Term 2 Module 1
Regulation of synaptic connectivity by glia (S21W1)
uptake of glutamate so cannot continuously provide signal (recycles) --> ion channels for Ca2+/ K+ - membrane to membrane - ION HOMEOSTASIS
What waveforms appear during thalamocortical signaling? (S34W7)
vertex sharp waves, going to sleep properly
Researching Capacity - Reasoning (S38W8)
"the ability to manipulate information rationally" - logical processes used when information they have is understood and appreciate in arriving at a decision - essence = engaging in process of weighing treatment options
Why is there a need for translational research? (S23W2)
- "cycle of translation" = Bench --> (translational research bridge over the valley of death) --> bedside - more research on drug discovery, but less drugs being found (BIG DISCONNECT) - need more collaboration between clinical and pre-clinical science - use same MRI between mice and humans (only diff magnitude)
Hexaco (S33W7)
- 6 dimensional model of personality Honest-Humility - sincerity, fairness, greed avoidance, modesty Emotionality (neuroticism) Extraversion Agreeableness vs Anger Conscientiousness Openness to experience
What are the biological mechanisms underlying the links between stress and psychiatric disorders? (S26W3)
- HPA Axis produces cortisol - corticosteroid receptors --> MR and GR - increased chronic cortisol levels in depression bc it has Glucocorticoid resistance, but not high enough levels to activate GR which stop production (negative feedback), therefore producing more circulating cortisol
What are the consequences of sustained increased cortisol levels? (S26W3)
- HPA axis alterations --> impaired cognitive function in depressed patients - HPA axis alterations --> more common in depressed patients with melancholic/ psychotic features - Possible damaging effects on brain and neurogenesis
HPA axis and inflammation (S26W3)
- HPA axis modulates release of cytokines - cytokines alter monamine metabolism, increase excitotoxicity, and decrease production of trophic factors
Acute Neuroinfection Syndromes (S22W1)
- Meningitis - Ventriculitis - Encephalitis - Myelitis - Radiculitis/ ganglionitis
Syndromes where infection is suspected to play a role in pathogenesis (S22W1)
- Monophasic demyelinating illnesses (acute disseminated encephalomyelitis, bilateral optic neuritis, transverse myelitis) - Chronic demyelination = MS - Others: ME/ CFS, postpolio syndrome, postherpetic neuralgia, encephalitis lethargica
Astrocytes (aka glia) (S21W1)
- Neuroectoderm (~50% glia population) - regulation of synaptic connectivity (close association, maintain ionic concentrations at synapse, form tight junctions) - maintenance of ionic/ NT homeostasis in extracellular - gap junctions & syncytial netowrk - wound healing and limitation of inflammation - guide circuit formation in development (brain wiring) - Express markers GFAP, vimentin, and GLAST
Excess mortality in SZ (S30)
- SZ patients die 15 - 20 years younger - medication, lifestyle, socioeconomic, smoking - healthcare issues --> less likely to receive screening/ preventative care, stigma, diagnostic overshadowing
What are the 4 phases of clinical trials, how much do they cost? (S23W2)
- TAKE DECADES LONG FOR NEW DRUGS 1) give drug to small # of healthy humans, look for side effects 2) give to actual patients (efficacy) 3) large clinical trials in many patients 4) files for FDA --> FDA approval --> give to market ** COSTS $2 BILLION DOLLARS FOR 1 NEW DRUG INTO THE MARKET
Pro-inflammation toxicity in AD (S21W1)
- TNF-alpha produced by microglia (higher synaptic excitatory/ inhibitory ratio at synapses) ---- increase glutamate - synaptic transmission, neuronal growth/ differentiation, synaptic plasticity, learning/ memory ---- inhibits glutamate transport on astrocytes --- increased ROS and excitatory damage - Evidence in AD: --- deficiencies in glutamate tyle (AB 1-42 increases TNF-alpha --> IL-1B activates astrogliosis)
What was Janet's idea of dissociation? (S27W4)
- abnormal compartmentalizations of mental functions that are normally closely associated - not accessible to consciousness, but "emancipated" in hysterical individuals who had abnormal weaknesses - historical individuals suggestible --> symptom formation and rendering them amenable to therapeutic suggestion
Loss of awareness during involuntary movement (S27W4)
- activated insula (involved in somatosensory processing) - decreased activation in precuneus --> normally active during controlled movements in mediated extra personal space sense of agency/ control can attenuate normal architecture of action control still active, but cognition weakened, loss of feeling/control
Evidence neuroinflammation contributes to AD (S21W1)
- activated microglia cluster around amyloid & correlate w/ disease (amoeboid shape) - unclear protective/ damaging!! - Immune-associated AD risk genes over-represented (GWAS) - rare variants in immune/ microglial genes - evidence for protection from AD w/ NSAIDS
Evidence in CoP (S38W8)
- all relevant evidence (not just professional) - not clear how tests of psychological and brain function used in evidence - usually evidence by psychiatrist Brain scanning only used a support of a diagnosis - never linked to reasoning skills
Why are animal models good to use? (S23W2)
- allow for direct tests of causality - basic physiologic, metabolic, and developmental pathways are conserved - Mouse/ rat genome easily manipulated - easy to control PRE and POST natal - genes-environment interaction - large groups of longitudinal studies - multiple imaging modalities
PET and SPECT (S32W6)
- allow us to measure protein targets (receptor densities, enzyme activities) - specific ligand - get into brain and bind to target with high affinity/ specificity - ligand synthesized w/ radioactive isotopes - pt injected w/ isotopes at beginning of PET scan - measure distribution of ligand over course of scan - kinetic modelling used after --> generate images of receptor density/ enzyme activity Safety: - no pregnant/ breastfeeding - w/in 5 1/2 lives of injection patient has negligible dose of radioactivity
Self-blaming bias and MDD (S36W7)
- anger and aggression in depression linked to rejection sensitivity and low self-worth overgeneralization must occur selectivity for self blame RELATIVE TO blaming others linked to Right Superior Anterior Temporal Lobe (seed region) & higher connectivity with subgenual area (guilt) = communication between brain areas
Alpha waveform (S34W7)
- appears when close eyes but not drowsy (stop visual input) - posterior/ occipital distribution
Microglia (S21W1)
- arise from myeloid progenitors in the blood island in the yolk sac - 1st wave of primitive hemopoiesis (similar to other hemopoietic cells - similarities w/ macrophages - monocytes (inflammatory cell) - resident inflammatory cells of CNS, INNATE immune system - Microglia respond quickly to minor pathological insults - IMPORANT role - shapes neural circuits and modulates synaptic transmission in adult brain - Express markers (Iba-1) - no other cell expresses - resident phagocytes - respond to pathogens and tissue damage for protection/ repair - maintenance and plasticity of neuronal circuits
What are the downstream consequences of abuse? (S25W3)
- attachment and relationship early on is very important - look @ genetics --> childhood interactions with genes child abuse --> Adult relationship difficult/ los self esteem --> severe events --> onset --> chronic course depression
Why is psychoneuroendorcinology important? (S26W3)
- better understanding of physiology of behaviour, and pathogenesis/ maintenance of psychiatric disorders - ex: Cushing's syndrome behavior symptoms - increased glucocorticoid secretion (depression, irritability, loss of recent memory)
Diagnosis of Acute Encephalitis - Bedside (S22W1)
- cardinal symptoms & signs = fever, alteration in LOC, seizures - Age - focal & lateralizing neurology - sporadic v epidemic - animals & vectors - immunocompetence
CSF tests for Neuro infection (S22W1)
- cell count & cytology - gram stain - antigen detection - microbial culture - CSF/ plasma glucose or CSF lactate - Nucleic acid detection (PCR) - CSF antibody tests
How are microglia highly plastic? (S21W1)
- change shape (have processes extending out from neuron, then once activated grow in size and become more rounded processes so not sticking out (structure = function)) - change what they secrete - change their behaviour *** signal cues lead to activation
What are the 3 classifications of Apnea? (S34W7)
- classification based on inspiratory effort 1) obstructive = continuous or increased respiratory effort throughout the entire period of absent airflow 2) central = absence of inspiratory effort throughout the entire period of absent airflow 3) mixed = absent inspiratory effort in the initial portion of event followed by resumption of inspiratory effort in the 2nd portion of the event
Austism Animal Models/ Research - Repetitive behaviors (S23W2)
- complex phenotype, more in males - unmet medical need, most heritable among neuropsychiatric disorders & most difficult aspect of disorder = negatively impact learning/ socialization (MUTATIONS IN GENES = synaptic proteins) - high frequency, co-occurrence, severity - corticostriatal circuitry BTBR mouse = repetitive behaviors & altered brain activity - used both NAC and Oxytocin -NAC = reduces digging (striatum) - mouse died after trx but human babies fine - OXT = rats more grooming, but affected humans = reduces **** MORE THAN 1 BRAIN CIRCUITRY CAUSES 1 FUNCTION = MULTIPLE CIRCUITS
Critical appraisal of cross-sectional designs (S36W7)
- confounded by: medication effects, distress, different motivations to participate/ recruitment, mood state not controlled - diff psychiatric diagnoses against each other - matching?
