content of words is widely distributed in the cortex.
Describe how language is produced?
Language production proceeds in the opposite direction, from the cortical semantic representations through the left temporal lexical nodes to either the oromotor phonological processing area (for speech) or the graphomotor system (for writing)
The garbled word salad or illogical utterances of an aphasic patient leave little uncertainty about the diagnosis of ?injury
left-sided cortical injury
What side of brain gives affective quality to language?
he right hemisphere contributes a somewhat more subtle, but equally important, affective quality to language. For example, the phrase “I feel good” may be spoken with an infinite variety of shadings, each of which is understood differently. The perception of prosody and the appreciation of the associated gestures, or “body language,” appear to require an intact right hemisphere.
? is defined as an unexpected difficulty with learning in the context of adequate intelligence, motivation, and education
Developmental dyslexia
Inability to ? is the best predictor of a reading disability
Inability to recognize distinct phonemes is the best predictor of a reading disability.

speech consists of the logical combination of 44 basic phonemes of sounds, reading requires a broader set of brain functions and, thus, is more susceptible to disruption
Functional neuroimaging studies have localized the identification of letters to the
occipital lobe adjacent to the primary visual cortex.
Phonological processing occurs in the ?, and semantic processing requires the ?
Phonological processing occurs in the inferior frontal lobe, and semantic processing requires the superior and middle gyri of the left temporal lobe
In children, developmental nonverbal learning disorder is postulated to result from ?
In children, developmental nonverbal learning disorder is postulated to result from right hemisphere dysfunction
Nonverbal learning disorder is characterized by
poor fine-motor control in the left hand,

deficits in visuoperceptual

organization,

problems with mathematics, and

incomplete or disturbed socialization.
Music is represented predominantly in the ? hemisphere,but the full complexity of musical ability seems to involve both hemispheres
Right
Arousal, or the establishment and maintenance of an awake state, appears to require at least three brain regions:
the ascending
reticular activating system (ARAS), a diffuse set of neurons, appears to set the level of consciousness. The ARAS projects to the
intralaminar nuclei of the
thalamus, and these nuclei in turn project widely throughout the
cortex.
Thalamus and cortex eeg firing rate awake? sleep?
Electrophysiological studies show that both the thalamus and the cortex fire rhythmical bursts of neuronal activity at the rates of 20 to 40 cycles per second. During sleep, these bursts are not synchronized
A small lesion here can do much messing up of arousal and attention?
In general, small discrete lesions of the ARAS can produce a stuporous state, whereas at the hemispheric level, large bilateral lesions are required to cause the same depression in alertness.
Vegetative state usually reflects what brain damage?
One particularly unfortunate but instructive condition involving extensive, permanent, bilateral cortical dysfunction is the persistent vegetative state. Sleep–wake cycles may be preserved, and the eyes may appear to gaze; but the external world does not register and no evidence of conscious thought exists. This condition represents the expression of the isolated actions of the ARAS and the thalamus.
The maintenance of attention appears to require an intact ?
For example, a widely used test of persistence requires scanning and identifying only the letter A from a long list of random letters. Healthy persons can usually maintain performance of such a task for several minutes, but in patients with ? dysfunction, this capacity is severely curtailed.
The maintenance of attention appears to require an intact right frontal lobe

right frontal lobe
more generally adaptive skill of maintaining a coherent line of thought is located?
diffusely distributed throughout the cortex
Functional neuroimaging studies, however, have variously documented ? in patients with ADHD, compared with normal controls .

These findings strengthen the notion that the ?—especially the ?—are essential to the maintenance of attention
Functional neuroimaging studies, however, have variously documented either frontal lobe or right hemisphere hypometabolism in patients with ADHD, compared with normal controls.

These findings strengthen the notion that the frontal lobes—especially the right frontal lobe—are essential to the maintenance of attention
Remembering a short story, what you had for dinner last night, and what you did on your last birthday
memory type? structure?
episodic, explicit

Medial temporal lobes, anterior thalamic nucleus, mamillary body, fornix, prefrontal cortex
Knowing who was the first president of the United States, the color of a lion, and how a fork differs from a comb
memory type? structure?
semantic, explicit

Inferolateral temporal lobes
Driving a car with a standard transmission (explicit) and learning the sequence of numbers on a touch tone phone without trying (implicit)
memory type? structure?
procedural, explicit or implicit

Basal ganglia, cerebellum, supplementary motor area
? memory functions over a period of seconds; ? memory applies on the scale of minutes to days; and ? memory encompasses months to years
Immediate memory functions over a period of seconds; recent memory applies on the scale of minutes to days; and remote memory encompasses months to years
A related concept, incorporating immediate and recent memory, is ? memory, which is the ability to store information for several seconds, whereas other, related cognitive operations take place on this information.
working
Some researchers localize working memory predominantly to the
left frontal cortex
Clinically, however,? lesions are required for severe impairment of working memory
Clinically, however, bilateral prefrontal cortex lesions are required for severe impairment of working memory
Three brain structures are critical to the formation of memories:
the medial temporal lobe,
certain diencephalic nuclei, and the
basal forebrain
The ? lobe houses the ?, an elongated, highly repetitive network. The ? is adjacent to the anterior end of the ?. The ? has been suggested to rate the emotional importance of an experience and to activate the level of ? activity accordingly. Thus, an emotionally intense experience is indelibly etched in memory, but indifferent stimuli are quickly disregarded.
The medial temporal lobe houses the hippocampus, an elongated, highly repetitive network. The amygdala is adjacent to the anterior end of the hippocampus. The amygdala has been suggested to rate the emotional importance of an experience and to activate the level of hippocampal activity accordingly. Thus, an emotionally intense experience is indelibly etched in memory, but indifferent stimuli are quickly disregarded.
Animal studies have defined a ? place code, a pattern of cellular activation in the ? that corresponds to the animal's location in space. When the animal is introduced to
a novel environment, the ? is broadly activated. As the animal explores and roams, the firing of certain ? regions begins to correspond to specific locations in the environment. In about 1 hour, a highly detailed internal representation of the external space (a “cognitive map”) appears in the form of specific firing patterns of the ? cells. These patterns of neuronal firing may bear little spatial resemblance to the environment they represent; rather, they may seem randomly arranged in the ?
Animal studies have defined a hippocampal place code, a pattern of cellular activation in the hippocampus that corresponds to the animal's location in space. When the animal is introduced to
P.88

a novel environment, the hippocampus is broadly activated. As the animal explores and roams, the firing of certain hippocampal regions begins to correspond to specific locations in the environment. In about 1 hour, a highly detailed internal representation of the external space (a “cognitive map”) appears in the form of specific firing patterns of the hippocampal cells. These patterns of neuronal firing may bear little spatial resemblance to the environment they represent; rather, they may seem randomly arranged in the hippocampus

