1. The Neuroanatomical Basis of Brain Disorders By Daniel Martinez M.D Zaid Syed MS4

2. Medical Model George L. Engel – 1977 Biological, psychological, social, spiritual, cultural factors affect disease and overall wellbeing How the cause of the illness stems from functioning of the individuals body

3. Eitheory.com

4. Biology Very important to stress medical follow up for each patient – Once a year Strong connection between body and mind

5. Biology Obtain medical records Physical Exam – Screening blood test CBC – Hematocrit – Hemoglobin » Rule out anemia CMP – Electrolytes – Glucose – Cr/BUN

6. Biology Screening Blood Test (cont) – Liver Function test – Thyroid Function Test Hyperthyroidism Hypothyroidism – Lipid panel – Drug screen – Pregnancy – Vitamin B12 – Folic Acid – Thiamine

7. http://blog.lib.umn.edu Neuron in Action

8. Synthesis and Release of Dopamine

9. SPECT Scan Neuroimaging in psychiatry By Tripura Medical College, Slide 23 http://www.slideshare.net/shaan_47/neuroimaging-in-psychiatry Neuroimaging in Psychiatry http://www.slideshare.net/shaan_47/neuroimaging-in-psychiatry

10. Images (c) Dr. Amen

13. http://www.brain-spect.com/SPECTscans/jpg/alz.JPG

14. OCD

15. Obsessive-Compulsive Disorder Epidemiology – Occurs in 2-3% of US population. – Bimodal distribution – 10 y/o and 21 y/o Signs and Symptoms – Obsession - Persistent thoughts, ideas and images that intrude into conscious awareness. – Compulsion – urges or impulses for repetitive intentional behavior performed in a stereotyped manner in an attempt to alleviate the anxiety caused by the obsessions.

16. Obsessive-Compulsive Disorder Pathogenesis – Orbitofrontal dysfunction and frontal/parietal white matter changes. – Prefrontal cortex, cingulate gyrus and basal ganglia dysfunction are implicated. – By using PET scan, patient after treatment had a reduction in cerebral metabolism in these areas. – Serotonin is also believed to play an integral role.

17. active front-on view Heavy increased cingulate activity and right and left anterior lateral prefrontal cortex activity (together termed hyperfrontality).

18. http://www.londonneurofeedback.com/uploads/2/2/9/8/2298352/8876880.jpg

19. Autism

20. Epidemiology 3 – 2- 1- 1 – Before the age of 3 – Two social problems (PRNS) – One communication problem (LISP) – One inflexible behavior problem (PIMP)

21. Autism Etiologys – Dr Andrew Wakefield measles vaccine  intestinal inflammation  “leaky gut syndrome”  harmful proteins can affect brain  Autism – In 1998, Wakefield & a group of colleagues published a research study in the British medical journal, The Lancet, which linked inflammatory bowel symptoms in 12 autistic children to the Measles-Mumps-Rubella vaccine

22. Autism More than 20 peer-reviewed epidemiologic studies have shown no link between MMR & autism. Functional brain-imaging studies show under activation in areas associated with planning & control of complex actions, & in areas linked with processing socioemotional information.

23. http://www.brain-spect.com/SPECTscans/jpg/normsag.jpg Autistic patient Normal

24. Schizophrenia

25. Pathogenesis – Overall unknown, however many associations are known. – Genetical component: observed concordance rate is about 40-50% in monozygotic twins, and 5-10% in dizygotic twins. – Environmental components Obstetrical complications Infections Inflamation Cannibus use

26. http://psycnet.apa.org/journals/szb/13/1/images/szb_13_1_115_fig11a.jpg

27. Depression

28. Epidemiology – 17% of the US population 10-14% of medical inpatients 1 – linked to social conditions Rule out hypothyroidism Association with Parkinson disease and dementia 1. Katon, W. Epidemiology of Depression in Primary Care. General Hospital Psychiatry 1992. July 14(4). 237-247

29. Depression Pathogenesis- – Deficiency in excitatory neurotransmitters – Neurotransmitter – Serotonin

30. http://img.webmd.com/dtmcms/live/webmd/consumer_assets/site_images/articles/health_tools/depression_overview_slideshow/mayo_c7_pet_depression.jpg

31. ADHD

32. Attention deficit hyperactivity disorder Pathogenesis – Genetic Factor Concordance as high as 92% in monozygotic twins and 33% in dizygotic twins.

33. Psychostimulant needed.

35. http://www.adhd.org.nz/petscan.jpg

36. Bipolar Disorder

37. Bipolar disorder Episodic mood shifts of mania, major depression, hypomania & mixed states Pathophysiology – Altered circadian rhythmicity

38. http://www.brain-spect.com/SPECTscans/jpg/alz.JPG

39. Thank You!!

45. Thank you again!