SlideShare a Scribd company logo

Neurobiology and functional brain circuits in mood disorders

Neurobiology of mood disorders

1 of 55
Download to read offline
Mood disorders
Neurobiology & functional brain circuits
Resource Person: Dr. Devrat Joshi
Presenter: Dr. Suman Prasad Adhikari
2nd year Resident
Department of Psychiatry
NAMS
Biological considerations
• Biological abnormalities are
reported in patients with mood
disorders
• May be of developmental in
origin
• Episodes may produce
neurobiological effects of
scarring---worsening subsequent
prognosis.
Martinowich et al, J Clin Invest, 2009; 119: 726-736.
Monoamine systems
Monoamine systems
SEROTONIN
Learning, reinforcement
Hedonic capacity
Motivation, concentration
Goal directed activity
Regulation of appetite,
body T, libido, metabolism
Regulation of Circadian
rhythm, sleep
Emotional memory
Behavioral sensitization to stress
MFB
Goal directed & reward seeking
NOR ADRENALINE
Interactwithsympatheticnervoussystemandadrenalmedulla
Hypothalamus
Nor epinephrine regulation of serotonin
Regulates serotonin by acting as a brake on serotonin release at alpha 2
receptors on axon terminals and as an accelerator of serotonin release at
alpha 1 receptors at the somatodendritic area
5HT2A

Recommended

Neuropsychiatric aspects of Cerebrovascular Disorders
Neuropsychiatric aspects of Cerebrovascular DisordersNeuropsychiatric aspects of Cerebrovascular Disorders
Neuropsychiatric aspects of Cerebrovascular DisordersDr. Subhendu Sekhar Dhar
 
The neurobiology and pharmacotherapy of bipolar
The neurobiology and pharmacotherapy of bipolarThe neurobiology and pharmacotherapy of bipolar
The neurobiology and pharmacotherapy of bipolarNick Stafford
 
Neurobiology of substance dependence
Neurobiology of substance dependenceNeurobiology of substance dependence
Neurobiology of substance dependenceDr. Sunil Suthar
 
Neurobiology of Schizophrenia
Neurobiology of SchizophreniaNeurobiology of Schizophrenia
Neurobiology of SchizophreniaEnoch R G
 
Psychiatric aspects of basal ganglion
Psychiatric aspects of basal ganglionPsychiatric aspects of basal ganglion
Psychiatric aspects of basal ganglionDr. Amit Chougule
 
Treatment resistant schizophrenia
Treatment resistant schizophreniaTreatment resistant schizophrenia
Treatment resistant schizophreniaGAURAVUPPAL23
 
Neurobiology of addiction
Neurobiology of addictionNeurobiology of addiction
Neurobiology of addictionVln Sekhar
 

More Related Content

What's hot

Indian research in schizophrenia
Indian research in schizophrenia Indian research in schizophrenia
Indian research in schizophrenia Sujit Kumar Kar
 
Attenuated psychosis syndrome, at risk mental state and ultra high risk
Attenuated psychosis syndrome, at risk mental state and ultra high riskAttenuated psychosis syndrome, at risk mental state and ultra high risk
Attenuated psychosis syndrome, at risk mental state and ultra high riskDr. Sriram Raghavendran
 
Neurobiology of OCD
Neurobiology of OCDNeurobiology of OCD
Neurobiology of OCDCijo Alex
 
TREATMENT RESISTANT DEPRESSION
TREATMENT RESISTANT DEPRESSIONTREATMENT RESISTANT DEPRESSION
TREATMENT RESISTANT DEPRESSIONMalathesh BC
 
Neurobiology of depression
Neurobiology of depressionNeurobiology of depression
Neurobiology of depressionSameeksha Das
 
Neuropsychiatric sequelae of stroke
Neuropsychiatric sequelae of strokeNeuropsychiatric sequelae of stroke
Neuropsychiatric sequelae of strokeDr. Sunil Suthar
 
Addiction circuitry in human brain
Addiction circuitry in human brainAddiction circuitry in human brain
Addiction circuitry in human brainkaushiktheone
 
Treatment resistant schizophrenia
Treatment resistant schizophreniaTreatment resistant schizophrenia
Treatment resistant schizophreniaTejaswi Tp
 
Metabolic side effects of drugs in Psychiatry
Metabolic side effects of drugs in PsychiatryMetabolic side effects of drugs in Psychiatry
Metabolic side effects of drugs in PsychiatryDr. Sriram Raghavendran
 
Neuropsychiatric Symptoms of Parkinson Disease
Neuropsychiatric Symptoms of Parkinson Disease Neuropsychiatric Symptoms of Parkinson Disease
Neuropsychiatric Symptoms of Parkinson Disease Ade Wijaya
 
Rapid cycling bipolar disorder
Rapid cycling bipolar disorderRapid cycling bipolar disorder
Rapid cycling bipolar disorderRajeev Ranjan Raj
 
Neurobiological understanding of anxiety disorder
Neurobiological understanding of anxiety disorder  Neurobiological understanding of anxiety disorder
Neurobiological understanding of anxiety disorder Devashish Konar
 
Neuropsychiatric aspects of cerebrovascular disease
Neuropsychiatric aspects of cerebrovascular diseaseNeuropsychiatric aspects of cerebrovascular disease
Neuropsychiatric aspects of cerebrovascular diseaseRAMASHANKAR MADDESHIYA
 
Temporal lobe and its role in psychiatry
Temporal  lobe  and  its  role  in  psychiatryTemporal  lobe  and  its  role  in  psychiatry
Temporal lobe and its role in psychiatryDr Kaushik Nandy
 
Treatment resistant schizophrenia & Treatment resistant depression
Treatment resistant schizophrenia & Treatment resistant depressionTreatment resistant schizophrenia & Treatment resistant depression
Treatment resistant schizophrenia & Treatment resistant depressionEnoch R G
 
Frontal lobe and its functions
Frontal lobe and its functionsFrontal lobe and its functions
Frontal lobe and its functionsdrnaveent
 

