Chapter 16 - Neuropsychology Flashcards
What is neuropsychology?
the relationship between brain processes, human behavior, and psychological functioning
What are the 2 main assumptions of neuropsychology?
- Everything can be broken down into subtasks, which can be studied
- Different Psychological Processes are controlled by different areas/ combinations
What are the two different types of neuropsychologists?
- experimental psychologists
2. clinical psychologists
Who was the first person to bring up localization of function?
Franz Gall
What were Gall’s two ideas
- localization
2. phrenology
When did Paul Broca arrive on the scene?
1861
What and where did Broca discover?
Tan’s lesion on his left frontal lobe, and then repeated results
Why was Paul Broca influence localization of function so significantly?
The French surgeon was very well respected
What is a lesion?
A small area of damage
What is the modularity view?
modules are regions that perform its own kind of analysis and are essential to the larger puzzle
What is a network?
A team of modules used to accomplish a certain function
What is lesion analysis?
Studying the localization of function by observing the results of brain damage
What is disconnection syndrome?
A type of syndrome that occurs when different modules are unable to interact with each other due to network issues
What is a neuropsychological assessment?
Tests designed to test mental functions
What are the different types of neuropsychological assessment?
- Test Batteries
- Tailored Tests
(3. General Tests)
How do most clinical neuropsychologists proceed when it comes to neuropsycholgical assessment?
Most give a test battery, and then proceede to more specific options
How will the test results be evaluated?
They will be compared to established averages, or norms.
What are the 3 listed test batteries?
A. Halstead-Reitan Battery
B. Wechsler Adult Intelligence Scale
C. Luria-Nebraska
What is the Halstead-Reitan Battery?
- It is the most popular test
- it uses 10 subtests for variety
What is the Luria-Nebraska Battery?
- 2nd most popular test
- has high reliability but is questioned by some
- many false positives
- 269 items
What are the 3 Mechanisms of Brain Dysfunction?
- Cerebrovascular Accidents (CVA’s, Strokes)
- Trauma Brain Injury
- Neurodegenerative Diseases
(4. Tumors?)
What is a CVA?
When the brain does not receive blood due to blood vessel blockage
What areas due CVA’s affect?
Where the brain tissue has died and the surrounding area
What are potential solutions to CVA’s?
Experimentation is taking place with chemicals and stem cells to potential grow new blood vessels and neurons
What is a potential problem with the proposed CVA solutions?
Cells must be influenced to be reestablished
What is traumatic brain injury?
The result of a sudden brain impact
What does traumatic brain injury do to the brain?
It potentially stretches and tears nerve fibers
Do we know more about symptom patterns from CVA’s or traumatic brain injury?
CVA’s, because they are more localized
What are 3 prominent examples of neurodegenerative diseases?
- Alzheimer’s
- Parkinsons’s
- Frontotemporal Degeneration
How do neurodegenerative diseases function?
They affect a particular type of brain cell, or cells in a particular area
What are the possible causes for neurodegenerative diseases?
- infections
2, nutritional deficiencies - genetic abnormalities
What are the 3 types of Neuropsychological Disorders (non-linguistic)
- Amnestic Disorders
- Conscious Disturbances
- Perceptual Disturbances
What are amnestic disorders?
disorders that involve memory loss
What was the famous case of “H.M.”
Henry Molaison has surgery to remove parts of both his right and left temporal lobe. He dealt with severe anterograde amnesia for the rest of his life
Where did H.M. have brain damage?
medial temporal lobe
hippocampus?
What can cause medial temporal damage?
- herpes encephalitis
2. CVA’s - but usually on one side
What other areas are vital to memory?
The thalamus and other parts of the limbic system
What is Korsakoff’s psychosis?
When the medial dorsal section of the thalamus is damaged due to lack of thiamine (vitamiin B1)
What are the symptoms of Korsakoff’s psychosis?
- anterograde amnesia
2. confabulation
What are conscious disturbances?
Problems that impair people’s ability to be accurately aware of the world around them
What part of the brain is a major player in consciousness?
The reticular activating system (RAS)
What are the 3 states of diminished consciousness?
