BIOLOGICAL SCIENCES

NEUROANATOMY
1. Embryology of the nervous system
2. Gross anatomy – Brain (hemispheres)
- Nervous system (CNS, PNS)
3. Histology – neurons
NEUROPHYSIOLOGY
- nerve impulse transmission
 BIOLOGICAL SCIENCES
NEUROCHEMISTRY
- neurotransmitters – synthesis, metabolism, its
significance in different psychiatric disorders
GENETICS
- schizophrenia
- mood disorders
- anxiety disorders
SLEEP RESEARCH – (REM, NREM, common
sleep disorders)
 EMBRYOLOGY
• The nervous system – ectoderm
Neural plate neural groove
lined on each side by neural fold
Fusion of neural folds neural tube
Neural crests – some cells from the neural
folds , gives rise to many nervous
structures (meninges of the brain, spinal
ganglia, pigment cells and others)
 EMBRYOLOGY
• The neural tube forms three primary
vesicles of the brain which gives rise to
five secondary brain vesicles
PROSENCEPHALON – telencephalon,
diencephalon
MESENCEPHALON - midbrain
RHOMBENCEPHALON – metencephalon
myelencephalon
 EMBRYOLOGY
PROSENCEPHALON
• TELENCEPHALON
- cerebral cortex
- hippocampus
- amygdala
- basal ganglia
• DIENCEPHALON
- thalamus
- hypothalamus
 EMBRYOLOGY
MESENCEPHALON

- midbrain
 EMBRYOLOGY
RHOMBENCEPHALON
METENCEPHALON
- pons
- cerebellum

MYELENCEPHALON
- medulla
 CEREBRAL CORTEX
• FUNCTIONS:
- thought
- voluntary movement
- language
- reasoning
- perception
 CEREBELLUM
• FUNCTIONS:
- movement
- balance
- posture
 BRAIN STEM
• FUNCTIONS:
- breathing
- heart rate
- blood pressure
 HYPOTHALAMUS
• FUNCTIONS:
- body temperature
- emotions
- hunger
- thirst
- circadian rhythms
 THALAMUS
• FUNCTIONS:
- sensory processing
- movement
 LIMBIC SYSTEM
• FUNCTIONS:
- emotions
 HIPPOCAMPUS
• FUNCTIONS:
- learning
- memory
 BASAL GANGLIA
• FUNCTIONS:
- movement
 MIDBRAIN
• FUNCTIONS:
- vision
- hearing
- eye movement
- body movement
 BRAIN HEMISPHERES
• FRONTAL LOBE – largest lobe of the
cerebrum. It is considered as the
emotional control center and home of our
personality
• PARIETAL LOBE – enables us to
comprehend spatial information and
differentiate shapes, sizes and texture.
The ability to express or comprehend
emotion
 BRAIN HEMISPHERES

• TEMPORAL LOBE – control hearing,

memory for speech, sights and music
• OCCIPITAL LOBE – controls sights,
reading and visual images
 FUNCTIONAL BRAIN
STRUCTURES
• THE THALAMOCORTICAL
• BASAL GANGLIA – center involved in the
control of movements. Major structures
involved the caudate nucleus, the
putamen, globus pallidus, subthalamic
nucleus and the substantia nigra
• THE LIMBIC SYSTEM
NEUROPHYSIOLOGY
NEUROPHYSIOLOGY

RESTING MEMBRANE POTENTIAL

NEUROPHYSIOLOGY
 NEUROTRANSMITTERS
• THREE MAJOR TRANSMITTERS
> the biogenic amines – dopamine,
norepinephrine, epinephrine,
acetylcholine, serotonin, histamine
> the amino acid neurotransmitters
> the peptide neurotransmitters
 NEUROTRANSMITTERS
DOPAMINE:
Four important dopaminergic pathways:
1. nigrostriatal
2. mesolimbic
3. mesocortical
4. tuberoinfundibular
The 4 Dopaminergic Pathways of the Brain

Basal ganglia

Nigrostriatal dopamine pathway

Mesolimbic
Dopamine pathway

Substantia
nigra Mesocortical
dopamine pathway
Hypothalamus

Tegmentum

Tuberoinfudibular
 NEUROTRANSMITTERS
• DOPAMINE AND PSYCHOPATHOLOGY
> The new dopamine hypothesis of
schizophrenia
cortical area – hypodopaminergic
subcortical area – hyperdopaminergic