What's hot (20)

Indian research in schizophrenia
Indian research in schizophrenia Indian research in schizophrenia
Indian research in schizophrenia
 
Neurobiology, Diagnosis & Treatment of PTSD & TBI in Veterans
Neurobiology, Diagnosis & Treatment of PTSD & TBI in VeteransNeurobiology, Diagnosis & Treatment of PTSD & TBI in Veterans
Neurobiology, Diagnosis & Treatment of PTSD & TBI in Veterans
 
Attenuated psychosis syndrome, at risk mental state and ultra high risk
Attenuated psychosis syndrome, at risk mental state and ultra high riskAttenuated psychosis syndrome, at risk mental state and ultra high risk
Attenuated psychosis syndrome, at risk mental state and ultra high risk
 
Glutamate and psychiatry
Glutamate and psychiatryGlutamate and psychiatry
Glutamate and psychiatry
 
Neurobiology of OCD
Neurobiology of OCDNeurobiology of OCD
Neurobiology of OCD
 
TREATMENT RESISTANT DEPRESSION
TREATMENT RESISTANT DEPRESSIONTREATMENT RESISTANT DEPRESSION
TREATMENT RESISTANT DEPRESSION
 
Neurobiology of depression
Neurobiology of depressionNeurobiology of depression
Neurobiology of depression
 
Neuropsychiatric sequelae of stroke
Neuropsychiatric sequelae of strokeNeuropsychiatric sequelae of stroke
Neuropsychiatric sequelae of stroke
 
Rewardsystem
RewardsystemRewardsystem
Rewardsystem
 
Addiction circuitry in human brain
Addiction circuitry in human brainAddiction circuitry in human brain
Addiction circuitry in human brain
 
Treatment resistant schizophrenia
Treatment resistant schizophreniaTreatment resistant schizophrenia
Treatment resistant schizophrenia
 
Metabolic side effects of drugs in Psychiatry
Metabolic side effects of drugs in PsychiatryMetabolic side effects of drugs in Psychiatry
Metabolic side effects of drugs in Psychiatry
 
Neuropsychiatric Symptoms of Parkinson Disease
Neuropsychiatric Symptoms of Parkinson Disease Neuropsychiatric Symptoms of Parkinson Disease
Neuropsychiatric Symptoms of Parkinson Disease
 
Rapid cycling bipolar disorder
Rapid cycling bipolar disorderRapid cycling bipolar disorder
Rapid cycling bipolar disorder
 
Neurobiological understanding of anxiety disorder
Neurobiological understanding of anxiety disorder  Neurobiological understanding of anxiety disorder
Neurobiological understanding of anxiety disorder
 
Schizophrenia outcome
Schizophrenia outcomeSchizophrenia outcome
Schizophrenia outcome
 
Neuropsychiatric aspects of cerebrovascular disease
Neuropsychiatric aspects of cerebrovascular diseaseNeuropsychiatric aspects of cerebrovascular disease
Neuropsychiatric aspects of cerebrovascular disease
 
Temporal lobe and its role in psychiatry
Temporal  lobe  and  its  role  in  psychiatryTemporal  lobe  and  its  role  in  psychiatry
Temporal lobe and its role in psychiatry
 
Treatment resistant schizophrenia & Treatment resistant depression
Treatment resistant schizophrenia & Treatment resistant depressionTreatment resistant schizophrenia & Treatment resistant depression
Treatment resistant schizophrenia & Treatment resistant depression
 
Frontal lobe and its functions
Frontal lobe and its functionsFrontal lobe and its functions
Frontal lobe and its functions
 

Viewers also liked

Role of Brain Derived Neurotrophic Factor (BDNF) in NEURODEVELOPMENT
Role of Brain Derived Neurotrophic Factor (BDNF) in NEURODEVELOPMENTRole of Brain Derived Neurotrophic Factor (BDNF) in NEURODEVELOPMENT
Role of Brain Derived Neurotrophic Factor (BDNF) in NEURODEVELOPMENTWasiu Adeseji
 
Etiology of mood disorder by swapnil agrawal
Etiology of mood disorder by swapnil agrawalEtiology of mood disorder by swapnil agrawal
Etiology of mood disorder by swapnil agrawalSwapnil Agrawal
 
From Concerns to Conditions 013 print_edition- jom and jaruwan
From Concerns to Conditions 013 print_edition- jom and jaruwanFrom Concerns to Conditions 013 print_edition- jom and jaruwan
From Concerns to Conditions 013 print_edition- jom and jaruwanatocmarketing
 
Prefrontal cortex
Prefrontal cortexPrefrontal cortex
Prefrontal cortex15michellem
 
The prefrontal cortex
The prefrontal cortexThe prefrontal cortex
The prefrontal cortexMatt Roberts
 
Anatomy And Connections Of Prefrontal Cortex
Anatomy And Connections Of Prefrontal CortexAnatomy And Connections Of Prefrontal Cortex
Anatomy And Connections Of Prefrontal Cortexfarhoudif
 
Bipolar Disorder Psych Pp
Bipolar Disorder Psych PpBipolar Disorder Psych Pp
Bipolar Disorder Psych Ppovrickalex
 
The prefrontal cortex: What is it? Its functions, Its dysfunctions and some e...
The prefrontal cortex: What is it? Its functions, Its dysfunctions and some e...The prefrontal cortex: What is it? Its functions, Its dysfunctions and some e...
The prefrontal cortex: What is it? Its functions, Its dysfunctions and some e...hermosadory
 
Informative speech schizophrenia powerpoint speech
Informative speech schizophrenia powerpoint speechInformative speech schizophrenia powerpoint speech
Informative speech schizophrenia powerpoint speechgiselleacc
 
Dissociative disorders 1
Dissociative disorders 1Dissociative disorders 1
Dissociative disorders 1sadaf89
 
