Samenvatting Central Nervous
System Disorders
Psychose, beroerte en ontwikkelingsstoornissen
Biomedische Wetenschappen
2020-2021
Door Nicole (studente BMW)
,Inhoudsopgave
Psychose, symptomen en etiologie ......................................................................................................... 5
Organische psychosen ......................................................................................................................... 6
Schizofrenie ......................................................................................................................................... 7
DSM-5 criteria.................................................................................................................................. 7
Epidemiologie ................................................................................................................................ 10
Prognose ........................................................................................................................................ 13
Behandeling ................................................................................................................................... 13
Milieurisico’s voor psychiatrische stoornissen ...................................................................................... 14
Homo sapiens .................................................................................................................................... 14
Nature vs. nurture ............................................................................................................................. 16
Bio-psycho-sociale model.................................................................................................................. 20
Omgevingsrisicofactoren ............................................................................................................... 21
Mechanismen .................................................................................................................................... 24
Epigenetica .................................................................................................................................... 24
Omgevingsfactoren en aandoeningen .................................................................................................. 26
Groep 1: Blootstelling aan lood en depressie ................................................................................... 26
Mechanisme .................................................................................................................................. 26
Mental health outcome................................................................................................................. 26
Conclusie ....................................................................................................................................... 26
Groep 2: Maternale influenza en bipolaire stoornissen ................................................................... 27
Groep 3: Ketamine en depressie ....................................................................................................... 28
Mechanisme .................................................................................................................................. 29
Voordelen ...................................................................................................................................... 30
Nadelen ......................................................................................................................................... 30
Groep 4: Slechthorenden en psychotische stoornissen .................................................................... 31
Directe oorzaken ........................................................................................................................... 31
Groep 5: Cocaïne en depressie.......................................................................................................... 33
Groep 6: Luchtvervuiling en depressie .............................................................................................. 34
Mechanisme .................................................................................................................................. 34
Mental health outcome................................................................................................................. 34
Groep 7: Hypoxie en ADHD ............................................................................................................... 35
Mechanisme .................................................................................................................................. 35
Mental health outcome................................................................................................................. 35
Groep 8: Valproïnezuur en ASS ......................................................................................................... 36
Mechanisme .................................................................................................................................. 36
1
, Mental health outcome................................................................................................................. 36
Voorspellen van reacties op behandelingen ......................................................................................... 37
Respons vs. remissie.......................................................................................................................... 37
Respons op behandeling ............................................................................................................... 37
Remissie......................................................................................................................................... 37
Meten van respons en remissie .................................................................................................... 37
Dopamine hypothese en antipsychotica ........................................................................................... 38
Dopamine hypothese .................................................................................................................... 38
Antipsychotica ............................................................................................................................... 38
Dysconnectie hypothese ................................................................................................................... 41
Prepare study .................................................................................................................................... 42
EEG-frequentiebanden .................................................................................................................. 42
Beroerte................................................................................................................................................. 46
Ischemische beroerte (herseninfarct) ............................................................................................... 46
Intracerebrale bloeding ..................................................................................................................... 47
Subarachnoïdale bloeding ................................................................................................................. 48
Ischemische beroerte: risicofactoren en classificatie ........................................................................... 50
Anatomie van cervicale en intracerebrale arteriën .......................................................................... 50
Risicofactoren .................................................................................................................................... 54
TOAST classificatie ............................................................................................................................. 54
Pathogenese van atherosclerose .................................................................................................. 55
Cardio-embolie .............................................................................................................................. 58
Occlusie van kleine bloedvaten (lacunair infarct) ......................................................................... 60
Andere oorzaak ............................................................................................................................. 64
Niet gedetermineerd ("cryptogeen") ............................................................................................ 66
Ischemische beroerte: cascade, penumbra en behandelingen ............................................................ 67
Cerebrale autoregulatie .................................................................................................................... 67
Ischemische cascade ......................................................................................................................... 68
CT-perfusie ........................................................................................................................................ 69
Casus .............................................................................................................................................. 71
Acute behandeling bij ischemische beroertes .................................................................................. 73
Intraveneuze recombinant tissue plasminogen activator (rtPA) .................................................. 73
Endovasculaire behandeling.......................................................................................................... 75
Stamcellen en beroertes ....................................................................................................................... 78
Ontwikkeling corticale lagen ............................................................................................................. 78
Immuunrespons ................................................................................................................................ 79
2
