Otak dan Neurotransmiter

Hadi Sarosa
Evolusi

Gen Pengalaman

Organisme saat ini Situasi saat ini

Perilaku saat ini

 Interaksi Faktor Genetik dan
Pengalaman
Tyron (1994) : Selective-breeding (maze-bright
dan maze-dull)
Asbjrn Flling (1934): Phenylketonuria (PKU)
Defisiensi fenilalamin hidroksilase
mengkonversi fenilalamin menjadi tyrosin, bahan
untuk disintesis menjadi dopamin
 Alzheimers Disease
Alois Alzhemer (1901), clinical case Auguste D, ,
ages : 51 years

Clinical (1901) Post mortem (1906)

Cognitive disturbance Presenile dementia
Disorientation Striking generalized
cortical atrophy
Delusions
Unique neuropathological
Aphasia changes
Behavior dyscontrol Publication (1911)
Histology
Neurofibrillary tangles
(NFT)
Neuritic plaques
Matthews B.R. & Miller B.L. (2009) Alzheimers disease. In The Behavioral Neurology of Dementia. Miller B.L. &
Boeve B.F. (ed). Cambridge University Press. pp. 56-73.
chromosome
19
 Behaviour (tingkah laku)
Menggambarkan fungsi seluruh sistem saraf
Kegiatan motorik bawah sadar
Reflek bawah sadar
Emosi, kesenangan, ketakutan, cemas, sex
Atur fungsi vegetatif
Kardiovaskuler,suhu tubuh,

Hormonal, metabolisma, berat badan

Pusat kenyang, pusat haus.

Fungsi luhur (moral) : Fungsi kognitif

Cognitive function
Cognitive function, an intellectual process by
which one becomes aware of, perceives, or
comprehends ideas. It involves all aspects of
perception, thinking, reasoning, and
remembering.

Mosby's Medical Dictionary, 8th edition. 2009, Elsevier.

Cognition: means of acquiring and processing

information about our selves and our world
 COGNITIVE DOMAINS :
Memory (acquiring, retaining, and retrieving new
information)
Attention and concentration (particularly divided
attention)
Information processing (dealing with information
gathered by the five senses)
Executive functions (planning and prioritizing)
Visuospatial functions (visual perception and
constructional abilities)
Verbal fluency (word-finding)
 Each hemisphere of the
cortex can further be
divided into four lobes:
Occipital - visual processing
Parietal - movement,
orientation, calculation,
recognition
Temporal - sound and
speech processing, aspects
of memory
Frontal - thinking,
conceptualisation,
planning.
 Cortical Functional Networks
Inferior
Parietal
Lobus