Opioid pharmacology an overview with emphasis on clinical relevance
Opioid pharmacology an overview with emphasis on clinical relevanceOpioid pharmacology an overview with emphasis on clinical relevance
Opioid pharmacology an overview with emphasis on clinical relevancemailrishigupta
 
Alternative Therapy Treatments for Depression and Anxiety
Alternative Therapy Treatments for Depression and AnxietyAlternative Therapy Treatments for Depression and Anxiety
Alternative Therapy Treatments for Depression and AnxietyMidtown TMS Treatment Center
 
Frontal lobe 2010
Frontal lobe 2010Frontal lobe 2010
Frontal lobe 2010PS Deb
 
Wwi,Wwii, Nationalism
Wwi,Wwii, NationalismWwi,Wwii, Nationalism
Wwi,Wwii, NationalismGreg Sill
 
Biology of schizophrenia
Biology of schizophreniaBiology of schizophrenia
Biology of schizophreniaHani Hamed
 

Viewers also liked (20)

Antidepressants Update
Antidepressants UpdateAntidepressants Update
Antidepressants Update
 
Role of Brain Derived Neurotrophic Factor (BDNF) in NEURODEVELOPMENT
Role of Brain Derived Neurotrophic Factor (BDNF) in NEURODEVELOPMENTRole of Brain Derived Neurotrophic Factor (BDNF) in NEURODEVELOPMENT
Role of Brain Derived Neurotrophic Factor (BDNF) in NEURODEVELOPMENT
 
Etiology of mood disorder by swapnil agrawal
Etiology of mood disorder by swapnil agrawalEtiology of mood disorder by swapnil agrawal
Etiology of mood disorder by swapnil agrawal
 
Depression
DepressionDepression
Depression
 
From Concerns to Conditions 013 print_edition- jom and jaruwan
From Concerns to Conditions 013 print_edition- jom and jaruwanFrom Concerns to Conditions 013 print_edition- jom and jaruwan
From Concerns to Conditions 013 print_edition- jom and jaruwan
 
Prefrontal cortex
Prefrontal cortexPrefrontal cortex
Prefrontal cortex
 
The prefrontal cortex
The prefrontal cortexThe prefrontal cortex
The prefrontal cortex
 
BDNF 2009
BDNF 2009BDNF 2009
BDNF 2009
 
Anatomy And Connections Of Prefrontal Cortex
Anatomy And Connections Of Prefrontal CortexAnatomy And Connections Of Prefrontal Cortex
Anatomy And Connections Of Prefrontal Cortex
 
Bipolar Disorder Psych Pp
Bipolar Disorder Psych PpBipolar Disorder Psych Pp
Bipolar Disorder Psych Pp
 
The prefrontal cortex: What is it? Its functions, Its dysfunctions and some e...
The prefrontal cortex: What is it? Its functions, Its dysfunctions and some e...The prefrontal cortex: What is it? Its functions, Its dysfunctions and some e...
The prefrontal cortex: What is it? Its functions, Its dysfunctions and some e...
 
Prefrontal Cortex
Prefrontal CortexPrefrontal Cortex
Prefrontal Cortex
 
Informative speech schizophrenia powerpoint speech
Informative speech schizophrenia powerpoint speechInformative speech schizophrenia powerpoint speech
Informative speech schizophrenia powerpoint speech
 
Dissociative disorders 1
Dissociative disorders 1Dissociative disorders 1
Dissociative disorders 1
 
Opioid pharmacology an overview with emphasis on clinical relevance
Opioid pharmacology an overview with emphasis on clinical relevanceOpioid pharmacology an overview with emphasis on clinical relevance
Opioid pharmacology an overview with emphasis on clinical relevance
 
Alternative Therapy Treatments for Depression and Anxiety
Alternative Therapy Treatments for Depression and AnxietyAlternative Therapy Treatments for Depression and Anxiety
Alternative Therapy Treatments for Depression and Anxiety
 
Frontal lobe 2010
Frontal lobe 2010Frontal lobe 2010
Frontal lobe 2010
 
Wwi,Wwii, Nationalism
Wwi,Wwii, NationalismWwi,Wwii, Nationalism
Wwi,Wwii, Nationalism
 
Mood disorder dr.saman
Mood disorder dr.samanMood disorder dr.saman
Mood disorder dr.saman
 
Biology of schizophrenia
Biology of schizophreniaBiology of schizophrenia
Biology of schizophrenia
 

Similar to Neurobiology and functional brain circuits in mood disorders

Neurobiology of depression
Neurobiology of depressionNeurobiology of depression
Neurobiology of depressionPriyash Jain
 
Neurobiology of depression
Neurobiology of depressionNeurobiology of depression
Neurobiology of depressionSalman Kareem
 
antidepressant drugs.pdf
antidepressant drugs.pdfantidepressant drugs.pdf
antidepressant drugs.pdfAtiqChohan2
 
Drugs acting on central nervous system introduction.pptx
Drugs acting on central nervous system introduction.pptxDrugs acting on central nervous system introduction.pptx
Drugs acting on central nervous system introduction.pptxsamrawitDemrew
 
DEPRESSION AND ANTI DIPRESSANT DRUG.pptx
DEPRESSION AND ANTI DIPRESSANT DRUG.pptxDEPRESSION AND ANTI DIPRESSANT DRUG.pptx
DEPRESSION AND ANTI DIPRESSANT DRUG.pptxDinamGyatsoAadHenmoo
 
3- Antipsychotic agents.ppt
3- Antipsychotic agents.ppt3- Antipsychotic agents.ppt
3- Antipsychotic agents.pptAshlynnElla3
 
Hanipsych, serotonine and depression
Hanipsych, serotonine and depressionHanipsych, serotonine and depression
Hanipsych, serotonine and depressionHani Hamed
 
Neurochemical basis of mood disorders
Neurochemical basis of mood disordersNeurochemical basis of mood disorders
Neurochemical basis of mood disordersSreedevi Remanan
 
Borderline Personality disorder.pptx
Borderline Personality disorder.pptxBorderline Personality disorder.pptx
Borderline Personality disorder.pptxRobinBaghla
 
