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PSYC311: Human Cognition and the Brain > Lecture 20: Balint-Holmes Syndrome > Flashcards

Lecture 20: Balint-Holmes Syndrome Flashcards

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1
Q

What is the other names given to Balint-Holmes syndrome?

A

Balint’s syndrome

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2
Q

What are the 3 symptoms of Balint-Holmes syndrome?

A
  1. Spatial restriction of attention/ simultagnosia
  2. Psychic paralysis of gaze/ oculomotor apraxia
  3. Optic ataxia
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3
Q

What does spatial restriction of attention/ simultagnosia mean?

A

Inability to combine visual details into a coherent whole.

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4
Q

What does Psychic paralysis of gaze / ocular apraxia/ oculomotor apraxia mean?

A

Inability to shift gaze voluntarily to objects.

Patients can move their eyes up, down, left, right on command but can’t look at an object.

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5
Q

What does optic ataxia mean?

A

Difficulty reaching under visual guidance.

Vision is good, they just can’t reach while looking at the object.

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6
Q

Where is the damage located in Balint-Holmes Syndrome patients?

A

Bilateral and nearly symmetric lesions in the posterior parietal lobe, upper temporal lobe an occipita lobe

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7
Q

What are the causes of the damage in Balint-Holmes syndrome?

A
  • cerebrovascular disease
  • tumour
  • trauma
  • prion disorders
  • neurodegenerative conditions
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8
Q

What are the associated symptoms and deficits to Balint-Holmes syndrome?

A
  • Left hemineglect syndrome
  • Apperceptive agnosia
  • Visual disorientation
    • fail to perceive distances between objects or between them and other objects.
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9
Q

Say examples of tasks that a patient with Balint-Holmes syndrome wouldn’t be able to do.

A
  • Defect in reading and writing
  • Falt to recognize position and distances between objects
  • Unable to grasp or point accurately to objects
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10
Q

What is the cookie theft picture test?

A
  • Stimuli:
    • image
  • Task:
    • report all items in the picture
  • Measurement:
    • compare patient’s report to list of items
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11
Q

What can you test with the Cookie Theft picture?

A

Simultagnosia/ Spatial disorder of attention

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12
Q

What is optic ataxia?

A

It is the inability to reach and grasp an object based on visual guidance

  • deficit in peripheral visual field
  • lack coordination between visual and motor output
  • Two effects:
    • Hand effect
    • Field effect
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13
Q

What is the letter test?

A

Recognition of double stimuli

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14
Q

What does the Letter Test allows you to find?

A

Simultagnosia and oculomotor apraxia

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15
Q

What is the hand effect?

A

It’s misreaching with one hand into any visual field

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16
Q

What is the field effect?

A

Difficulty reaching in the contralesional field with any hand

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17
Q

True or False

Optic Ataxia only happens with Baltin-Syndrome

A

False, it can happen on its own

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18
Q

What is isolated Optic ataxia?

A
  • It’s optic ataxia but without any other deficit present
  • rare
  • intact visual fields and stereoscopic vision
  • normal oculomotor control
  • normal proprioception
  • normal motor abilities except for misreaching
  • Lesion:
    • discrete unilateral lesions
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19
Q

With what other deficits may optic ataxia appear?

A
  • Balint-Holmes triad
  • Deficit in proximal hand movements
20
Q

Where is the lesion for optic ataxia? How about isolated optic ataxia?

A
  • Optic ataxia
    • Large bilateral posterior lesions involving multiple functional areas
      • Superior parietal lobule
      • Parieto-occipital region
      • Areas around intraparietal sulcus (IPS)
  • Isolated optic ataxia
    • discrete unilateral lesions
21
Q

What is dysmetria?

A

It is the deficit in reaching under visual guidance.

No deficit when guidance is not visual

22
Q

What are the two hypothesis that expain optic ataxia?

A
  1. disruption of an online correction mechanistm
  2. Failure to convert the location of the visual stimulus coded in eye coordinates into the appropriate action in motor coordinates

Note, there are not the only hypothesis there is

23
Q

What test can we use to test the first hypothesis?

A

Jumping Targets

24
Q

Explain the test called Jumping Targets

A
  • Ask a patient to reach for an object
  • When the patient is about to reach the object, move the object
  • Patient has to change location of hand to the new location target
    *
25
Q

What is deficitent coordinate transformation?

A

It is when you have a problem going from eye coordinates when you see a visual stimulus to motor coordinates to reach for it.

26
Q

True or False

Brain lesions which produce optic ataxia are quite extensive.

A

True

27
Q

How do we figure out which brain area is critically involved in optic ataxia?

A
  • Multiple sources of information
    • ex) animal research
28
Q

Give an example of an animal research that was done regarding optic ataxia.

A
  • Process:
  • Subdivided the posterior parietal cortex into functional areas in monkey:
    • LIP
    • AIP
    • PRR
  • Results:
    *
29
Q

What are the names of the subdivisions of the posterior parietal cortex?

A
  • LIP: Lateral Intraparietal
  • AIP: Anterior Intraparietal
  • PRR: Parietal Reach Region
30
Q

Where is the Lateral Intraparietal region?

A

Pink area

31
Q

Where is the Anterior Intraparietal area?

A

The highlighted yellow region

32
Q

Where is the Parietal Reach Region?

A

Yellow contour

33
Q

What is the function of the LIP?

A
  • motor plan for eye movement
  • Saccadic eye movements
  • Attention processing
34
Q

What is the funciton of the AIP?

A
  • Grasping movement
35
Q

What is the function of the LIP and AIP together?

A
  • Connect with inferotemporal areas
36
Q

What is the function of the parietal reach region?

A
  • Includes areas MIP, V6A
  • Reach-related activity
  • Plan of reaching movements
37
Q

True or False

All of the three regions/areas explored in the animal research act independently and are not connected between each other.

A

False, there is extensive connections between the reach (PRR), saccade (LIP) and grasp (AIP) regions

38
Q

Why would the PRR, LIP and AIP regions be connected or not?

A
  • Coordination of complex behaviours such as reach-to-grasp and eye-hand coordination through inter-areal pathways
39
Q

True or False

Once the information arrives to the PRR, AIP and LIP, the information is already in motor coordinate system.

A

False,

AIP, LIP and PRR seem to encode targets and actions mostly in eyes coordinates

40
Q

Why may we think that this region (PRR, LIP, AIP) may be linked to optic ataxia?

A

Because optic ataxia seems to be represented largely in eye-coordinates as well.

41
Q

Describe the fMRI studies of Reaches and Saccades

A
  • Participants were asked to fixate the red dot and to point to the moving green dot on a screen
42
Q

True or False

The fMRI studies for optic ataxia were only administered to animals.

A

False

Only to humans.

It studied the same areas that were previously studied in monkeys.

43
Q

What where the results from the fMRI studies on humans on optic ataxia?

What are the reach areas in the human brain?

A
  • Medial complex
  • Lateral complex
44
Q

What is the medial complex?

A
  • Caudal intraparietal sulcus
    • Reaching activity
  • Parieto-occipital junction
  • Superior Medial Parietal Occipital cortex
  • Precuneus
45
Q

What is the lateral complex?

A
  • Medial bank of the intraparietal sulcus
  • Middle part of the intraparietal sulcus

PSYC311: Human Cognition and the Brain (26 decks)

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