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Whishaws
Fundamentals of
Human Neuropsychology,
Sixth Edition
Chapter 27
Lecture PPT
Chapter 27
Psychiatric and
Related Disorders
Schizophrenia
DSM-IV R
Delusions or beliefs that distort reality
Hallucinations
Disorganized speech, senseless rhyming
Disorganized, agitated behavior
Blunted emotions, loss of interest and drive
Structural Abnormalities in
Schizophrenic Brains
Less than average weight
Enlarged ventricles
Reduction in the number of neurons in the
prefrontal cortex
Abnormal cellular structure in the
prefrontal cortex and hippocampus
Hypofrontality during card sorting
Biochemical Abnormalities in
Schizophrenic Brains
Dopaminergic function
Anti-psychotics
Act on the dopamine synapse
Glutamate
GABA
Types of Schizophrenia
Type I: Acute Schizophrenia
Positive symptoms
More responsive to neuroleptics (antipsychotics)
Schizophrenia As a Disorder of
Development
Develops during late adolescence
Slow emergence of brain abnormalities
Combination of genetics and environment
No single gene
More likely to have experienced a
combination of adverse events
Neuropsychological Assessment
Poor performance on long-term verbal and
nonverbal memory
Poor frontal-lobe functioning
May not perform well on any test
Mood Disorders
Clinical Depression
Prolonged feelings of worthlessness and guilt
Behavioral slowing
Disrupted eating and sleeping
Mania
Excessive euphoria
Hyperactivity
Bipolar disorder
Periods of depression and mania
Neurochemical Aspects of
Depression
Reduction of monoamines
Brain-derived neurotrophic factors (BDNF)
Downregulated by stress
May affect functioning of monoamine
synapses
Neurochemical Aspects of
Depression
Fluoxetine
SSRI
Stimulates BDNF and neurogenesis in the
hippocampus
Amygdala
May increase HPA-axis activity
Medial thalamus
Thyroid-hormone
Decrease in production may influence mood
Sensitization Model
Bipolar patients are sensitive to stress and
drugs
Episodes of mood disorder change the brain
Psychosurgery
Destruction of a region of the brain to
alleviate psychiatric symptoms
Neurosurgery
Brain surgery intended to repair damage to
alleviate symptoms
Egas Moniz
Prefrontal lobotomy
Psychosurgery
Modern Psychosurgery
13 targets
Smaller lesions
Rarely performed
Does not replace abnormal activity with
normal activity
Motor Disorders
Hyperkinetic
Increase motor activity
Hypokinetic
Loss of movement
Hyperkinetic Disorders
Huntingtons chorea
Genetic disorder
Intellectual deterioration and abnormal
movements
Begins as a reduction of activity and a
restriction of interest
Involuntary movements begin about a year
later
Hyperkinetic Disorders
Huntingtons chorea
Movements
Entail whole limbs
Irregular, no pattern
Affect head, face, trunk and limbs
Behavioral Symptoms
Personality changes
Cognitive impairments
Anxiety, depression, mania, and schizophrenic-like
psychoses
Hyperkinetic Disorders
Huntingtons chorea
Brain abnormalities
Shrinkage of the cortex
Atrophy of the basal ganglia
Imbalance among the various neurotransmitter
systems
Death of GABA and ACh neurons in the basal ganglia
Tourettes Syndrome
Three stages
1. Multiple tics
2. Inarticulate cries are added to the tics
3. Articulate words
Echolalia: Repeating what others say
Coprolalia: Obscene or lewd speech
Tourettes Syndrome
Subcortical origin
Small cells in the basal ganglia
Treatment
Antidopaminergic drugs
Norepinephrine receptor agonists
Hypokinetic Disorders
Parkinsons Disease
Degeneration of the substantia nigra
Loss of dopamine
Variety of symptoms that vary from patient to
patient
Symptoms resemble changes in motor activity
that occur with age
Hypokinetic Disorders
Parkinsons Disease
Rigidity
Tremor
Akinesia
Postural disturbances
Hypokinetic Disorders
Parkinsons Disease: Positive Symptoms
Resting tremor
Muscular rigidity
Cogwheel rigidity
Involuntary movements
Akathesia
Cruel restlessness
Oculogyric crisis
Involuntary turns of the head and eyes to the side
Hypokinetic Disorders
Parkinsons Disease: Negative Symptoms
Disorders of posture
Disorder of fixation
Disorder of equilibrium
Disorders of righting
Disorders of locomotion
Festination
Disorders of speech
Akinesia
Hypokinetic Disorders
Progression of Parkinsonism
Begins with tremors in the hand
Face becomes masklike and movement slows
10-20 years of progression
On-again-off-again quality
Causes of Parkinsonism
Idiopathic
Familial
Part of the aging process
Viral origin
Postencephalitic
Occurs after encephalitis
Causes of Parkinsonism
Drug Induced
Ingestion of major tranquilizers
Contaminant of synthetic heroin (MPTP)
Environmental toxins
Depletion of dopamine
Stem-cell research
Deep brain stimulation (DBS)
Psychological Aspects of
Parkinsons Disease
Cognitive functions
Generalized behavior slowing
Show symptoms similar to individuals with
frontal lobe or basal ganglia lesions
Impaired on the WAIS
Dementia
DSM-IV-R
Memory and other cognitive deficits
Impairment in social and occupational
functioning
Degenerative dementias
Intrinsic to the nervous system
Affects the CNS selectively
Nondegenerative dementias
Diverse etiologies
Dementia
Alzheimers disease
Most prevalent form of dementia
Neuritic Plaques
Found in the cortex
Positively correlated with cognitive decline
Amyloid surrounded by degenerative cellular
fragments
Dementia
Alzheimers disease
Neocortical Changes
Shrinkage of the cortex; not uniform
Dementia
Alzheimers Disease
Paralimbic cortex changes
Degeneration of the limbic system and entorhinal
cortex
Cell changes
Shrinking of neurons
Loss of dendritic aborizations
Dementia
Alzheimers Disease
Neurotransmitter changes
Reduction in two or more transmitter systems
ACh, Noradrenaline, DA, 5-HT, and glutamate
receptors
Immune Reactions
Antibrain antibodies that cause neuronal
degeneration
Abnormal Proteins
Increased production of abnormal proteins
that accumulate in the brain
Language impairments