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CU-Boulder PSYC 2012 - bio psych lecture 19 notes

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3/31/15 – Lecture 19 – Cognitive Impairment- Goal: to learn how cognition can be impaired and what happens to the brain during cognitive impairment- Cognitive Impairment – a defect in the generation, perception, recognition, understanding, or organization of thoughts and ideaso Causes of Cognitive Impairment Trauma – anything that damages the brain (strokes, tumors, infections, TBI, toxins, etc) Birth Defects – trauma during birth, maternal drug/alcohol use, malnutrition Neurodegenerative Diseases and Psychiatric Disorders – Schizophrenia, anxiety and depression Drug Use – acute and chronic usage, legal and illegal drugs Genetics – mental retardation, downs syndrome, chromosomal abnormalities Lack of a stimulating environment after birtho Symptoms of Cognitive Impairment Amnesia – the loss of memory and the ability to store and recall information … Memory loss / difficulty of forming new memories (amnesia) Attention Deficit – inability to sustain concentration on a particular object, action, or thought … Attention or Concentration Issues (ADHD) Executive function Defects – reduced ability to plan and execute a goal, increased impulsiveness in behavior … Issues with impulse control, following andcreating a plan Hallucinations – Perception in the absence of sensory stimuli Delusions – beliefs held despite evidence to the contrary Aphasia – impairment of language ability or the ability to translate sounds into words and to generate verbal output- Cognitive Impairment in Childreno Attention Deficit Hyperactivity Disorder (ADHD) – disorder characterized by deficits in attention and hyperactivity Don’t have an inability to pay attention, rather the wrong kind of attention- Tends to manifests in childhood around school age (9.5% or 5.4 million children 4-17 years old have been diagnosed as of 2007) and diagnosis has increased 3% per year on averageo Boys are twice as likely as girls to be diagnosed with ADHD- 4.4% of adults between 18 and 44 experience the symptoms and disabilities from ADHD- Costs approximately 32 billion dollars a year in the US Symptoms of ADHD- Not able to sit and focus for long periods of time, fidgety- How well they process information and remember information- Inappropriate attention style – distributed attentional style or hyper-focused attention style (videogames)- Poor decision making and impulse control – procrastination, disorganized work habits, forgetfulness in daily activities, more risk taking- Hyperactivity – fidgeting, squirming, getting up frequently to walk or runaround, running or climbing excessively, having difficulty playing quietly or engaging in quiet leisure activities- Emotional Regulation – greater emotional swings, more tantrums, etc. Factors Contributing to ADHD- Genetics – up to 75% of ADHD variability may be inherited- Pre/Perinatal Factors – maternal stress during pregnancy or prenatal exposure to tobacco, alcohol and other drugs/environmental toxins, or pregnancy/birth complication (low birth weight/prematurity, neonatal anoxia and seizures, brain injury)- Chemical in foods or the environment – lead, polychlorinated biphenyls, food dyes, or other additives- Psycho-Social Factors – high family adversity, high levels of family conflict, inconsistent parentingo FOR MOST PEOPLE, it is a combination of genetic susceptibility and environmental factors that probably leads to ADHD Brain Changes with ADHD- Reduced size and connectivity of the prefrontal cortex which may reflectdifficulties in decision making and impulse control- Decreased volume of striatum of the basal ganglia, involved with motivation as well as inhibition of impulsive motor behavior (hyper activity)- Decreased amygdala size and connectivity, could contribute to problems with emotion regulation Neurotransmitter Alterations in ADHD- Decreased dopamine signaling – decreases in reward pathways that maycause children to seek out new stimuli for greater rewards and increasedimpulsivity- Decreased acetylcholine signaling – may decrease attention- Decreased norepinephrine signaling – may decrease arousal in response to certain sensory cues- Increased glutamate signaling – may globally increase arousal through out the braino Different subtypes of ADHD may be associated with larger or smaller changes in one or more of the neurotransmitters above Neural Changes with ADHD- Very little is currently known about the specific neural changes with ADHD- Research is hampered by the lack of effective animal models of ADHD- Defects in dendritic branching, neurogenesis, angiogenesis (blood vesselformation) may underlie some or all of the changes observed in the brains of ADHD patients- Cognitive Impairment in Adultso Schizophrenia – psychiatric disorder characterized by defects in cognitive ability and in emotional and social responsiveness Doesn’t manifest until the late teens (16-19) and affects about 7.2 people per 1000 people (costs about 63 billion dollars a year in the US) Symptoms of Schizophrenia- Positive Symptoms (they have, normal people don’t have) – more treatableo Hallucinationso Delusionso Paranoiao Disorganized thoughts and speech- Negative Symptoms (they don’t have, normal people do have) – not as treatable and so have a large negative impact on quality of lifeo Blunted emotional responsivenesso Social withdrawalo Catatonia (stop responding almost entirely) Brain Changes with Schizophrenia- Smaller brain size and larger ventricles- Specifically (the prefrontal cortex, cingulate, hippocampus and medial temporal cortex) are smaller … regions associated with cognition, memory, and emotion regulation Dopamine Hypothesis of Schizophrenia- Brains of schizophrenics may have increased dopamine signaling – dopamine receptor levels are increased in the frontal cortex and striatumo Dopamine is involved in motivation and reward and excessive dopamine signaling may facilitate many otherwise undesirable behaviors- Dopamine receptor antagonists are effective therapeutic agents for schizophrenia, while amphetamines (promote the release of dopamine) can exacerbate schizophrenic symptomso Best kind of drug to help with positive symptoms Glutamate Hypothesis of Schizophrenia- Have increased glutamate signalingo Used throughout the brain and especially the cortex as an excitatory neurotransmitter- Excessive glutamate release onto these neurons may


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