NEUROBIOLOGY OF DEPRESSION .pptx
NEUROBIOLOGY OF DEPRESSION  .pptxNEUROBIOLOGY OF DEPRESSION  .pptx
NEUROBIOLOGY OF DEPRESSION .pptxTapendra Satpathy
 
Serotonin pharmacology
Serotonin  pharmacologySerotonin  pharmacology
Serotonin pharmacologyAliLaith5230
 
Neuroleptics & Anxiolytics (Abstract)
Neuroleptics & Anxiolytics (Abstract)Neuroleptics & Anxiolytics (Abstract)
Neuroleptics & Anxiolytics (Abstract)Eneutron
 
Neurobiology of mental disorders
Neurobiology of mental disordersNeurobiology of mental disorders
Neurobiology of mental disordersLeeshma Punnath
 
Hanipsych, updates on neurobiology and neurotoxicity of depression
Hanipsych, updates on neurobiology and neurotoxicity of depressionHanipsych, updates on neurobiology and neurotoxicity of depression
Hanipsych, updates on neurobiology and neurotoxicity of depressionHani Hamed
 
Antidepressant pharmacology
Antidepressant pharmacology Antidepressant pharmacology
Antidepressant pharmacology Ahmed Morgan
 
Anti depressant , antidepressant
Anti depressant , antidepressantAnti depressant , antidepressant
Anti depressant , antidepressantRavish Yadav
 

Similar to Neurobiology and functional brain circuits in mood disorders (20)

Neurobiology of depression
Neurobiology of depressionNeurobiology of depression
Neurobiology of depression
 
Neurobiology of depression
Neurobiology of depressionNeurobiology of depression
Neurobiology of depression
 
antidepressant drugs.pdf
antidepressant drugs.pdfantidepressant drugs.pdf
antidepressant drugs.pdf
 
Drugs acting on central nervous system introduction.pptx
Drugs acting on central nervous system introduction.pptxDrugs acting on central nervous system introduction.pptx
Drugs acting on central nervous system introduction.pptx
 
HPA axis
HPA axis HPA axis
HPA axis
 
DEPRESSION AND ANTI DIPRESSANT DRUG.pptx
DEPRESSION AND ANTI DIPRESSANT DRUG.pptxDEPRESSION AND ANTI DIPRESSANT DRUG.pptx
DEPRESSION AND ANTI DIPRESSANT DRUG.pptx
 
3- Antipsychotic agents.ppt
3- Antipsychotic agents.ppt3- Antipsychotic agents.ppt
3- Antipsychotic agents.ppt
 
Hanipsych, serotonine and depression
Hanipsych, serotonine and depressionHanipsych, serotonine and depression
Hanipsych, serotonine and depression
 
Neurochemical basis of mood disorders
Neurochemical basis of mood disordersNeurochemical basis of mood disorders
Neurochemical basis of mood disorders
 
Borderline Personality disorder.pptx
Borderline Personality disorder.pptxBorderline Personality disorder.pptx
Borderline Personality disorder.pptx
 
NEUROBIOLOGY OF DEPRESSION .pptx
NEUROBIOLOGY OF DEPRESSION  .pptxNEUROBIOLOGY OF DEPRESSION  .pptx
NEUROBIOLOGY OF DEPRESSION .pptx
 
Antipsychotics
AntipsychoticsAntipsychotics
Antipsychotics
 
Serotonin pharmacology
Serotonin  pharmacologySerotonin  pharmacology
Serotonin pharmacology
 
Anti depression
Anti depressionAnti depression
Anti depression
 
Neuroleptics & Anxiolytics (Abstract)
Neuroleptics & Anxiolytics (Abstract)Neuroleptics & Anxiolytics (Abstract)
Neuroleptics & Anxiolytics (Abstract)
 
Lect. 5 Psychoses and Antipsychotic Agents
Lect. 5 Psychoses and Antipsychotic AgentsLect. 5 Psychoses and Antipsychotic Agents
Lect. 5 Psychoses and Antipsychotic Agents
 
Neurobiology of mental disorders
Neurobiology of mental disordersNeurobiology of mental disorders
Neurobiology of mental disorders
 
Hanipsych, updates on neurobiology and neurotoxicity of depression
Hanipsych, updates on neurobiology and neurotoxicity of depressionHanipsych, updates on neurobiology and neurotoxicity of depression
Hanipsych, updates on neurobiology and neurotoxicity of depression
 
Antidepressant pharmacology
Antidepressant pharmacology Antidepressant pharmacology
Antidepressant pharmacology
 
Anti depressant , antidepressant
Anti depressant , antidepressantAnti depressant , antidepressant
Anti depressant , antidepressant
 

Recently uploaded

Staphylococcus.ppt.........ali.rasool.badr
Staphylococcus.ppt.........ali.rasool.badrStaphylococcus.ppt.........ali.rasool.badr
Staphylococcus.ppt.........ali.rasool.badrssuser06f49d
 
PAEDIATRICS RHEMATOLOGY PROTOCOLS SHEET FOR PEDIATRICS ORTHOPAEDICS
PAEDIATRICS RHEMATOLOGY PROTOCOLS SHEET FOR PEDIATRICS ORTHOPAEDICSPAEDIATRICS RHEMATOLOGY PROTOCOLS SHEET FOR PEDIATRICS ORTHOPAEDICS
PAEDIATRICS RHEMATOLOGY PROTOCOLS SHEET FOR PEDIATRICS ORTHOPAEDICSDr.Shrikrushna Sobaji
 
Psychedelic Treatment Planning: Opportunities in Integrated Care
Psychedelic Treatment Planning: Opportunities in Integrated CarePsychedelic Treatment Planning: Opportunities in Integrated Care
Psychedelic Treatment Planning: Opportunities in Integrated CareBrian Peacock
 