, Stamcellen ......................................................................................................................................... 79
Neurale stamcellen........................................................................................................................ 82
Neurogenese ................................................................................................................................. 84
Stamceltherapie ................................................................................................................................ 90
Stamceltherapie voor neonataal ischemisch hersenletsel .................................................................... 94
Ischemisch hersenletsel .................................................................................................................... 94
Typen hersenletsel ........................................................................................................................ 95
Pathofysiologie .................................................................................................................................. 98
Endogene herstelcapaciteit van de hersenen ................................................................................. 100
Mesenchymale stamcellen .............................................................................................................. 101
Modellen ..................................................................................................................................... 102
Klinische studie ............................................................................................................................ 106
Imaging van beroertes......................................................................................................................... 108
MRI-scan .......................................................................................................................................... 108
Neuro-imaging ................................................................................................................................. 109
Identificeren van de eigenschappen van een laesie ................................................................... 110
Detecteren van secundair letsel of therapiedoelen .................................................................... 114
Monitoren of voorspellen van herstel......................................................................................... 117
Hersenstimulatie ......................................................................................................................... 124
ADHD ................................................................................................................................................... 125
Classificatie ...................................................................................................................................... 125
ADHD ........................................................................................................................................... 125
Neurobiologie .................................................................................................................................. 127
Hersenontwikkeling ..................................................................................................................... 127
ADHD ........................................................................................................................................... 130
Comorbiditeit .................................................................................................................................. 136
Heterogeniteit ................................................................................................................................. 139
Autisme spectrum stoornis (ASS) ........................................................................................................ 140
Neurobiologie .................................................................................................................................. 140
Structurele connectiviteit ................................................................................................................ 143
Functionele connectiviteit ............................................................................................................... 144
Obsessive-compulsive disorder (OCD) ................................................................................................ 145
Cortico-striato-thalamo-cortical circuit (CSTC) ............................................................................... 148
Structurele connectiviteit ................................................................................................................ 150
Functionele connectiviteit ............................................................................................................... 151
Triple Network Model ................................................................................................................. 152
3
System Disorders
Psychose, beroerte en ontwikkelingsstoornissen
Biomedische Wetenschappen
2020-2021
Door Nicole (studente BMW)
,Inhoudsopgave
Psychose, symptomen en etiologie ......................................................................................................... 5
Organische psychosen ......................................................................................................................... 6
Schizofrenie ......................................................................................................................................... 7
DSM-5 criteria.................................................................................................................................. 7
Epidemiologie ................................................................................................................................ 10
Prognose ........................................................................................................................................ 13
Behandeling ................................................................................................................................... 13
Milieurisico’s voor psychiatrische stoornissen ...................................................................................... 14
Homo sapiens .................................................................................................................................... 14
Nature vs. nurture ............................................................................................................................. 16
Bio-psycho-sociale model.................................................................................................................. 20
Omgevingsrisicofactoren ............................................................................................................... 21
Mechanismen .................................................................................................................................... 24
Epigenetica .................................................................................................................................... 24
Omgevingsfactoren en aandoeningen .................................................................................................. 26
Groep 1: Blootstelling aan lood en depressie ................................................................................... 26
Mechanisme .................................................................................................................................. 26
Mental health outcome................................................................................................................. 26
Conclusie ....................................................................................................................................... 26
Groep 2: Maternale influenza en bipolaire stoornissen ................................................................... 27
Groep 3: Ketamine en depressie ....................................................................................................... 28
Mechanisme .................................................................................................................................. 29
Voordelen ...................................................................................................................................... 30
Nadelen ......................................................................................................................................... 30
Groep 4: Slechthorenden en psychotische stoornissen .................................................................... 31
Directe oorzaken ........................................................................................................................... 31
Groep 5: Cocaïne en depressie.......................................................................................................... 33
Groep 6: Luchtvervuiling en depressie .............................................................................................. 34
Mechanisme .................................................................................................................................. 34
Mental health outcome................................................................................................................. 34
Groep 7: Hypoxie en ADHD ............................................................................................................... 35
Mechanisme .................................................................................................................................. 35
Mental health outcome................................................................................................................. 35
Groep 8: Valproïnezuur en ASS ......................................................................................................... 36
Mechanisme .................................................................................................................................. 36