What role does the posterior parietal network play in Consciousness? (S37W8)
- consciousness --> combines information together to create unified whole, so in most densely connected regions (PPN) - innermost core of anatomical network in monkey (most densely interconnected set of regions in the brain
Imaging biomarkers in mood disorders (S36W7)
- currently no imaging biomarkers in mood disorders - good to look for prognostic biomarkers - best biomarker we have now --> role of subgenus and septal area in MDD (abnormal metabolism)
Specific Criteria for Autism in Animal Models (S23W2)
- deficits in behaviors that are similar to core symptoms (early onset) = impaired social interaction and communication, increased stereotypes - phenotype due to insult present during early development = genetic modification, prenatal exposure to teratogen/ infection - additional phenotypes that are present in subsets = co-morbid symptoms, neurostructural abnormalities, cellular modifications, macrocephaly
Principles of fMRI (S32W6)
- detects local increase in [O2] following neuronal activity, reflected in BOLD signal (blood oxygen level dependent) - measure oxy v deoxyhemoglobin (hemoglobin = iron rich) based off of magnetic properties - short burst of neuronal activity --> BOLD changes after few seconds --> back to baseline - temporal resolution ('snapshot')
Limitations & Solutions of BOLD fMRI studies (S36W7)
- diff subjective experience of stimuli confounds activation differences --> control by obtaining covariate ratings, choose stimuli to minimize differences - signal drop-outs near cavities or bones --> use optimized sequencing - define ROIs before analyze data - fMRI shows lots of regions --> use rTMS, neuro patients or neurofeedback to confirm causal role - BOLD is slow --> also use MEG, EEG, or fMRI/EEG
What are international differences and similarities in moral judgement? (S33W7)
- disadvantageous inequity aversion emerged across all populations by middle childhood - advantageous equity aversion more variable fairness is more common in western cultures (WEIRD cultures)
Why is early intervention important in Neurodevelopmental disorder (S23W2)
- early treatment = optimal outcome - late treatment = less than optimal, but still above no intervention - no intervention = full phenotype/ lasting impairment trx in adult patients --> offer significant opportunities for benefits: - symptomatic improvement possible depending on MoA - phenotype reversibility - demonstrated in animal models
Why is there increased inflammation in psychosis? (S26W3)
- elevated circulating pro-inflammatory cytokines (IL1B, IL6, TGFB) --> in SZ - elevated cytokines (above) in 1st episode psychosis
TREM2 gene (S21W1)
- gene associated with FTLD, AD, and PD - expressed & enriched in macrophages including microglia - damage sensing receptor by: --- polyanionic damage signal (damaged neurons) and phospholipid signals from demyelination - cleaved --> soluble (higher in AD CSF) - receptor dysfunction leads to impaired phagocytosis
What are 4 key strategies to creating novel drugs for mental disorders? (S23W2)
- genetics influencing target/ pathway selection - determining synaptic changes - integrating circuit knowledge of the disease pathology - translational behavioral testing genes --> synapses --> circuits --> behavior
Why is assessing sleep stage important? (S34W7)
- gold standard of measuring sleep quality & quantity - identifies sleep stage dependent pathologies - identifies the degree and cause of sleep disruption - provides differential diagnoses
Psychopathy (S33W7)
- grandiosity, egocentricity, deceptiveness, shallow emotions, lack of empathy/ remorse, irresponsibility, impulsivity sensation-seeking and socially deviant - feelings of others ignored or violatedv - mask of sanity - cost society a LOT of money - lack of the fairness (H) dimension of HEXACO theory (cognitive style with little/ no fair treatment of others)
Adjustment Disorder (S30)
- onset symptoms <1 month of exposure to identifiable social stressor, not of unusual or catastrophic type - symptoms or behavioural disturbance --> depressed or anxiety reaction - symptoms do not persist for > 6 months after cessation of stress
Animal Models - Williams Syndrome (S23W2)
- great music abilities, bad math, v sociable (too much - can't make good relationships) - Williams = amygdala under activation (don't fire when should, i.e. doesn't fire for social anxiety) - deletion of elastin gene & vascular abnormality - mouse models show cognitive impairments, brain morphology, behavior, some craniofacial abnormalities, and other)
Relationship between IL-6 and hippocampal volume in 1st ep psychosis (S26W3)
- higher the inflammation, smaller the hippocampus
What is DTI? (S32W6)
- identifies/ looks at axon fiber tracts connection different regions of cortex - preferred direction of H2O molecule diffusion in brain at each voxel Fractional anisotropy (FA) = degree of diffusion anisotropy at every voxel estimated by tensor model map structural connectivity (tractography)
How can a microbe indirectly affect CNS function? (S22W1)
- immune mediated CNS damage (acute disseminated encephalomyelitis) - infection-triggered metabolic catastrophes (Reye's syndrome) - Toxin-mediated diseases (tetanus) - consequence of systematic sepsis (septic encephalopathy)
What happens when you give HC LSD? (S37W8)
- increase information levels in brain -conscious levels increasing
Depression and Immune Activation (S26W3)
- increased concentration of TNF-alpha - IL-6 concentrations higher - raised inflammatory markers --> significant association with subsequent development of depression
Childhood Trauma and Inflammation (S26W3)
- increased elevation of C reactive protein (CRP), IL-6 and TNFalpha in adults with history of childhood trauma - also CRP increased in 1st ep psychosis
Why are common infections rarely neurovirulent? (S22W1)
- infectious dose/ load of organism - host innate & adaptive immune response - neurovirulent features of organism
Psychosis & Specific Life Events (S25W3)
- intrusiveness = interference or attempted control of an individual personal boundaries (i.e. being assaulted/ arrested) - people w/ SZ --> 20x intrusive events - Exposure to previous 3 months increased odds of disorder x 17times
How can a microbe directly affect CNS function? (S22W1)
- invasion of parenchyma of brain --- viral encephalitis/ cerebral abscess - invasion of supporting structures of the brain --- VZV large-vessel vasculopathy
Investigation & Treatment of Pneumococcal Meningitis
- investigation = blood cultures & CSF if not contraindicated Treatment = high dose IV antibiotics (3rd generation cephalosporin, add vancomycin if resistance) - Steroids Prognosis (w/ out steroids) - mortality up to 30$ morbidity 30-50% neurological sequelae
Problem with standard models of MDD (S36W7)
- overfitting regression line --> quirks of sample rather than relationships in populations SOLUTION = regularization (& machine learning)
Key Results of Capacity Assessment (S38W8)
- little standardization in how capacity is assessed - evidence interpreted by Court in variety of ways, not integrated into reasoning behind judge's decision - MMSE and IQ test most commonly used - Psychiatrists = evidence; Psychologists = testing cognitive function - psych measures used to support diagnosis
Mental & Physical health interactions (S30)
- long-term physical health -- more likely to experience mental health problems - co-morbid health problems greater effect on QoL than physical co-morbidities - depression --> increases risk of hospitalization
Importance of Neurofeedback in MDD (S36W7)
- longer-term replication over long time, powered to estimate effect sizes needed diff types of depression --> respond differently to neurofeedback targets - potential new treatments of MDD over next decade
Limitations of Brain Imaging (S32W6)
- measures of neuronal activity/ structure/ proteins remains indirect w/ many unknowns (relationship btwn neuronal activity & BOLD signal) - resolution (spatial and temporal) still crude - complex heterogeneous analysis practices make comparison between results sometimes difficult - many un-replicated findings in literature due to underpowered studies, publication bias, researcher degrees of freedom...
