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38 Cards in this Set
- Front
- Back
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Define: Mood
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Subjective experience of feeling or emotion *as described by the patient*
Tends to be pervasive and sustained |
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Define: Affect
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Feeling or emotion manifested by the patient and *observed by others* (including doc)
Can be variable even over short time intervals |
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Define: Euthymia
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normal mood state
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Which pathways are involved in mood?
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Cortical-limbic pathway
Cortical-Striatal pathway |
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Which structures are part of the limbic system?
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cingulate cortex
hippocampus amygdala (hypothalamus, orbitofrontal cortex, n. accumbens, septal n.) |
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Function of the limbic system
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Coordinates emotional, cognitive, vegetative*, autonomic, & motor processes
Memory, cognition, mood & anxiety, social behavior, drives & impulses *Note - vegetative states = sleep, appetite, sexual functioning |
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What are the divisions of the limbic system, their components, and their functions?
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1) Archicortical division - hippocampus and Papez circuit; modulates sensory processing, encoding of info, and attentional control
2) Paleocortical division - amygdala and its connections to basal forebrain & hypothalamus; *emotional processing,* attaches emotional valence to sensory stimuli, modulates fear responses & emotional memories, integrates affect and drives |
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Injury to the hippocampus and amygdala can cause what disorders?
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partial complex epilepsy
depression memory loss (especially episodic) attention disturbance PTSD panic disorder |
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Which brain structure has been shown to atrophy in patients with depression?
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Hippocampus
(finding: pts with depression can experience a 7-15% decrease in hippocampal size) |
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Which patient would experience more hippocampal atrophy: depressed pt undergoing treatment or an untreated pt with depression?
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Untreated pt
(the longer the pt goes untreated, the more hippocampal damage can be incurred) |
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What is the function of subcortical regions?
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Gating & monitoring
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What structures are considered subcortical?
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Rostral anterior cingulate, striatum, thalamus, brainstem
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What is the function of cortical regions of the brain?
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Attention, control, motor, executive
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What structures are considered cortical regions?
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Prefrontal, premotor, parietal, dorsal anterior cingulate, posterior cingulate
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What neurotransmitters are important in the regulation of mood?
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**Serotonin (5-HT)
Dopamine (DA) Norepinephrine (NE) Acetylcholine (Ach) GABA Glutamate |
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Where are the cell bodies for serotonin located and to where do they project?
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Rostral raphe nuclei (midbrain) --> striatum, limbic system (hypothalamus, amygdala, n. accumbens), cortex, cerebellum
Caudal raphe nuclei (pons, medulla) --> spinal cord & brainstem |
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What is the rate-limiting step in the synthesis of serotonin?
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The availability of tryptophan
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Which serotonin receptor causes the turnover of phospholipase and phosphatidylinositide (PI)?
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5-HT2
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Which serotonin receptor inhibits adenylyl cyclase?
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5-HT1
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Which serotonin receptors stimulate adenylyl cyclase?
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5-HT4,6,7
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In PET studies, which serotonin receptor has been shown to have decreased imaging in depressed patients?
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5-HT1A
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What type of receptor is 5-HT3 and with what symptom is it associated?
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Ligand-gated, associated with nausea
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The receptors of which neurotransmitter have been implicated in depression?
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Norepinephrine
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Which receptor(s) have been linked to inhibition of adenylyl cyclase?
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alpha 2, located at presynaptic nerve terminals throughout the brain
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Which receptor(s) have been linked to stimulation of adenylyl cyclase?
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Beta 1 & 2
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Inhibition of what enzyme causes relapse of depression?
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Tyrosine hydroxylase (reduces amount of norepinephrine produced)
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What occurs with the depletion of tryptophan?
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Relapse of depression (less serotonin produced)
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Which neurotransmitter is associated with mania and psychosis?
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Dopamine
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The activity of which noradrenergic receptor is increased in persons with depression?
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alpha 2 (inhibits adenylyl cyclase)
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What level of activity does MAO-A have in a person with depression?
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increased activity
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What organs are found to be enlarged in depressed pts?
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Adrenals and pituitary gland
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What effects does a hyperactive hypothalamic-pituitary-adrenal axis cause in depressed pts?
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- increased basal cortical levels in plasma, urine, and CSF
- increased cortisol response to ACTH - increased levels of CRH in CSF - diminished glucocorticoid negative feedback - decreased glucocorticoid receptor binding on lymphocytes |
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The buildup of glucocorticoids in severely stressed or depressed pts has been shown to have what effect on hippocampal neurons?
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Glucocorticoids interfere with transcription of BDNF (via CREB)
*BDNF is important for long-term memory & the growth/differentiation of new neurons/synapses |
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In which pts is a hypoactive HPA axis especially found?
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Pts with milder depression and hx of early life stress
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What is meant by ''activity-dependent refinement of synaptic connections'?'
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The more a given neural pathway is utilized, the stronger it becomes
The less it is used, the weaker it becomes |
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What interaction between genetics and social factors have been found to contribute to the development of stress?
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Hx of neglect or abuse as a child
Presence of certain genotype determines lesser resilience to severe maltreatment |
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What is the role of stress in depression?
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stress = inducer of depression in persons with the genotype
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What is the role of genetics in depression?
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Increases a person's *risk* of developing depression, depending on social factors
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