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Atypical Brain Development and Degeneration > Cognitive Deficits Following a Stroke > Flashcards

Cognitive Deficits Following a Stroke Flashcards

1
Q

Attention affected by stroke

A

Focus attention

Sustained attention

Selective attention

Divided attention

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2
Q

Memory affected by stroke

A

Visual memory

Auditory memory

Working memory

Episodic memory

Semantic memory

Procedural memory

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3
Q

Executive function affected by stroke

A

Initiation

Processing speed

Problem solving

Planning

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4
Q

Perception affected by stroke

A

Visuo-spatial

Visuo-Perceptual

Unilateral spatial neglect

Inattention

Dyspraxia/apraxia

Agnosia

Prosopagnosia

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5
Q

What is unilateral spatial neglect?

A

Where a person will only see one side of their body

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6
Q

Is there a problem with vision in unilateral spatial neglect?

A

No, there is no visual defect, they are just not attending to the side of the body that they cannot see

It is a sensory issue

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7
Q

What part of the brain is affected in unilateral spatial neglect?

A

Parietal lobe

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8
Q

Assessment of unilateral spatial neglect

A

Line bisection test

Clock drawing test

Behavioural Inattention Test

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9
Q

What is the line bisection test?

A

Participant presented with lines and asked to cross them

If the deviate from the middle then this indicates neglect

Those with neglect often leave one half of the page because they cannot process the information on the side and think they have crossed all the lines

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10
Q

Strengths of the line bisection test

A

Simple

Inexpensive

Doesn’t require training

Noninvasive

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11
Q

Limitations of the line bisection test

A

Lack of sensitivity

Can’t tell how severe the neglect is

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12
Q

What is the clock drawing test?

A

Asked to draw a clock with all the numbers and hands on

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13
Q

Strengths of the clock drawing test

A

Easy to administer

Inexpensive

Provides a more complete picture of cognitive function when used with other assessments

Has demonstrated reliability

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14
Q

Limitations of the clock drawing test

A

Confounded by age and education

May be affected by motor coordination

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15
Q

Improvements to the clock drawing test

A

Addition of other tests to improve sensitivity and avoid confounds of age and educational level

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16
Q

Behavioural Inattention Test

A

Wilson et al. (1987)

Comprehensive battery of tests

Conventional section

and

Behavioural section

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17
Q

Conventional section of BIT

A

Line crossing

Letter cancellation

Star cancellation

Shape copying

Line bisection

Representational drawing

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18
Q

Behavioural section of BIT

A

Picture scanning

Phone dialling

Menu reading

Article reading

Telling and setting the time

Coin sorting

Address and sentence copying

Map navigation

Card sorting

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19
Q

Strengths of the Behavioural Inattention Test

A

Comprehensive

Ecologically valid

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20
Q

Limitations of the Behavioural Inattention Test

A

Time consuming

Expensive

Have to train people to do the tests to ensure consistency between therapists

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21
Q

What parts of the brain are affected in dyspraxia/apraxia?

A

Parietal lobe
- Detects sensory information around them

Frontal lobe
- Planning and coordination of movement

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22
Q

What is dyspraxia?

A

Problems with motor coordination

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23
Q

What is apraxia?

A

Problems with organising speech

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24
Q

Assessment of dyspraxia/apraxia

A

Butler (2002)