Activated microglia in AD (S21W1)
- microglia surround plaques, NFTs, and damaged neurons - change morphology - ramified to amoeboid - increase in # = proliferation - Correlate w/ disease markers - neuronal cell death and emergence of behavioural symptoms
Monkey & Perceptual Experience (S37W8)
- monkey have stimuli, but stimuli never change just perceptual experience - 80-95% of neurons respond to change in monkey's experience - issue = only small portion of brain they sampled Monkey Electrophysiology & LPFC: - larger brain portions - same results --> when stimuli changing, perceptual change on right - proportions of neurons same in cortices
Lorazepam & Moral Dilemma task (S33W7)
- moral personal dilemmas have significantly less ruthless answers when pts take lorazepam
Why use longitudinal design? (S36W7)
- more informative bc disentangles correlates of symptoms from vulnerability - if imaging occurs prior and after medication --> medication effects can be observed
Animal Models - Fragile X Syndrome (S23W2)
- most common cause of inherited ID, 2nd most common genetic cause of ID - mild to moderate ID, social anxiety, poor math, hyperactivity, etc - Etiology = Xq27.3 - untranslatable region of FMR1 gene (polymorphic CCG repeat - dyscalculia = decreased brain activation in math regions MOUSE MODEL: - FMR1 gene inactivated = cog problems & audiogenic seizures, affects glutamate pathway, regulates strength of neural connections needed for learning (overactive so this messes up) - DENDRITIC SPINES ARE ABNORMAL W/ IMMATURE LONG SPINES - FXS mouse model = chronic CTEP treatment normalized neural activity in amygdala and lateral hypothalamus, decreased activity in hippocampus and increased activity in primary sensorimotor cortical areas - CTEP corrects elevated dendritic spine density and hyperactivity, partially corrects macroorchidism
Unsound Mind (S39W8)
- need medical expertise and medical evidence - time at which person reliably established of unsound mind = time of detention - no rule that relevant medical evidence must be supplied by person independent of institution where person detained - confinement HAS to be necessary, and least restrictive - persistence of disorder = mechanism to ensure disorder kept under appropriate review by detaining authority
Which areas does dissonance induction and disagreement activate in the brain? (S28W4)
- negative arousal (Anterior Insula) - conflicting monitoring (anterior cingulate cortex) higher activation in negative arousal sates correlates with individual differences in ability to disagree and inability to change your mind
Oligodendrocytes (S21W1)
- neuroectoderm origin (similar to astrocytes) - from late gestation (Oligodendrocyte Progenitor Cells (OPCs) or Neuronal Stem Cells (NSCs) - form myelin sheaths around axons in CNS - needed for cell conductance - metabolic support to neurons (physical connection) - express markers NG2, Olig1, MBP
What does the diagnosis of FND entail? (S30W5)
- neurological symptoms in absence of neurological disease - new emphasis on "positive" diagnostic features - NOT PART ANYMORE = psychological formulation and not feigned
Animal Models - Down syndrome (Ts65Dn) (S23W2)
- no treatment for cognitive defects - MOST common genetic cause of ID - Ts65Dn = mouse model - THERAPY = GABA(A) antagonism - GABA activity (inhibition) too high in animal models, so drug dampens this (increased inhibitory tone) - mouse models = maintenance of LTP (long-term potentiation), hippocampus impaired by this excessive inhibition) - GABA Antagonism = rescue explicit learning, memory, and LTP (Since GABA(A) alpha 5 receptors in hippocampus and cortex = enhance memory performance in rats, monkeys, and humans FINDINGS: - NAMs = rescue neurogenesis and GABAergic synapse density in mouse hippocampus
Court of Protection - approaches to capacity assessment (S38W8)
- non-standardized ways outside of the court - need to replicate decision in question, "yes or no" - structured tools exist (intelligence tests) - CoP may struggle to interpret valid and consistent manners these tools, given range of possibilities to use - inconsistency in outcomes
What are the 3 elements of deprivation of liberty? (S39W8)
- objective element = person's confinement to a certain limited place for not negligible length of time - subjective element = not validly consented to confinement in question - confinement imputable by the state (responsible)
General Anesthesia & Consciousness experiment (S37W8)
- patient more likely to say basic language sounds or words similar to those while unconscious - patient not more likely to understand meaning while unconscious
Functional Connectivity (S32W6)
- patient not doing task, slow fluctuations in BOLD signal = reliable finding that brain regions show similar 'resting state' BOLD fluctuations --> indicate shared information processing in resting state
Blindsight Research (S37W8)
- patients can reach for stuff and identify objects w/ blindsight --> dissociation between information available to them and sensations? - when asked perceptual awareness scale --> similar to HC --> maybe not strong dissociation
Animal Models - Down syndrome (Ts1Cje mouse) (S23W2)
- prenatal Down syndrome treatment - give momma mouse w/ Down syndrome induced fetus ALGERNON (chemical) compound to help nerve cells proliferate - newborn = normal cerebral growth and LD improves, prevented abnormal behaviors - ONLY worked in mice
LEDS interview (S25W3)
- q's cover actual occurrences & transfers of information (revelations, disclosures) - collect each detailed E or D - everything dated, questions go back and forth between dates to improve accuracy - contextual rating of threat (short v long term) - rated by researcher - ordinal scales for events -separate self-report rating
What are different inferential mechanisms to reach true/ false decisions? (S28W4)
- religious vs factual - testable vs non-testable - politics vs non-political true/ false & certainty/ uncertainty are dealt with separately
Confounds of Neuroimaging studies for ASD (S23W2)
- small and heterogeneous patient groups - cross-sectional design - no multimodal imaging within same subjects - lack of correlation with postmortem analysis *** NO BIOLOGICAL MARKERS OR PHARMACOLOGICAL TREATMETNS
Conscious over-strategizing (S37W8)
- sometimes our brain overspots a "pattern" - humans w/ damaged lateral prefrontal cortex = do better in guessing task (whether light will appear L or R, if light does appear 80% on R)
What is cognitive dissonance? (S28W4)
- state of discomfort/ distress when our beliefs are challenged - particularly beliefs about ourselves as good, kind, and competent - distress --> acts as force to reduce dissonance
What 3 theories of freud were never properly tested, and still prominent? (S30W5)
- stressors/ childhood trauma are very common around time of onset, but not in all - secondary gain now more evidence (ulterior motives) - repression/ suppression has evidence of a 'real' mechanism in brain both in conversion disorder and healthy individuals
Subacute & Chronic Neuroinfection Syndromes (S22W1)
- subacute sclerosing panencphalitis - progressive multifocal leukoencephalopathy - HIV dementia - tropical spastic paraparesis
What are the roles of the subgenus area and septal area? (S36W7)
- subgenus = how prone one is to experiencing guilt and self-blame - septal = association w/ loss of guilt and pity
What is the surface-based analysis in structural MRI? (S32W6)
- treats cortex as 2D mesh --> ask questions about thickness and folding pattern (gyrification) of cortex - Free-surfer, pre-processing steps
Dexamethasone Suppression Test (S26W3)
- used to elevate cortisol levels enough to activate GR receptors, so keeps endogenous cortisol levels low!
