Class notes - brain in trouble

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Samenvatting - Class notes - brain in trouble

  • 1443650400 Etiology of brain disorders

  • Which factors van contribute to brain disease?
    Genes & environment
  • What is the problem with most brain disorders?
    They are very complex, multifactorial disorders
  • What should etiological models for psychiatric diseases need to be?
    Pluralistic or multilevel
  • What is the problem with the nature vs nurture discussion?
    Dichotomy should be broken down, but the brain should be viewed as in constant interaction with environment, society and culture.
  • A person inherits risk not illness
  • What are endophenotypes?
    Measurable biological phenomena
  • Why are more molecular abnormalities not more penetrant at behavorial level?
    Multiple genes complementary/redundant effects
    Risk genes are not necessary sufficient to cause mental illness
    Combination with environmental risk factors
  • What are pre/perinatal risk factors?
    Maternal stress
    Maternal nutritional deficiency
    Maternal use of tobacco

    Birth complications

    Perinatal nutritional deficiency
    Maternal separation
  • What is the circuit of the HPA axis?
    Cortisol binds to glucocorticoid receptor
    GR acts as transcription factor and can alter gene expression

    GR in hypothalamus, hypophysis and hippocampus: negative feedback loop shuts down CRF loop
  • What happens in early life stress with the HPA axis?
    life long overactive(=less GR=less negative feedback to shut system down)
  • how does parentl care influence the activity of the neural systems that regulate stress reactivity and cognition in offspring?
    Through epigenetic regulation of gene expression
  • What is the diathesis stress model?
    The combination of stress and one's predisposition to the negative effects of stress
  • 1443736800 Addiction is a brain disease

  • What is addiction?
    A substance-related psychiatric disorder characterized by a persistent loss of control
    A chronic relapsing disorder characterized by obsessive craving
  • What is the dsm v?
    Diagnostic and statistical manual of mental disorders 5th edition. A manual to check if one has a substance disorder.
    2/3 Mild substance
    4/5 indicate a moderate substance disorder
    6 or more-> sever
  • What are key characteristics of drug addiction?
    A chronic disease process that develops into a relatively rigid pattern of behavior.

    Compulsive use of a substance
    High probability of relapse
    Difficulty stopping
  • What is the most harmful drug in our society? What was a substantial contributor to compiling the list?
    Alcohol
    Drug specific mortality and economic cost
  • What is the most addictive substance in our society?
    Tobacco
  • What are the two main views on addiction?
    Drug is the driving force
    Individual is the driving force
  • What are the drug-centered views on addiction?
    Negative reinforcement-> anhedonia view
    Positive reinforcement-> euphoria
    Neuroadaptation model
  • How is addiction maintained in the negative model?
    Addiction behaviour is maintained because the aversive symptoms associated with withdrawal are alleviated by the drug.
    Self medicate symptoms
  • What are shortcomings of the negative model?
    Drugs are self-administered in the absence of withdrawal symptoms
    There are many drugs used medically  that produce withdrawal symptoms
    Relief of withdrawal is minimally effective in treating addiction
    High tendency to relapse
  • What is the positive reinforcement model?
    Addiction behaviour is maintained because of the euphoric state drugs induce, not because of alleviation
    Drugs act as positive reinforcers
  • What are shortcomings of the positive reinforcement model?
    No clear relationship between the ability of drugs to produce euphoria and their addictive potential
    Negative consequences of drug use seem enormous relative to pleasure effect
    Drug taking can be maintained in the absence of subjective pleasurable effects
  • What is the leading hypothesis regarding addiction?
    The neuroadaptation model, addictive behavior is cause by progressive and persistent changes in the brain resulting from repeated drug/alcohol consumption.
  • How come the drugs becomes increasingly attractive in the neuroadaptation model?
    Neuronal system mediating the motivational effects of drugs gradually becomes hypersensitive to drugs. This sensitization phenomenon makes drugs more attractive.
  • What is the cause of relapse regarding the neuroadaptation model?
    Development of addictive behaviour is a pathological learning process and relaps is caused by retrieval of drug-associated information that is persistently stored in the brain.
  • What does cocaine do?
    Blocks reuptake of dopamine
  • What do opiates do?
    They disinhibit the dopamine neurons directly
  • What does TCH do?
    Disinhbits the dopamine neurons indirectly
  • What is relapse?
    Often preceded by craving can be elicited by:
    Drug associated cues
    Drugs of abuse
    Stressful stimuli
  • What enhance cue sensitivy?
    Abstinence
  • What is considered to be the final common pathway of relapse?
    mPFC glutamate projections to accumbens
  • What are the two pathways?
    Ventral and dorsal
  • Where do synaptic protein changes occur after re-exposure to heroin?
    in the mPFC, it downregulates ampa receptors
  • What gets modulated by dbs in addiction?
    the NAc and thereby the reward circuit might improve symptoms. it reduces connectivity between dorsal mpfc and NA core
  • What are co-mobordity and risk factors in drugs abuse?
    Mental disorders such as: 
    Depression
    Anxiety disorder
    PTSD

    Personality traits:
    Antisocial
    Sensation seeking
    Impulsivity
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Voorbeelden van vragen in deze samenvatting

Which factors van contribute to brain disease?
1
What is the problem with most brain disorders?
1
What should etiological models for psychiatric diseases need to be?
1
What is the problem with the nature vs nurture discussion?
1
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