MODULE 9: NEUROSCIENCES AND BEHAVIOUR

Section One: Introduction to Neurosciences

Neuroscience is the umbrella term for the multi-disciplinary study of the nervous system.
It has 4 divisions namely:
 Neuroanatomy- studies the neurons physical structure
 Neurophysiology- studies the function of the neurons
 Neurochemistry- analyses neurons chemical activity
 Behavioral neuroscience- focuses on nervous system connection and behavior
The nervous system is divided into CNS and PNS
Section 2: Neuroanatomy and Behaviour
The brain has two hemispheres with grey matter in the cerebral cortex, cerebellar cortex
and subcortical nuclei. It has the 4 known lobes and sulci and gyri. Brainstem has its
parts, and ventricular system.
Frontal Lobe- the part of the brain concerned with emotional and some higher mental
functions. The hippocampus and adjacent regions may show some reduction in size. This
can affect the "sensory filtering" that takes place in this region of the brain. The ventricles
(fluid-filled spaces) may be larger than normal. This may put pressure on surrounding
brain tissue. Patient with frontal lobe disorders will present with emotional and
behavioural problems including disinhibition.
Basal ganglia-
group of nuclei containing cholinergic neurons. The nuclei include corpus striatum,
substantia nigra and subthalamic nuclei.
This anatomic area is associated with a number of clinical disorders such as Parkinson's
disease, Huntington's chorea Wilson's disease and Fahr syndrome. These are neurological
disorders mostly associated with symptoms of psychosis, depression and dementia.
schizophrenics ( a form of mental illness)show many movement disorders eg, extreme
opening & closing of eyes, flaring of the nose, grimacing, protrusion of the tongue, and
shaking of head, all of which imply an involvement of the basal ganglia.
Meninges-
Covered by dura mater, arachnoid and pia mater. Sub dural space beneath dura, sub
arachnoid space with CSF.
Abnormalities and affect on body function: Hydrocephalus and content of metabolites is
a measure of response to pharmaceutical treatment. Subdural hematoma and epidural
hematoma and meningitis.
In all the above conditions patient may show signs and symptoms of delirium, behaviour
and psychological symptoms. It is therefore important to rule out brain meningeal
abnormalities in who present with behaviour problems.

Neurons and Glia- A neuron is the basic functional unit of the nervous system. Neurons
are also called nerve cells. Glial cells (neuroglia) are a class of neuronal cells in CNS.
There are four types of glial cells, the astrocytes, oligodendrites, ependymal and
microglia cells. Ependymal and microglia cells line the brain ventricles and the central
canal of the spinal cord. They facilitate the flow of the CSF. The glial cells also
contribute to blood brain barrier (BBB), a semi-permeable membrane between blood
vessels and the brain. The ability of compounds to pass from the blood into the brain and
vice versa depends on their molecular size, electrical charge, solubility, and specific
transport system. The BBB is important in regulating the brain chemistry.
Thalamus - is involved with perception of pain which is relayed and eventually ascend
along spinothalamic and reticulothalamic tracts to the thalamus. The Thalamus is a relay
station for all of the sensory messages that enter the brain. It is this area that the
conscious awareness of messages as sensations such as temperature, pain and touch
probably begin.
The hypothalamus- is located beneath the thalamus and on either side of the third
ventricle. It has many nuclei and those relevant to psychiatry include: mamillary, supra-
chiasmatic, optic and paraventricular nuclei.
The hypothalamus has several connecting pathways to other parts the brain. It is a major
integrating and output system of the entire CNS. It controls biological rhythms and
regulates the immune systems. It is also involved with appetite and sexual regulation,
since it is a part of the limbic system. The pineal gland secretes melatonin which is useful
in sleep regulation and also secretes various peptides.
Dysfunctions of the thalamus are due to many factors including tumours which produce
severe pain syndrome Pain transmission to the thalamus can be inhibited by projections
from periaqueductal region of the midbrain and the nucleus raphe of the medulla. These
regions have high concentrations of opiate receptors and these endogenous opiates
(endorphins enkephalins) play a role as neurotransmitters for the control of pain.
Tumours of the thalamus may present with extreme pain. Disorders of the hypothamus
will affect appetite, sleep and sexual behaviour.
The Brain Stem- contains nerve fibres (neurons) which transmit information from the
spinal cord to the brain. Higher concentrations of serotonin and norepinephrine binding
sites may be present in these areas. The second important function of the brain stem is
hosting of the medial forebrain bundle, the nuclei of ascending biogenic-amine pathways.
Thus, there are high concentrations of dopamine, noradrenalin and serotonin levels in the
brain stem
Cerebellum. - Functions of the cerebellum are control of movement and posture and
therefore its lesions will cause loss of balance. It is also involved in higher mental
functions resulting to abnormal behaviour.
Reticular Activating System.
Since the reticular activating system is responsible for the state of alertness and
wakefulness, those psychiatric disorders where motivation and arousal are affected, may
be due to pathology within the reticular activating system.

