Adolescence is a period between childhood and adulthood, characterized by specific physical and psychological development. It is a transitional developmental period, rather than a single snapshot in time. Traditional neurobiological and cognitive explanations of adolescent development of behavior have failed to account for the changes in behavior observed during adolescence. Magnetic resonance imaging studies have discovered that myelinogenesis continues from childhood to adulthood in the brain's region-specific neurocircuitry, which remains structurally and functionally vulnerable to impulsive habits. The maturation of the adolescent brain is influenced by heredity, environment, and sex, and they play a crucial role in myelination. Furthermore, one of the measures extracted out of MRI studies is also the thickness of cerebral cortex, a part that harbors synapses. It is the complexity of these synapses that allows humans to generate and understand complex thoughts and feelings in the real world, including the ability to solve analogies. And it is the complexity of those connections, remaining under construction during adolescence, that may be responsible for immature and impulsive behavior and neurobehavioral excitement during the adolescent life. 9 SAŽETAK Adolescencija je period fizičkog i psihološkog razvoja, koji se odvija između detinjstva i perioda odraslog života. To je više prelazni razvojni period nego što je izolovan trenutak u vremenu. Tradicionalna neurobiološka i kognitivna objašnjenja razvoja adolescenta nisu uspela da obrazlože promene u ponašanju koje se primećuju tokom adolescencije. Naučne studije su otkrile da se mijelogeneza nastavlja u specifičnim neuronskim mrežama mozga od detinjstva do zrelosti. Sazrevanje adolescentnog mozga je pod uticajem nasleđa, okruženja i pola, koji igraju presudnu ulogu u mijelinizaciji. Složenost razvoja sinapsi omogućava ljudima stvaranje i razumevanje kompleksnih misli i oseća-nja, uključujući i sposobnost rešavanja analogija u realnom svetu. I sama kompleksnost ovih veza, koje nastavljaju razvoj tokom adolescencije, može da bude odgovorna kako za nezrelo i impulsivno ponašanje, tako i za neurobihejvioralno uzbuđenje tokom adolescentnog života
Background: Accumulated evidence indicates that exposure to trauma is associated with the development of cognitive impairments and psychiatric symptoms in children and adolescents. Objective: In this case study of a female adolescent of 17 years, we aimed to evaluate how cortical positron emission tomography (PET) abnormalities relate to psychogenic non-epileptic seizure (PNES) dissociative state, post-traumatic stress disorder (PTSD), attention-deficit/hyperactivity disorder (ADHD), and domestic violence exposure. Methods: Detailed psychiatric and neuropsychological assessment was performed initially, followed by a PET study. The PET imaging was carried out in the resting-state and in the dissociative-state. Results: The adolescent was suffering from multiple episodes of unconsciousness, all found to be psychogenic; thus, PNES was diagnosed. However, at the psychopathology symptom level, the adolescent had heightened impulsivity, hyperactivity, hyperarousal, anxiety, somatic, and dissociative/ functional neurological symptoms present separately or concurrently at some point during her life; thus, the criteria for PTSD and ADHD were also fulfilled. In the resting state, significant hypometabolism was observed in the occipital, occipitotemporal, polar, and mesial parts of the temporal regions bilaterally, fronto-parietal medial and lateral pericental regions, and fronto-temporal and insular region on the left. The most intense metabolism was observed in the posterior cingulate gyrus and the medial parts of the posterior parietal lobe. In the dissociative state, there was a slight increase in the metabolism of the brain globally compared with the resting state, but with identical distribution of the regional changes observed. Conclusions: Widespread cortical PET abnormalities were found, possibly indicating alterations in large-scale brain networks, in a patient with PNES and a dissociative state, PTSD, and ADHD, who was exposed to chronic domestic violence
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