Cognition: Language... (15 A) EXAM 4 Flashcards
The use of complex abstract symbols to represent one’s perception of the world to another:
Language
T or F: Language is both innate and learned, verbal and nonverbal?
True
Language is located on which area of the brain?
Lateral surface of LEFT hemisphere
Language pathway from auditory cortex:
Primary auditory area –> secondary auditory area –> Wernicke’s Area –> Arcuate Fasciculous –> Broca’s Area –> Lateral surface of motor cortex (because face is most lateral)
Wernicke’s Area
Responsible for the recognition and comprehension of words
Broca’s Area
Responsible for producing coherent speech (NOT motor, sends instructions to UMN).
Arcuate fasciculus
The pathway connecting Wernicke’s Area and Broca’s area
Three key features of language:
- Wernicke’s Area
- Broca’s Area
- Arcuate Fasciculus
What is a disturbance of language caused by an insult to specific regions of the brain?
Aphasia
T or F: Aphasia is similar to dysarthria (slurred speech) and dysphonia (tightness of larynx)?
FALSE, Aphasia is caused by trauma to brain, dysarthria and dysphonia are mechanical disorders of speech
What is the most common cause of Aphasia?
Traumatic brain injury, stroke (cerebrovascular accident)
Wernicke’s Aphasia is caused by damage where?
PTO area
What disorder is characterized by deficit in comprehension of language? (listening to other people speak is meaningless)
Wernicke’s Aphasia
Which disorder is characterized by meaningless speech and meaningly phrases that may be repeated?
Wernicke’s Aphasia
Paraphrasia:
Word substitutions
What are co-occuring disorders with Wernicke’s Aphasisa?
Alexia, Agraphia, Sensory & Motor impairments (hemiplegia), contralateral homonymous hemianopia
What is Broca’s Aphasia caused from?
Damage to Broca’s area in the frontal lobe
What disorder is characterized by difficulty getting words out
Broca’s Aphasia
What are co-occuring disorders with Broca’s Aphasia?
Difficulty reading aloud, writing impaired, R hemiplegia almost always present
What type of aphasia is damage to arcuate fasciculus?
Conduction Aphasia
T or F: In conduction aphasia the person can understand written and spoken language?
TRUE
Which disorder is this:
Can speak fluently, but speech does not make sense; can write, but writing does not make sense and there is a severe deficit in repeating out loud?
Conduction Aphasia
What disorder is caused by an extreme of the L lateral cerebrum?
Global Aphasia
Which disorder is this?
Deficits in all aspects of spoken and written language
Can’t produce understandable speech, comprehend spoken language, speak fluently, read or write
Global Aphasia
Alexia
Loss in reading the printed word
Dyslexia
Impairment in reading the printed word
Loss in reading the printed word
Alexia
Impairment in reading the printed word
Dyslexia
Acquired Alexia
A reading impairment that accompanies or is part of aphasia
Dyslexia:
Inability to read at a level commensurate with the person’s overall intelligence
Inability to read at a level commensurate with the person’s overall intelligence
Dyslexia
A reading impairment that accompanies or is part of aphasia
Acquired Alexia
Agraphia / Dysgraphia:
Loss/impairment of writing ability in the absence of limb dysfunction
Loss/impairment of writing ability in the absence of limb dysfunction
Agraphia / Dysgraphia
Acalculia
Inability to perform mathematical calculations
Inability to perform mathematical calculations
Acalculia
T or F: The right hemisphere typically does not process language?
True
Aprosodia
damage to right hemisphere that is a disturbance in the affective, nonverbal components of language
What is the right hemisphere associated with controlling?