Structural MRI (S32W6)
- uses magnetic fields (1.5-7 T), aligns protons in water molecules, alignment perturbed by radio frequency energy, then protons relax back into resting alignment and emit FR energy in the process - distinguishes tissue types by diff relaxation properties -T1 = grey v white matter - DWI/DTI = white matter tracts, water diffusion - MT = iron rich structures (substantia nigra in midbrain, DA neurons)
How do CNS infections cause damage? (S22W1)
- vicious cycle! -microbial invasion causes inflammatory response --> BBB breakdown, cytokine release, endarteritis & microvascular thrombosis - raised ICP (brain pushes down - locked-in/ death bc brainstem) - Direct neuronal injury (resulting in neuronal necrosis or apoptosis)
Problems w/ applying cognitive neuroscience to DMC assessment (S38W8)
1) functional impairments relate to groups rather than individuals 2) individuals w/ TBI appear to lack DMC do well on neuropsychological tests 3) what is the conceptual relationship of the functional impairments to legal decision-making inabilities? lack of insight, ability to disengage impulses? detach oneself from impulses?
How does the signal for microglia activation in illness transfer to the brain? (S21W1)
1) humoral pathway (via blood, capillaries) 2) Neural pathway (ventricles?) Cytokine signalling
Which areas are dissonance reduction and resolution related to in the brain? (S28W4)
-decreased activity in the Anterior Insula and Amygdala - increased activity in the reward system (ventral striatum) negative arousal leaves --> positive emotion
What are the 3 stages of response to a 'stressor'? (S25W3)
1) Alarm --> appraisal of threat and physiological fight/ flight response 2) Resistance --> bodily defenses weakened by maintenance of threat and physiological responses 3) Exhaustion --> bodily defenses (various) breakdown leading to illness susceptibility
What are the 3 types of suggestions? (S27W4)
1) Ideomotor (involuntary limb movement) 2) challenge (subject unable to perform movement) 3) Cognitive (complex changes in experience, hallucinations, amnesia, analgesia)
Two Stage test of MCA (S38W8)
1) Impairment of brain or mind (S2) (misleadingly known as 'diagnostic' --> leads to test 2 2) impairment in function (S3) - understand information - retain that information - use and weigh that information to generate a choice - communicate that choice ** PROMOTE PASSING THE TEST --> hearing aids, communication, re-attempt
What are 3 major weaknesses of checklists for life events? (S25W3)
1) Independence - some events may be the result rather than the cause of an illness (i.e. people in more stressful experiences before onset of depression = man got fired due to depression --> unemployed) 2) Context - impact of event may be influenced by wider circumstances in which it occurs (i.e. birth - more stressful when unplanned for and not supported) 3) Biased Appraisal - effort after meaning (i.e. negative thinking pattern - depressed person only recall negative life events)
Koch's Postulates (S22W1)
1) Microbe must be present in every case 2) Microbe must be isolated from diseased host and grown in pure culture 3) Disease must be reproduced when pure culture is introduced to a susceptible host 4) Microbe recoverable form experimentally infected host
What are the two approaches to measurement tools of life events? (S25W3)
1) Self-report checklists (subjective, pre-defined) - respondents identify which events they have experienced from a standard list of options 2) Interview measures (more broad categories) - use of semi-structured interview to elicit descriptions
What can the coordinated activity of thousands of neurons produce? (S32W6)
1) changes in local electromagnetic field --> EEG/ MEG 2) increases in regional blood flow (dilation), such that O2 supply exceeds demand, and ratio of oxy- to deoxyhemoglobin changes (fMRI)
What is necessary and sufficient for consciousness? (S37W8)
1) enabling structures --> e.g. thalamus (vegetative state patients have damage to this) 2) content specific regions (inferotemporal cortex for conscious visual object recognition) 3) "inner core" of highly interconnected prefrontal parietal network, supporting more general role for consciousness consciousness intimately tied to complex cognition/ integrated information
Criteria for Selecting Animal Models (S23W2)
1) face validity = extent to which animal phenotype resembles human syndromes 2) Construct validity = same etiology and underlying mechanisms as human disorder (ex: genetic mutation) 3) reliably predicts treatment response in human patients (still have NOT found for Autism!)
What are the requirements for adequate stress research? (S25W3)
1) measure difficulties as well as life events 2) date events and onsets/ offsets of difficulties 3) attempt to date onset dependent variable (or offset in studies of recovery) ( can be long time & small - like argument over long time = perpetual stress) 4) comprehensive list of events & difficulties (do not omit revelations) 5) use comparable definitions of events across groups (strict investigator-based criteria) 6) dimensions not just occurrence of events & difficulties 7) contrast contextual and self-reported measures of dimensions (context specific point in your life) 8) utilize a probing style interview 9) regular consensus meetings ANALYSIS: - appropriate comparison group -causal period -do not assume additivity of events - both independent and dependent events - interaction with vulnerability factors
What are 3 things you need to generate consciousness? (S37W8)
1) network structure/ function 2) two way crosstalk ("feedback" and "feedforward") 3) Integrated/ combined information
What 2 metaphors are used for thinking about supportive relationships and onset/ offset of depression? (S25W3)
1) the fire engine (crisis support - support people rush around you) 2) the milk van (background) - loving, caring family
What are the foundational assumptions of neuroimaging? (S32W6)
1) understanding the brain structure and function can help us understand cognition/ symptoms of the mind 2) our brain imaging modalities can be used to make inferences about underlying brain activity and structure 3) the spatial/ temporal resolution of neuroimaging tools captures useful information about brain function
Human fMRI & Changes in Visual Consciousness (S37W8)
2 clusters: - posterior parietal cortex -DLPFC - bistable image --> later visual regions necessary to provide specific contexts for visual awareness DLPFC + PPC = prefrontal parietal network (PPN) - when stimuli conscious perceived --> ~300 ms after stimulus onset high gamma frequency spike
How many items can a newborn baby and bee process? (S37W8)
4 items consciously process
What 3 facets of the Big 5 relate to moral judgment? (S33W7)
Altruism, Modesty, and Dutifulness
How do you investigate suspected CNS infections? (S22W1)
Anatomy - imaging techniques & EEG Pathology & aetiology - analysis of CSF (LP) Contraindications to LP (without imaging) - reduced LOC, focal neurological signs, immunosuppression, papilloedema, anticoagulation/ bleeding disorder
Researching Capacity - Appreciation (S38W8)
Appreciation = ability to apply information abstractly understood to oneself failure only when patient's choices are based on premises (beliefs) that 1) substantially irrational, unrealistic, or considerable distortion of reality 2) consequence of impaired cognition or affect 3) relevant to treatment decision
What is a brain-derived neurotrophic factor (BDNF), and its relation to stress? (S26W3)
BDNF = plays crucial role in promoting proliferation, regeneration, and survival of neurons - early adverse experiences & chronic stress --> persistent reduction of BDNF levels in various areas of the brain - lower levels of BDNF in patients with depression AND 1st episode psychosis AND abuse (than depression w/out abuse) - more childhood trauma --> lower BDNF levels - more recent stressful life events --> lower BDNF expression