If the animal is manually placed in a certain part of a familiar space, only the corresponding hippocampal regions show intense neural activity. When recording continues into sleep periods, firing sequences of hippocampal cells outlining a coherent path of navigation through the environment are registered, even though the animal is motionless. If the animal is removed from the environment for several days and then returned, the previously registered hippocampal place code is immediately reactivated. A series of animal experiments has dissociated the formation of the hippocampal place code from either visual, auditory, or olfactory cues, although each of these modalities may contribute to place code generation. Other factors may include internal calculations of distances based on counting footsteps or other proprioceptive information
data suggest that the hippocampus is a significant site for
formation and storage of immediate and recent memories.
Although no data yet support the notion, it is conceivable that the ? cognitive map is inappropriately reactivated during a déjà vu experience.
Although no data yet support the notion, it is conceivable that the hippocampal cognitive map is inappropriately reactivated during a déjà vu experience.
Case of HM
had epilepsy

both hippocampi and amygdala removed
left with inability to form and recall memories of facts

H. M.'s learning and memory skills were relatively preserved, which led to the suggestion that declarative or factual memory may be separate within the brain from procedural or skill-related memory
severe inability to form new memories and a variable inability to recall remote memories.
What disorder
etiology?
Within the diencephalon, the dorsal medial nucleus of the thalamus and the mamillary bodies appear necessary for memory formation. These two structures are damaged in thiamine deficiency states usually seen in chronic alcoholics, and their inactivation is associated with Korsakoff's syndrome.
The most common clinical disorder of memory is
Alzheimer's disease
Clinicopathological studies have suggested that the cognitive decline is best correlated with the loss of
synapse
In alzheimer's, Initially, the ?? lobes are affected, with relative sparing of the ? lobes.

This pattern of degeneration correlates with the early loss of memory, which is largely a ? lobe function
Initially, the parietal and temporal lobes are affected, with relative sparing of the frontal lobes

This pattern of degeneration correlates with the early loss of memory, which is largely a temporal lobe function
Also, syntactical language comprehension and visuospatial organization, functions that rely heavily on the ? lobe, are impaired early in the course of Alzheimer's disease
parietal
In contrast, personality changes, which reflect ? lobe function, are relatively late consequences of Alzheimer's disease
frontal
rarer, complementary cortical degeneration syndrome, Pick's disease, first affects the ? lobes while sparing the ? and ? lobes.
rarer, complementary cortical degeneration syndrome, Pick's disease, first affects the frontal lobes while sparing the temporal and parietal lobes.
In ? ds disinhibition and impaired language expression, which are signs of ? dysfunction, appear early, with relatively preserved language comprehension and memory
Pick's Disease,
frontal
Emotion derives from basic drives, such as feeding, sex, reproduction, pleasure, pain, fear, and aggression, which all animals share. The neuroanatomical basis for these drives appears to be centered in the ?
limbic system
Distinctly human emotions, such as affection, pride, guilt, pity, envy, and resentment, are largely learned and most likely are represented in the ?
cortex
The regulation of drives appears to require an intact ?
frontal cortex
The ? hemisphere houses the analytical mind but may have a limited emotional repertoire
left
For example, lesions to the right hemisphere, which cause profound
?, may be noted with ? by the intact left hemisphere.
For example, lesions to the right hemisphere, which cause profound
functional deficits, may be noted with indifference by the intact left hemisphere.
The denial of illness and of the inability to move the left hand
name
lesion
in cases of right hemisphere injury is called anosognosia.
In contrast, ? lesions, which cause profound aphasia, can trigger a catastrophic depression, as the intact ? hemisphere struggles with the realization of the loss
In contrast, left hemisphere lesions, which cause profound aphasia, can trigger a catastrophic depression, as the intact right hemisphere struggles with the realization of the loss
The ? hemisphere also appears dominant for affect, socialization, and body image
right
Damage to the ? hemisphere produces intellectual disorder and loss of the narrative aspect of dreams
left
Damage to the right hemisphere produces?
ffective disorders,
loss of the visual aspects of dreams, and a
failure to respond to humor, shadings of metaphor, and connotations
hemisensory changes representing conversion disorders have been repeatedly noted to involve the ? half of the body more often than the ?, an observation that suggests an origin in the ? hemisphere
hemisensory changes representing conversion disorders have been repeatedly noted to involve the left half of the body more often than the right, an observation that suggests an origin in the right hemisphere
Within the hemispheres, the ? and ? lobes play a prominent role in emotion.
temporal and frontal
Temporal lobe epilepsy: personality?
A proposed TLE personality is characterized by
hyposexuality,
emotional intensity, and a perseverative approach to interactions, termed viscosity.
TLittlesexualinterestEmotionalPerseverative
TLEPersonality
Patients with ? TLE may generate references to personal destiny and philosophical themes and display a humorless approach to life.

In contrast, patients with ? TLE may display excessive emotionality, ranging from elation to sadness.
right TLE,

Left TLE
LE=left emotional
The inverse of a TLE personality appears in persons with ? injury to the ? lobes after head trauma, cardiac arrest, herpes simplex encephalitis, or Pick's disease
bilateral injury
temporal
Behavior in this syndrome is characterized by hypersexuality, placidity, a tendency to explore the environment with the mouth, inability to recognize the emotional significance of visual stimuli, and constantly shifting attention, called hypermetamorphosis

name of syndrome
lesion
This lesion resembles the one described in the Klüver-Bucy syndrome,
temporal lobe ablation in monkeys.
In contrast to the ? spectrum sometimes seen in patients with TLE, complete experimental ablation of the ? lobes appears to produce a uniform, bland reaction to the environment, possibly because of an inability to access memories
In contrast to the aggression–fear spectrum sometimes seen in patients with TLE, complete experimental ablation of the temporal lobes appears to produce a uniform, bland reaction to the environment, possibly because of an inability to access memories.
The prefrontal cortices influence mood in a complementary way. Whereas activation of the ? cortex appears to lift the mood, activation of the cortex causes depression
left prefrontal

right prefrontal
A lesion to the ? area, at either the cortical or the subcortical level, abolishes the normal mood-elevating influences and produces depression and uncontrollable crying.