Nonverbal communication, gestures, facila expressions, tone of voice, posture
Right Wernicke’s
Interpretation of nonverbal signs from other people
Right Broca’s
Instruction for producing nonverbal communication (emotional gestures, speech intonation)
Damage to “R Wernicke’s”
Difficulty understanding nonverbal communication
ex: Statement said in jest vs. anger
Damage to “R Broca’s”
Difficulty in producing nonverbal motor responses
ex: speak in monotone, lack emotional facial expressions, lack gestures
Parietotemporal Occipital Association Area (PTO)
Cognitive intelligence, perception/spatial relationships, understanding language
Dorsolateral Prefrontal Association Area
Anterior part of frontal lobe)
Goal-oriented behaviors, self-awareness, executive function
Limbic Association Area
Ventral and medial prefrontal association cortex
Personality, emotion, motivation
If there is damage to the dorsolateral prefrontal association area, what is the outcome?
Profound influence on compliance and outcomes, can negatively impact daily life (deciding on a goal, planning a goal, impulse control, etc…)
If there is damage in the ventral and medial prefrontal association cortex, what is the outcome?
Can lead to inappropriate and risky behavior, poor social judgement (empathy, embarrassment, guilt, regret)
What 5 structures recognize emotional stimuli and generate and perceive emotions?
- Amygdala
- Area 25
- Mediodorsal Nucleus of thalamus
- Ventral striatum
- Anterior insula
When an individual’s reaction to an experience disrupts homeostais, this is called:
The stress response
What activates in the physiological aspect of the stress response?
- Somatic nervous system (muscles)
- Sympathetic division of the ANS (blood flow, stop digestion)
- Neuroendocrine system (release stress hormones - HPA axis)
What is the HPA Axis?
Hypothalamus, Pituitary, Adrenal
What does the HPA axis do (broadly)?
Starts and stops the stress response through a cascade of events
Steps in HPA Axis response:
- Hypothalamus: Neurons in hypothalamus synthesize and secrete CRH / CRF
- Pituitary: CRH causes pituitary gland to release ACTH
- Adrenal: ACTH acts on adrenal gland to produce cortisol (stress response) and other glucocorticoids
What does the production of cortisol in the HPA Axis stress response do?
- Mobilizes energy
- Suppresses immune response
- Acts as anti-inflammatory agent
What does the production of glucocorticoids in the HPA Axis stress response do?
Acts on the hypothalamus and other structures to suppress CRH and ACTH production
What disorders is the HPA Axis involved in the neurobiology of?
- Panic disorder
- Phobias
- Post-traumatic stress disorder
- Major depressive disorder
Excessive amounts of cortisol are associated with what?
Stress-related diseases
Post-Traumatic stress disorder
Severe anxiety disorder that can develop after exposure to any event that results in psychological trauma
In PTSD, there is an abnormality where?
HPA Axis
Symptoms of PTSD:
- Reduced regulation of autonomic reactions to internal and external stimuli
- Decreased capacity to respond normally to emotional arousal or external stressors
- Hyperarousal and hyperstartle
What disorder is characterized by a combination of symptoms that interfere with a person’s ability to work, sleep, study, eat and enjoy once-pleasurable activities?
Major Depressive Disorder
Medications for Major Depressive Disorder:
- Selective serotonin reuptake inhibitors
- Serotonin and norepinephrine reuptake
- Tricyclics
- Monoamine oxidase inhibitors (MAO)
Selective Serotonin Reuptake inhibitors (SSRI’s)
Prozac, Zoloft
Increase available 5HT (Serotonin) by blocking it from being reuptaken by presynaptic neuron
Serotonin and Norepinephrine reuptake inhibitors (SNRI’s)
Symbalta and Effector
Increase available 5HT and NE
Tricyclics
Inhibit reuptake of 5HT and NE, less specific, not selective what they are blocking
Monoamine oxidase inhibitors (MAOI’s)
Prevent MAO from metabolizing the NE, 5HT and DA in the brain
(usually cause severe side effects so not used unless other drugs have been tried)
Schizophrenia
A group of serious brain disorders in which reality is interpreted atypically. Results in positive, negative and cognitive symptoms
Is Schizophrenia a chronic or acute condition?