When do glial changes occur in patient w/ AD? (S21W1)
BEFORE diagnosis pre-symptomatic
What happens to mechanisms underpinning suggested effects in various practices? (S27W4)
CHANGE! each symptom related to diff activation pattern/ pathway in brain - ex: conscious imaging vs implicit associative learning
MHA and MCA issues w/ CRPD
CRPD says that mere existence of laws discriminates against these disabilities
PRRs for pathogens (S21W1)
Cell membrane (bacteria, virus fungi - toll-like receptors = family of receptors w/ similar functions, recognize unique patterns in bacteria) - outcome = cytokine release, Type 1 INF-gamma Intracellular (virus - ssRNA/ DNA) - recognition system inside cell - Outcome = phagocytosis, killing Cell membrane - Virus (ssRNA) - RIG-1 and MDA5 receptors - kill pathogens and degrade it
What mental disorder is increased cortisol levels a risk factor of developing? (S26W3)
Depression
What mental disorders is stress related to? (S26W3)
Depression & Psychosis
Relationship between Depression, Psychosis, and HPA Axis (S26W3)
Depression/ psychosis (enlarged pituitary gland, cortisol hyper secretion, dexamethasone non-suppression) <----> stress
Who is the father of personality science and what are his 3 personality dimensions? (S31W6)
Hans Eysenck --> extraversion, neuroticism, and psychoticism
What are the fundamental rights for decision making capacity? (S39W8)
ECHR - Article 5 and Article 8 Article 5: everyone has right to liberty and security, need legal procedure for depriving people of liberty - lawfulness of detention decided by court
EEG & MEG (S32W6)
EEG = measures electrical signals resulting from neurons directly MEG = measures magnetic signals resulting from neurons directly - temporal resolution, can detect sub-second fluctuations in brain activity - POOR spatial resolution (more sensitive to signals near scalp than deep brain structures) MEG = better for anatomically localizing neuronal source BECAUSE MAGNETIC SIGNALS NOT DISTORTED BY BIOLOGICAL TISSUE, but much more expensive
What physiological measurements are used in PSGs? (S34W7)
EEG/EOG/EMG, airflow, chest & abdominal movement, snoring, O2 saturation, ECG, limb movement, body position, and video
Acute Infectious Meningitis - Etiologies and Symptoms
Etiology = bacterial causes (diff organisms in diff age groups, high morbidity & mortality) symptoms = Headaches, fever, meningismus, vomiting, seizures, focal neuro findings, papilloedema
Forward v Back Translation (S23W2)
Forward = preclinical (rodent --> nonhuman primate --> healthy volunteer. --> patient) clinical back is the reverse of this
Decreasing levels of Consciousness
Fully awake --> dreaming sleep --> deep sleep --> general anaethesia/ coma
What is the proportion of patients with depression having an event or difficulty before onset? (S25W3)
HIGH proportion - most have severe event or difficulty before (psychiatric patients & onset cases). Only 30% seen in 'normal' and 'borderline' women
Who introduced the term hysteria? (S30W5)
Hippocrates in 400 B.C. --> attributions of neurological symptoms to wandering womb
What dimension of "threat" has the highest onset of depression? (S25W3)
Humiliation! vs loss, danger, or "any"
What can cortisol awakening response possibly predict in 1st episode psychosis? (S26W3)
If the patient will respond to antipsychotic - the lower the cortisol awakening, the more likely not to respond to stress ** possible Biomarker!
Who were important figures in Neuropsychiatry in the 19th century? (S30W5)
Jean-Martin Charcot --> functional disorder, hypnosis as mechanism and treatment Pierre Janet --> Dissociative disorder, attentional mechanism ("psych free") Sigmund Freud --> conversion disorder, psychodynamic mechanism: stressor repression, primary/ secondary gain
Criteria for Detention - MHA vs MCA (DoLS)
LEAST RESTRICTIVE PRINCIPLE MHA: - hospitals - mental disorder (nature or degree) - health, safety, protection of others (risks rather than best interests) - appropriate medical treatment is available MCA (DoLS): - care home or hospitals - if deprived of liberty - Mental Disorer - Capacity assessment --> must lack capacity - best interests - authorization under DoLS
What is the golden standard method to assess impact of life events? (S25W3)
LEDS Interview - allows for variety of contextual information to be collected
What 2 different behaviors can activated microglia have? (S21W1)
M1 Microglia - Pro-inflammatory: -"NON-SELF" = PATHOGENS - "classically activated" - LPS, IFNgamma, TNFalpha, IL-1, AB, etc - Up-regulates free radicatls, H2O2, chemokine, IL-1B, TNF-alpha - defense against pathogens and tumor cells - triggers damage to healthy neurons M2 Microglia - Anti-Inflammatory - "SELF" --> Tissue remodeling, repair, cell clearance!!! - "alternatively activated" = IL-4, IL-10, TGFB, etc - Up-regulates IL-10, arginase, CD68, etc - Tissue remodelling/ repair - Angiogenesis - not clear cut
What are the conflicts of MCA and CRPD? (S38W8)
MCA can ONLY be failed if a person has "impairment of, or a disturbance in the functioning of, the mind or the brain" - MCA defines a group of humans with fewer legal rights
What do specific imaging modalities look at? (S32W6)
MEG, EEG, fmRI, CT --> Neural Activity CT, MRI --> structure PET, SPECT --> Receptor/ NT function
Deprivation of Liberty (S39W8)
MHA (part 3) - keep someone in place for their mental health treatment MCA - DoLS
Compulsory Treatment (S39W8)
MHA - part IV MCA (sometimes w/out DoLS)
MHA vs MCA (S39W8)
MHA = (narrower, mainly psych) legislation covering compulsory assessment, treatment, and rights of people with mental disorders MCA = (broad - every medical issue) empowers individuals to make own decision where possible and protect rights of those who lack capacity by allowing someone to act in best interests
MHA v MCA (DoLS) (S39W8)
MHA: - detention in hospital for purpose of assessment and treatment of MENTAL DISORDER - treatment of mental disorder - treatment of physical illness outside scope MCA: - authorize psychiatric treatment in hospital, but ONLY when patient lacks capacity to consent to treatment and IS NOT OBJECTING - can authorize in patient's best interesting --> other forms medical treatment where patient lacks capacity to consent, even when objects - can treat physical disorder, but not really used for treatment of mental disorder hospital --> deprives liberty --> MHA and MCA achieve compliance (consent vs doors locked, etc)
Treatment without Consent - MHA vs MCA (S39W8)
MHA: - purpose of alleviating, preventing, worsening of, a mental disorder or one or more of its manifestations - purpose is not same as likelihood (trx doesn't have to be likely to be effective) - does not have to achieve desired outcome MCA: - best interests - except when DNR - still incorporates person's views even though they lack capacity - covers financial, personal welfare, and healthcare decisions
MR vs GR Glucocorticoid Receptors (S26W3)
MR = binds endogenous glucocorticoid w/ high affinity; regulation of circadian fluctuations of these hormones GR = binds endogenous glucocorticoids with low affinity --> regulation of response to stress when endogenous glucos are high (aka need LOTS to bind GR, receptors for stress response, bc when separate HSP complex activate, but then negatively feedback to stop cortisol
What are the imaging modalities of Structural Neuroimaging? (S32W6)
MRI Diffusion tensor MRI
What is the tool used to research DMC in neuropsychiatry? (S38W8)
MacCAT-T (Grisso & Applebaum, USA) 4 diff decisions: Understanding, Appreciation, reasoning, expressing a choice
What are the consequences of long term stress? (S26W3)
Mal-adaptation leads to psychiatric disorders
How do you diagnose neurological infection? (S22W1)
Neurological formulation: Anatomy, Pathogenetic mechanism, Aetiology ID mantra: Why did this person? From this place? At this time, get this disease?
