Ch 5 NP functions and Neurobehavioral disorders Flashcards
Spearman’s general factor theory states that
all abilities share a general factor, g
global IQ can summarize all abilities
Cattell Horn Carroll model
Gf-Gc (fluid and crystalized intelligence) by Cattell and Horn
Three Stratum Theory (Carroll)
Howard Gardner
theory of multiple intelligence (linguistic, logical-math, musical, spatial, bodily-kinesthetic, naturalistic, interpersonal, intrapersonal)
Intellectual Disability
developmental disorder
onset before 18
substantially subnormal IQ (> 2SD below the mean)
deficits in 2+ adaptive skills
Savantism
individual with ID or ASD has one or more specific or narrow remarkable talent that is in contrast with their ID
exceptional memory, calculation, calendar knowledge, art, language ability
Savantism prevalence
6 times more in makes than females
What test measures simple attention
digit span, Corsi blocks
What test measures focused attention
digit symbol coding
What test measures selective attention
cancellation
What test measures sustained attention
CPT
What test measures alternating attention
Trails B
What test measures divided attention
PASAT (paced auditory serial addition test)
Posner and Petersen’s model of attention states that
attention is divided into 2 major areas
1) posterior network
2) anterior network
According to Posner and Petersen, Posterior network
has to do with orienting and shifting attention
According to Posner and Petersen, Anterior network
serves as the detection system (executive attention) and detects stimuli either from sensory events or from memory
Alerting network of attention is subserved by which system?
Ascending reticular activating system (ARAS)
What is the alerting network of attention?
influence both anterior and posterior networks, operates at both high and low levels of arousal
Processing speed is dependent on
- white matter that makes up cortico-cortical connection
- basal ganglia
- frontal regions (DLPFC)
- cerebellum
Ascending Reticular Activating System (ARAS) is responsible which type of attention
arousal and attention
Anterior cingulate and limbic system is responsible for which type of attention
determines saliency and stimuli and associated emotion/motivation
Prefrontal area is responsible for which type of attention
response selection control sustained attention and focus switching searching alternating
Orbitofrontal/Ventromedial is responsible for which type of attention
inhibition of responses
sustained attention
Dorsolateral Frontal is responsible for which type of attention
initiation of responses
sustained attention
shifting attention
Medial Frontal is responsible for which type of attention
motivation
consistency of responding
focused attention
Thalamus is responsible for which type of attention
sensory relay between subcortical areas and cortex
pulvinar nuclei is responsible for which type of attention
extracting info from target location and filtering distraction
superior colliculus is responsible for which type of attention
shifting attention
eye movement
inferior colliculus is responsible for which type of attention
orientation to auditory stimuli
inferior and posterior parietal is responsible for which type of attention
hemispatial neglect and inattention
right hemisphere is responsible for which type of attention
spatial attention
appreciation of gestalt
hemispatial inattention and neglect
components of language competence include 4 areas
phonology, syntax, semantics, pragmatics
how is language different from speech?
speech is the physical oral expression of language
etiology of aphasia
stroke (40% of patients have some degree of aphasia)
neoplasm
intracranial tumor and infection
brain injury
speech disturbances that are not considered aphasia
dysarthria, dysphonia, apraxia of speech
disconnection syndrome is proposed by
Geschwind
According to Geschwind, aphasia, apraxia, agnosia are examples of
disconnection syndrome - result of lesions interrupting the transfer of info from one neural region to another
spontaneous speech include 2 specific content areas
Form
Content
Form of speech
form - whether patient’s speech is fluent or nonfluent (examined by effort required to produce speech, rate, melody, length)
Content of speech
word choice and syntax
presence or absence of paraphasic errors in spontaneous speech
Describe fluent aphasic speech content
word output normal
content not informative
empty meaning
Describe nonfluent aphasic speech content
critical words present but in wrong order and wrong grammar
agrammatism/telegraphic speech
Describe fluent aphasic speech form
output normal, length normal
articulation and melody normal
speech maybe non meaningful with paraphasia
Describe nonfluent aphasic speech form
output diminished, length decreased
laborious articulation
poor rhythm
impaired initiation and impaired grammatical sequence
Comprehension of spoken and written language difficulties
Syntactic errors- anterior lesion, disturbed comprehension of phonological, syntactic information
Lexical/semantic errors - posterior lesion, disturbed comprehension of meaningful word sounds to convey meaning
Why is repetition important to be assessed for aphasia?
ability to repeat indicates perisylvian language centers are functional
Anomia/Naming difficulties
problems naming an object, color, body part, finding words
- harder to localize
Alexia can be seen in isolation without other features of aphasia, true or false
True
Aphasic disorders without repetition difficulties are located in which areas?
Borderzone language areas
Aphasic disorders with repetition difficulties are located in which areas?
Perisylvian areas
Which types of stroke will have a better outcome? Strokes isolated to the cortex OR strokes that include deeper structures?