In contrast, a comparable lesion to the ? area may produce laughter, euphoria, and witzelsucht, a tendency to joke and make puns
A lesion to the left prefrontal area

right prefrontal
A seizure focus within the ? cortex can cause gelastic seizures, for example, in which the ictal event is laughter
left prefrontal
Functional neuroimaging has documented ? during depressive states, which normalized after the depression was treated successfully.
left prefrontal hypoperfusion
The Papez circuit consists of the ?
hippocampus, the fornix, the mamillary bodies, the anterior nucleus of the thalamus, and the cingulate gyrus
Limbic system boundaries
Papez circuit (hippocampus, fornix, mammillary bodies, anterior nulceus of thalamus, cingulate gyrus) +
amygdala,
septum
basal forebrain
nucleus accumbens,
orbitofrontal cortex
The ? appears to be a critically important gate through which internal and external stimuli are integrated.
amygdala
Fxn of amygdala?
Information from the primary senses is interwoven with internal drives, such as hunger and thirst, to assign emotional significance to sensory experiences.
The ? may mediate learned fear responses, such as anxiety and panic, and may direct the expression of certain emotions by producing a particular affect.
amygdala
What is more influential, amygdala or cortex?
Neuroanatomical data suggest that the amygdala exerts a more powerful influence on the cortex, to stimulate or suppress cortical activity, than the cortex exerts on the amygdala
Pathways from the sensory thalamic relay stations separately send sensory data to the amygdala and the cortex
The subsequent effect of the amygdala on the cortex is (less, equally, more) potent of the two reciprocal connections
more
damage to the amygdala has been reported to a
Persons with such injuries may have a preserved ability to
blate the ability to distinguish fear and anger in other persons' voices and facial expressions

Persons with such injuries may have a preserved ability to recognize happiness, sadness, or disgust
The ?? appears to house the emotional association areas, which direct the ? to express the motor and endocrine components of the emotional state
limbic system

hypothalamus
Electrical stimulation of animals throughout the subcortical area involving the limbic system produces
rage reactions (e.g., growling, spitting, arching of the back). Whether the animal flees or attacks depends on the intensity of the stimulation.
The limbic system has been particularly implicated in neuropathological studies of ? disorder?
schizophrenia
Several clinicopathological studies have found a reduction in the brain weight of the ? matter but not of the ? matter in persons with schizophrenia
Several clinicopathological studies have found a reduction in the brain weight of the gray matter but not of the white matter in persons with schizophrenia
In pathological as well as in magnetic resonance imaging (MRI) reports, persons with schizophrenia may have reduced volume of the ?
hippocampus, amygdala, and parahippocampal gyrus
Functional neuroimaging studies have demonstrated decreased activation of the ? in many patients with schizophrenia, particularly during tasks requiring willed action.

A reciprocal increase in activation of the ? lobe can occur during willed actions, such as finger movements or speaking, in persons with schizophrenia.
frontal lobes

temporal
In sz,
Neuropathological studies have shown a decreased density of in the frontal lobes of these patients
neuropil, the intertwined axons
and dendrites of the neurons,
During development, the density of neuropil is highest around age ? year and then is reduced somewhat through synaptic pruning;
1
Neuropil density as age?
the density plateaus throughout childhood and is further reduced to adult levels in adolescence
One hypothesis of the appearance of schizophrenia in the late teenage years is that (related to brain wiring)?
excessive adolescent synaptic pruning occurs and results in too little frontolimbic activity.

Some experts have suggested that hypometabolism and paucity of interneuronal connections in the prefrontal cortex may reflect inefficiencies in working memory, which permits the disjointed discourse and loosening of associations that characterize schizophrenia
Other lines of investigation aimed at understanding the biological basis of schizophrenia have documented inefficiencies in the formation of ? in the middle of the ? trimester of gestation, which may result from a ?
Other lines of investigation aimed at understanding the biological basis of schizophrenia have documented inefficiencies in the formation of cortical synaptic connections in the middle of the second trimester of gestation, which may result from a viral infection or malnutrition
The ? lobes, the region that determines how the brain acts on its knowledge, constitute a category unto themselves
FRONTAL
There are four subdivisions of the frontal lobes:
The first three—the motor strip, the supplemental motor area, and Broca's area—are mentioned above in the discussion of the motor system and language. The fourth, most anterior, division is the prefrontal cortex
The prefrontal cortex contains three regions in which lesions produce distinct syndromes:
the orbitofrontal, the dorsolateral, and the medial
Indeed, frontal lobe injury usually impairs the executive functions:
motivation, attention, and sequencing of actions.
Bilateral lesions of the frontal lobes are characterized by changes
in personality
The frontal lobe syndrome, which is most commonly produced by ?, consists of ?
The frontal lobe syndrome, which is most commonly produced by trauma, infarcts, tumors, lobotomy, multiple sclerosis, or Pick's disease, consists of slowed thinking, poor judgment, decreased curiosity, social withdrawal, and irritability.

Patients typically display apathetic indifference to experience that can suddenly explode into impulsive disinhibition
Unilateral frontal lobe lesions sx?
may be largely unnoticed because the intact lobe can compensate with high efficiency
Frontal lobe dysfunction may be difficult to detect by means of highly structured, formal neuropsychological tests. Intelligence, as reflected in the intelligence quotient (IQ), is usually?
normal
Functional neuroimaging studies have shown that the IQ seems to require mostly ? activation
parietal lobe
How test parietal lobe vs frontal lobe fxn?
For example, during administration of the Wechsler Adult Intelligence Scale-Revised (WAIS-R), the highest levels of increased metabolic activity during verbal tasks occurred in the left parietal lobe, whereas the highest levels of increased metabolic activity during performance skills occurred in the right parietal lobe. In contrast, frontal lobe pathology may become apparent only under unstructured, stressful, real-life situations.
In one study of right-handed males, lesions of the ?? cortex eliminated the tendency to use internal, associative memory cues and led to an extreme tendency to interpret the task at hand in terms of its immediate context


In contrast, right-handed males who had lesions of the ? cortex produced no context-dependent interpretations and interpreted the tasks entirely in terms of their own internal drives.
right prefrontal

left prefrontal
At the peak of neuronal proliferation in the middle of the ? trimester, 250,000 neurons are born each minute
2nd
A group of such incorrectly placed neurons is called a heterotopia. Neuronal heterotopias have been shown to cause
epilepsy and are highly associated with mental retardation
The subplate neurons then degenerate. Some brains from persons with schizophrenia reveal an abnormal persistence of ? neurons, suggesting a failure to complete axonal pathfinding in the brains of these persons.
subplate
The peak of synaptogenesis occurs within the first ? postnatal years, when as many as 30 million synapses form each second
2
Ensheathment of axons by myelin begins ?; it is largely complete in early ?, but does not reach its full extent until late in the ? decade of life
Ensheathment of axons by myelin begins prenatally; it is largely complete in early childhood, but does not reach its full extent until late in the third decade of life
Brain myleination sequence?
Myelination occurs first in brain areas involved with leg movements, primitive vision, and primitive hearing.

brain areas involved in arm movements, the supplementary motor areas, the higher visual and auditory areas, and the lower association areas.