Psychosocial vulnerability (S25W3)
Non-intimate relationships have severe stress before the onset of depression
Bayesian (Attentional) Model of Conversion Disorder (S30W5)
Normal sensation = wide prior distribution, posterior distribution, then likelihood distribution (prediction error) Negative sensory symptom (anesthesia) = small, high very precise prior of "no sensation", posterior distribution, far away --> likelihood distribution (prediction error) Positive Sensory Symptom (pain) = likelihood distribution (prediction error), posterior distribution, very precise prior of pain
What are the different types of glial cells in the brain? (S21W1)
Oligodendrocytes Astrocytes Microglia
Which glia cells are involved in which disease? (S21W1)
Oligodendrocytes: - MS, MSA, Charcot-Marie-Tooth (Schwann), leukodystrophies, TBI Astrocytes: - AD, epilepsy, ALS, SCA, PD, HD, stroke, cerebral ischemia, hepatic encephalopathy, TBI Microglia: - AD, CJD, Batten's Disease, PD, ALS, HD, TBI glial activation and function/ dysfunction <----> neuronal function/ dysfunction
What is optogenetics? (S23W2)
Optogenetics = use of light to control neurons that have been genetically modified to express light-sensitive proteins - ex: attach luminescent protein to virus --> only go to certain cells that express it; when shine light = activated - used for mapping aggression in teh brain - laser light of specific wavelength opens ion channels also can be used for silencing activity of proteins Act locally --> observe globally (can do fMRI identification of brain-wide effects)
Neuroimaging and Brain Correlates of FND (S27W4)
PET Studies: - in FND/ hypnotised patients compared to HC = increased activation in contralateral anterior cingulate & orbitofrontal cortex; DECREASED activation in primary motor cortex fMRI: - involvement in brain regions in affective modulation of motor function (OFC, vmPFC, VLPFC) and vmPFC/ precuneus
What can systemic immune activation do to microglia? (S21W1)
PRIME IT! - initiates microglia - chronic inflammation = activate microglia and cause neuronal damage - increased immune activation in the brain (Dementia, depression, SZ) -increased activation in periphery (obesity/ metabolic, aging, infections, autoimmune, DM, etc)
Choice - MHA v MCA (S39W8)
People who are NOT OBJECTING to hospital admission for treatment of mental disorder (and lack capacity to consent) --> MHA
Pros and Cons of Structured Interview Life Events (S25W3)
Pros: - context measure - strategies to reduce bias of self report - more precision in definition of what Events and Difficulties to include (need scope) - covers wide range of experiences - measurement of meaning Cons: - cost of implementation - need for training - respondent burden
What is the HPA axis activity in psychosis and depression? (S26W3)
Psychosis: - increased cortisol levels during the day - decreased awakening cortisol - decreased cortisol response to stress Depression: - increased cortisol levels during the day - increased or equal to awakening cortisol - increased or equal to cortisol response to stress
What are the 3Rs of good science for animal welfare and scientific accuracy? (S23W2)
Refinement = finding ways of making animals' lives better in labs (toys or better trained lab technicians) Reduction = using as few animals as possible to get good results Replacement = using non-animal alternatives wherever they exist
What areas in the brain activate on fMRI when recalling etiological escape stressor? (S30W5)
SMA (motor planning area) dorsolateral prefrontal cortex memory suppression
What theory is behind and supported functional limb paralysis? (S27W4)
SMA theory - increased activation in SMA (supplementary motor area) which inhibits movement, but shows intention is there - motor areas show reduced functional connectivity when SMA activated others: - precuneus sensory imagery and memories (imaginal self) - VMPFC - affective relevance and memories (emotional self)
What is an EEG signature for entering into REM sleep? (S34W7)
Sawtooth waves
What are the differences between shellshocked v FND v PTSD? (S30W5)
Shell shock = triggering stressor, limb weakness/ movement disorders/ speech impairments, exhaustion/ impaired memory/ poor [ ] FND = limb weakness/ movement disorders/ speech impairments, exhaustion/ impaired memory/ poor [ ] PTSD = triggering stressor, exhaustion/ impaired memory/ poor [ ], flashbacks, situational hyper vigilance, and avoidance
Microglia - Signals, Receptors, Outcomes (S21W1)
Signals - PAMPS, DAMPs (pathogen/ damage associated molecular patterns) Receptors: - PRRs - signals on microglia (pattern recognition receptors) - "eat me" signals Outcomes: - Phagocytosis - Chemotaxis (relocate, signal other microglia) - Cytokines & chemokine (other cells receive this signal) - Complement and coagulation factors (tagging cell for phagocytosis)
PRRs for DAMPs (S21W1)
TBI/ damage/ neurodegeneration - series of receptors able to be recognized by microglia Phosphotital serine (facing one way to inside) - when cell dies neuronal) - phosphotital serine flips in membrane so tries of cells can recognize it - APOPTOSIS
How can M1 be toxic to the self? (S21W1)
TLR activation + ATP results in inflammasome activation - increased production of reactive oxygen species --> causes bystander damage when chronically activated = continuous cycle of neuroinflammation
fMRI analysis pipeline (S32W6)
Takes series of pictures --> realign --> coregister/ white normalize --> smooth Tasks: - take pictures when A stimulus and B stimulus are shown, subtract images from each other = get contrast map/ activation map
Treatment & Outcome of HSE (S22W1)
Treatment: - IV acyclovir at 10mg/kg - acyclovir triphosphate - competitive inhibitor of viral DNA polymerase - acts as chain terminator - duration of treatment not clearly established Outcome: - mortality reduced from 70 to <20% - early treatment essential - morbidity high (memory impairment, behavioural changes, dysphasia, epilepsy) - relapse?
