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NSCI438- Midterm Exam Guide - Comprehensive Notes for the exam ( 18 pages long!)


Department
Neuroscience
Course Code
NSCI438
Professor
Rosen Jeffrey
Study Guide
Midterm

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UD
NSCI438
MIDTERM EXAM
STUDY GUIDE

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Clinical Neuroscience Exam II Study Guide Schizophrenia
Positive symptoms: symptoms that are present that shouldn’t be
o Hallucinations: heightened perceptual experiences that are not due to external
stimuli (most commonly auditory)
o Delusions: rigidly held beliefs that are inconsistent with reality
Persecutory, referential, grandiose, somatic, religious (bizarre or non-
bizarre)
Negative symptoms: symptoms that should be present but are not
o Anhedonia
o Alogia
o Avolition
o Blunted affect
Disorganized symptoms
o Disorganized speech tangential, difficult to follow
o can be child-like behavior
o catatonia motoric immobility
gender differences
o equally common in men and women
o earlier onset in men; women have better premorbid social function
men have more negative symptoms
men have more chronic course
men respond poorer to treatment
potential causal factors
o before birth
genes, maternal exposure to virus, complications or illness during
pregnancy
o during birth
complications during pregnancy
o during childhood or adolescence
socioeconomic status, family factors
o genetic influence: adoption and twin studies
o environmental: twin concordance rate
o SES status
Hypothesis 1: negative factors related to low SES lead to development of
illness
Hypothesis 2: cognitive/social impairments associated with the illness lead
individuals to drift to a lower SES
o Expressed emotion: negative critical and hostile attitudes and behavior towards
patients and/or emotional over-involvement
Patients that return to live with families are more likely to relapse if at
least one relative is high in EE
Families may also exhibit high EE following a relapse
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o Gene: COMT
Involved in metabolism of DA in synapse
MET version of allele associated with slower DA breakdown
o Environment: marijuana use during adolescence
MET/MET: doesn’t matter if you smoked MJ
VAL/VAL: higher likelihood of SCZ only if you smoked MJ
Evolutionary perspective: risk for SCZ associated with greater creativity
Diathesis-stress model = stress during development
Sources of stress
o Prenatal: viral theory
o Adolescence: adrenarche (HPA axis activation), adrenal steroids enhance DA
function, more stress = higher HPA function
Sensory gaiting: filtering out unnecessary stimuli
o ROI: Pulvinar nuclei of thalamus
o Paired click: most reliable findings for SCZ
o Self-generated signals: touching own arm
Treatment
o Hydrotherapy: unsupported and not currently used
o Pharmacological treatment: several waves of antipsychotics; all impacting DA
transmission
Typical antipsychotics
Chlorpromazine (thorazine) = antihistamine and then tranquilizer
o Primarily impacts positive symptoms
o Antagonist for all types of DA receptors
Mesolimbic system decreases + symptoms
Nigrostriatal system movement side effects
o Very widespread effect
o Due to feedback system, DA is initially increased, then
decreases
o Severe side effects = Parkinsonism
Haloperidol: 100 times more potent than chlorpromazine
o Antagonizes D2 receptors
o Primarily impacts positive symptoms
o Serious side effects: parkinsonism, movement disorder,
hypotension
Atypical antipsychotics
Clozapine: both positive and negative symptoms
o DA antagonist and partial 5HT agonist (negative
symptoms)
o Serious side effects: agranulocytosis (decrease in white
blood cells)
o Primarily used for patients who don’t respond to other
treatment
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