Intro to Neuropsych

Question 1

What is neuropsychology?

Answer 1

The study of relationships between brain function and behaviour, and the effects of brain damage on psychological processes.

Question 2

What is clinical neuropsychology?

Answer 2

The clinical application of knowledge about the effect of brain dysfunction on a person’s behaviour.
Use background information (medical and psychological history), presenting symptoms, various cognitive tests.

Question 3

Why is it important to standardize tests?

Answer 3

So we can compare our clients to the normative sample (to make inferences)

Question 4

Related disciplines: what is the difference of cognitive neuropsychology and cognitive neuropsychiatry?

Answer 4

Cog. neuropsychology - study of abnormal cognition to understand normal cognition.

Cog. neuropsychiatry - application of models from cognitive psychology to understand cognitive underpinnings of psychopathology (what in the brain causes hallucinations?)

Question 5

Other related disciplines: medical disciplines

Answer 5

Neuropsychiatry, behavioural neurology, cognitive neurology

Question 6

Other related disciplines: occupational therapy

Answer 6

functional impact of neuropsychological conditions

Question 7

Other related disciplines: speech pathology

Answer 7

characterisation and diagnosis of language disorders

Question 8

Where do clinical neuropsychologists work?

Answer 8

Public hospitals
Private hospitals
Private practices
Medicolegal settings –> assessing if someone has the capacity to stand trial, combatting malingering, etc
Research (scientist practitioner model) –> big supporters of this model because of the specificity of each case

Question 9

What is the idea of variable recovery?

Answer 9

• 2 people who sustain the same brain injury can recover at different rates
• 2 skills in one person can recover at varying rates and be impaired to differing extents
• different people are sensitive to brain damage in different ways

Question 10

What is ‘The Brain Theory’

Answer 10

• the brain is the source of behaviour
• consists of two almost symmetrical hemispheres
• surrounded by cerebrospinal fluid (CSF) to cushion the brain and carry away waste

Question 11

Neocortex =

Answer 11

outer layer of brain, where bumps and grooves allow for increased surface area (higher level of cognitive function)

Question 12

Gyri

Answer 12

bumps

Question 13

sulci

Answer 13

grooves

Question 14

longitudinal fissure =

Answer 14

the large groove separating the 2 hemispheres

Question 15

lateral fissure

Answer 15

separates the temporal and frontal lobesc

Question 16

commissures

Answer 16

connection between parts of the brain (e.g. corpus callosum connecting the 2 hemispheres)

Question 17

what are the 4 lobes

Answer 17

• frontal
• temporal
• parietal
• occipital

Question 18

Mentalism - Aristotle (350 BCE)

Answer 18

Aristotle was among the first philosophers to develop theory of behaviour.

A non-material psyche (independent from the body, works via the heart, translates to ‘mind) responsible for thought, perception, emotion, memory and reasoning.

i.e. the mind is responsible for behaviour

Question 19

What did Galen do to challenge the common idea that the soul was housed in several body parts, with intellect located in the head?

Answer 19

He performed experiments using animals - found evidence that the brain was the centre of the nervous system and responsible for sensation, motion and thinking.

Question 20

Dualism - Descartes (1600 BCE)

Answer 20

Descartes wrote what is considered to be the first neuropsychology textbook.
Accepted the concept of mind - idea: the brain had an important role in behaviour!!

Body: the body is material - it responds mechanically (reflexes)
Mind: nonmaterial thing that could independently decide to respond / behave without a mechanical response (thought to be in the pineal gland)

Mind body interaction!

If a person is only capable of having consciousness and rationality because of the mind, how can a nonmaterial mind produce movements in a material body?