SECTION 3: NEUROPHYSIOLGY/CHEMISTRY AND BEHAVIOUR

Most neurons receive synaptic input, an individual neuron can be affected by hormones,
the immune system, and chronobiological rhythms of the organism. There are integrating
mechanisms with the neurons. This includes regulation of protein function and regulation
of gene function. Many important molecules within the neuron are proteins including
neurotransmitters receptors, enzymes and cytoskeletal elements. In as much as the
function of its shape and electrical charge, biochemical processes such as protein
phosphorylation, that can affect the shape and charge of a protein can affect its function.
Specifically, an individual protein molecule may have its function regulated by several
reversible, post-translation modifications, initiated by a different source e.g. synaptic
input hormonal effects and chronobiological rhythms.
Neuro-messengers, also known a neuro-transmitters or neuro-modulators are grouped
into;
 Biogenic amines (5-10%) - include cate-cholamines (dopamine, epinephrine and
norepinephrine); indole amines (serotonin, also called 5-hydroxy tryptamine),
quaternary amines (acetyl-choline) and ethyl amines (histamine).
 Amino acids, (60%)
 Peptides
 Endocannabinoids ( this group is the least understood)
Dopamine-containing neuronal cell bodies are located in the Nigrostriatal, Mesolimbic,
Mesocortical and Tubero-infundibular pathways. There are 5 major types of dopamine
receptors. D1 and D5 receptors are members of the D1 like family of dopamine receptors,
whereas the D2, D3, D4 receptors are members of the D2-like family. Activation of the
D1-like family receptors is typically excitatory, while D2-like activation is typically
inhibitory. The D2 family of receptors is the most relevant in behavior and in psychiatry.
The function of dopamine involves the initiation and co-ordination of movements.
BASIC EXPLANATION OF NERVES FROM PHYSIO- KNOWN INFORMATION
I’VE SKIPED IT
Behavioural problems associated with neurochemical and
neurophysiological abnormalities
a. The clinical potency of antipsychotic drugs is associated with their binding affinity to
the D2 receptors in the caudate and putamen. Blockage of this receptors produce
unwanted motor disturbances such as extra pyramidal side effects (Pseudoparkinsonism)
and tardive dyskinesia, Lack of dopamine due to degeneration of neurons in the basal
ganglia results in Parkinson's disease, which is characterized by rigidity, akathisia and
tremors.
b. Dopamine acts as a prolactin release inhibiting factor in the anterior pituitary, which is
the main source of prolactin, a hormone that induces lactation and breast engorgement.
c. Antipsychotic drugs that block dopamine receptors in the tuberoinfundibular pathways
lead to excess prolactin release. This may result in gynaecomastia (enlarged breasts),
galactorrhea and amenorrhea. There is a relationship between dopamine and
psychopathology of schizophrenia.
d. It is postulated that hyperactivity of the dopaminergic systems results in symptoms of
schizophrenia.
e. Mania is theoretically due to dopaminergic hyperactivity, while depression is due to
dopaminergic hypoactivity.
f. Patients suffering from Parkinsonism are treated with L-dopa (levodopa), which is a
precursor of dopamine.

The role of norepinephrine and epinephrine

Norepinephrine (noradrenaline) is formed by action of dopamine 13-hydroxylase, which
converts dopamine to noradrenaline.). Adrenergic neurons are fewer compared to the
noradrenergic neurons located in the locus ceruleus within the pons.
From locus ceruleus neuronal projections go to brain stem, cortex (concerned with
arousal), Spinal cord, thalamus, hypothalamus and limbic system (concerned with drive,
motivation, mood and response to stress). Norepinephrine plays a major role in the
pathophysiology of mood disorders.
Monoamine hypothesis of mood disorder assumes that depression is due to too little
noradrenergic and serotonergic activity.
Antidepressants e.g. Tricyclic antidepressants block reuptake of norepinephrine and
serotonin, increasing their concentration in the synapse
Due to blockade of the alpha 1 receptors, sedation and hypotension are experienced as
side effects of the above drugs