Normal Roles & Functions of Glia (S21W1)
Tissue maintenance & homeostasis: - clearing apoptotic cells - neuron protection - synaptic pruning (learning lost), microglia important - tissue maintenance (remodel extracellular space) Protective: - trauma - pathogens (HIV - enters BBB)
Physical & Mental health, social determinants (S30)
all interact!! Social determinants <--> Mental health / Physical Health (interact w/ each other) e.g. social isolation, mental health impact of living with a chronic condition, physical health side effect of psychotropic medication
EEG Frequencies (S34W7)
alpha - normal, waking posterior beta - normal, waking anterior theta - normal drowsy, light sleep delta - normal deep sleep
Thought Insertion & Alien control of movement (S27W4)
altered connectivity increased SMA action automatic writing paradigm feels like loss of control - reduced activation in superior parietal lobule and precuneus and posterior cingulate cortex (involved in self-related processing and awareness of body in space)
What is the mass-univariate approach? (S32W6)
analyzing one voxel at a time, report statistical effect at each voxel separately LIMITATIONS: misses PATTERNS of brain activity across multiple voxels
Mental Capacity Act (2005) (S38W8)
anything not psychiatric where you lack capacity capacity = assumed until shown otherwise, is decision-specific, is time-specific, and can be tested by any person less restriction and freedom of action possible
Level of consciousness in SWS, Anesthesia, Locked-In, & Vegetative State (S37W8)
applied rTMS, examined EEG activity, quantify information in EEG signal - deep sleep of HC --> similar to vegetative state - locked-in state = high score (normal consciousness) - vegetative/ coma = lower score (not conscious)
Why is hypnosis a good model for FNS? (S27W4)
because it draws attention to how radical alterations in experience and behavior conform to content of mental representations through effects on cognition and brain function
Why is PSG a useful too? (S34W7)
because it helps in identifying the cause of unexplained EDS and supporting certain other clinical diagnoses - labour intensive & strict scoring rules - performed and interpreted by qualified personnel
What are 3 different brain states of beliefs? (S28W4)
belief = accepting as true (DEFAULT) disbelief = rejecting as false (overriding default) uncertainty = not knowing all constant across facts, morals, religions, etc belief states --> independent of category of belief
Causal effects of personality on life outcomes (S31W6)
bidirectional (employment resistant personality <---> increasing risk of unemployment OR product of unemployment)
What can prolonged chronic stress lead to a dysfunction of? (S26W3)
biological pathways involved in stress response and contributes to the development of psychiatric disorders
What are the humors in greek physiology? (S29W5)
black bile, phlegm, blood, and yellow bile
What is a 'suggestion'? (S27W4)
broad term - representations underlying experiential change can be embedded in a variety of cognitive processes (explicit or implicit memory, verbal or non-verbal) and be linked to a range of internal or external cues
Why is digital video important in PSGs? (S34W7)
can align events w/ digital image to assist in diagnosis of nocturnal seizures, unusual behaviors in SWS/ REM, sleep/ wake activity, and medico-legal cases
FND and 'Autosuggestive Disorder' (S27W4)
can't test/ measure brain function every single symptom can be produced by hypnosis/ suggestion - hypnosis & FND = subjectively realistic, involuntary alterations in experience & behavior that conform to ideas, beliefs, and expectations
What are the Classifications of Neuroses? (S29W5)
cerebral function, locomotion, senses, nutrition, and sexual function
Self esteem in adulthood in children (S25W3)
children with adverse childhood grow up to have low self esteem in adulthood - also have higher case of depression and NES when have childhood adversity
What physiological measurement is most common for sleep paralysis? (S34W7)
chin EMG
What are effects of HPA axis and high cortisol levels on neuroplasticity? (S26W3)
chronic stress - dendrites to become shorter in total length in CA3 - reversible within several weeks
What enables a novel translational approach to drug development? (S23W2)
circuit based understanding (brain behavior = due to different circuits and networks) - imaging has improved our understanding of this
What are 2 general design issues of research? (S36W7)
co-morbidity often poorly controlled sample size often insufficient
what occurs in the prefronto-striato-thalamic loops? (S36W7)
complex interactions of monoaminergic systems (serotonin, noradrenaline) and DA dopaminergic and glutamatergic systems interaction - degeneration of DA neurons in substantia nigra = Parkinson's disease PD --> at risk for depression
What is hypnosis? (S27W4)
controlled modulation of components of cognition (i.e. awareness, volition, perception, belief) by an external agent or oneself using attentional focusing on ideas/ images that evoke intended effects - verbal communication for effects = 'suggestions' - classic suggestion affection --> responses experienced as involuntary, effortless
Metacognition - Capacity(S38W8)
could be the new window into assessing capacity
Flow chart of Animal Models (S23W2)
define abnormality of interest --> build model system to recreate abnormality --> find and characterize the abnormality in the model --> define genes/ mechanisms --> pursue treatment to reduce expression of gene or block the mechanism
Emerging Infections (definitions & new infections) (S22W1)
definition = emerging infections are infectious diseases that have either 1) not been previously recognized by medical science or 2) have jumped a species barrier or 3) have translocated to a discrete geographical area in which the disease was not previously found Emerging Infections: - newly evolved virus (EV 71) Environmental changes (West Nile virus in USA) Virus crossing species barrier (H5N1)
What wave forms occur during very deep sleep? (S34W7)
delta waves asymmetrical, frontal distributions
Polysomnagraphy (PSG) (S34W7)
diagnostic test during which a number of physiological measurements (including EEG, EOG, and EMG) are recorded immediately before and during sleep - used for accurate assessment of sleep physiology, identification of sleep stage dependent pathologies, cause and severity, effectiveness of treatment, and medico-legal cases
What is voxel based morphometry (VBM) in structural imaging? (S32W6)
differences in grey/ white matter density using T1 MRI Scan - "how does regional grey/WM density (volume) differ btwn groups/ variable of interest?" (3D) voxel = 1 mm cube of brain - segmentation = segments each brain scan into grey matter, WM, or cCSF - normalisation = brings each brain scan into 'standard space' - smoothing = smooths image to help with statistical inference run statistical test (GLM) at each voxel to quantify homework much signal in region varies w/ variable fo interest Visualize result at corrected significance threshold = statistical parametric map
What is graph theory? (S32W6)
divided brain into discrete regions & characterize connectivity --> use this on resulting network ex: disconnectivity theory of SZ
What do glucocorticoids increase activity of in the mesolimbic system? (S26W3)
dopaminergic activity
New methods beyond univariate analysis in imaging (S32W6)
e- take into account pattern of activity across multiple voxels, paired with powerful machine learning analysis tools - train a machine learning classier to decode representation content of a pattern of brain activity - representational similarity analysis = investigate how neuronal representations evolve with time and repeated presentations EX: Stimulus functional localizer
What treatment strategies are useful in neurological infections? (S22W1)
early treatment = optimal outcome prevention strategies = urgently required they have HIGH morbidity and mortality HIGH economic burden
What is a possible inflammation biomarker for non-responders to treatment in 1st episode psychosis? (S26W3)
elevated IL-6 levels (shows chronic inflammation)
What is circuit-based understanding? (S23W2)
enables a novel translational approach to drug development - imaging improved relationship neuron --> synapse --> (disruption) --> no process --> no sending of signals --> no change in function
Key differences between endocrine and the nervous system (S26W3)
endocrine = wireless, slow, long duration, close or far anatomical proximity NS = wired, rapid, brief duration, close anatomical proximity
Relationship between disease pathology and glia cells (S21W1)
environment, aging, genetics, vascular, TBI --> activate all glia cells (but microglia can activate astrocytes and vice versa) --> Cell dysfunction --> cell death Causes White Matter changes, plaques + other protein aggregates
What 3 neuropsychiatric conditions had evidence dated back to 2nd millennium BC? (S29W5)
epilepsy, depression, and anxiety
