Slide 2 The Role of Specific Brain Areas in Psychosis and
Schizophrenia An 11 year old boy diagnosed with Early Onset
Schizophrenia (EOS) Slide 3 Schizophrenia A. Characteristic
symptoms: Two (or more) of the following, each present for a
significant portion of time during a 1-month period (or less if
successfully treated): (1) delusions (2) hallucinations (3)
disorganized speech (e.g., frequent derailment or incoherence) (4)
grossly disorganized or catatonic behavior (5) negative symptoms,
i.e., affective flattening, alogia, or avolition Slide 4 Role of
Specific Brain Areas Orbital Frontal Cortex Amygdala Anterior
Cingulate Basil Ganglia Dorsolateral Prefrontal Cortex Slide 5
Orbital Frontal Cortex The Orbital Frontal Cortex (OFC) is involved
in decision making Functions in concert with other brain areas
Influences the Limbic system which is involved with emotions Slide
6 Orbital Frontal Cortex and EOS Schizophrenia and the case of the
11 year old boy Role of the OFC: The OFCs is involved in decision
making and therefore as a result will more than impact someone with
a Psychosis because he or she will be influenced in his or her
decision making process by external and internal influences.
Effect: May struggle with making decisions that are based in
reality We can draw parallels between Doidges OCD Brain lock
creating difficulty for subject to shift gears struggles with
constant firing or misfiring resulting in client not understanding
normal behavior Slide 7 Orbital Frontal Cortex contd The Orbital
Frontal Cortex does play a small factor in perpetuating ones
psychosis or schizophrenia if untreated. There is evidence which
claims the limbic system is the site of pathology for some, if not
most, cases of schizophrenia is strong. The limbic system is
involved in all of the brain areas. Slide 8 Amygdala Consists of
two areas fairly close together. Located deep within front of
temporal lobe Just above hypothalamus gland Contains three main
groups of nuclei: Lateral nuclei Corticomedial nuclei Central
nuclei Slide 9 The Amygdala and EOS Schizophrenia and the case of
the 11 year old boy Amygdala is necessary for learning Thought to
be the main component in the neural pathways involving emotions
Functions to moderate approach/avoidant activity by inhibiting or
perusing Associates neutral present experiences with previously
threatening experiences and works with the hippocampus (re. memory)
Plays a key role in regulating responses to fear, drive, pleasure
and motivation Key in social responses, perceives emotions in
others Slide 10 The Amygdala and EOS Schizophrenia and the case of
the 11 year old boy Role of Amygdala in Schizophrenia Chemical
changes in Amygdala are involved in disturbance in affect,
perception, motivation, and psychomotor agitation Excessive firing
of Amygdaloid Neurons disrupt Dopamine levels Influence of Amygdala
throughout cortex and stratum has impact on motivation of movement
and cognition Slide 11 Anterior Cingulate Part of the Limbic System
Regulates blood pressure and heart rate Divided into two parts
Dorsal and Ventral Slide 12 Anterior Cingulate Dorsal section of
Anterior Cingulate is central station for processing bottom-up and
top-down stimulus Ventral is involved in assessing the salience of
emotion and motivational information Typically involved in effort
of a task, in early learning or problem solving Divergent theories
claim anterior cingulate is involved in error detection and
conflict monitoring respectively Slide 13 Anterior Cingulate
Biology Studies have shown loss of two to three neural layers of
the ACC in patients with Schizophrenia (Heckers, 1997) Various
early studies of the brains of patients with schizophrenia showed
results that varied from reduced neural density to altered
arrangement of axons (Heckers, 1997) Slide 14 Anterior Cingulate
and EOS Schizophrenia and the case of the 11 year old boy Evidence
that damage to the Anterior Cingulate Cortex (ACC) is associated
with schizophrenia Most likely when patients struggle with
conflicting spatial location Based on theory of Primary function in
patients with Schizophrenia: May decrease error detection due to
lack of inhibitory ability in conjunction with excitatory input May
perceive increased conflict Slide 15 Basil Ganglia Located at base
of forebrain Closely linked with cerebral cortex and thalamus
Conduit for information to and from the cortex Associated with
functions such as voluntary motor control, procedural learning
related to routine behaviors or habits, eye movements, etc. Slide
16 Basil Ganglia Basil Ganglia are associated with cognitive and
emotional functions Basil Ganglia are implicated in action
selection, and the decision on timing of the execution of several
pertinent behaviors Provide an inhibitory influence via GABA for
the activation of several motor systems Basil Ganglia are
influenced by many parts of the brain including the prefrontal
cortex Slide 17 Basil Ganglia and EOS Schizophrenia and the case of
the 11 year old boy Underactive caudate nucleus portion of the
Basil Ganglia may play a role in the negative and cognitive
symptoms of schizophrenia such as: Flattened affect, poverty of
speech, lack of goal- directed behavior and memory impairment
Difficulty in the functioning of the putamen portion of the Basil
Ganglia is a likely culprit in any movement disorders associated
with schizophrenia Slide 18 Dorsolateral Prefrontal Cortex The
Dorsolateral Prefrontal Cortex (DL- PFC) primary function is to
provide an information look-up system (Kosslyn, 2009) The DL-PFC
also shares responsibility for organization, regulation and is
involved in motor planning. Retrieves information related to
pertinent stimulus in the environment Slide 19 Dorsolateral
Prefrontal Cortex The Dorsolateral Prefrontal Cortex (DL- PFC) is
involved in the integration of information received from senses The
DL-PFC provides a route for information to enter memory for storage
and for retrieval when circumstances demand it Slide 20
Dorsolateral Prefrontal Cortex and EOS Schizophrenia and the case
of the 11 year old boy DL-PFC may contribute to the symptoms by
failing to associate Information received from environmental
stimulus with needed information stored in associative memory
DL-PfC and its ability to properly connect with other areas of the
brain may be connected to the efficacy of treatment. Therefore.
altered or impaired function may contribute to the severity of the
disorder (Kumari, 2009). Evidence has shown that lesions in the DPC
created abnormalities in visual tracking. In addition studies have
shown changes in blood flow and metabolism in the DPC, in persons
w/ schizophrenia. Those studied showed difficulty in completing
tasks such as the Wisconsin Card Sort Test (Pardes et al., 1987)
The WCST tests the ability of the subject to alter response sets,
in response to variation in a reinforcement schedule Slide 21
Conclusion Various brain areas not only contribute to the healthy
and adaptive functioning of the human brain but they also often
play a role in exacerbating the symptoms of a variety of mental
disorders including schizophrenia. It is difficult in a disorder as
pervasive as schizophrenia to isolate any one brain area or system
that is responsible for the myriad of associated symptoms and
attempts may lead to more questions than answers. Slide 22 Brain
Areas Orbital Frontal Cortex by Stephen Milburn Amygdala by June
Martinez Anterior Cingulate by Michelle Minette Basil Ganglia by
Margo Townley Dorsolateral Prefrontal Cortex by John Pacheco Slide
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