Strokes isolated to the cortex have better outcomes than those including deeper structures
Strokes affecting cortex are less disruptive than those that affect
multiple systems needed for normal language (eg. structures that are connected by white matter pathways)
Hallmark of perisylvian aphasia syndromes
Impaired repetition
Discuss characteristics for Broca's aphasia in spontaneous speech comprehension repetition naming reading writing
spontaneous speech impaired comprehension intact repetition impaired naming impaired/limited reading impaired/limited writing impaired
Discuss characteristics for Wernicke's aphaisa: spontaneous speech comprehension repetition naming reading writing
spontaneous speech intact comprehension impaired repetition impaired naming impaired reading impaired writing impaired
Discuss characteristics for Conduction aphasia in: spontaneous speech comprehension repetition naming reading writing
spontaneous speech intact comprehension intact repetition impaired naming impaired reading intact writing impaired
Discuss characteristics for Global aphasia in: spontaneous speech comprehension repetition naming reading writing
spontaneous speech impaired comprehension impaired repetition impaired naming impaired reading impaired writing impaired
Discuss characteristics for Anomic aphasia in: spontaneous speech comprehension repetition naming reading writing
spontaneous speech intact empty comprehension intact repetition intact naming impaired reading intact writing impaired empty
Discuss characteristics for Subcortical aphasia in: spontaneous speech comprehension repetition naming reading writing
spontaneous speech intact comprehension intact repetition intact naming impaired reading ? writing ?
Discuss characteristics for Transcortical motor aphasia in: spontaneous speech comprehension repetition naming reading writing
spontaneous speech impaired comprehension intact repetition intact naming impaired/limited reading intact writing impaired
Discuss characteristics for Transcortical sensory aphasia in: spontaneous speech comprehension repetition naming reading writing
spontaneous speech intact comprehension impaired repetition intact naming impaired reading impaired writing impaired
Discuss characteristics for Transcortical mixed aphasia in: spontaneous speech comprehension repetition naming reading writing
spontaneous speech impaired comprehension impaired repetition intact naming impaired reading impaired writing impaired
Common cause of transcortical mixed aphasia
Hypoxic brain injury
Common cause of global aphasia
entire perisylvian region
occlusion early in the MCA
Prognosis for entirely subcortical aphasia is usually
GOOD
Which part of the brain is usually involved in alexia with agraphia?
lesion in the posterior parietal lobe (angular gyrus)
Which part of the brain is usually involved in alexia without agraphia?
word blindness
lesion in visual word form area
lesion in L occipital area and L adjacent corpus callosum
disconnection syndrome isolating visual from language systems
Which part of the brain is usually involved in pure word deafness?
damage to both temporal lobes
destruction of L Heschl’s gyrus
damage to white matter tract connecting L Heschl’s gyrus and R auditory association
Auditory agnosia
inability to recognize the nature of formerly familiar nonverbal acoustic stimuli
intact hearing
intact recognition of speech
Agnosia for Sounds
inability to recognize meaning of nonverbal environmental stimuli (eg. sound of train, dog bark)
bilateral lesion in primary auditory cortex around Heshl’s gyrus
Another term for Agnosia for Music
Amusia
Agnosia for Music
inability to recognize the meaning of musical sounds, rhythm
lesion in R or bilateral temporal lobe
Ventral visual processing pathway projects to
occipital temporal association cortex
Dorsal visual processing pathway projects to
parietal occipital association cortex
Ventral processing disorder
Visual agnosia
Dorsal processing disorder
Visual processing, spatial analysis impairment
Tests to measure ventral visual processing
HVOT
picture completion
Tests to measure dorsal visual processing
JoLO
Block Design
Prosopagnosia
inability to recognize, identify, or revisualize holistic face representations of familiar or unfamiliar people
right fusiform gyrus
Constructional Apraxia
loss of ability to carry out purposeful movements
visuospatial disorder that signals inability to construct shapes and geometric designs and assemble blocks
Dressing Apraxia
inability to localize objects in space
inability to dress
a form of constructional apraxia
Lesion of Dressing Apraxia
Right parietal occipital
Spatial analysis is localized to
posterior R hemisphere
Impairment in location of objects in space
unilateral or bilateral occipital parietal junction
Achromatopsia is localized to
posterior medial region
calcarine cortex
Lesion location of spatial Acalculia
right parietal
Achromatopsia
impairment in color perception (see only black and white)
Lesion location of Achromatopsia
occipital temporal
Another word for declarative memory
Explicit memory
Another word for procedural memory
implicit memory
Retrograde amneisa
amnesia for events prior to accident or illness
Ribot’s Law
oldest memory is the most resistant to amnesia
Anterograde amnesia
inability to learn or encode new information or form new memories, continuous memory
Post traumatic Amnesia (PTA)
anterograde amnesia
best indicator or predictor of TBI outcome
Functional Amnesia
psychogenic amnesia, fugue
psychiatric
Infantile Amnesia
failure to recall autobiographical info from early childhood
Transient Global Amnesia
hypoperfusion of medial temporal or diencephalic areas
disconnection of lateral and medial limbic circuits
strategic infarction
migraine
ECT
acute onset memory loss that lasts for less than 10 hours
profound anterograde amnesia and variable retrograde amnesia
alert and oriented
confabulation
Anoxia/Hypoxia
damage to medial temporal lobe (CA1 of hippocampus)
insight may be preserved
confabulation not as common
ACoA (Anterior Communicating Artery) Aneurysm
damage to basal forebrain, striatal, frontal system
disruption of cholinergic neurons that project to medial and lateral limbic circuits
frontal amnesia - confabulation, attention, disorientation, apathy, lack of insight
Wernicke-Korsakoff Syndrome
chronic alcohol use and thiamine deficiency diencephalic amnesia anterograde and retrograde amnesia proactive interference temporal order impairment confabulation poor insight gait ataxia, oculomotor palsy, encephalopathy
Herpes Encephalopathy
infection caused by the herpes virus
affects medial and inferior temporal lobes and amygdala
amnesia, aphasia, agnosia (TRIPLE A!)
