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Home , Cerebral hypoxia, Hypoxic hypoxia

International Journal of Neuroscience & Research Review Article

Cerebral can lead to Personality Changes: A

Review

Swati Srivastava*

Scientist, Defence Research and Development Organization, India

*Corresponding Author: Swati Srivastava, Scientist, Defence Research and Development Organization, India. E-mail: [email protected]

Received: December 1, 2017; Accepted: December 5, 2017; Published: December 15, 2017

Copyright: @ 2017 Srivastava S. can lead to Personality Changes: A Review. Int J Neurosci Res; 1(1): 1-6. Introduction overdose of drugs and anaesthesia, during and , and low The term ‘Cerebral hypoxia’ refers to blood pressures. Acute brain injury can occur reduced supply of to the brain tissues. as a result of cerebral or hypoxic If a brain cell becomes completely deprived of ischemia after an incidence of stroke, cardiac oxygen, the condition is referred to as arrest, vasospasm or . cerebral anoxia. Since brain needs constant supply of oxygen for its vital functioning, Cerebral damages due to hypoxia cerebral hypoxia can have major impact of cerebral hemispheres, leading to cognitive, Mammalian brain is highly oxidative behavioural as well as personality changes organ and has high demands for oxygen. including anxiety, depression and memory Although, brain only weighs 2% of the total loss [1]. In simple words, it is condition body weight, approximately 20% of the entire wherein brain does not get sufficient oxygen oxygen output of the body is used by to meet its energy demands and its in the brain. These neurons are extremely functioning is adversely affected. There are sensitive to changes in the oxygen levels. several causes which may lead to cerebral Thus even brief periods of cerebral hypoxia hypoxia; including sudden exposure to high can cause severe damage to brain tissues [2]. altitudes (wherein the barometric pressure is A large number of enzymes which have high low resulting in lowered partial pressure of affinity for oxygen and are actively involved oxygen), inhalation of smoke, poisoning due in the process of oxidative phosphorylation to , strangulation and and ATP production (such as cytochrome C chocking. Supply of oxygen to brain in oxidase) ensure the maintenance of low sufficient amounts could also be interrupted partial pressure of oxygen in brain. When the or stopped during medical conditions such as supply of oxygen to brain tissues becomes

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Srivastava S (2017) Cerebral Hypoxia can lead to Personality Changes: A Review. Int J Neurosci Res; 1(1): 1-103. low, the process of oxidative phosphorylation perform various physiological tasks. is adversely affected [3,4], thereby decreasing Personality of an individual is controlled by ATP production and affecting functioning of frontal lobe of the brain. A remarkable change ion channels. Free oxygen radicals thus in the behavior of a person can be noticed generated further contribute to the oxidative when the neurons in the frontal lobe are injury of brain [5], leading to disruption in affected due to lower oxygen availability. transmission of electrical impulse. If the brain Oxygen supply positively affects cognitive is not supplied with oxygen for just few behavior and it has been demonstrated in minutes, a large number of cells in the brain various studies [8-12]. In such cases, begin to die. The most oxygen sensitive areas cognitive performance as well as memory is of brain include cerebral cortex (including improved by supply of concentrated oxygen parietal and occipital lobes), the [13]. The supply of concentrated oxygen not hippocampus, basal ganglia and cerebellum only improvises cognitive performance but [6]. Hypoxia leads to oxidative stress and also increases blood oxygen saturation (SpO2) neuronal damage as the redox cycle is and maintains a lowered during the disturbed. Neurons of hippocampus region process [14]. Thus the speed and accuracy of are amongst the first ones to lose their cognitive performance largely depends on electrical activity in a hypoxic event [6]. oxygen flow to brain tissues [15-17].This is Hypoxia related cerebral damages include the precise reason why cognitive ability is various neurological disorders which affect compromised at high altitudes. Since personality, behaviour and motor skills of a cognitive tasks are highly energy demanding person. and requires continuous supply of ATP, increase in ATP production enhances Personality changes due to cerebral hypoxia cognitive ability [9].