Based on a differential diagnosis of what it is not

Comprehension deficit

Muscle weakness

Sensory impairment

Tone of abnormality

Other movement disorder

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25
What is agnosia?
Inability to interpret sensations and therefore recognise things
26
What is prosopagnosia?
Inability to recognise faces
27
What has been damaged in prosopagnosia?
The fusiform gyrus
28
Language affected by stroke
Broca's aphasia Wernicke's aphasia Transcortical motor/sensory or mixed aphasia Conductive aphasia Global aphasia
29
Broca's aphasia
Motor based Difficulty producing speech
30
Wernicke's aphasia
Can produce speech well but have poor comprehension or understanding
31
Global aphasia
Poor understanding of speech and poor motor control to produce speech
32
Mini Mental State Examination
Folstein et al. (1975) 5 parts - Orientation - Registration - Attention and calculation - Recall - Language Given score out of 30 (higher = better cognitive function)
33
Orientation
Asked about the time and date
34
Registration
Asked to name objects
35
Attention and calculation
Mental arithmetic
36
Recall
Recall the objects named in the registration task
37
Language (MMSE)
Asked to name objects and follow instructions
38
Strengths of the Mini Mental State Examination
Easy to complete Quick Inexpensive Does not require training Used widely Easy to interpret
39
Limitations of the Mini Mental State Examination
Lacks sensitivity - Can tell if someone has an impairment in the cognitive function but cannot distinguish between differences Lacks evaluation of executive function Confounded by age Confounded by level of education Confounded by sociocultural background
40
Improvements to the Mini Mental State Examination
Addition of other tests to improve sensitivity and avoid confounds of age and education level
41
Montreal Cognitive Assessment
Assesses 7 things - Visuospatial executive function - Naming - Memory - Attention - Abstraction - Language - Orientation
42
Visuospatial executive function
Individuals have to draw a clock or a cube for example
43
Naming
Name some objects
44
Memory
Read a list of words and have to recall them
45
Attention
Given a list of letters and have to tap when they hear a specific letter
46
Abstraction
Similarities or differences between objects
47
Language (MoCA)
Asked to repeat three sentences | Asked to say 3 words beginning with P
48
Strengths of the MoCA
More sensitive than the MMSE Available in alternate languages Freely accessible
49
Limitations of the MoCA
Relatively new Reliability and validity are not thoroughly tested
50
Neuropsychological Test
- Visuospatial memory tests - Verbal learning test - Wechsler Memory Scale - Delis-Kaplan Executive Function System - Number/Letter Sequencing - Boston Naming Test - Wechsler Adult Intelligence Scale - Phonemic/Category Fluency
51
Strengths of Neuropsychological Test
In depth assessment of cognitive deficits
52
Limitations of Neuropsychological Test
Takes a long time to administer People may not perform well as they are tired of all the tests and not because they have deficits
53
Remedial treatments for unilateral spatial neglect
Visual scanning Computer based scanning Virtual reality therapy
54
Visual scanning
Constantly prompting the patient to scan the environment and try and process the side they cannot process Can often forget that it is there and so don't do this by themselves
55
Computer Based Scanning
Games that encourage the patient to use both sides
56
Pros of computer based scanning
Can be administered at home Doesn't require a therapist in the room at the time
57
Virtual reality therapy
Using virtual reality to encourage individuals to attend to the neglected side
58
Compensatory treatment for unilateral spatial neglect
Prisms adaptation Limb activation strategies Sensory feedback strategies Eye patching and hemispatial glasses
59
Prisms adaptation
Wear a specific type of glasses that shift the visual field so that patients are forced to attend to the neglected side
60
Limb activation strategies
Activation of the body on the neglected side Actively encourages them to attend to the neglected side
61
Sensory feedback strategies
Visual/auditory feedback to encourage them to attend to the neglected side
62
Eye patching and hemispatial glasses
Left neglect, cover their right eye - Forces them to use their left eye to attend to things - Can become overly reliant on their right eye and therefore only attend to the right side of the body - Covering this eye means they are forced to attend to the neglected side
63
Therapy for dyspraxia/apraxia
Strategy training Sensory stimualtiom Proprioceptive stimulation Cueing, verbal, physical prompts
64
Strategy training
Gives them instructions on how to do basic tasks such as plugging in a plug
65
Sensory stimulation
Stimulation of the nerve cells Not much research to back this up
66
Proprioceptive stimulation
Switch from doing something on one side to the other Encourages activation across the hemispheres
67
Cueing, verbal, physical prompts
Helps them to know what is coming next
68
Therapy for aphasia
Speech and language therapy Group therapy Training conversation/communicative partners Computer based therapy Constraint induced therapy
69
Speech and language therapy
Works with the individual and helps them with the sounds and production of speech Like teaching a child to speak
70
Group therapy
Elman & Bernstein-Ellis (1999) Forced into a group situation means that they will communicate in any way they can
71
Training conversation/communication partner
Train family members/people living with them People who have lost the ability to speak may feel embarrassed and stupid Important that people around them are sensitive and encouraging
72
Computer based therapy
Seeing pictures of words and hearing words read out Can see instantly if they are producing and pronouncing the words correctly Can be used in homes and doesn't require a therapist
73
Constraint induced therapy
Can become overly reliant on gestures/objects to communicate and so will never improve This therapy stops individuals using these methods and encourages them to use speech

Atypical Brain Development and Degeneration (10 decks)

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