Blame rebalance neurofeedback & psychological intervention (S36W7)
equivalent in reducing BDI for patients with MDD' targets posterior subgenus & anterior temporal hyperconnectivity Neurofeedback better in MDD w/out anxious distress Psychological intervention better in MDD w/ anxious distress Anxious v non-anxious patients = increased anger and stressful life events
What is the DoLS? (S39W8)
framework of safeguards under MCA for people who need to be deprived of their liberty in their best interests for care and treatment to which they lack capacity to consent themselves - brought in to remedy lack of a procedure prescribed by law to cover people lacking capacity to consent who are deprived of liberty in hospitals/ care homes and are not detained/ detainable under MHA
Where are K complexes and Delta usually seen? (S34W7)
frontal region
What are the imaging modalities of Functional Neuroimaging? (S32W6)
functional MRI (fMRI), EEG, magnetoencephalography (MEG)
What is the global workspace theory of attention? (S37W8)
general aim to filter or shape information processing strongly towards what is currently relevant (salience filters) bottum-up processing influenced by. top-down goals
What are hormones and their functions? (S26W3)
hormones = chemical messengers, produced in all multicellular organisms by glands, transported to distant target organ to coordinate physiology/ behaviour Functions: - regulate physiological and behavioral activity of digestion, metabolism, growth, development, reproduction, body temp, cognitive function, mood, circadian rhythm
MHA/ MCA Interface in Hospital (S39W8)
if admission --> deprivation of liberty (does not consent to admission/ treatment) --> under MHA or DoLS DoLS only available if patient lacks capacity to consent Patient ineligible for DoLS if OBJECTS to admission or treatment for mental disorder MHA uses decline with age, DoLS usage increases with age
Diagnosis of Acute Encephalitis - Imaging & Lab (S22W1)
imaging modalities - CT (look for progression, early changes) - MRI, DWI EEG - periodic lateralized epileptiform discharges (PLEDs) CSF analysis - PCR of CSF (detect HSV DNA) - CSF antibody studies (don't do anymore) - brain biopsy ("gold standard" - V RARE
What is important in hypnotic contexts/ symptom formation for FNS? (S27W4)
implicit beliefs and expectancies cued by non-verbal stimuli
EOG (S34W7)
important for determining stages of sleep - records diff in electrical potential between cornea (+ve) and retina (-ve)
BPD & Grey matter volume (S36W7)
in comparison w/ SZ, pts w/ BPD have increased right amygdala volume
Childhood and Adult Adversity interaction (S25W3)
increase the rate significantly to develop depression/ psychosis basically their effects combine - more likely to get functional disorder (somatization) - severely increased for somatization disorder in order to get secondary gain
Negative Evaluation of Self (S25W3)
indexes of NES for: - personal attributes (e.g. personality, attractiveness, intelligence) - role performance - self-rejection (global dislike of self) - ONSET DEPRESSION HIGHER FOR THOSE W/ NES AND SEVERE EVENTS occurring
Results of the Dunedin & Terman Study of personality (S31W6)
individuals w/ low self-control as children --> less satisfactory life histories (especially in work)
IMPARTS (S30)
initiative by King's - support clinical teams at King's acute trusts - integrating mental & Physical healthcare
How do personality traits interact with intelligence and behavior? (S31W6)
intelligence = problem-solving ability, functionally diff than personality personality --> don't operate in isolation, used to shape behavior ex: high level conscientiousness, agreeableness, & intelligence = use intelligence altruistically to become a doctor
What is conscientiousness positively associated with? (S31W6)
job performance
What are key parts of the "social and emotional brain"? (S36W7)
limbic forebrain areas = cortical structures (orbitofrontal cortex, hippocampus) & subcortical structures (septal region, amygdaloid complex) hypothalamus
What is the employment-resistant personality profile? (S31W6)
low agreeableness and low conscientiousness = not hirable similar to patients with a prefrontal brain injury troubled families/ poor families - adults may have this personality type
What waveforms appear during light sleep/ stage 1 sleep? (S34W7)
low amplitude mixed
What disorders are PSGs used for? (S34W7)
narcolepsy, nocturnal seizures, parasomnias, violent sleep behaviors, periodic limb movement disorder NOT FOR: - circadian rhythm, depression, restless leg syndrome, and insomnia
What is the Neo version of the 'Big Five'? (S31W6)
neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness
What is agreeableness positively associated with? (S31W6)
non-contracted behaviors that benefit organizational cohesion
According to lecture, which 'Big 5' trait has questionable validity? (S31W6)
openness to experience because positively correlated with intelligence
Causality - increasing likelihood of being a causative agent of infection (S22W1)
organism carriage - detection in non-sterile site and no specific immune response --> organism carriage and evidence of specific immune response --> organism in sterile site +/- specific immune response --> organism within CNS +/- intrathecal or CSF specific immune response
What is the 2nd commonest bacterial meningitis in the UK? (S22W1)
pneumococcal meningitis - risk factors = age, splenic, myeloma, alcoholism, chronic disease)
What are the imaging modalities of Molecular/ Neurochemical Imaging? (S32W6)
positron emission timography (PET)/ SPECT Magnetic resonance spectroscopy
What are all mental disorders association with an increased risk of? (S30)
premature death
What are the principles of the code of practice? (S38W8)
presumption of capacity value neutrality protection of best interests proportionality
What are neurodegenerative diseases characterized by? (S21W1)
protein aggregates and dysfunctional dying neurons
Complex Model for Depression after Life Events (S25W3)
provoking agent (E or D)/ vulnerability factors (early loss mother, unemployment, etc( --> specific hopelessness/ low self esteem helplessness --> generalized hopelessness --> Depression
What is one more evolution of neuroses or neuropsychiatry that is needed? (S29W5)
psychoneurosis
Adjustment to Illness - Stirling Moorey (S30)
social/ cultural meanings, past experiences, life-style, social support ---> Appraisal of illness & self --> uncertainty -> anxiety/ helpessness/ defeat --> low mood or social withdrawal --> challenge --> adjustment, focused coping
What stage of sleep occurs during Sleep Spindles? (S34W7)
stage 2 fast discharges also shows Benzo use if occur during daytime
Stress & Neurotrophic Factors (S26W3)
stress induces release of cytokines cytokines alter monoamine metabolism, increase excitotoxicity, and decrease production trophic factors
What can prospectively predict recurrence in MDD? (S36W7)
subgenus- anterior temporal lobe connectivity
What is Charcot's hypothesis? (S27W4)
symptoms could derive from unconscious 'fixed' ideas based on suggestions or autosuggestions remaining isolated from the rest of the mind and expressing themselves outwardly through corresponding motor phenomena
Functional Connectivity & SZ (S32W6)
thalamocortical functional connectivity abnormalities in SZ not higher in cognitive areas
Key Limitations of Animal Models (S23W2)
they aren NOT humans - so can't be accurate
What is the pyramid of self-persuasion? (S28W4)
tip of pyramid: - either believe or don't believe - once tentative decision, going to this option - justifying choice to ourselves explains how choices and actions can lead to polarization - priming and exposure as a cause --> self justification --> polarization Dissonance reduction
What are the speculations on main (evolutionary) purpose of consciousness? (S37W8)
to generate innovative structured/ patterned solutions to novel/ complex problems, via analysis of attentional boosted relevant information
Article 8 - ECHR (S39W8)
treatment without concert is interference, unless justified by law for protection of health - therapeutic necessity, treatment in best interest, proportionality (need to treat patient bc disease so severe, no matter capacity)
NHS 5 year forward view (S30)
triple integration MORE INTEGRATIVE CARE MODEL - mental health needs of everyone is important - major overlap with those who have long-term physical health issue and mental health issue - enhance psychiatry liasion
What is the "acid test"? (S39W8)
where person is unable to give a valid consent to his confinement: 1) not free to leave AND 2) continuous supervision and control NOT RELEVANT = compliance or lack of objection, relative normality of placement, purpose of placement
Problems w/ DMC research (S38W8)
which decision to use? - if not real decision by person, can't truly claim to be measuring capacity capacity decisions need to be binary - issues with "cut-off" scores
How early do concepts of hysteria, brain, psyche/mind, and self-awareness go? (S29W5)
~4000 years ago (2000 BC) into ancient Egypt