Personality of an individual, which is However, brain requires more and marked by patterns of emotional and more oxygen to metabolize this fuel during motivational behavior, is highly dependent on cognitive processing. In absence of sufficient cognitive responses [7]. In case of effect on oxygen supply, cognitive performance is cerebellum, loss of coordination and balance compromised to a variable extent. Insufficient is seen. In severe conditions, cranial nerve oxygen supply to neurons results in influx of reflexes, apnea, and even sodium and calcium ions which cause the occurs. Initial exposure to low concentration cells to swell and produce free oxygen of oxygen may lead to , dizziness, radicals. Since, these free oxygen radicals are sweating and increase in rate of breathing. In extremely reactive they cause cell injury. [18] case of brief cerebral anoxia, a person can reported changes in psychomotor experience the loss of concentration, performance, reaction time, vigilance, overall coordination, speech difficulty and short term mental skill, memory and logical reasoning in memory loss. However, most of these short individuals ascending to altitudes above term changes are reversible in nature, as the 3,000 m (9,843 ft). Long term exposures to oxygen supply to brain resumes. Long term low oxygen levels may lead to permanent exposure to lowered oxygen levels may lead damages. Synthesis of several to irreversible damages. Cerebral hypoxia neurotransmitters is highly oxygen may also result in confusion, hallucinations, dependent. Changes in the concentration, decreased memory, attention problems, utilization and metabolism of these disorientation, lowered consciousness and neurotransmitters also attribute to eventually death. behavioural changes [19,20]. Neurotransmitter systems which get highly Constant supply of glucose and affected due to hypoxic changes are oxygen to the nervous tissues is required to cholinergic system and acetylcholine (ACh)

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Srivastava S (2017) Cerebral Hypoxia can lead to Personality Changes: A Review. Int J Neurosci Res; 1(1): 1-103.

[19]. Other lesser oxygen sensitive hypoxic . With advances in neurotransmitters are dopamine and medical facilities and intensive care, more serotonin. These neurotransmitters play a and more patients receive good neurological crucial role in regulating physiological and care and early treatment in rehabilitation emotional responses, mood changes, facilities [28]. In case of temporary damage controlling pain and memory functions. such as hallucinations, paralysis, memory loss Personality changes are evident after damage etc. using hyperbaric oxygen to specific areas of brain like frontal and therapy (HBOT) is extremely helpful in temporal lobes, hippocampus and amygdala. recovery of lost abilities. This therapy has In such cases, a person may show changes in shown success in cases of global cerebral mood by behave agitated, may show volatile ischemia/anoxia, head injury and coma emotions or even physical aggression and patients and has been practiced since several verbal attacks apart from memory decades [29-33]. It makes breathing easier, impairment. Mood changes are often visible reduces anxiety and quality of life is restored. in the form of increased irritability, This treatment strategy has been very depression and anxiety. A person may get popular as it is painless and non-invasive. more addicted and may show sexually Study has been conducted on rehabilitation of inappropriate compulsions. hypoxic-ischemic patients which emphasized on recovery of consciousness during In case of memory loss, a person may rehabilitation [34], and prognosis of hypoxic find difficult to recall names and recognize brain damage during early neurological faces. Sometimes, one is unable to respond to rehabilitation [35]. Other treatment plans pain signals. Struggle in walking, writing and may include exercise therapy, which other coordination is seen in case of changes increases the flow of blood to the brain; in motor skills. Hypoxic exposure in early physical therapy, to regain lost motor skills; stages of brain development may lead to speech therapy; psychotherapy etc. behavioural abnormalities [21]. Little data is available on changes in endocrinological Summary parameters such as TSH, prolactin, cortisol or somatomedin in relation to hypoxic brain Personality or behavioral changes in damage. Few studies report hormonal an individual largely depends on supply of changes like somatotropic, gonadotropic and oxygen to the brain tissues. Insufficient or thyroid hormone disturbances in patients of interrupted oxygen flow to the neurons in the brain injury and subarachnoid brain may lead to impairment of cognitive haemorrhage [22,23]. Many arginine rich functioning which in turn causes changes in peptides such as CARP’s (cationic arginine- overall personality! Rapidly changing rich peptides) have been recently environmental conditions and lifestyle of demonstrated as potent neuroprotective people are causing increase in incidences and agents. They have shown the capacity to severity of brain damage due to hypoxia. Thus reduce reduce neuronal calcium influx this area needs to be explored and studied in [24,25] by down-regulating calcium channels more details to find out the and TNF receptor proteins [26,27] and thus pathophysiological causes of hypoxic brain reduce neuronal death. damage for its early detection, prevention and treatment. Studies should aim towards Treatment identification of effective neuroprotective compounds and new therapeutic targets. Neuro-imaging along with other clinical, biochemical and neurophysiological data are helpful in determining the extent of

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Srivastava S (2017) Cerebral Hypoxia can lead to Personality Changes: A Review. Int J Neurosci Res; 1(1): 1-103.

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Srivastava S (2017) Cerebral Hypoxia can lead to Personality Changes: A Review. Int J Neurosci Res; 1(1): 1-103.

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