INFECTIVE ENDOCARDITIS-BLOOD CULTURE NEG
INFECTIVE ENDOCARDITIS-BLOOD CULTURE NEGINFECTIVE ENDOCARDITIS-BLOOD CULTURE NEG
INFECTIVE ENDOCARDITIS-BLOOD CULTURE NEGJuliethKabirigi1
 
Ways to Manage Ovarian Cancer Treatment Side Effects
Ways to Manage Ovarian Cancer Treatment Side EffectsWays to Manage Ovarian Cancer Treatment Side Effects
Ways to Manage Ovarian Cancer Treatment Side Effectsbkling
 
Vertigo and Nystagmus - Clinical approach part-2.pptx
Vertigo and Nystagmus - Clinical approach part-2.pptxVertigo and Nystagmus - Clinical approach part-2.pptx
Vertigo and Nystagmus - Clinical approach part-2.pptxYasser Alzainy
 
Fetal and Neonatal Physiology - Dr Faiza.pdf
Fetal and Neonatal Physiology - Dr Faiza.pdfFetal and Neonatal Physiology - Dr Faiza.pdf
Fetal and Neonatal Physiology - Dr Faiza.pdfMedicoseAcademics
 
Typhoid.pptx Department of Physiotherapy, SHUATS, Prayagraj
Typhoid.pptx Department of Physiotherapy, SHUATS, PrayagrajTyphoid.pptx Department of Physiotherapy, SHUATS, Prayagraj
Typhoid.pptx Department of Physiotherapy, SHUATS, PrayagrajSurabhi Srivastava
 
Radicular cyst or periapical odontogenic cyst
Radicular cyst or periapical odontogenic cystRadicular cyst or periapical odontogenic cyst
Radicular cyst or periapical odontogenic cystJani253068
 
Physiology of Pituitary gland and its hormones -3.pptx
Physiology of Pituitary gland and its hormones -3.pptxPhysiology of Pituitary gland and its hormones -3.pptx
Physiology of Pituitary gland and its hormones -3.pptxSai Sailesh Kumar Goothy
 
Shodhanagha snehapana.pptx Dr Akshay Shetty
Shodhanagha snehapana.pptx Dr Akshay ShettyShodhanagha snehapana.pptx Dr Akshay Shetty
Shodhanagha snehapana.pptx Dr Akshay ShettyAkshay Shetty
 
Introduction to anatomy and physioligy.pptx
Introduction to anatomy and physioligy.pptxIntroduction to anatomy and physioligy.pptx
Introduction to anatomy and physioligy.pptxMarbahunJalaKharbhih
 
Analyzing Performance of the Twist Exome with CNV Backbone at Various Probe D...
Analyzing Performance of the Twist Exome with CNV Backbone at Various Probe D...Analyzing Performance of the Twist Exome with CNV Backbone at Various Probe D...
Analyzing Performance of the Twist Exome with CNV Backbone at Various Probe D...Golden Helix
 
Hydrocele and tumors of testis Introduction.pptx
Hydrocele and tumors of testis Introduction.pptxHydrocele and tumors of testis Introduction.pptx
Hydrocele and tumors of testis Introduction.pptxSizan Thapa
 
Malaria Disease.pptx Department of Physiotherapy, SHUATS, Prayagraj
Malaria Disease.pptx Department of Physiotherapy, SHUATS, PrayagrajMalaria Disease.pptx Department of Physiotherapy, SHUATS, Prayagraj
Malaria Disease.pptx Department of Physiotherapy, SHUATS, PrayagrajSurabhi Srivastava
 
Physiology of Growth hormone and applied aspects 4.pptx
Physiology of Growth hormone and applied aspects 4.pptxPhysiology of Growth hormone and applied aspects 4.pptx
Physiology of Growth hormone and applied aspects 4.pptxSai Sailesh Kumar Goothy
 
PTERYGIUM ,clinical picture and its management.pptx
PTERYGIUM ,clinical picture and its management.pptxPTERYGIUM ,clinical picture and its management.pptx
PTERYGIUM ,clinical picture and its management.pptxvideosfildr
 
Ascariasis.pptx Department of Physiotherapy, SHUATS, Prayagraj
Ascariasis.pptx Department of Physiotherapy, SHUATS, PrayagrajAscariasis.pptx Department of Physiotherapy, SHUATS, Prayagraj
Ascariasis.pptx Department of Physiotherapy, SHUATS, PrayagrajSurabhi Srivastava
 
Yantropakaranani 2: Heating Devices used in Ayurveda
Yantropakaranani 2: Heating Devices used in AyurvedaYantropakaranani 2: Heating Devices used in Ayurveda
Yantropakaranani 2: Heating Devices used in AyurvedaAparnaNandakumar12
 

Recently uploaded (20)

Staphylococcus.ppt.........ali.rasool.badr
Staphylococcus.ppt.........ali.rasool.badrStaphylococcus.ppt.........ali.rasool.badr
Staphylococcus.ppt.........ali.rasool.badr
 
PAEDIATRICS RHEMATOLOGY PROTOCOLS SHEET FOR PEDIATRICS ORTHOPAEDICS
PAEDIATRICS RHEMATOLOGY PROTOCOLS SHEET FOR PEDIATRICS ORTHOPAEDICSPAEDIATRICS RHEMATOLOGY PROTOCOLS SHEET FOR PEDIATRICS ORTHOPAEDICS
PAEDIATRICS RHEMATOLOGY PROTOCOLS SHEET FOR PEDIATRICS ORTHOPAEDICS
 
Psychedelic Treatment Planning: Opportunities in Integrated Care
Psychedelic Treatment Planning: Opportunities in Integrated CarePsychedelic Treatment Planning: Opportunities in Integrated Care
Psychedelic Treatment Planning: Opportunities in Integrated Care
 
INFECTIVE ENDOCARDITIS-BLOOD CULTURE NEG
INFECTIVE ENDOCARDITIS-BLOOD CULTURE NEGINFECTIVE ENDOCARDITIS-BLOOD CULTURE NEG
INFECTIVE ENDOCARDITIS-BLOOD CULTURE NEG
 