Serotonin and Behaviour

A precursor amino acid called tryptophan is acted upon by the enzyme tryptophan
hydroxylase and an amino acid decarboxylase and is converted to 5-hydroxyl-tryptamine
also called serotonin. Serotonin is involved in pain regulation and has antidepressant
properties.
Agents that selectively block the reuptake of serotonin cause accumulation of this amine,
which is positively correlated with amelioration of depressive symptoms.
Low levels of serotonin are implicated in the pathophysiology of mood disorders,
anxiety, and violence

Acetylcholine and behaviour

Acetylcholine has been implicated;
In mood disturbances where over activity of cholinergic pathways has been associated
with depression and sleep disorders.
Degenerative’ conditions like dementia, and parkinson’s acetylcholine’s muscarinic
receptors are blocked by many psychotropic drugs, causing the effects of blurred vision,
dry mouth, parkinsonism and constipation.
Confusion and delirium occur following excessive blockade of the central nervous
cholinergic receptors, a condition referred to as neuroleptic malignant syndrome.

UNIT 2: ENDOCRINOLOGY AND PSYCHIATRIC DISORDERS

Section 1: Thyroid Disorders
Hyperthyroidism: Results to a condition called thyrotoxicosis. symptoms of what may
appear like an anxiety disorder, including restlessness, irritability, distractibility and
anxiety. The discriminating symptoms of thyrotoxicosis include; preference of cold
weather, weight loss despite increased appetite, palpable thyroid gland, sleeping pulse
rate of above 90/min and tremors. Measurement of the T3 and T4 shows elevated levels.

Hypothyroidism: If it happens in early life it leads to retardation of mental development.

In adults, lack of thyroid hormones results to poor memory, slowness, apathy akin to
depression and dementia. The symptoms of hypothyroidism are less distinctive than those
thyrotoxicosis including; poor appetite, constipation, generalized aches and sometimes
angina.
Section 2: Adrenal Gland Disorders

Hypoadrenalism/Addison’s Disease- This symptom includes: withdrawal, apathy, fatigue

mood disturbance and memory loss. This may be mistaken be mistaken for dementia, a
disorder that presents with memory loss. A patient in Addisonnian crises (when the levels
of adrenaline are too low) may present in an acute confusion. Occasionally Addison's
disease may coincide with depression or schizophrenia

Hyperthyroidism/Cushing Syndrome- As described by Cushing’s, it is usually associated

with emotional disorder. Depressive symptoms are the most frequent manifestation in
these patients.

Phaecomocytroma- Benign tumours of chromaffin cells. They secrete adrenaline almost

continuously or paroxysmal. It is associated with headaches, anxiety attacks and
occasionally episodes of confusion. Increased catecholamine’s in urine is an important
diagnostic finding.

Section 3: Pituitary Disorders

Acromegaly is a disorder resulting from hyper secretion of hormones from the pituitary
gland. The psychiatric symptoms in acromegaly include apathy and lack of initiative.
Depression sometimes occurs.

Hypopituitarism- The psychiatric manifestations of this disease include; depression,

apathy, lack of initiative, somnolence, and cognitive impairment similar to that found in
patient with dementia.

Section 4: Parathyroid Disorders

Hyperparathyroidism related to raised blood level of calcium. The psychiatric symptoms

include; depression anergia (lack of energy), irritability and cognitive impairment. In
cognitive impairment, the patient has poor concentration, memory, orientation, attention
and judgment.

Hypoparathyroidism: disorder include depression, irritability, nervousness, manic

depressive and schizophrenic symptoms. Patients may also present with epilepsy.
Section 5: Corticosteroid treatment and Insulinomas

Patients on corticosteroid treatment may develop psychological problems. Psychological

symptoms may include; euphoria, mild manic syndrome, depressive disorder.

An insulinoma is a tumor of the pancreas that is derived from beta cells and secretes
insulin. The patient gives a long history of transient but recurrent attacks in which the
patient behaves out of character, often in an aggressive and uninhibited. A low blood
glucose concentration either during the episode or immediately after helps in diagnosis.

