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Brown Medical School Biomed 370 the Brain and Human Behavior

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Brown Medical School Biomed 370 the Brain and Human Behavior Brown Medical School Biomed 370 The Brain and Human Behavior The Brain and Human Behavior Biomed 370 A first year, second semester course sponsored by the Department of Psychiatry and Human Behavior Course Directors: Robert Boland, M.D. 455-6417 (office), 455-6497 (fax) [email protected] Stephen Salloway, M.D., M.S. 455-6403 (office), 455-6405 (fax) [email protected] Web site available through WebCT Teaching Assistants: Nancy Brim ([email protected]) Marisa Kastoff ([email protected]) Stan Pelosi ([email protected]) Grace Farris ([email protected]) Table of Contents. Overall Course Objectives.....................................................................4 Section 1. Basic Principles. ...................................................................7 Chapter 1. Limbic System Anatomy........................................................8 Chapter 2. Frontal Lobe Function And Dysfunction..............................13 Chapter 3. Clinical Neurochemistry......................................................19 Chapter 4. The Neurobiology Of Memory............................................36 Chapter 5. The Control Of Feeding Behavior .......................................46 Chapter 6. Principles Of Pharmacology................................................51 Chapter 7. Principles Of Neuroimaging.................................................55 Chapter 8. The Mental Status Examination...........................................74 Section 2. The Clinical Disorders.......................................................89 Chapter 9. Anxiety Disorders.................................................................91 Chapter 10. Obsessive-Compulsive Disorder .....................................105 Chapter 11. Mood Disorders ................................................................109 Chapter 12. Psychotic Disorders .........................................................138 Chapter 13. The Cognitive Disorders..................................................157 Chapter 14. Substance Abuse..............................................................168 Chapter 15. Obesity.............................................................................182 Chapter 16. Eating Disorders ..............................................................201 Section 3. Other Subjects..................................................................205 Chapter 17. Childhood And Adolescent Disorders.............................206 Chapter 18. Personality Disorders........................................................212 Overall Course Objectives 1. Students will better understand the neural organization of key functional brain systems that regulate behavior such as fear, mood, psychosis, feeding, executive function and memory. 2. Students will learn about the diagnosis and treatment of the major syndromes in psychiatry. 3. Students will appreciate the importance of anatomy, neurochemistry and brain imaging for understanding brain and behavior relationships. Overview And Format The brain mediates all complex behaviors. Advances in brain imaging and basic neuroscience have greatly increased our understanding of the brain systems involved in behavior. Advances in pharmacology have greatly improved the treatment of mental illness. This course will highlight the functional organization of key brain systems involved in behavior and review the diagnosis and treatment of major psychiatric disorders. The importance of anatomy, brain imaging and neurochemistry for understanding behavior will be emphasized. Becoming more familiar with the neurobiology of neural systems underlying behavior will provide a foundation for understanding the clinical syndromes that you will learn about in Neurosciences 262 and will better prepare you for diagnosing and treating neurological and psychiatric disorders in your future practice of medicine. This course will contribute to lifelong learning by providing a basis for incorporating new advances in the rapidly evolving area of brain and behavior research. Biomed 370 has been reorganized as the initial step toward achieving the Medical School’s goal of developing an integrated pre-clinical neuroscience curriculum. The new Biomed 370, Brain and Behavior, has integrated the core material from Biomed 278, Introduction to Clinical Psychiatry, and the old Biomed 370, The Human Brain and Behavior plus added introductory lectures on neuroanatomy and psychopharmacology lectures. The intention of the new curriculum is to provide students with a more organized multidisciplinary framework for understanding, diagnosing and treating neuropsychiatric disorders. The first part of the course will present an overview of functional neuroanatomy, psychophamacology and neuroimaging. Clinical disorders will be discussed in the second part of the course. Direction Of The Course Dr. Salloway and Dr. Boland are the course leaders for Brain and Behavior. Their telephone numbers and email addresses are located on the first page of the syllabus. Brown is fortunate to have many faculty with expertise in brain/behavior relationships to teach in this course. The lectures will be given by faculty with strong teaching skills from the Department of Psychiatry and Human Behavior, and the Departments of Clinical Neurosciences, Psychology and Neuroscience. The faculty appreciates your constructive suggestions for improving this class. Please feel free to contact the course directors or lecturers with your suggestions. Relationship To MD 2000 Objectives And Other Medical Student Courses This course helps prepare students for Part I and II of the Boards and provides education toward competencies III (using basic science to guide therapy), IV (diagnosis, management and prevention) and V (lifelong learning) outlined in the Educational Blueprint for the Medical School and addresses a number of the content areas under Knowledge Base II (single organ system), and IX (behavioral encounters) in the MD 2000 curriculum plan. Small Groups In addition to lectures, the class will have an opportunity to visit an area clinical site and observe patients directly in a small group setting. This small groups experience is an opportunity to both see psychiatric disorders in a clinical setting, and to practice psychiatric interviewing skills. Syllabus, Computer, And Internet Resources The syllabus contains material relevant to of each lecture. Lecture slides, sample questions, relevant background reading, links to related sites, review packets and other information will be posted on the course website. The course website is part of Brown’s WebCT and can be accessed at the WebCT home page: https://webct.brown.edu/ Simply log in with your Brown ID and password, and you should see a link for Biomed 370. Click on that to access the Brown web page. There is no specific textbook assigned for this course. Reading relevant to each lecture are available online. The outlines and background reading complement the lectures and will help you integrate material presented in the course. Students are strongly encouraged to use a self guided introductory neuroimaging 5 tutorial software program developed by members of the faculty for learning about brain imaging, which is installed in the Biomed Computer Learning Cluster. Additionally, the neuroanatomy tutorial installed on the same computers will be very useful, particularly in understanding the anatomy of the limbic system. Grading Grading is based on 2 tests and a paper. Tests. There will be one midterm worth 40% and a final examination worth 60%. A multiple choice format will be used with material drawn from the lectures and syllabus. The lectures will highlight the material most relevant to the course, and therefore most represented on the test. The examinations will be similar in format and complexity to the USMLE examinations, and as is typical of that format, many questions will utilize clinical vignettes. Honors Paper. 2 pages maximum. In the paper you are to describe, clinically, a patient you have seen this year. This can be a patient you have seen during the small group hospital experience (which takes place on 4/4/06) or a patient during any other clinical encounter, such as during your On Doctoring course. Preferably, this will be a patient you either interviewed yourself, or saw interviewed in a small group setting. Patients seen on film, or interviewed in a large group setting (ex. brought in by one of the lecturers during the course) are not eligible. You should describe the patient in a formal way and discuss more the diagnosis/syndrome with which the patient presents. References are encouraged. The purpose of the paper is to show that you can integrate your didactic and clinical experiences. Grading. Grading will be Honors/Satisfactory/No Credit. To achieve honors, students should score in the top 15-20% on the examinations, and complete an honors paper that is judged to be at least satisfactory. An honors paper must be completed to be eligible for honors in this course (but is not a guarantee of honors, of course). We hope that all students will pass this course. However, students with very low scores will not receive credit. 6 Section 1. Basic Principles. Chapter 1. Limbic System Anatomy The brain is organized into three tiers (Figure 1): a lower tier made up by the brainstem and cerebellum, a middle tier containing the thalamus, basal ganglia and many components of the limbic system, and an upper tier comprised by the cortex. The brainstem regulates arousal, autonomic
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