Ways to Manage Ovarian Cancer Treatment Side Effects
Ways to Manage Ovarian Cancer Treatment Side EffectsWays to Manage Ovarian Cancer Treatment Side Effects
Ways to Manage Ovarian Cancer Treatment Side Effects
 
Vertigo and Nystagmus - Clinical approach part-2.pptx
Vertigo and Nystagmus - Clinical approach part-2.pptxVertigo and Nystagmus - Clinical approach part-2.pptx
Vertigo and Nystagmus - Clinical approach part-2.pptx
 
Fetal and Neonatal Physiology - Dr Faiza.pdf
Fetal and Neonatal Physiology - Dr Faiza.pdfFetal and Neonatal Physiology - Dr Faiza.pdf
Fetal and Neonatal Physiology - Dr Faiza.pdf
 
Typhoid.pptx Department of Physiotherapy, SHUATS, Prayagraj
Typhoid.pptx Department of Physiotherapy, SHUATS, PrayagrajTyphoid.pptx Department of Physiotherapy, SHUATS, Prayagraj
Typhoid.pptx Department of Physiotherapy, SHUATS, Prayagraj
 
Radicular cyst or periapical odontogenic cyst
Radicular cyst or periapical odontogenic cystRadicular cyst or periapical odontogenic cyst
Radicular cyst or periapical odontogenic cyst
 
Physiology of Pituitary gland and its hormones -3.pptx
Physiology of Pituitary gland and its hormones -3.pptxPhysiology of Pituitary gland and its hormones -3.pptx
Physiology of Pituitary gland and its hormones -3.pptx
 
Shodhanagha snehapana.pptx Dr Akshay Shetty
Shodhanagha snehapana.pptx Dr Akshay ShettyShodhanagha snehapana.pptx Dr Akshay Shetty
Shodhanagha snehapana.pptx Dr Akshay Shetty
 
Introduction to anatomy and physioligy.pptx
Introduction to anatomy and physioligy.pptxIntroduction to anatomy and physioligy.pptx
Introduction to anatomy and physioligy.pptx
 
Analyzing Performance of the Twist Exome with CNV Backbone at Various Probe D...
Analyzing Performance of the Twist Exome with CNV Backbone at Various Probe D...Analyzing Performance of the Twist Exome with CNV Backbone at Various Probe D...
Analyzing Performance of the Twist Exome with CNV Backbone at Various Probe D...
 
Hydrocele and tumors of testis Introduction.pptx
Hydrocele and tumors of testis Introduction.pptxHydrocele and tumors of testis Introduction.pptx
Hydrocele and tumors of testis Introduction.pptx
 
Malaria Disease.pptx Department of Physiotherapy, SHUATS, Prayagraj
Malaria Disease.pptx Department of Physiotherapy, SHUATS, PrayagrajMalaria Disease.pptx Department of Physiotherapy, SHUATS, Prayagraj
Malaria Disease.pptx Department of Physiotherapy, SHUATS, Prayagraj
 
A case of Trichobezoar in a teenage female
A case of Trichobezoar in a teenage femaleA case of Trichobezoar in a teenage female
A case of Trichobezoar in a teenage female
 
Physiology of Growth hormone and applied aspects 4.pptx
Physiology of Growth hormone and applied aspects 4.pptxPhysiology of Growth hormone and applied aspects 4.pptx
Physiology of Growth hormone and applied aspects 4.pptx
 
PTERYGIUM ,clinical picture and its management.pptx
PTERYGIUM ,clinical picture and its management.pptxPTERYGIUM ,clinical picture and its management.pptx
PTERYGIUM ,clinical picture and its management.pptx
 
Ascariasis.pptx Department of Physiotherapy, SHUATS, Prayagraj
Ascariasis.pptx Department of Physiotherapy, SHUATS, PrayagrajAscariasis.pptx Department of Physiotherapy, SHUATS, Prayagraj
Ascariasis.pptx Department of Physiotherapy, SHUATS, Prayagraj
 
Yantropakaranani 2: Heating Devices used in Ayurveda
Yantropakaranani 2: Heating Devices used in AyurvedaYantropakaranani 2: Heating Devices used in Ayurveda
Yantropakaranani 2: Heating Devices used in Ayurveda
 