> dopamine – also involved in

pathophysiology of mood disorders
 NEUROTRANSMITTERS
• NORADRENALINE (NE)
- referred as the noradrenergic and adrenergic
system
NE and psychopathology
- the biogenic amine hypothesis of mood
disorder
- was based on the observation that the
antidepressants are effective (TCA and MAOI) in
alleviating symptoms of depression
 NEUROTRANSMITTERS
• SEROTONIN
Upper pons and midbrain – the major site
of serotonergic cell bodies
Tryptophan – is the precursor amino acid
once synthesized, 5HT is packaged into
the vesicles for release with action
potential
 NEUROTRANSMITTERS
SEROTONIN
serotonin and psychopathology
- too little 5HT in depression.
- too much 5HT in mania
 NEUROTRANSMITTERS
GABA
- found exclusively in the CNS, it does not
cross the BBB
- synthesized from glutamate by glutamic
acid decarboxylase which need pyridoxine
as a cofactor
- in anxiety and mood disorders
 GENETICS
• SCHIZOPHRENIA – prevalence
general population 1%
no twin sibling of schizo px 8%
child w/ one schizo parent 12%
dizygotic twin of schizo px 12%
child with both schizo parents 40%
monozygotic twin of schizo px 47%
 GENETICS
MOOD DISORDERS – family studies
More significant in transmitting bipolar
disorder than MDD (major depressive
disorder)
1st degree relative of bipolar I is 8-18 times,
while MDD 2-10 times
Likelihood of having mood disorder decreases
as the degree of relationship widens
About 50% of all bipolar 1 disorder patient
have at least one parent with mood disorder –
most likely MDD.
 GENETICS
MOOD DISORDERS
 If one parent has bipolar 1 – 25% that any
child will have mood disorder
 If both parents have bipolar 1 – there is
50-75% chance that child will have mood
disorder
adoption studies – biological children of
affected parents remain at increased risk
for mood disorder even if they are reared
in a non-affected adoptive family
 GENETICS
MOOD DISORDERS – twin studies
 Found a concordance rate for bipolar
disorder in monozygotic twins of 33 to
90%
 MDD concordance rate in monozygotic
twins is 50% by contrast, concordance
rates in dizygotic twins are 5 to 25% for
bipolar 1 disorder and 10 to 25% for MDD
 GENETICS
ANXIETY DISORDERS
 Genetic studies – has at least some
genetic component contributes to the
development of anxiety disorders
 Almost half of patient with panic disorder –
at least one affected relatives
 PHYSIOLOGY OF SLEEP
• Two physiological states of sleep:
NREM
REM
• Normal sleep patterns
waking EEG – characterized by alpha
waves, and a low voltage activity
 PHYSIOLOGY OF SLEEP
• NREM – 4 stages
Stage 1 – brief
transitional phase,
lightest sleep, may
have hypnogogic Alpha Rhythm and
Slow Rolling Eye Movement
experiences
- characterized by low
voltage regular activity
at 3-7 cycles per
second
- 5% of TST
 PHYSIOLOGY OF SLEEP
• NREM
stage 2 – 1st stage of
true sleep, characterized
as a light sleep
- comprised 50 % of K complexes
TST
- presence of sleep
spindles and k
complexes on EEG at
12-14 cycles
spindles
 PHYSIOLOGY OF SLEEP
• NREM
Stage 3 and 4
- presence of delta
waves, are referred to
as “slow wave sleep”,
growth hormone is
secreted
- comprised 20% of
TST
Delta waves
 PHYSIOLOGY OF SLEEP
• REM
- known as D or
dreaming sleep,
paradoxical sleep
- makes up 20% of
TST
 PHYSIOLOGY OF SLEEP
NREM REM
• Vital signs reduced • Vital signs increased
• Involuntary muscle • Near total paralysis of
movement skeletal muscle
• Few rapid eye • More rapid eye
movement movement
• Seldom with penile • Partial or full
erections in male erections in male
• Occasional dreams • Dreams typically
but lucid & purposeful abstract & surreal
 Physiology of sleep
NREM REM
• Most occur during 1st • Most occur on the last
3rd of the night 3rd of the night
• Sleep terror - • A poikilothermic
phenomenon may
occur
• There is increased
brain oxygen use
 Age Avg. Wake Light Deep REM
hours Sleep Sleep
of
Sleep

