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E. Drugs and Disorders © SPMM Course E. Drugs and Disorders Disorder / drugs Changes Alcohol  Increase SWS (chronic use – loss of SWS)  Reduce initial REM but increase second half REM Alcohol withdrawal  Loss of SWS  Increased REM  Intense REM rebound Anx...

6. Neurophysiological measurements

A. EEG

Wave forms noted in EEG © SPMM Course 6. Neurophysiological measurements A. EEG  EEG records the electrical activity of the brain. In psychiatric practice, it is primarily used to rule out seizures, monitor ECT and in polysomnogram for sleep disorders.  Stan...

Abnormalities in EEG © SPMM Course Abnormalities in EEG EEG in various disorders Absence seizures (petit-mal) Regular 3 Hz Complexes Alzheimer’s dementia Rarely normal in advanced dementia; may be helpful in differentiating pseudodementia from dementia Angelma...

Effect of drugs on EEG

B. MEG

C. ERP © SPMM Course  Diffuse slowing of background is the most common EEG abnormality; it is nonspecific and signifies the presence of encephalopathy. Focal slowing suggests local mass lesions; e.g. edema, haematoma or focal seizure.  Epileptiform discharge...

1. Synaptic transmission © SPMM Course Synaptic transmission  The presynaptic neuron synthesises, transports and stores the chemical messenger (neurotransmitter). Synthesis takes place in cell body / soma which contains the essential protein synthesis machin...

2. Classification of receptors © SPMM Course 2. Classification of receptors Receptors may be categorized into three categories: (1) Ligand-gated channels (ionotropic), in which binding of a chemical messenger alters the probability of opening of transmembrane ...

3. Dopamine © SPMM Course 3. Dopamine •tyrosine l-dopa  dopamine Source Source •tyrosine hydroxylase Rate limiting step Rate limiting step •Monoamine oxidase (MAO) & Catechol-o-methyl transferase (COMT). •MAO-A more selectively metabolizes norepinephrine and...

4. Noradrenaline © SPMM Course 4. Noradrenaline •tyrosine l-dopa dopamine  norepinephrine  epinephrine Source Source •tyrosine hydroxylase Rate limiting step Rate limiting step •dopamine-b-hydroxylase modulates norepinephrine production; phenylethanolamine...

5. Serotonin © SPMM Course 5. Serotonin •tryptophan5 hydroxy l-tryptophan  serotonin Source Source •availability of tryptophan (hence it is possible to conduct tryptophan depletion studies and manipulate 5HT system) Rate limiting step Rate limiting step •try...

6. Acetylcholine © SPMM Course 6. Acetylcholine •choline and acetyl-coenzyme A Source Source •availability of choline Rate limiting step Rate limiting step •choline acetyltransferase Synthetic enzymes Synthetic enzymes •acetylcholinesterase – rapid metabolism ...

7. GABA © SPMM Course 7. GABA •Glutamic acid (glutamate) Source Source •glutamic acid decarboxylase (GAD) catalysis Rate limiting step Rate limiting step •glutamic acid decarboxylase (GAD) Synthetic enzymes Synthetic enzymes •GABA transaminase Breakdown enzyme...

8. Glutamate © SPMM Course 8. Glutamate •1. from 2-oxoglutarate and aspartate by aspartate aminotransferase, •2. from glutamine by glutaminase, or •3. from 2-oxoglutarate by ornithine aminotransferase Source Source •accumulation of precursors such as glutamine...

9. Glycine

10. Endocannabinoids