- Coma
- Persistent Vegetative State
- Minimally Conscious State (+ or -)
What are other causes of diminished consciousness?
Impairment of both sides of the cortex
What are the more complex states of consciousness?
- Delirium
2. Anosognosia
What is delirium?
Alternating states of heightened and diminished consciousness.
What are some symptoms of delirium?
- poor attention, memory
- disorientation
- mental agitation
What are the causes of delirium?
- CVA’s
- Traumatic Brain Injury
- Encephalitis
- Lesions
- blood infections, poisons, side effects, fever, ect.
What do assessments of delirium look like?
It is difficult, but pretty much all performance is poor
What is anosognosia?
An absence of knowledge of disease
Is anosognosia more likely to occur in the left or right side of the brain?
The right
What are the causes of anosognosia?
- It occurs after 25% of CVA’s
- some neurodegenerative diseases
Why does the ego defense argument of agosognosia not hold up?
- Different halves of brain react differently
- Aware of some but not all problems
- Deny some problems that are not of concern
What is the Wada technique?
Intentional anesthetization to research anosognosia
What are perceptual disturbances?
Disorders in which there are impairments in the ability to organize, recognize, interpret, and make sense of sensory information
What route does the “what” pathway take?
- Occipital
2. Temporal
What route does the “where” pathway take?
- Occipital
2. Parietal
What condition is caused by damage to the “what” pathway?
Visual Agnosia - can’t describe based on appearance
What condition is caused by damage to a specific face region in the “what” pathway?
Prosopagnosia - can’t recognize faces
Does Prosopangnosia usually require damage on both temporal lobes?
Yes
What is Capgrass syndrome/delusion?
The belief that people have been replaced by imposters
usually permanent
What conditions are caused by damage to the “where” pathway?
- Simultanagnosia - can perceive the whole but not the parts
- Hemineglect
What is the main cause of Hemineglect?
CVA
What side is typically neglected?
The left side of the world, right side of the brain
Do hemineglect patients have sensory problems?
only some do
Who conducted the hemineglect experiements?
Edoardo Bisiach
What are the two main types of language disorders?
- Wernicke’s Aphasia
2. Broca’s Aphasia
On what side of the brain do most aphasia’s occur?
The left
What is Primary Progressive Aphasia (PPA) ?
A neurogenerative disease process caused by frontotemporal degeration (FTD), killing nerve cells
What is Broca’s Aphasia?
The loss of language fluency
- concrete nouns
- naming/sound errors
- agrammatism
What is paraphasis, phonemic paraphasis
Naming errors, errors in how a word should sound
What is Wernicke’s Aphasia
Everything sounds like nonsense, everything they say is nonsense but fluid
-use words that have the wrong meaning
What is semantic paraphasis?
Naming errors in which words are used that have the wrong meaning
What language problems can accompany damage in the right hemisphere?
aprosodia -difficulties understanding or expressing tone and inflection
What are the types of movement disorders (apraxias)?
- Ideational apraxia - movements in wrong order
2. Idemotor apraxia - improper movement
What is needed for a diagnosis of dementia?
- Notable memory impairment
2. Other impairment (perceptual, language, learned motor)
What is mild cognitive impairment (MCI)?
A condition that precedes the appearance of dementia, medication and a low-fat diet can still slow progress
What are the causes of dementia?
Dementia is usually caused by a neurodegerative disease
-60-80% caused Alzheimer’s Disease
What are the main abnormalities present in Alzheimer’s patients?
- degenerative nerve cells (tangles)
- clumps of protein deposits (amyloid plaques
- (damage to mitochondria)
What neurons have been found to be most affected by Alzheimer’s?
Neurons that use acetylcholine
What lobes are affected by Alzheimer’s disease?
- (medial) temporal, hippocampus
2. parietal
How common is Alzheimer dementia & vascular dementia?
Alzheimer - 1st
Vascular -2nd (17% ages 71+)
What are some differences in vascular dementia?
- hippocampus relatively unaffected
- can form memories, can’t retrieve
What are some subtle symptoms that may lead to early diagnoses?
- inability to smell certain odors
- loss of ability to appreciate sarcasm