Chronic, requires lifelong treatment
Etiology of Schizophrenia
Idiopathic
typically develops in late adolescence/early adulthood when person is under a lot of stress/changes
Neuroanatomical changes in Schizophrenia
- Reduction in the volume of gray matter (esp in frontal and temporal lobes)
- Hippocampus and Amygdala shrinks
- Enlarged ventricles
- Differences in brain activities in certain areas
- Imbalance in Neurotransmitters
In Schizophrenia, Where is the reduction of gray matter most seen?
Frontal and temporal lobes
What happens to the ventricles in Schizophrenia?
They become enlarged
What happens in the hippocampus and amygdala in Schizophrenia?
They become reduced
What are the positive symptoms of schizophrenia (things that are there that shouldnt be)?
- Hallucinations
- Delusions
- Thought Disorders
- Movement Disorders
What are the negative symptoms of schizophrenia?
- Alogia (Speaking less)
- Blunted / flat affect
- Avolition
- Anhedonia
Blunted/Flat affect
Reduction in range/intensity of emotional expression
Avolition
Difficulty/loss of ability to initiate and persist in goal-directed behavior
Anhedonia
Lack of pleasure in everyday life
Cognitive symptoms of Schizophrenia
- Poor executive functioning
- Trouble focusing or paying attention
- Problems with working memory
Neurochemical Hypothesis: Dopamine Hypothesis (Schizophrenia): Too much dopamine
Over activity in the mesolimbic DA pathway
causes positive symptoms because DA binds over and over again
Neurochemical Hypothesis: Dopamine Hypothesis (Schizophrenia): Too little dopamine
Under activity in the mesocortical DA pathway causes negative and cognitive symptoms because there is not enough DA binding
Neurochemical Hypothesis:
Serotonin Hypothesis (Schizophrenia)
Hypoactivity
(Likely to be indirectly related to Schizophrenia)
Decreased density of serotonin 5-HT(2) receptors int he prefrontal cortex causing negative and cognitive symptoms
Neurochemical Hypothesis:
Serotonin Hypothesis (Schizophrenia)
Hyperactivity
(Likely to be indirectly related to Schizophrenia)
Too much 5HT hanging out in synaptic cleft
Neurochemical Hypothesis:
NMDA receptor hypofunction:
Dysfunctional glutamatergic neurotransmission in prefrontal cortex
What happens in NMDA receptor hypofunction to the mesolimbic DA pathway?
Can’t inhibit mesolimbic DA neurons –> mesolimbic hyperactivity –POSITIVE symptoms
What happens in NMDA receptor hypofunction to the mesocortical DA pathway?
- Can’t excite mesocortical DA pathways –> mesocortical hypoactivity –> negative and cognitive symptoms
What happens TYPICALLY in the mesolimbic and mesocortical pathways with NMDA receptors?
- Mesolimbic DA pathway is inhibited
2. Mesocortical DA neurons are excited
Traditional Antipsychotic Drugs (1st generation) for Schizophrenia manage what symptoms?
- Manage POSITIVE symptoms
Traditional Antipsychotic Drugs (1st generation) for Schizophrenia: How do they work?
Block ALL dopamine (D2) receptors
What is a side effect of blocking ALL D2 receptors (1st gen Schiz drugs)
Tardive Dyskinesia
Why is Tardive Dyskinesia developed with the use of 1st gen antipsychotic drugs for Schiz?
Because of the long term use of the antipsychotic drugs (the D2 receptors become hypersensitive)
What is Tardive Dyskinesia?
Abnormal, involuntary movements, especially of the face and tongue (grimacing, tongue protrusion, lip smacking, puckering/pursing of lips)
What symptoms do Atypical anti-psychotic medications (2nd gen) manage for Schiz?
Positive and negative symptoms
What receptors do atypical anti-psychotic meds have an effect on (Schiz)?
Dopamine and Serotonin receptors
Dont block all D2 receptors, but rather specific DA receptors
With atypical anti-psychotic drugs there are fewer ______ side effects but increased chance of ______ side effects?
Fewer motor side effects
Increased chance of metabolic side effects
Examples of atypical anti-psychotic medications (Schiz)
- Clozapine
- Risperidone
- Olanzapine
