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Lectures Neurological and Psychiatric disorders (minor biomedical topics in healthcare)
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Lecture notes of 106 pages for the course Neurological and Psychiatric disorders at VU
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InhoudBrain imaging ........................................................................................................................................... 2
Depression clinical aspects ...................................................................................................................... 8
Depression: preclinical aspects ............................................................................................................. 11
ADHD ..................................................................................................................................................... 17
Preclinical models of compulsive drug use ........................................................................................... 23
Dementia diagnosis and treatment....................................................................................................... 27
Dementia: preclinical aspects................................................................................................................ 35
Autism spectrum disorder ..................................................................................................................... 41
Obsessive-Compulsive Disorder ............................................................................................................ 45
Multiple sclerosis: an overview of clinical aspects ................................................................................ 54
Pathogenesis of MS ............................................................................................................................... 61
Brain injury rehabilitation & holistic neuropsychological rehabilitation .............................................. 68
Stroke .................................................................................................................................................... 74
Parkinson’s disease: preclinical aspects ................................................................................................ 80
Rehabilitation in Parkinson’s disease .................................................................................................... 87
Parkinson’s disease: clinical aspects ..................................................................................................... 93
Brain tumours ...................................................................................................................................... 103
,Brain imaging
Why use imaging
- Clinic
o Diagnosis and prognosis
o CT, MRI, MRA, MRS, PET, X-ray
- Research
o Improve diagnostics; better understanding of diagnosis
o Prediction; better understanding of disease progression
o Understand biological processes (using advanced imaging techniques)
Anatomical planes
Structural brain imaging
Functions:
- identifying the effects of a stroke
- locating cysts and tumours
- finding swelling and bleeding
- disease-related lesions
,- X-ray = image of the bones
- CT scan = computer tomography scan = 3d x-ray scan, so bones (skull) light up
o Much faster than MRI
- MRI = magnetic resonance imaging = strong magnetic field
o based on differences of water context in tissue (bones little water so scull is dark)
o Shows brain tissue a lot better
o Used more for long term symptoms
o Advantages
▪ Non-invasive
▪ Non-ionizing radiation
▪ High soft tissue resolution and discrimination between tissue types
▪ Morphological information as well as functional information
o Disadvantages
▪ Time consuming
▪ Contraindications: if a patient has a pacemaker or other metal part in his
body that is not compatible with MRI
▪ Hard noise, patients have ear protection
▪ Sequences need to be adapted to question (different types of MRI scans)
How it works:
MRI uses magnetism and radiofrequency signals to acquire images
MR images are based on density of protons
In your body are hydrogen atoms spinning, magnet zorgt ervoor dat alle atomen de
zelfde kant op bewegen, radiopulse zorgt ervoor dat ze teruggaan, daarna weer
alligned, de tijd die hiervoor nodig is wordt gemeten (ieder lichaamsdeel bepaalde
hoeveelheid/dichtheid hydrogen atomen?)
Main techniques in MRI: (what you want to see determines what sequence u use)
1. T1 weighted images
a. Contrast fat/water
b. Anatomy enhancement → neuro anatomical changes
2. T2 weighted images
a. White matter is dark, grey matter is lighter, water is white
b. Contrast water (white) /tissue
c. Pathology → changes related to water, oedema
3. Flair (Fluid-attenuated inversion recovery) = T2 with supress the water(CSF;
cerebrospinal fluid) signal → easier to see the damaged area
, 4. DIR (double inversion recovery) suppress (T2+FLAIR) = suppress both CSF and
white matter signal → this makes lesions/plaques in white matter or between
gray/white matter visible
AVM: arteriovenous malformation
MRA (magnetic resonance angiography)– measure abnormalities in blood vessels
stroke:
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