NEUR3002 Lecture Notes - Lecture 8: Prolactin, Etiology, Olanzapine
The Psychotic Brain: Schizophrenia
Abnormalities in the perception or expression of reality (delusional beliefs) no distinguishing between
reality & delusion
1. Overview
Schiz YLD rankings 1990-2016 still no.1
Mental health affects mosotly younger individuals
@ older age, disease takes the bulk of YLD
Identification of psychosis & hallucinations
Nicotine self-medication
1.2. Symptoms Clusters
- Positive hallucinations, disorganised behaviour
- Cognitive working memory, attention, exec function
- Negative Flattening of affect, impaired attention, social withdrawal
(Medications for positive symptoms only)
1.3. Diagnostic Criteria
- DSM-IV no more subtypes (symptoms change often, overlapping subtype symptoms, no clear distinction)
- ICD-10
- Psychiatric diagnostics (non-biomarker) based on spectrum
- Spectrum influences treatment (different symptoms, durations) personalised medicine
- Exposure variation around the world
- Males ↑ risk, earlier onset
- Females equally affected but usually after menopause Testosterone bad?
2. Anatomy
MRI: Diagnostic marker
Cerebral ventricles enlarge neurodevelopmental disorder?
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2.1. Other anatomical changes in Schizophrenia
Cortical volume ↓
Temporal lobe volume ↓
Thalamus volume ↓
Loss of cortical asymmetry
Caudate volume ↑ DA receptors in striatum DA drugs affect
2.2. Post-mortem changes
Absence of gliosis (scar) unlike Alzheimer’s
Subtle changes in cytoarchitecture
Altered synaptic connectivity
Loss of cortical asymmetry
Hippocampus reduction
Grey matter loss failure in normal maturation in schizophrenic adolescents
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Abnormalities in the perception or expression of reality (delusional beliefs) no distinguishing between reality & delusion: overview. @ older age, disease takes the bulk of yld. Negative flattening of affect, impaired attention, social withdrawal (medications for positive symptoms only) Dsm-iv no more subtypes (symptoms change often, overlapping subtype symptoms, no clear distinction) Spectrum influences treatment (different symptoms, durations) personalised medicine. Females equally affected but usually after menopause testosterone bad: anatomy. Caudate volume da receptors in striatum da drugs affect. Grey matter loss failure in normal maturation in schizophrenic adolescents: genetics. Identical twins most at risk followed by both parents schiz. Inherited gene changes not caused by dna sequence change. Neuregulin + erbb4 enzyme regulate synaptic plasticity. Disrupted in schizophrenia (disc)-1 named after the gene disruption. However, still widespread: energy metabolism hypothesis. Usually glucose main energy source for brain (comes from mitochondria) Brain energy supply scarce due to mitochondrial dysfunction. Brain shift energy supply towards ketone bodies alternative.