Question 21

Materialism - Darwin (1800s)

Answer 21

No need for a mind because behaviour can be fully explained by workings of the nervous system.
Debate: how are mental activities (cognitive processes) are organised in the brain

• Localizationist view: proposed that specific mental functions were carried out by specific parts of the brain
• equipotential view: all parts of the brain were equally involved in all mental activity
• general idea now = a combination of both - we know that specific parts of the brain specialize in certain functions, but we also know that if a particular part of the brain is damaged, we don’t fully lost that function and other parts of the brain compromise for it

Question 21

Explain the localizationist perspective!

Answer 21

19th Century: Gall and Spurzheim
BIG CLAIM: the brain was the undisputed organ of the mind - and could be grown like a muscle.
- The first to come up with a very clear localizationist view of the brain. Proposed that the neocortex had functions of its own.
- Gall’s hypothesies: there was a relationship between bulging eyes and superior verbal memory - i.e the part of the brain responsible for verbal memory was behind the eyes and grown like a muscle
- found: if you cut the cortico-spinal tract it can lead to paralysis
- distinguished between grey and white matters (idea = grey matter contains specific functions, white matter connects them)
- recognised 2 interconnected hemispheres

Question 22

The Localizationist perspective: Organology

Answer 22

Relied on comparative anatomy to develop his doctrine or organology - correlating physical aspects of skulls to prominent aspects of human behaviour / personality.
Mapped grooves and bumps of the skull to the function (big bumps = superior development) - mapping 27 faculties

Falling out:
- Gall tried to determine the existence of faculties through observation and experimentation, retrospectively - remained sceptical about the applicability of these correlations.
- Spurzheim wanted to use a prospective approach - invented phrenology - modified Gall’s original organology - which became popularly accepted.

Question 23

The emergence of equipotentiality

Answer 23

Started with French physiologist: Pierre Flourens (Pigeon boy)
- Idea: the brain was a homogenous substance similar to other organs - there was some degree of localized function, but the cerebral cortex could not be divided into functional units (all responsible for intelligence, will and perception)
- Experimented on pigeons - removed cerebral hemisphere (they were in a state of perceptual sleep - i.e. lost all higher cognitive abilities but retained basic motor skills)
- If you made a small lesion - no behavioural effects are noted - the larger the lesion, the more behavioural deficits –> and when a function was lost due to cortical lesion, it would be restored overtime by other brain matter

Question 24

Localization and Lateralization of Language - the renaissance of Gall’s ideas

Answer 24

• Gall had localized the memory of words and sense of language in the orbital portion of the inferior surface of the frontal lobe
• Bouillart (enthusiastic supporter) accumulated clinical cases where he aimed to establish this link between frontal lobe damage and loss of speech
• Auburtin (firm believer in Bouillaud’s hypothesis) issued a challenger to offer contrary views
• only 5 days after, Broca brought forward his evidence:
• A patient who repeatedly said the word Tan but didn’t have any deficits in speech areas or muscles responsible for speech. He had lots of areas of brain damage but none fell in the portion of the frontal lobe that Bouillard and Auburtin mapped it - it was on the inferior gyrus of the frontal lobe.
• broca had many patients who had this same area of damage and who had lost speech and motor problems on one side of the body
• this created a development in support for both lateralization and localization

Question 25

The cookie theft picture:

Answer 25

People with Broca’s aphasia: very brief, lots of pauses, uses the main content words rather than the filler words.
People with Wernicke’s aphasia: speak a lot but their speech doesn’t make much sense - there isn’t much meaning

Question 26

Wernicke’s area - further support of localization and lateralization of language

Answer 26

• Wernicke saw a different aphasia associated with left hemisphere damage in the superior temporal gyrus
• these patients did NOT have motor problems, and they spoke quite fluently but their speech didn’t make much sense and they couldn’t understand what other people were saying.

Question 27

What is the Geschwind model?

Answer 27

Recognised that cognitive deficits can arise due to disconnection between functioning local areas.

When people have problems in the connections between Broca’s and Wernicke’s area, they can speak fluently and can understand, but they cannot repeat what they have just heard and understood!

This is how pure word blindness (pure alexia) works - severe deficits in reading but other aspects in language are mostly fine.