Neurobiology and functional brain circuits in mood disorders

  • 1. Mood disorders Neurobiology & functional brain circuits Resource Person: Dr. Devrat Joshi Presenter: Dr. Suman Prasad Adhikari 2nd year Resident Department of Psychiatry NAMS
  • 2. Biological considerations • Biological abnormalities are reported in patients with mood disorders • May be of developmental in origin • Episodes may produce neurobiological effects of scarring---worsening subsequent prognosis.
  • 3. Martinowich et al, J Clin Invest, 2009; 119: 726-736. Monoamine systems
  • 4. Monoamine systems SEROTONIN Learning, reinforcement Hedonic capacity Motivation, concentration Goal directed activity Regulation of appetite, body T, libido, metabolism Regulation of Circadian rhythm, sleep
  • 5. Emotional memory Behavioral sensitization to stress MFB Goal directed & reward seeking NOR ADRENALINE Interactwithsympatheticnervoussystemandadrenalmedulla Hypothalamus
  • 6. Nor epinephrine regulation of serotonin Regulates serotonin by acting as a brake on serotonin release at alpha 2 receptors on axon terminals and as an accelerator of serotonin release at alpha 1 receptors at the somatodendritic area 5HT2A
  • 7. Classic monoamine hypothesis of depression The monoamine hypothesis of depression states that if the "normal" amount of monoamine neurotransmitter activity becomes reduced, depleted, or dysfunctional for some reason, depression may ensue Deficient monoamine--> depression
  • 8. Monoamine receptor hypothesis of depression Extends the classic monoamine hypothesis of depression, stating that deficient activity of monoamine neurotransmitters causes up regulation of postsynaptic monoamine neurotransmitter receptors, and that this leads to depression
  • 9. Monoamine system Changes in depression Serotonin Decrease in 5-HT1A receptor binding throughout cortical and subcortical regions Reduction in 5-HT reuptake sites 5-HT mediated endocrine responses blunted Nor epinephrine Decreased MFB neurotransmission Leading to: anergia, anhedonia, and diminished libido Dopamine Hypoactive D1 receptor Increased binding of D2/D3 receptors in striatal regions Consistently low CSF level of homovanilic acid(HVA)
  • 12. acetylcholine • Cholinergic neurons have reciprocal relationship with all 3 monoamine systems • Abnormal levels of choline, found in autopsy of brain of some depressed patients • Cholinergic agonist can exacerbate symptoms in depression and reduce symptoms in mania
  • 13. Other neurotransmitters • GABA have inhibitory effect on ascending monoamine pathways • Reductions in GABA observed in plasma, CSF and brain areas in depression • GABA receptors up regulated by antidepressants • Some GABAergic medications have weak antidepressant effects • Excess glutamate- neurotoxic effects • Drugs antagonizing NMDA receptors (ketamine) may have antidepressant effects • Abnormalities in G-protein signalling/ second messenger system dysregulation
  • 14. Endocrine systems • HPA Activity • Thyroid Axis Activity • Growth Hormone • Prolactin
  • 15. Decreased inhibitory 5-HT tone Increased drive from NE, ACh or CRH Decreased feedback inhibition from the hippocampus Hypercortisolemia HPA activity Elevated HPA activity as stress responses has clearest links between depression and biology of chronic stress Alterednegativefeedback
  • 16. PATHOPHYSIOLOGICAL BASIS OF MOOD DISORDERS --2006 Elsevier Glucocorticoid receptor theory of mood disorders Increases LC activity Decreased BDNF
  • 18. HPA activity is found to be increased apparently in 20 to 40% of depressed outpatients and 40 to 60% of inpatients Laboratory evidence: • Administration of dexamethasone (0.5 to 2.0 mg) : non suppression of cortisol secretion at 8:00 AM the following morning or is -indicative of impaired feedback inhibition • Non suppression may implicate a loss of inhibitory hippocampal glucocorticoid receptors more than increased CRH drive
  • 20. Thyroid axis activity • 5 to 10% depressed patients have previously undetected hypothyroidism • Reflected by :  low levels of circulating thyroid hormone,  elevated basal TSH level,  increased TSH response to TRH • Often associated with elevated anti- thyroid antibody levels • 20 to 30% of depressed patients have blunted TSH response to TRH challenge • Blunted TSH response is evidence of an increased risk of relapse • blunted TSH response to TRH does not normalize with effective treatment
  • 21. Other hormones Growth hormone Characteristic secretory surge during the first few hours of sleep Blunted GH response to Clonidine, an α2-receptor agonist Blunted response to nonselective adrenergic agonists (Desipramine) Decreased CSF somatostatin levels Prolactin Blunted prolactin response to various 5-HT agonists
  • 22. Decreased lymphocyte proliferation in response to mitogens Decreased natural cell killer activity Increased positive acute phase reactants Increased cytokines levels(IL-1,IL-6) Immune system
  • 23. Impaired sleep continuity and duration Decreased stage 3 and 4 sleep Decreased REM latency Increased proportion of REM sleep in the early part of the night Sleep changes Decreased REM latency may persist in recovered depressed patients and indicate a vulnerability to relapse
  • 24. OFC Brain circuits in Mood Disorders DMPFC VMPFC DLPFC
  • 25. Brain circuits in Mood Disorders • Neuroimaging, lesion analysis and post mortem methodologies • Extensive interconnecting neural networks are responsible • Cortical-striatal-limbic circuits Dorsomedial/DL Prefrontal Cortex (DM/DL PFC) (Cognition-decision making, planning) VM PFC (Emotion) OFC (Social)
  • 26. The Dorsal “Cognitive” Circuit • Receives input from DL and DM cortex • DLPFC has top-down inhibitory control over amygdala and other limbic tissue • Hypometabolism of the dorsal PFC in both unipolar and bipolar depression • Global decreases in both GM and WM volume, including areas of the DLPFC
  • 27. Orbital Frontal Circuit • Receives inputs from the OFC • Projects to amygdala, hypothalamus, and brainstem • Integrates limbic data with sensory input and provides early analysis of reward or aversiveness of stimuli • Data then processed by higher-level circuits (MPFC) to guide behavior
  • 28. • Lesions to OFC region manifests as : - depression, - mood instability and - anxiety • Has central role in self-regulation of emotion and social behavior • Elevated metabolic activity or perfusion of the OFC in young to middle- aged Unipolar acutely depressed subjects • Potentially elevated OFC activity and tissue loss is consistent with the operation of an excitotoxic process