Dorsomedial
Prefrontal
Cortex

Posteromedial Cortex : Hippocampus

Retrosplenial Cortex Parahippocampal
Posterior Cingulate Cortex Cortex
Precuneus

Ventromedial
Prefrontal
Cortex

Lateral
Temporal
Cortex

Glutamatergic excitatory input

Frontal Lobe
Conscientiousness
Judgments
How we initiate activity in response to our environment.
Controls our emotional response.
Controls our expressive language.
Assigns meaning to the words we choose (abstract thought)
Attention span
Involves word associations (language planning)
Memory for habits and motor activities (short term memory)
Motor cortexVoluntary movement
Impulse control
Perseverance
 Frontal Lobe DeficitProblems
Loss of simple movement of various body parts (Paralysis).
Inability to plan a sequence of complex movements needed to
complete multi-stepped tasks, such as making coffee
(Sequencing).
Loss of spontaneity in interacting with others.
Loss of flexibility in thinking.
Persistence of a single thought (Perseveration).
Inability to focus on task (Attending).
Mood changes (Emotionally Labile).
Changes in social behavior.
Changes in personality.
Difficulty with problem solving.
Inablility to express language (Broca's Aphasia).
 Parietal Lobe Function
Location for visual attention.
Location for touch perception.
Goal directed voluntary movements.
Manipulation of objects.
Integration of different senses that allows for
understanding a single concept.
 Parietal LobeProblems resulting from
deficit
Inability to attend to more than one object at a time.
Inability to name an object (Anomia).
Inability to locate the words for writing (Agraphia).
Problems with reading (Alexia).
Difficulty with drawing objects.
Difficulty in distinguishing left from right.
Difficulty with doing mathematics (Dyscalculia).
Lack of awareness of certain body parts and/or
surrounding space (Apraxia) that leads to difficulties in
self-care.
Inability to focus visual attention.
Difficulties with eye and hand coordination.
 Temporal Lobe Function
Hearing ability
Memory acquisition
Some visual perceptions
Categorization of objects.
 Temporal Lobe DeficitsProblems
Difficulty in recognizing faces (Prosopagnosia).
Difficulty in understanding spoken words
(Wernicke's Aphasia).
Disturbance with selective attention to what we
see and hear.
Difficulty with identification of, and verbalization
about objects.
Short-term memory loss.
Interference with long-term memory
Increased or decreased interest in sexual behavior.
Inability to catagorize objects (Catagorization).
Right lobe damage can cause persistant talking.
Increased aggressive behavior.
Occipital Lobe Function

Vision
 Occipital Lobe Deficits--Problems
Defects in vision (Visual Field Cuts).
Difficulty with locating objects in environment.
Difficulty with identifying colors (Color Agnosia).
Production of hallucinations
Visual illusions - inaccurately seeing objects.
Word blindness - inability to recognize words.
Difficulty in recognizing drawn objects.
Inability to recognize movement of an object
(Movement Agnosia).
Difficulties with reading and writing.
 Amygdala,
Hippocampus dan
nuclei septal
Fungsi
Pengaturan olfactori
Respon autonom
Perilaku sexual
Emosi : marah, takut
Motivasi
 Komunikasi Neuron di Otak
A. IMPULS LISTRIK
B. ZAT KIMIA : NEUROTRANSMITTER
1. Asetil kolin 4. Neuropeptide
2. Asam amino Somatostatin
Gama-aminobutyric acid (GABA) Endorphin
Glutamat
Enkaphalin
Aspartat
substance P
Glycine
3. Monoamine
Dopamin
Histamin
NE
Serotonin
Otak : listrik & Neurotransmitter
Potensial membran
Neurotransmitter
 Neurotransmiter
Glutamat eksitatorik

Aspartat
Asam Amino
Glisin
Gammaaminobutyric acid (GABA) Inhibitorik
Molekul Kecil
Konvensional dopamin
Catecholamines ( Tirosin) epinefrin
Mono Amine
norepinefrin
Indolalamin (Tryptophan) serotonin
Asetilkolin Asetilkolin
Gas gas yang dapat Oksida Nitrit
Molekul Kecil tak larut Karbon monosida
Konvensional
Endokanabinoida
Anandamida
Peptida pituitaria
Molekul Besar Neuropeptide Peptida hipotalamik
Peptida opiat
Neurotransmiter
Sistem ekstrapiramidal
Neurotransmitter
 The Dopamine
Pathways

Nigrostriatal pathway
Substantia Nigra to Striatum
. Motor control
. Death of neurons in
this pathway can result in
Parkinson's Disease
Tuberoinfundibular pathway
Hypothalamus to Pituitary gland
. Hormonal regulation
Mesolimbic and Mesocortical pathways . Maternal behavior (nurturing)
Ventral Tegmental Area to Nucleus . Pregnancy
Accumbens, Amygdala & Hippocampus, . Sensory processes
and Prefrontal Cortex
. Memory
. Motivation and emotional response
. Reward and desire
. Addiction
. Can cause hallucinations and schizophrenia if
not functioning properly
 The Serotonin Pathways

Dihasilkan oleh nuclei

Raphe
Dipengaruhi oleh obat :
Amphetamin, alkohol,
cocaine Raphe Nuclei
Berperan penting dalam
proses di otak : pengaturan
temperatur, mood, lapar,
nyeri dan tidur

