Neurological and psychiatric disorders
Introduction
Course contains:
- Lectures
- Group sessions/debate (Sept. 28th): morning group 1-5, afternoon group 6-10.
- Project assignment and presentation (Oct. 12th, 14th): 30%
o Main goal: describe and provide arguments for the pros and cons of pharmacological
and non-pharmacological therapies used for one of the disorders presented in the
course.
o Describes: background of the disease (1), what is the target of the therapy? (2), how
easily can the therapy be applied? (2), what is the effect size of the therapy? (3), are
there any side effects associated with the therapy (medically or socially) (4),
conclusion and therapy recommendation (5).
o One feedback moment
- Virtual site visit nursing home (in the week of oct. 5th – 9th)
- Exam: oct. 22th.
o Material for the exam: literature and lectures provided via Canvas.
o Open and multiple choice questions based upon the presentation and literature: 70%
¼ people suffer from a brain disease
The human brain:
- 100.000.000.000 neurons
- With 7000 synapses on average
- Multiple neurotransmitters: used to communicate between neurons (serotonin,
acetylcholine, adrenalin)
- Glial cells: contributes to the communication between neurons and plays important part in
the immunity.
Aim from the course: acquire knowledge on certain neurological and psychiatric disorders. Also
knowledge on diagnostics, therapies, biological mechanisms underlying psychiatric/neurological
disorders.
Lecture: brain imaging
Learning objectives:
- Understand application/possibilities of neuroimaging in clinic and research
- Recognize abnormalities on brain scans
- Understand their underlying pathology
- Understand application of different MRI sequences/techniques in MS
Neuroanatomy:
The brain consists of four regions: frontal, parietal, temporal, occipital lobes.
,Anatomical planes:
1. Axial/transverse: from top to bottom
2. Coronal: from back to front
3. Sagittal: from right to left
,Neuroimaging: why do we use it?
- In clinic it is used for diagnosis, prognosis.
o There are lots of techniques: CT, MRI, MRA, MRS, angiography, X-ray
o F.e. Disease for which neuroimaging is used are: stroke/cerebrovascular accident
(CVA) for this CT-scans are used, because these are faster than MRI (these are
slower, but better). For a stroke it is important that the scan is as fast as possible to
see how much damage there is.
- In research neuroimaging is also used to improve diagnostics, prediction and post-mortem
MRI and histopathology. By this researchers understand biological processes (using advanced
imaging techniques).
Stroke/cerebrovascular accident
A stroke occurs because of a loss of brain function due to disturbance in blood supply, this is because
of:
- Hemorrhage/hematoma (1) = bleeding trauma, this happens in 20% of the cases with a
stroke.
, - A disturbance in blood supply can also be because of ischemia (2), this is a lack of blood flow
(non-bleeding trauma), this happens in 80% of the cases with a stroke. There are two types,
transient ischemic attack (TIA), in a TIA the symptoms disappear within 24 hour and the
second type of ischemia is reversible ischemic neurological deficit (RIND), in a RIND the
symptoms disappear between 24 hours and 6 weeks.
1. Hemorrhage
This is a CT-scan of a epidural hematoma. This often happens in the arteries, the tissue
between dura mater and skull is pushed inside (this is caused by acute trauma) in the
formation of a lens (lens-shaped). During a epidural hematoma there is a delay of symptoms.
In the case of an epidural hematoma a CT is taken in stead of a MRI. A CT is a faster scan.
Symptoms of epidural hematoma are loss of consciousness (this symptom will disappear),
progressive headache, nausea and fluid draining from nose or ears (CSF).
This is a subdural hematoma, this happens in the veins and is because of a slow buildup of blood. This
happens between the dura mater and arachnoid. This happens more than the epidural hematoma.
This can be acute (<24 hours), subacute (<10 days) and chronic (>10 days). During a subdural
hematoma symptoms such as less consciousness and stiff pupils appear, because of the intracranial
pressure.