Finally, the frontal executive cortex, the parieto-occipital association area, the temporal object recognition areas, shown in white, do not complete their myelination until the time of puberty
A remarkable recent discovery has been that new neurons can be generated in certain brain regions (?) in adult animals, including humans
particularly the dentate gyrus of the hippocampus
Define attunement
For example, the concept of attunement is defined as the process by which caregivers “play back a child's inner feelings.”

If a baby's emotional expressions are reciprocated in a consistent and sensitive manner, certain emotional circuits are reinforced.
Trauma and infancy and amygdala?
Recent work suggests that a pattern of terrifying experiences in infancy may flood the amygdala and drive memory circuits to be specifically alert to threatening stimuli, at the expense of circuits for language and other academic skills.

Thus, infants raised in a chaotic and frightening home may be neurologically disadvantaged for the acquisition of complex cognitive skills in school.
A PET scanning study of patients with PTSD revealed abnormally high activity in the? while the patients were reliving their traumatic memories
right amygdala
The researchers hypothesized that the stressful hormonal milieu present during the registration of the memories may have served to burn the memories into the brain and to prevent their erasure by the usual memory modulation circuits.
many norepinephrine-releasing neurons have presynaptic α2-adrenergic receptors that, when occupied by the released norepinephrine, cause the releasing neuron to
decrease or stop the release of norepinephrine
Role of synaptic transporters?
Transporters take neurotransmitters up from the synaptic cleft for recycling or degradation.
Two terms often used in conjunction with receptors are supersensitivity and subsensitivity. Super = , sub =?
Super= to a greater than usual response and
SUB a less than usual response of the receptor to a constant amount of neurotransmitter
What are the two major types of receptors?
seven-transmembrane-domain receptors, which require G proteins,

and ligand-gated ion channels, in which the channel is an integral part of the complex that binds the ligand
Another type of postsynaptic membrane receptor, which does not cause changes in membrane potential, is the family of ? receptors, which triggers a cascade of intracellular phosphorylations that ultimately lead to ?
Another type of postsynaptic membrane receptor, which does not cause changes in membrane potential, is the family of tyrosine kinase receptors, which triggers a cascade of intracellular phosphorylations that ultimately lead to changes in gene expression
Tyrosine kinase receptors bind growth factors and mediate the plasticity of synaptic associations. Two such factors are nerve growth factor? and ?, which have opposite effects on the size of developing cortical somatosensory receptive fields and, thus, may collaborate in the remodeling of neuronal circuits that underlies synaptic plasticity during development and in adults.
(NGF) and brain-derived neurotropic factor (BDNF)
In psychiatry, lithium therapy has been shown to reduce the activity of ? in concert with its salutary effects on bipolar disorder
protein kinase
5-HT1A ... ?
Antidepressant action; partial agonist; anxiolytic
5-HT1B
locomotor activity
aggression
5-HT1D
Target of antimigraine drug sumatriptan
5-HT1F
Target of antimigraine drug sumatriptan
5-HT2A
Target of hallucinogens, atypical antipsychotics
5-HT2B
Regulation of stomach contraction
5-HT2C
Regulation of appetite, anxiety, seizures; target of hallucinogens, antipsychotics
5-HT3
Antagonists antiemetic, anxiolytic, cognitive enhancement
5-HT4
Modulation of cognition, anxiety
5-HT6
Target of hallucinogens, atypical antipsychotics
5-HT7
Possible regulation of circadian rhythms
H1
Antagonists produce sedation, weight gain
H2
Antagonists for peptic ulcer disease
H3
Antagonists produce arousal, appetite suppression
D1
D1 and D2 receptor stimulation synergistic; required for stimulant effects of cocaine
D2
Target of therapeutic and extrapyramidal effects of dopamine receptor antagonists (“typical antipsychotics”)
D3
Unknown
D4
target of atypicals
d5
unknown
α1
Antagonists antihypertensive
α2A,B,C
Agonists sedative and antihypertensive
β1
Regulation of cardiac function
β2
Regulation of bronchial muscle contraction
β3
Regulation of adipose tissue function
M1
Regulation of cognition, seizures
M2
Regulation of cardiac function
M3
Regulation of smooth muscle contraction
M4
Target of antiparkinsonian anticholinergic drugs
M5
Unknown
NAChR (cholinergic)
Regulation of tobacco use, seizures; possible cognitive enhancement
3 key dopamine tracts?
1. nigro-striatal
2. mesolimbic - mesocortical
3. tubero-infundibular tract
The nigrostriatal tract projects from its cell bodies in the ? to the ?

When the D2 receptors at the end of this tract are blocked by classic antipsychotic drugs, results?
The nigrostriatal tract projects from its cell bodies in the substantia nigra to the corpus striatum

parkinsonian side effects emerge
D2 receptors in the caudate nucleus ? the activity of the caudate nucleus.
suppress
The caudate neurons regulate motor acts by gating, in which intended acts are actually carried out.

The absence of D2 receptor activity allows the caudate to
dampen motor activity excessively, resulting in the bradykinesia that typifies parkinsonism
excess dopamine activity in the caudate ?
removes the gating control and may result in extraneous motor acts, such as tics.
The mesolimbic-mesocortical tract projects from its cell bodies in the ? , which lies adjacent to the ?, to ?
The mesolimbic-mesocortical tract projects from its cell bodies in the ventral tegmental area (VTA), which lies adjacent to the substantia nigra, to most areas of the cerebral cortex, and to the limbic system.
Which tracts associated with antipsychosis?
The mesolimbic-mesocortical tract projects from its cell bodies in the ventral tegmental area (VTA), which lies adjacent to the substantia nigra, to most areas of the cerebral cortex, and to the limbic system.
The cell bodies of the tuberoinfundibular tract, which are in the ?, project to the ? and the ?
The cell bodies of the tuberoinfundibular tract, which are in the arcuate nucleus and the periventricular area of the hypothalamus, project to the infundibulum and the anterior pituitary.
Dopamine role in tubero-infundibular tract?
Dopamine acts as a release-inhibiting factor in the tract by inhibiting the release of prolactin from the anterior pituitary.

