A Case of Transient Global Amnesia: A Review and How It May Shed Further Insight into the Neurobiology of Delusions

Conclusion In closing, our patient’s episode of TGA combined with her emotional and perceptual response lends credence to the proposal of a “fear/paranoia” circuit in the genesis of paranoid delusions—a circuit incorporating amygdala, frontal, and parietal cortices. Here, neutral or irrelevant stimuli, thoughts, and percepts come to engender fear and anxiety, while dysfunction in frontoparietal circuitry engenders inappropriate social predictions and maladaptive inferences about the intentions of others.[54] Hippocampus relays information about contextual information based on past experiences and the current situation to amygdala, which the latter requires for threat assessment. Simply stated, in the absence of true threat, hippocampus, as well as ventromedial prefrontal (vMPFC) and anterior cingulate cortex (ACC), “inhibits” potential hyper-responsivity of amygdala.The hippocampus contains local glutamatergic and gamma aminobutryic acid (GABA). In the presence of negligible threat, hippocampus inhibits amygdala overactivity through inhibitory GABAergic (or anti-glutamatergic) neurotransmission.[56] Thus, diminutions in hippocampal function can result in amygdalar disinhibition, precipitating “fear.” Additionally, there are extensive reciprocal connections between amygdala and the vMPFC and ACC. Glutamatergic efferents from both vMPFC and ACC likely synapse on ?-aminobutyric acid neurons and thus provide an important inhibitory ...
Source: Innovations in Clinical Neuroscience - Category: Neuroscience Authors: Tags: Anxiety Disorders Behavioral and Cognitive Neurology Case Report Cognition Current Issue Dementia Medical Issues Neurologic Systems and Symptoms Psychiatry Schizophrenia delusions hippocampus neurobiology Transient global amnesia Source Type: research

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