Newborn 16 1% 24% 25% 50%

Adolesc 8 2% 53% 19% 26%

ent

Middle 7 3% 61% 11% 25%

Age

Elderly 6 15% 62% 5% 18%

 PHYSIOLOGY OF SLEEP
Functions of sleep:
- serves as a restorative, homeostatic
function which appears crucial for normal
thermoregulation and energy restoration
Sleep requirements:
short sleepers – requires 6 hours to sleep
long sleepers – those who sleep more
than 9 hours each night to function
normally
 SLEEP DISORDERS
4 MAJOR SYMPTOMS IN SLEEP D/O:
1. Insomnia – difficulty in initiating or
maintaining sleep
2. Hypersomnia – excessive amounts of
sleep
3. Parasomnia – is unusual or undesirable
phenomenon that appears suddenly
during sleep, occurs during stage 3 & 4
4. Sleep wake schedule disturbances – the
displacement of sleep from its desired
circadian period
 SLEEP DISORDERS
I. PRIMARY SLEEP DISORDERS:
A. DYSOMNIAS
1. primary insomnia
2. primary hypersomnia
3. narcolepsy
4. breathing related sleep disorders
5. circadian rhythm sleep disorders
6. dysomnias not otherwise specified
 SLEEP DISORDERS
B. PARASOMNIA
1. nightmare disorder
2. sleep terror
3. sleepwalking disorder
4. parasomnia NOS
II. SLEEP DISORDERS RELATED TO ANOTHER
MENTAL DISORDER
III. OTHER SLEEP DISORDERS (substance
induced sleep disorder)
PRIMARY SLEEP DISORDERS
PRIMARY INSOMNIA
1. Inadequate sleep hygiene
2. Psychophysiological insomnia (conditioned
insomnia) – they develop a conditioned
arousal associated with sleep. Often occurs in
combination with other causes of insomnia
(stress, anxiety disorders, delayed sleep phase
syndrome, hypnotic drug use and withdrawal
PRIMARY SLEEP DISORDERS
PRIMARY HYPERSOMNIA
- is diagnosed when no other cause for
excessive somnolence occurring for at
least month can be found
NARCOLEPSY
- excessive daytime sleepiness and
abnormal manifestations of REM sleep
occurring daily for at least 3 months. The
most common symptoms is sleep attacks
 PRIMARY SLEEP DISORDERS
BREATHING-RELATED SLEEP D/O
- characterized by sleep disruption leading to
excessive sleepiness or insomnia that is due to
sleep related breathing d/o
1. Obstructive sleep apnea syndrome – refers to
cessation of airflow at the nose or mouth, may
lasts 10 seconds or more
2. central alveolar hypoventilation – refers to
several conditions marked by impaired
ventilation in which the respiratory abnormality
appears or greatly worsens only during sleep
and in which no significant apneic episodes are
present
PRIMARY SLEEP DISORDERS
CIRCADIAN RHYTHM SLEEP DISORDERS
1. delayed sleep phase type – is marked
by sleep and wake times that are
intractably later than the desired.
Complaint is often the difficulty of falling
asleep at the desired conventional time
2. jet lag type – length of the east to west
trip and individual sensitivity
PRIMARY SLEEP DIORDERS
3. Shift work type –
occur in persons who
change their work
schedules repeatedly
and rapidly
PRIMARY SLEEP DISORDERS
DYSOMNIAS NOS
1. restless leg syndrome
2. menstrual associated syndrome
3. sleep disturbance in pregnancy
4. insufficient sleep
5. nocturnal myoclonus
6. kleine-levin syndrome
 PARASOMNIAS
1. Nightmare Disorder – are long frightening
dreams in which person awakened scared.
Almost occur during REM sleep. Tricyclics and
benzodiapines may help
2. sleep terror disorders – is an arousal in the first
3rd of the night during deep NREM sleep.
3. sleep walking disorder (somnambulism)-
usually initiated in the first 3rd of the night during
deep NREM sleep
 PARASOMNIAS NOS
1. sleep-related bruxism
2. sleeptalking (somniloquy) – in all stages
of sleep
3. sleep paralysis
4. REM sleep behavior disorder
5. sleep related head banging