Patients who take dopamine receptor antagonists often have roughly threefold elevated prolactin levels because the blockade of dopamine receptors in the tract eliminates the inhibitory effect of dopamine.
Dopamine is one of the three catecholamine neurotransmitters that are synthesized, starting with the amino acid ?
tyrosine
Dopamine is one of the three catecholamine neurotransmitters that are synthesized, starting with the amino acid tyrosine. The other two neurotransmitters are ?
norepinephrine and epinephrine
rate-limiting enzymatic step in the synthesis of any of the catecholamines is
catalyzed by tyrosine hydroxylase
Do diet change influence synthesis of catecholamines/
NO, because rate limiting step is tyr hydroxylase catalysis
Tyrosine hydroxylase transforms tyrosine into ?
3,4-dihydroxyphenylalanine (DOPA)
Why?, ? can be administered orally to increase the rate of synthesis of its product, dopamine, and ? is used for this purpose to treat Parkinson's disease
Because it is beyond the rate-limiting synthetic step, dopa can be administered orally to increase the rate of synthesis of its product, dopamine, and dopa is used for this purpose to treat Parkinson's disease
actions of dopamine are terminated by two general routes:
1. reuptake by presynaptic dopamine transporter
2. metabolism by MAO or COMT
MAO is localized on ?, principally in the (pre or post?) synaptic terminal, where it acts on dopamine that has been taken up into the (pre or post) synaptic terminal but not yet repackaged into vesicles
MAO is localized on the outer mitochondrial membrane, principally in the presynaptic terminal, where it acts on dopamine that has been taken up into the presynaptic terminal but not yet repackaged into vesicles
COMT is a soluble enzyme localized i?. When dopamine is metabolized by COMT, the resulting metabolites are then?
COMT is a soluble enzyme localized in the cytoplasm of the postsynaptic cell and of glial cells and, possibly also, extracellularly. When dopamine is metabolized extraneuronally by COMT, the resulting metabolites are then taken back into the neuron and further metabolized by MAO.
There are two types of MAOs. MAO? selectively metabolizes dopamine.
B
The primary metabolite of dopamine is ?, and many research studies of cerebrospinal fluid, urine, and serum attempt to assess dopamine activity in the CNS by measuring concentrations of ?
homovanillic acid (HVA)
the D1 and D5 receptors stimulate the formulation of ? by ?
the D1 and D5 receptors stimulate the formulation of cAMP by activating the stimulatory G protein, Gs.
One difference between these D1 and D5, receptors is that the D5 receptor has a ? affinity for dopamine than does the D1 receptor
One difference between these two receptors is that the D5 receptor has a much higher affinity for dopamine than does the D1 receptor
The D2 receptor inhibits the formation of ? by ? and some data indicate that the D3 and D4 receptors act similarly
he D2 receptor inhibits the formation of cAMP by activating the inhibitory G protein, Gi, and some data indicate that the D3 and D4 receptors act similarly
D2 receptor primary distribution?
D2 receptor is prominent in the striatum (caudate nucleus and putamen)
D3 receptor is especially concentrated in the
nucleus accumbens,
D4 receptor is especially concentrated in the
frontal cortex, in addition to other regions.
blockade of dopamine receptors, particularly the D2 receptor, has been associated with the efficacy of antipsychotic drugs, long-term administration of dopamine receptor antagonists results in an ? (down, up regulation) in the number of dopamine receptors present.
upregulation
This upregulation of D2 receptors may be involved in the development of ?
This upregulation may be involved in the development of tardive dyskinesia.
Why are atypical less associated with EPS/TD?
he serotonin-dopamine antagonists because they block predominantly the serotonin type 5-HT2 and, to a lesser extent, the D2 receptors, is associated with a greatly reduced risk of development of parkinsonian side effects and tardive dyskinesia.
Amphetamines cause the release of ?, and cocaine ? dopamine
Amphetamines cause the release of dopamine, and cocaine blocks the uptake of dopamine
Cocaine and ? are among the most addicting substances
methamphetamine
Mutant knockout mice, in which the dopamine transporter gene has been experimentally deleted, respond ?How? biochemically or behaviorally to cocaine. This suggests that the dopamine transporter is ?
Mutant knockout mice, in which the dopamine transporter gene has been experimentally deleted, do not respond biochemically or behaviorally to cocaine. This suggests that the dopamine transporter is necessary for the pharmacological effects of cocaine.
Studies in rats showed that D2 receptor agonists ? cocaine self-administration, whereas D1 receptor agonists ? cocaine self-admin
Studies in rats showed that D2 receptor agonists increased cocaine self-administration, whereas D1 receptor agonists lowered the desire for cocaine
Nicotine, the most psychoactive ingredient in cigarette smoke, ?Neurotrans fx?
Nicotine, the most psychoactive ingredient in cigarette smoke, stimulates the release of dopamine and glutamate
The dopamine transporter can be blocked by ?? although it is unlikely that sufficient CNS concentrations of this drug are routinely obtained to have an appreciable effect on dopamine transport.
bupropion (Wellbutrin),
Dopamine-containing storage vesicles are depleted irreversibly by ? and reversibly by ?.
Dopamine-containing storage vesicles are depleted irreversibly by reserpine (Serpasil) and reversibly by tetrabenazine
Dopamine activity may be ? in depression and ? in mania
Dopamine activity may be low in depression and high in mania
Although norepinephrine and epinephrine are discussed together, ? is the more important and more abundant of the two related neurotransmitters in the brain, although adrenally derived ? is more abundant than ? in the serum
Although norepinephrine and epinephrine are discussed together, norepinephrine is the more important and more abundant of the two related neurotransmitters in the brain, although adrenally derived epinephrine is more abundant than norepinephrine in the serum
The norepinephrine system and the epinephrine system are also referred to as the ? system and the ? system, respectivel
The norepinephrine system and the epinephrine system are also referred to as the noradrenergic system and the adrenergic system, respectivel
The receptors are referred to simply as ? receptors, however, because they are receptors for both epinephrine and norepinephrine.
adrenergic
The major concentration of noradrenergic (and adrenergic) cell bodies that project upward in the brain is in ?.

