Lecture 1. Introduction

Question 1

Recovery after brain insult, resitution

What is diaschisis?

Answer 1

Occurs immediately after brain insult, this is a period of very rapid recovery of function

Question 2

Recovery after brain insult, resitution

What is regeneration?

Answer 2

After diaschisis period, this is a process where neurons/axons that have become damaged, regenerate (but this is very limited)

Question 3

Recovery after brain insult, resitution

What is sprouting?

Answer 3

Undamaged neurons try to locate new cells and reconnect functional systems or networks (also quite limited)

Question 4

Recovery after brain insult, resitution

What is denervation super sensitivity?

Answer 4

Cells become very sensitive –> if only a small amount of neurotransmitter is leaking, the postsynaptic neuron will become very sensitive to that. In this way, activation of pathways and restoration of normal functioning is facilitated (also limited)

Question 5

Recovery after brain insult, substitution

What is interhemispheric transfer?

Answer 5

Transfer of functioning to the other hemisphere, after unilateral lesions –> same area in the other hemisphere will take over function

Question 6

Recovery after brain insult, substitution

What is intrahemispheric transfer?

Answer 6

Transfer of functioning within a certain hemisphere, after unilateral focal lesions –> surrounding brain tissue takes over function

Question 7

Recovery after brain insult, substitution

What is intrahemispheric maintenance?

Answer 7

Least favorable, the function is maintained within a hemisphere, after diffused lesions in which both hemispheres are affected

Question 8

What is neural plasticity?

Answer 8

A physiological process, anatomical reorganization. But even if this occurs, it doesn’t necessarily mean that it will lead to a functional recovery

Question 9

What is functional plasticity?

Answer 9

Behavioral change, we aim for this in rehabilitation. We try to adapt behavior by for example compensating impairments –> new strategies, or changing the environment to deal better with difficulties

Question 10

What is crowding?

Answer 10

A general depression of functioning. If plasticity occurs, an area might take over the function of another area, resulting in a lower quality in both functions. A child’s brain is much more vulnerable to crowding than that of an adult.

Question 11

When does plasticity mainly occur?

Answer 11

Plasticity mainly occurs after small focal injuries, and children often sustain global injury in which there is less healthy tissue left to take over functions

Question 12

Where a child ends up on the recovery continuum, depends on for example the extend/severity of the lesion. What lesions will lead to better recovery? (2x)

Answer 12

Unilateral + focal lesions, instead of bilateral + diffuse lesions

And small and large unilateral lesions, instead of intermediate unilateral lesions –> but why?

In large lesions interhemispheric transfer of functions might be forced, which leads to less impact on functioning

Question 13

Where a child ends up on the recovery continuum, depends on for example sex & age. What leads to better recovery?

Answer 13

Sex: better recovery in girls than in boys

Age: non-linear relationship, which interacts with lesion characteristics (early + severe lesions have worser recovery than early + mild or later + severe lesions)

Question 14

Neuropsychological tests for cognition

1. Flanker test
2. Test of Everyday Attention for Children (TEA-Ch)

Answer 14

1. Flanker test = if you see an arrow pointing to left you hit a certain button, and if you see an arrow pointing to right you hit another button
2. Test of Everyday Attention for Children (TEA-Ch) = measures sustained and divided attention –> you need to do 2 things at once with equally importance

Question 15

Neuropsychological test for learning difficulties

Reading

Answer 15

let the child read words and pseudowords (words that don’t exist) to see whether the child is able to decode letters into a word

Question 16

What are (neuropsychological) projective tests?

1. Drawing
2. Sentence Completion Test
3. Columbus

Answer 16

The idea behind these tests is that the child’s response is some kind of projection of conscious or unconscious desired, emotions, beliefs, relations, etc.

1. Drawing = this says something how they perceive things. With house drawings you can say something about how accessible a child is to others. With family drawings, the middle person is often the most important one to the child, however, you cannot just draw conclusions based on this test, you have to integrate all information.
2. Sentence Completion Test = you give the child a list of sentences that he/she has to complete.
3. Columbus = a child’s story based on a certain drawing