UNIT 3: PHYSIOLOGY OF SLEEP

Physiology of Sleep
Sleep serves a regenerative function. Deprivation can lead to:
 Disorganization
 Hallucination
 Delusions

In studies with rats, sleep deprivation produces a syndrome that includes:

 Debilitated appearance
 Skin lesions
 Increased food intake, weight loss, increased energy expenditure, decreased body
temperature and death\

Sleep Cycle
Without external influence it follows 25 hour cycle, but it is reduced to 24 due to night
and day. Within the 24 hours sleep once or twice. And it develops over the first 2 years of
life.
Sleep is made of two parts:
a. Non-Rapid Eye Movement Sleep (NREM)
b. Rapid Eye Movement Sleep (REM)

NREM Sleep
Characterised by:
Slowed pulse rate
Slow respiration
Blood pressure is slower than normal
Involuntary body movements
Blood flow through tissues and cerebrum is reduced

REM SLEEP
Blood pressure, heart rate and respiration is high during REM
Brain Oxygen use increases

NREM has 4 stages with stage 3 and 4 being the deepest portion of NREM. The
percentage of time spent in each of the stages is as follows:
a. Stage 1 - 5%
b. Stage 2 - 45%
c. Stage 3 - 12%
d. Stage 4 - 4 -13%
Stage 3 & 4 are the deepest portions of NREM sleep.

REM SLEEP
1. Accompanied by partial or full penile erection. If doesn’t occur it can be used to
diagnose impotence.
2. NO body movements occur in REM sleep.
3. Dreams occur in REM sleep, while in NREM sleep its lucid, purposeful dreams.
4. A REM period occurs about every 90-100mm during the night. The first REM
period tends to be short usually less than 10 minutes. The latter REM periods may
last 15-40 minutes.
5. Most REM periods occur in the last third of the night.
6. Sleep patterns change of over life span in neonates 50% of sleep is REM, while in
adults only 25% of sleep is REM.
7. Neonates sleep around 16 hours a day

SLEEP AMOUNT
2 Groups:
a. Short sleepers who require fewer than six hours of sleep each night and who
function adequately.
b. Long sleepers - who require more than nine hours each night in order to function
adequately.

Short sleepers are generally efficient, ambitious, and content and socially outgoing. Long
sleepers tend to be mildly depressed, anxious and socially withdrawn.
However increased sleep needs occurs with:
 Exercise
 Physical work
 Illness
 Pregnancies
 General mental stress
 Increased mental activity

MEMORY

The memory process includes:

1. Registration- Adding info to stores
2. Retention- Ability to retain memory
3. Recall- Bring it back to awareness
4. Recognition- A feeling of familiarity that something has been encountered before.

Memory may be divided into:

 Working (recall) memory: also called short term retained for as long as 30 secs
unless information is rehearsed.
 Recent memory: holds recent information
 Long term memory: a relatively permanent type of memory that holds huge
amounts of information for a long time.

Encoding Memory

Some of the encoding processes that require effort are:

 Rehearsal- Conscious repetition of information.

 Deep processing- Fergus Craik and Robert Lockhart (1972) proposed that people
process information at different levels. Their theory, levels of processing theory,
states that memory is on a continuous from shallow to deep, with deeper
processing producing better memory. At the shallow level only the sensory of
physical features of the stimuli are analyzed while at the intermediate level the
stimulus is recognized and labeled while at the deepest level information is
processed semantically in terms of its meaning.
WHAT THE FUCK DOES THIS EVEN MEAN?
  Elaboration- Elaboration is the extensiveness of processing at any given depth in
memory e.g. rather than memorizing the definition of memory, you would do
better to learn the concept of memory by coming up with some examples of how
information enters your mind, is stored, is retrieved, until to understand it.

 Imagery- Studies by Allan Palvio (1977, 1986) document how imagery can
improve memory. Palvio argues that memory is stored in one of 2 ways as verbal
code or as image code e.g. a picture can be remembered by a label (verbal code) or
mental image (image code). Palvio believes that image code, which is highly
detailed and distinctive produces better memory.
The dual-code hypothesis claims that memory images is better because the
memory for concept image is stored both as an imaginal code and verbal code thus
providing 2 potential avences by which information can be retrieved.

 Organization- In many instances we remember information better when we

organize it hierarchically. A hierarchy is a system in which items are organized
from general to specific classes.

RETEIVAL

a. Tip of Tongue Phenomenon- Forceful retrieval when confident that you know
something but cant pull it from memory
b. Serial Position Effect- Recall information that’s at the beginning and end of a list
than other info.

Retreival cues already explained in unit 1

Priming- Associate different memories together

FORGETTING
1. Interference- It is either proactive where info learned earlier disrupts info learned
later or retroactive which is the opposite.
2. Decay theory- Explained from name

Amnesia- Retrograde: Loss of the past events but not new events, frequently occurring
from head injury
Anterograde: Opposite.