The axons of these neurons project through the medial forebrain bundle to the
the compact locus ceruleus in the pons


cerebral cortex, the limbic system, the thalamus, and the hypothalamus.
Where is the locus ceruleus?
The projections reach many areas in the ?
he locus ceruleus, which is located immediately underneath the floor of the fourth ventricle in the rostrolateral part of the pons, is the most important noradrenergic nucleus in the brain.

forebrain, the cerebellum, and the spinal cord
In neurons that release norepinephrine, the enzyme ? converts dopamine to norepinephrine; neurons that release dopamine lack this enzyme.
the enzyme dopamine β-hydroxylase converts dopamine to norepinephrine; neurons that release dopamine lack this enzyme.
In neurons that release epinephrine, the enzyme ? converts norepinephrine into epinephrin
phenylethanolamine-N-methyltransferase (PNMT)
Neurons that release either dopamine or norepinephrine do not have?
Neurons that release either dopamine or norepinephrine do not have PNMT
As with dopamine, the two major routes of deactivation are uptake back into the presynaptic neuron and metabolism by ? and ?. The MAO?subtype preferentially metabolizes norepinephrine and epinephrine, as well as serotonin
As with dopamine, the two major routes of deactivation are uptake back into the presynaptic neuron and metabolism by MAO and COMT. The MAOA subtype preferentially metabolizes norepinephrine and epinephrine, as well as serotonin
Difference between alpha and beta receptors?
Although the field is changing rapidly, all α1-receptors seem to be linked to the phosphoinositol turnover system, α-receptors seem to inhibit the formation of cAMP, and β-receptors seem to stimulate the formation of cAMP.
Significant data have long been available on the β1- and β2-receptors, which regulate the function of ? often in antagonism to the effects of the α-receptors.
nearly every organ in the body,
The ?-receptors have recently been found to regulate energy metabolism.
They are expressed in ?, and their activation by agonists reduces the amount of ?
The β3-receptors have recently been found to regulate energy metabolism.
They are expressed in adipocytes, and their activation by agonists reduces the amount of body fat
The tricyclic drugs, venlafaxine, bupropion, and nefazodone, block the ? into the presynaptic neuron, and the MAOIs block the ? of norepinephrine (and serotonin
The tricyclic drugs, venlafaxine, bupropion, and nefazodone, block the reuptake of norepinephrine (and serotonin) into the presynaptic neuron, and the MAOIs block the catabolism of norepinephrine (and serotonin
Because antidepressants take 2 to 4 weeks to exert their therapeutic effects, it is obviously not the immediate effect alone that results in their beneficial effects.

The immediate effects, however, may eventually lead to a ?(down or upregulation) of the number of postsynaptic ?-receptors, and this ?regulation of postsynaptic ?-receptors has been correlated with clinical improvement.
Because antidepressants take 2 to 4 weeks to exert their therapeutic effects, it is obviously not the immediate effect alone that results in their beneficial effects.
Mirtazapine acts by ? and thus removing the ?

The net effect of mirtazapine is to ?
Mirtazapine acts by blocking the presynaptic α2-receptors and thus removing the feedback inhibition normally exerted on the release of norepinephrine.

The net effect of mirtazapine is to increase norepinephrine secretion.
Blockade of the α1-receptors is commonly associated with ? and ?
Blockade of the α1-receptors is commonly associated with sedation and postural hypotension
Another drug that affects the α-adrenergic system is ? which is an ? receptor agonist
Another drug that affects the α-adrenergic system is clonidine (Catapres), which is an α-receptor agonist
alpha 2 receptor located? activation results in?
The α2-receptors are generally located on the presynaptic neuron in the CNS, and activation of these receptors downregulates the production and the release of norepinephrine.
Clonidine why used in withdrawal?
because it block sympathetic response
it's a sympatholytic
yohimbine moa?
The α2-receptor antagonist yohimbine (Yocon) is used to reverse the antisexual effects of antidepressants, especially those of the serotonergic class.
propranolol moa?
The β-adrenergic receptor antagonists, such as propranolol (Inderal), have also been used in psychiatry
In general, β-receptors are located ?synaptically, and ? of their activity results in a ? in cAMP formation in the ?synaptic neuron
In general, β-receptors are located postsynaptically, and inhibition of their activity results in a decrease in cAMP formation in the postsynaptic neuron
The β-adrenergic antagonists have been used to treat?
The β-adrenergic antagonists have been used to treat social phobia (e.g., performance anxiety), akathisia (a movement disorder associated with antipsychotic compounds), and lithium-induced tremor.
The major site of serotonergic cell bodies is in the

These neurons project to the
upper pons and the midbrain—specifically, the median and dorsal raphe nuclei and, to a lesser extent, the caudal locus ceruleus, the area postrema, and the interpeduncular area