1
, Mental health outcome................................................................................................................. 36
Voorspellen van reacties op behandelingen ......................................................................................... 37
Respons vs. remissie.......................................................................................................................... 37
Respons op behandeling ............................................................................................................... 37
Remissie......................................................................................................................................... 37
Meten van respons en remissie .................................................................................................... 37
Dopamine hypothese en antipsychotica ........................................................................................... 38
Dopamine hypothese .................................................................................................................... 38
Antipsychotica ............................................................................................................................... 38
Dysconnectie hypothese ................................................................................................................... 41
Prepare study .................................................................................................................................... 42
EEG-frequentiebanden .................................................................................................................. 42
Beroerte................................................................................................................................................. 46
Ischemische beroerte (herseninfarct) ............................................................................................... 46
Intracerebrale bloeding ..................................................................................................................... 47
Subarachnoïdale bloeding ................................................................................................................. 48
Ischemische beroerte: risicofactoren en classificatie ........................................................................... 50
Anatomie van cervicale en intracerebrale arteriën .......................................................................... 50
Risicofactoren .................................................................................................................................... 54
TOAST classificatie ............................................................................................................................. 54
Pathogenese van atherosclerose .................................................................................................. 55
Cardio-embolie .............................................................................................................................. 58
Occlusie van kleine bloedvaten (lacunair infarct) ......................................................................... 60
Andere oorzaak ............................................................................................................................. 64
Niet gedetermineerd ("cryptogeen") ............................................................................................ 66
Ischemische beroerte: cascade, penumbra en behandelingen ............................................................ 67
Cerebrale autoregulatie .................................................................................................................... 67
Ischemische cascade ......................................................................................................................... 68
CT-perfusie ........................................................................................................................................ 69
Casus .............................................................................................................................................. 71
Acute behandeling bij ischemische beroertes .................................................................................. 73
Intraveneuze recombinant tissue plasminogen activator (rtPA) .................................................. 73
Endovasculaire behandeling.......................................................................................................... 75
Stamcellen en beroertes ....................................................................................................................... 78
Ontwikkeling corticale lagen ............................................................................................................. 78
Immuunrespons ................................................................................................................................ 79
2
, Stamcellen ......................................................................................................................................... 79
Neurale stamcellen........................................................................................................................ 82
Neurogenese ................................................................................................................................. 84
Stamceltherapie ................................................................................................................................ 90
Stamceltherapie voor neonataal ischemisch hersenletsel .................................................................... 94
Ischemisch hersenletsel .................................................................................................................... 94
Typen hersenletsel ........................................................................................................................ 95
Pathofysiologie .................................................................................................................................. 98
Endogene herstelcapaciteit van de hersenen ................................................................................. 100
Mesenchymale stamcellen .............................................................................................................. 101
Modellen ..................................................................................................................................... 102
Klinische studie ............................................................................................................................ 106
Imaging van beroertes......................................................................................................................... 108
MRI-scan .......................................................................................................................................... 108
Neuro-imaging ................................................................................................................................. 109
Identificeren van de eigenschappen van een laesie ................................................................... 110
Detecteren van secundair letsel of therapiedoelen .................................................................... 114
Monitoren of voorspellen van herstel......................................................................................... 117
Hersenstimulatie ......................................................................................................................... 124
ADHD ................................................................................................................................................... 125
Classificatie ...................................................................................................................................... 125
ADHD ........................................................................................................................................... 125
Neurobiologie .................................................................................................................................. 127
Hersenontwikkeling ..................................................................................................................... 127
ADHD ........................................................................................................................................... 130
Comorbiditeit .................................................................................................................................. 136
Heterogeniteit ................................................................................................................................. 139
Autisme spectrum stoornis (ASS) ........................................................................................................ 140
Neurobiologie .................................................................................................................................. 140
Structurele connectiviteit ................................................................................................................ 143
Functionele connectiviteit ............................................................................................................... 144
Obsessive-compulsive disorder (OCD) ................................................................................................ 145
Cortico-striato-thalamo-cortical circuit (CSTC) ............................................................................... 148
Structurele connectiviteit ................................................................................................................ 150
Functionele connectiviteit ............................................................................................................... 151
Triple Network Model ................................................................................................................. 152
3