Surgical Ablation
bilateral medial temporal resection for intractable epilepsy
damage to hippocampal, parahippocampal and amygdala damage
preserved insight
not prone to confabulation
Posterior Cerebral Artery (PCA) Stroke
involves medial temporal and posterior occipital lobes
deficits are visual deficits, hemianopic alexia, color agnosia, object agnosia
Which part of the brain is involved with motor sequencing?
prefrontal
DLPF
Which part of the brain is involved with poor directed attention?
prefrontal
frontal eye lids
Which part of the brain is involved with poor working memory
DLPFC
Which part of the brain is involved with perseveration
DLPFC
Which part of the brain is involved with failure to maintain response set
Prefrontal
Which part of the brain is involved with poor reasoning
Dorsolateral prefrontal area
Which part of the brain is involved with lack of motivation
DLPFC, basal ganglia, anterior cingulate
amygdala
Which part of the brain is involved with poor planning and organization
DLPFC, orbitofrontal
Which part of the brain is involved with impulsivity
Orbitofrontal
Which part of the brain is involved with emotional lability
Orbitofrontal
Which part of the brain is involved with utilization behavior/stimulus-bound behavior
Orbitofrontal, mesial frontal, anterior cingulate
Which part of the brain is involved with Witzelsucht
Orbitofrontal
Which part of the brain is involved with disinhibition
Orbitofrontal
Which part of the brain is involved with akinetic mutism
Dorsomedial prefrontal/anterior cingulate
Which part of the brain is involved with depression
damage to the left frontal
Which part of the brain is involved with reduplicative paramnesia
right posterior parietal
frontal
Which part of the brain is involved with capgras syndrome
right temporal
bilateral frontal
Which part of the brain is involved with anosognosia
posterior parietal
frontal
right hemisphere
Finger agnosia
loss of ability to name or identify the fingers of own hand or other person’s hand
- lesion in left inferior parietal lobe (angular gyrus)
Gertsmann syndrome
acalculia
right left disorientation
agraphia
finger agnosia
Right left disorientation
inability to identify R and L side of body of self or others
- lesion of L inferior parietal (angular gyrus)
Autotopagnosia
the disturbance of body schema involving the loss of ability to localize, recognize, or identify the specific parts of one’s body
Somatagnosia
cannot recognize one’s body schema
Astereoagnosia
inability to recognize nature of an object by tactual ability or other physical features such as size or shape
- lesion in posterior parietal lesion
Asomatognosia
loss of knowledge or sense of one’s body and bodily condition
- lesion in bilateral parietal lobes
Apraxia
inability to carry out previously learned purposeful, skilled movements
normal motor skills and comprehension of act
Location of apraxia
lesions near language zone of L hemisphere
L inferior parietal lobule
frontal lobe systems (premotor cortex, supplementary motor area, frontal convexity)
disconnection of corpus callosum
Ideational apraxia
- inability to plan, sequence, execute complex gestures (lost the idea behind gesture or use of tool even though knowledge of tool is unaffected)
- L posterior temporal parietal junction
Ideomotor apraxia
- inability to perform a skilled gesture with a limb upon verbal command and/or by imitation
- L inferior parietal lobe
- supplementary motor area
- lesion in corpus callosum
Limb Kinetic apraxia
- inability to make precise or exact movements with a finger, an arm or a leg
- pyramidal motor system
Apraxia of speech
NOT language d/o
impairment in planning the movements needed for speech production
Dysarthria
disorder of motor coordination
Buccofacial Apraxia
difficulty performing voluntary skilled motor movements of face, tongue, lips, cheeks on command
Gait apraxia
loss of normal capacity to use legs appropriately for walking
Anosodiaphoria
one is aware that they have impairment but show no emotional concern or distress
neglect
R parietal or frontal systems
Alexithymia
inability to understand, process, or describe one’s own emotions
- R hemisphere
Emotional lability localized to
orbitofrontal system
limbic system
rumination localization
subgenual prefrontal cortex
Pseudobulbar affect
damage to upper motor neuron corticobulbar tract and connections to cerebellum
Dysphonia
A speech disorder involving difficulty in vocalization
Hesch’s gyrus
aka transverse temporal gyrus
gyrus on the upper surface of the temporal lobe
contains the primary auditory cortex