basal ganglia, the limbic system, and the cerebral cortex
The precursor amino acid is ? for serotonin?
The precursor amino acid is tryptophan
Serotonin rate limiting step?
In contrast to the catecholamines, the availability of tryptophan is the rate-limiting function, and the enzyme tryptophan hydroxylase is not rate limiting
tryptophan depletion causes ?, whereas tryptophan supplementation can induce ?.
tryptophan depletion causes irritability and hunger, whereas tryptophan supplementation can induce sleep, relieve anxiety, and increase a sense of well-being.
The key enzyme involved in the metabolism of serotonin is ?, preferentially MAO?, and the primary metabolite is ?
The key enzyme involved in the metabolism of serotonin is MAO, preferentially MAOA, and the primary metabolite is 5-hydroxyindoleacetic acid (5-HIAA)
buspirone (BuSpar), a clinically effective anxiolytic, is a potent 5-HT? ?
buspirone (BuSpar), a clinically effective anxiolytic, is a potent 5-HT1A agonist
Clozapine, the prototypical serotonin-dopamine antagonist antipsychotic agent, has significant activity as an antagonist of 5-HT? receptors
2
Antagonists of the 5-HT? receptor are also under study as potential antianxiety and antipsychotic compounds
3
Serotonin receptors in the ? may be responsible for akathisia and agitation
Serotonin receptors in the basal ganglia may be responsible for akathisia and agitation
5-HT? receptors in the ? may cause nausea and vomiting
5-HT3 receptors in the brainstem vomiting center (area postrema) or the hypothalamus may cause nausea and vomiting
receptors in the ? may cause an initial increase in anxiety
receptors in the limbic system may cause an initial increase in anxiety
receptors in various parts of the ? may produce either insomnia or somnolence
receptors in various parts of the brainstem sleep centers may produce either insomnia or somnolence
? location of serotonin receptors may produce sexual dysfunction
spinal cord pathways may produce sexual dysfunction
serotonin receptors in the ? may cause gastrointestinal upset and diarrhea
in the intestines (where 90 percent of the body's serotonin is found)
receptors in the ?may cause headache
receptors in the cranial blood vessel may cause headache
With respect to serotonin, both trazodone (Desyrel) and nefazodone ? serotonin and directly ? 5-HT? receptors, with the net effect stimulating 5-HT? receptors
With respect to serotonin, both trazodone (Desyrel) and nefazodone block the reuptake of serotonin and directly antagonize 5-HT2 receptors, with the net effect stimulating 5-HT1 receptors
Trazodone and nefazodone and the 5-HT? receptor agonist buspirone are the first of what will likely be a series of drugs that target subtypes of serotonin receptors.
Trazodone and nefazodone and the 5-HT1 receptor agonist buspirone are the first of what will likely be a series of drugs that target subtypes of serotonin receptors.
MDMA 3, 4-methylenedioxymethamphetamine, "ectasy"; MOA?
MDMA has dual effects: blocking the uptake of serotonin and inducing the massive release of the serotonin contents of serotonergic neurons
Biogenic amine hypothesis of mood ds?
biogenic amine hypothesis of mood disorders. This hypothesis is simply that depression is associated with too little serotonin and that mania is associated with too much serotonin
The ? hypothesis postulates that low levels of serotonin permit abnormal levels of norepinephrine to cause depression or mania
permissive
Neurons that release histamine as their neurotransmitter are located in the ?
Neurons that release histamine as their neurotransmitter are located in the hypothalamus and project to the cerebral cortex, the limbic system, and the thalamus.
Types of Histamine receptors?
H1, 2, 3
H1 stimulation, blockade?
Blockade of H1 receptors is the mechanism of action for allergy medications and is partly the mechanism for commonly observed side effects (e.g., sedation, weight gain, and hypotension) of some psychotropic drugs

H1-receptor stimulation increases the production of IP3 and DAG;
H2 stimulation increases the production of ?;
cAMP
H3 receptor may regulate
vascular tone
A group of cholinergic neurons in the ? projects to the ? and the?

Additional cholinergic neurons in the ? project to the ?.
A group of cholinergic neurons in the nucleus basalis of Meynert projects to the cerebral cortex and the limbic system.

Additional cholinergic neurons in the reticular system project to the cerebral cortex, the limbic system, the hypothalamus, and the thalamus.
Some patients with dementia of the Alzheimer's type or Down syndrome appear to have specific ? of the neurons in the ?
Some patients with dementia of the Alzheimer's type or Down syndrome appear to have specific degeneration of the neurons in the nucleus basalis of Meynert
Acetylcholine is synthesized in the cholinergic axon terminal from ? and ? by the enzyme ?
Acetylcholine is synthesized in the cholinergic axon terminal from acetylcoenzyme A (acetyl-CoA) and choline by the enzyme choline acetyltransferase
Acetylcholine is metabolized in the synaptic cleft by ?, and the resulting choline is taken back up into the presynaptic neuron and is recycled to make new acetylcholine molecules
Acetylcholine is metabolized in the synaptic cleft by acetylcholinesterase, and the resulting choline is taken back up into the presynaptic neuron and is recycled to make new acetylcholine molecules
? is affected by the drugs currently in use for the treatment of Alzheimer's disease
Acetylcholinesterase is affected by the drugs currently in use for the treatment of Alzheimer's disease
The two major subtypes of cholinergic receptors are ?
The two major subtypes of cholinergic receptors are muscarinic and nicotinic
Muscarinic receptors are antagonized by ? and by ? drugs
Muscarinic receptors are antagonized by atropine and by the anticholinergic drugs
There are five recognized types of muscarinic receptors with various effects on ?, ? and ? production, and ? ion channel activity.
There are five recognized types of muscarinic receptors with various effects on phosphoinositol turnover, cAMP and cGMP production, and potassium ion channel activity.
The nicotinic receptors are ? ion channels that have the receptor site where
The nicotinic receptors are ligand-gated ion channels that have the receptor site directly on the ion channel itself.
he nicotinic receptor is actually made up of ? subunits
The nicotinic receptor is actually made up of four subunits (α, β, γ, and δ).
The most common use of anticholinergic drugs in psychiatry is in treatment of?
The most common use of anticholinergic drugs in psychiatry is in treatment of the motor abnormalities caused by the use of classic antipsychotic drugs (e.g., haloperidol).
In healthy people, the activity of the nigrostriatal dopamine pathway is partially balanced by the activity of ? pathways in the ?
In healthy people, the activity of the nigrostriatal dopamine pathway is partially balanced by the activity of cholinergic pathways in the basal ganglia.
Blockade of muscarinic cholinergic receptors is a common pharmacodynamic effect of many psychotropic drugs. Blockade of those receptors leads to
commonly seen adverse effects of blurred vision, dry mouth, constipation, and difficulty in initiating urination
Excessive blockade of CNS cholinergic receptors causes
confusion and delirium.
Drugs that increase ? by blocking breakdown by ? have been shown to be effective in the treatment of dementia of the Alzheimer's type
Drugs that increase cholinergic activity by blocking breakdown by acetylcholinesterase (e.g., donepezil [Aricept]) have been shown to be effective in the treatment of dementia of the Alzheimer's type
When bound by ?, CNS presynaptic nicotinic receptors mediate a large influx of calcium and, therefore, cause neurotransmitter release in many types of neurons
When bound by nicotine, CNS presynaptic nicotinic receptors mediate a large influx of calcium and, therefore, cause neurotransmitter release in many types of neurons
nicotine ? the strength of synaptic connections in the hippocampus, the brain region that supports short-term memory.
nicotine increases the strength of synaptic connections in the hippocampus, the brain region that supports short-term memory. Several
Several nicotine-like compounds that stimulate acetylcholine release are under study as ?.
Several nicotine-like compounds that stimulate acetylcholine release are under study as cognitive enhancers for treatment of Alzheimer's disease.
? agents can impair learning and memory in healthy people.
Anticholinergic agents can impair learning and memory in healthy people.
Key peptide in brain?
opiods
Which opiod receptor involved in stress, pain, mood?
stress mu
kappa pain
sigma mood?
4 classes of endogenous opiods?
enkephalins, endorphins,
dynorphins
endomorphins
a true role for endogenous opioid neurotransmission has been established in the ?, where associative learning may contribute to addiction
a true role for endogenous opioid neurotransmission has been established in the hippocampus, where associative learning may contribute to addiction
Endogenous opioid-containing neurons are found in several brain regions, including the ?
Endogenous opioid-containing neurons are found in several brain regions, including the medial hypothalamus, diencephalon, pons, hippocampus, and midbrain, and their axons project both locally and widely
The long-standing observation that a subpopulation of depressed patients has elevated ? levels, sometimes evidenced by ? on a dexamethasone suppression test, has led to the hypothesis that a CRF ? might be useful in the treatment of depression.
The long-standing observation that a subpopulation of depressed patients has elevated cortisol levels, sometimes evidenced by nonsuppression on a dexamethasone suppression test, has led to the hypothesis that a CRF antagonist might be useful in the treatment of depression.
? is the primary neurotransmitter in most primary afferent sensory neurons and in the striatonigral pathway, which are most prominently associated with mediation of the perception of pain. Abnormalities affecting ? have been hypothesized for Huntington's disease, dementia of the Alzheimer's type, and mood disorders.
Substance P
? has been hypothesized to be involved in the pathophysiology of schizophrenia, mostly because of its coexistence with dopamine in some axon terminals. Some preliminary reports suggest that ?-related peptides or drugs have beneficial effects for some psychotic symptoms.
Neurotensin
As with neurotensin and for the same reasons, ? has been hypothesized to be involved in the pathophysiology of schizophrenia. ? has also been implicated in the pathophysiologies of eating disorders and movement disorders. It causes anxiety and triggers panic attacks in people with panic disorder. ? antagonists are under study as possible anxiolytic agents.
CCK
? is also known as growth hormone-inhibiting factor. Postmortem studies have implicated ? in Huntington's disease and dementia of the Alzheimer's type
Somatostatin
? and ?, two related peptides, have been postulated to be involved in the regulation of mood and most recently, social behavior. They are both synthesized in the hypothalamus and are released in the posterior pituitary
vasopressin & oxytocin
? Y has been shown to stimulate the appetite, and development of ? receptor antagonists is an active area of interest for obesity researchers.
Neuropeptide Y
The two major amino acid neurotransmitters are :?
The two major amino acid neurotransmitters are GABA and glutamate
? is an inhibitory amino acid, and ? is an excitatory amino acid
GABA is an inhibitory amino acid, and glutamate is an excitatory amino acid
Recent discoveries have further increased the importance of the study of amino acid neurotransmitters. These discoveries include the observations that the benzodiazepines, barbiturates, and several anticonvulsants act primarily through ?mechanisms and that an important substance of abuse, ?, acts at glutamate receptors
Recent discoveries have further increased the importance of the study of amino acid neurotransmitters. These discoveries include the observations that the benzodiazepines, barbiturates, and several anticonvulsants act primarily through GABAergic mechanisms and that an important substance of abuse, phencyclidine (PCP), acts at glutamate receptors
GABA is found almost exclusively in the CNS, and it? the blood-brain barrier.
GABA is found almost exclusively in the CNS, and it does not cross the blood-brain barrier.
GABA:
The highest concentrations are in the ? and ?, with lower amounts in the ?
The
P.109