Problems with the serotonin pathway can cause obsessive-

compulsive disorder, anxiety disorders, and depression. Most of the
drugs used to treat depression today work by increasing serotonin
levels in the brain.
 Alcohol Caffeine
decreases inhibits

Glutamate and GABA glutamate

activity
GABA
release

(gamma-aminobutyric
acid) are the brain's major
"workhorse"
neurotransmitters. Over PCP
"angel Tranquilize
dust" Caffeine Alcohol rs increase
half of all brain synapses increases increases
glutamate
increases GABA
activity
glutamate GABA
release glutamate, and 30- activity activity activity

40% of all brain synapses

release GABA.
 Sedatif-Hipnotik dan Ansiolitik
Golongan Barbiturat
meningkatkan respon
GABA
membuka kanal ion Cl-
meski tanpa GABA
Golongan
Benzodiazepin
 Anti Depresan
Depresi : Kadar dopamin, serotonin dan NE menurun

1. Serotonin Spesific Reuptake inhibitor (SSRI)

misal : Fluoxetin
2. Heterosiklik
mengeblok reuptake serotonin dan norepinefrin,
dan sebagai antagonis reseptor muskarinik.
sehingga kadar serotonin dan NE tinggi (misal :
desipramin, imipramin)
3. Serotonin Norephinefrin Reuptake Inhibitor (SNRI)
 Anti Depresan
4. MAO inhibitor
menghambat MAO
menghancurkan
serotonin, dopamin dan
NE (misal :
isokarboksamid)
5. Lain-lain
antagonis reseptor alfa 2
presinaptik sekresi serotonin
dan NE meningkat (misal :
Mirtazapiin)
 Antipsikotik (neuroleptik)
Psikotik : Kadar Dopamin & Serotonin >>
Typical neuroleptik
Untuk mengobati gejala positif
dengan menurunkan dopamin
Mekanisme :
mengeblok reseptor dopamin,
kolinergik muskarinik, alfa adrenergik
dan H-1 histaminergik
Contoh :
Klorpromasin, Haloperidol (potensi
besar namun efek samping paling
besar yaitu parkinson), Acetofenasin
Atypical, 5-HT DA Antagonist
Untuk mengobati gejala postif & negatif :
menghambat reseptor dopamin dan
serotonin
Mekanisme :
antagonis serotonin-dopamin, mengeblok
reseptor kolinergik muskarinik, alfa-1
adrenergik dan H-1 histaminergik
Contoh :
Clozapine, Quetiapine
 Parkinson
Ganglia Basalis : serabut dopaminergik <<
asetyl cholin >>
1. Pengganti dopamin (terapi utama)
a. levodopa : prekursor metabolik dopamin
b. karbidopa : inhibitor dekarboksilase dopamin -> menurunkan
metabolisme levodopa -> kadar levodopa meningkat
c. tolkapon : inhibitor COMT (Catechol-O-Methyl-transferase) sehingga
levodopa bisa hidup lebih lama (waktu paro lebih panjang) dan kadarnya dalam
darah meningkat
2. Agonis reseptor dopamin (misal : bromokriptin, pergolid, pramipexole)
3. Antikolinergik (misal : triheksifenidil, benzotropin)
 NEUROPLASTISITAS OTAK

Kemampuan Otak untuk berubah dan mengubah

strukturnya sebagai
Respon terhadap rangsangan dari luar (lingkungan)

Menunjukkan bahwa situasi dan lingkungan yang tepat

Dapat memberikan pengaruh kuat terhadap perubahan otak
 Keadaan lingkungan yang berkaitan
dengan Neuroplastisitas Otak

1. Kegiatan Fisik (Voluntary Gross Motor)

2. Pembelajaran baru, menantang dan penuh
makna
3. Kesulitan yang logis (tidak bikin kacau)
4. Stresor yang dapat dikelola dengan baik
5. Dukungan sosial (rumah dan komunitas)
6. Nutrisi yang baik
7. Waktu yang mencukupi