  • 29. Ventromedial “Emotion” Circuit • Ventromedial prefrontal (ACC) plays a pivotal role in translating OFC-derived valenced data into behavior • More ventral and caudal to the SGPFC (24/25), BA 32pl is also an integral part of the ventral “emotional” circuit • Right-sided lesions produced anosognosic and manic symptomatology • Emotional distress and depression often associated with left-hemisphere lesions
  • 30. prefrontal cortex inhibits the amygdala The mPFC, OFC, and ACC all inhibit amygdalar activity When these structures are dysregulated, amygdalar activity is less modulated by the prefrontal cortex: anxiety and emotional responses are less controlled; fear may be more easily aroused OFC AC mPFC A
  • 31. OFC AC mPFC A Anticipatory anxiety Fear, panic Sym. Arousal Altered NE, 5-HT, DA, Ach release Increased CRH, cortisol BNST Hypothalamus NB, LC, VTA PAG Amygdala
  • 32. Cortical and limbic connections When prefrontal-striatal-thalamic processing is dysregulated, prefrontal function inhibition of hippocampus/amygdala will be disconnected resulting in: • abnormal function in the mPFC, ACC, and the OFC • autonomic arousal, hypothalamic pituitary axis (HPA) activation OFC AC mPFC GABA excitatory inhibitory Amygdala Hippocampus
  • 33. OFC AC mPFC A Anticipatory anxiety Fear, panic Sym. Arousal Altered NE, 5-HT, DA, Ach release Increased CRH, cortisol BNST Hypothalamus NB, LC, VTA PAG Amygdala Hippocampus
  • 34. Cortical and limbic connections: role of monoamines
  • 35. Dorsomedial/DL Prefrontal Cortex (DM/DL PFC) (Cognition-decision making, planning) VM PFC (Emotion) OFC (Social) Striatum Amygdala Decreased reward/ goal directed behavior Disinhibition of Amygdala Bed nuclei of striae terminalis Hypothalamus Nucleus basalis VTA; LC PAG (Periaqueductal gray) Anticipatory anxiety Increased CRH Increased Cortisol Altered Ach, DA, 5HT, NE release Fear, panic, social isolation Functional hypersensitivity
  • 36. Kindling effect • First discovered in 1967 by a scientist in Nova Scotia, named Graham Goddard – somehow he had created epileptic rats • First applied to Bipolar Disorder by Dr. Robert Post of the NIMH • Like seizures, mood episodes can occur without obvious triggers, and have fairly abrupt beginnings and endings • Initial stress---mood episodes----episodes beget episodes—frequency increases/ worsens
  • 37. DSM-IV symptoms of depression.
  • 38. Matching depression symptoms to circuits Functionality in each brain region is hypothetically associated with a different constellation of symptoms. PFC, prefrontal cortex; BF, basal forebrain; S, striatum; NA, nucleus accumbens; T, thalamus; HY, hypothalamus; A, amygdala; H, hippocampus; NT, brainstem neurotransmitter centers; SC, spinal cord; C,cerebellum.
  • 39. diffuse DA reduction NE dysfunction Diffuse 5-HT reduction NE dysfunction
  • 40. Diffuse DA reduction Diffuse 5-HT reduction NE dysfunction
  • 41. Diffuse DA reduction Diffuse 5-HT reduction NE dysfunction Dysfunction of subcortical circuits Thalamus, BG, striatum
  • 42. Diffuse DA reduction Diffuse 5-HT reduction NE dysfunction Decreased neuro- transmission in MFB
  • 43. Diffuse DA reduction Diffuse 5-HT reduction NE dysfunction
  • 44. Diffuse DA reduction Diffuse 5-HT reduction NE dysfunction
  • 47. Functionality in each brain region may be associated with a different constellation of symptoms. PFC, prefrontal cortex; BF, basal forebrain; S, striatum; NA, nucleus accumbens; T, thalamus; HY, hypothalamus; A, amygdala; H, hippocampus; NT, brainstem neurotransmitter centers; SC, spinal cord; C, cerebellum Matching mania symptoms to circuits.
  • 49. Note:- Grandiosity, Flight of Ideas, Racing thoughts are due to hyperactivity in the nucleus accumbens Regulated by 5HT & DA Risk taking, pressured speech (poor impulse control) due to hyperactivity in OFC,DLPFC,VMPFC Regulated by 5HT, DA & NE
  • 51. uses of Neuroimaging in mood disorders MRI Reduced hippocampal volume in individual with MDD (Average 8% on left, 10% on right)  Reduction in grey matter volume in PFC ventral to genu of corpus callosum Findings remain inconclusive in regard to amygdala (In adults -increased amygdala volume, reverse in children and adolescents) MRS Specific studies suggest that NAA may be reduced in the hippocampus of depressed patients Elevated choline levels in the basal ganglia of mood disorder subjects White mater changes White matter hyperintensities (WMHs), especially of the deep frontal cortex and BG- characteristic of UPD and BD Increased white matter hyperintensities associated with - late onset depressive disorder - greater severity and poorer treatment response - presence of vascular risk factors
  • 52. uses of Neuroimaging in mood disorders Postmortem study of UPD and BD showed volumetric reductions of : - left nucleus accumbens, - bilateral pallidum, and - right putamen Metabolic activity/perfusion elevated in manic or hypomanic as well as depressed samples Enlargement of the BG nuclei - antipsychotic regimens for BD patients Ventricular enlargement (mostly of the third or lateral ventricles) in UPD: In old or chronically depressed samples with late-onset illness Excitotoxic processes operating in medial-temporal or lateral-prefrontal cortical tissue could cause ventricular enlargement Decreased glial cell numbers(ACC) Decreased neuronal size and density(ACC,PFC) Decreased synaptic markers(PFC)
  • 53. Summary • Neuroimaging, lesion analysis, post-mortem analysis, drug analysis support the role of neurobiology and brain circuitry • Neurobiology extends further from neurotransmitters, secondary messengers to the relevant genes • Neurohumoroendocrinal connectivity is being established • Brain areas and circuitry forming reciprocal connectivity of limbic-cortico-striato- pallido-thalamic circuits
  • 55. references  Kaplan and Sadock’s Comprehensive Textbook of Psychiatry, 9th edition  New Oxford Textbook of Psychiatry, 2nd edition  Shorter Oxford Textbook of Psychiatry, 6th edition  Stephan M. Stahl, Essential psychopharmacology; 4th edition  Other Internet sources

Editor's Notes

  1. Cell bodies of all ne neurons lies in locus ceruleus. Cell bodies of 5ht neurons lie in raphe nucleus.
  2. This may explain the MoA if atypical antipsychotics in depression.. 5HT2A inhibit DA release in the PFC. So atypical antipsychotics having full antagonistic activity of 5HT2A receptor will disinhibit DA release so ultimately DA is increased in PFC leading to improvement of negative affect symptoms of depression..!!!
  3. Fatigue MENTAL fatigue—due to deficient NT functioning in PFC  PHYSICAL fatigue—due to deficient NT in rest areas(spinal cord, striatum.nucleus accumbens)