highest concentrations are in the midbrain and diencephalon, with lower amounts in the cerebral hemispheres, the pons, and the medulla
Describe GABA synthesis
GABA is synthesized from glutamate by the rate-limiting enzyme glutamic acid decarboxylase (GAD), which requires pyridoxine (vitamin B6) as a cofactor
Because GABA is thought to suppress ?, considerable effort has been devoted to synthesizing drugs that potentiate GABA activity.
Because GABA is thought to suppress seizure activity, anxiety, and mania, considerable effort has been devoted to synthesizing drugs that potentiate GABA activity.
Gabapentin (Neurontin), a GABA derivative, is an effective anticonvulsant with good brain penetration
It has ? activity at GABA receptors or the GABA transporter
NO
The GABA receptor has binding sites for the
benzodiazepines, and the barbiturates
The benzodiazepines increase the affinity of the ?-receptor for GABA
A
GABA linked mainly to what type of disorders?
Anxiety
Describe GLycine synthesis
Glycine is synthesized primarily from serine by the actions of serine trans-hydroxymethylase and β-glycerate dehydrogenase, both of which are rate limiting.
Improvement of NMDA receptor activity by occupancy of the ?-binding site has been hypothesized to present an adjunctive mode for the treatment of schizophrenia
Improvement of NMDA receptor activity by occupancy of the glycine-binding site has been hypothesized to present an adjunctive mode for the treatment of schizophrenia
Some, but not all, clinical trials of this hypothesis have shown a reduction in the ? symptoms of schizophrenia by glycine
negative
Describe glutamate synthesis?
Glutamate is synthesized from glucose and glutamine in presynaptic neuron terminals and is stored in synaptic vesicles.
? is the primary neurotransmitter in cerebellar granule cells, the striatum, the cells of the hippocampal molecular layer and entorhinal cortex, the pyramidal cells of the cortex, and the thalamocortical and corticostriatal projections
Glutamate
Glutamate release is ? by nicotine
stimulated
Excitotoxicity relates to the hypothesis that excessive stimulation of glutamate receptors leads to prolonged and excessive intraneuronal concentrations of
calcium and NO

Such conditions activate many enzymes (especially proteases) that are destructive to neuronal integrity
Glutamate and psychopathology is observed by what model drug?
PCP

In this model, a reduction in NMDA receptor activity is thought to cause psychotic symptom
Attempts to reduce excitotoxicity during strokes with the NMDA receptor blocker MK-801 were terminated because of precipitation of
psychosis
too much NMDA receptor activity ? and too little NMDA receptor activity induces ?
kills neurons,
too little induces psychosis
Memantine (Namenda), an NMDA ?, however, was recently approved for the treatment of Alzheimer's disease.
antagonist
What are anandamides?
novel compound formed from arachidonic acid and ethanolamine, N-arachidonoylethanolamine (anadamide), and 2-arachnidonylglycerol are now recognized as weak and strong endogenous ligands, respectively, for the cannabinoid receptor family.