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neuropsych > lesson 8 > Flashcards

lesson 8 Flashcards

1
Q

reading

A

the conversion of a sequence of a grapheme (printed letters) into a sequence of sounds (phonemes) – reading aloud tasks

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2
Q

writing

A

the conversion of a sequence of sounds (phonemes) into a sequence of graphemes (printed letters) –> dictation exercises

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3
Q

reading and writing neural correlates

A

broca’s area, wernicke’s area, left angular gyrus, visual cortex, splenium of the corpus callosum

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4
Q

left angular gyrus

A

center for visual memory

lesion = alexia with agraphia

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5
Q

lesion in visual cortex and splenium of the corpus callosum

A

pure alexia

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6
Q

pure alexia

A

alexia without agraphia

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7
Q

alexia

A

acquired dyslexia

deficit in reading after brain damage in literate individuals

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8
Q

agraphia

A

acquired dysgraphia

loss or impairment of the ability to write

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9
Q

motor plans for handwriting

A

exner’s area

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10
Q

motor plans for vocalizations

A

part of broca’s area

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11
Q

auditory representations of phonemes

A

planum temporale

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12
Q

visual representations of letters

A

visual word form area (VWFA)

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13
Q

peripheral stages

A

processing of perceptive features (visual aspect of the stimulus) or selection of motor pattern (non-linguistic processes)

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14
Q

peripheral stages e.g.

A

analysis of single letters while reading, actual movement planning while writing

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15
Q

central stages

A

based on lexico-semantic knowledge and grapheme-phoneme conversion mechanisms –> enabling the spelling of words

identification of the correct sequence of letters that constitute each words

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16
Q

reading peripheral deficits

A

neglect dyslexia, attentional dyslexia, pure alexia

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17
Q

reading central deficits

A

phonological/sublexical dyslexia, lexical/surface dyslexia, deep dyslexia

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18
Q

writing peripheral deficits

A

impairments of the graphemic buffer, apraxia agraphia (with or without ideomotor apraxia), spatial agraphia

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19
Q

writing central deficits

A

phonological/sublexical agraphia. lexical/surface agraphia, semantic agraphia, deep agraphia

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20
Q

ACQUIRED disorders vs.

A

DEVELOPMENTAL learning disordesr

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21
Q

alexia - cortical network for reading

A

parietal-temporal: access to pronunciation and articulation

temporal-frontal-occipital: access to meaning

anterior temporal: visual word form area (the brain’s letterbox)

inferior occipital: visual inputs

superior occipital: top-down attention and serial reading

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22
Q

dual-route model for reading - sublexical route

A

non words, unfamiliar words

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23
Q

Neuropsych tried to explain:

A

(1) the processes involved in reading and writing in healthy subjects and (2) reading (dyslexia, alexia) and writing (agraphia) deficits in patients

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24
Q

dual-route model for reading - lexical route

A

irregular words

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25
Q

dual-route model for reading - direct route

A

familiar regular words

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26
Q

dual-route model for reading - real words

A

both routes

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27
Q

alexia with agraphia (/pure alexia)

A

disruption of a system specialize for the recognition of visually presented words

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28
Q

alexia with agraphia (/pure alexia) lesion

A

left occipito-temporal lesion PLUS posterior part of the corupus callosum or even left fusiform gyrus

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29
Q

alexia with agraphia - disconnect

A

‘disconnection’ of the left hemisphere (word recognition system) from the visual information (only presented in the right hemisphere)

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30
Q

alexia with agraphia - naming

A

naming lettersin a serial fashion (letter-by-letter), effect of word length

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31
Q

alexia with agraphia (/pure alexia) - performance

A

not impacted by linguistic effects like regularity of word orthography, imaginability of words, etc.

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32
Q

alexia with agraphia (/pure alexia) - implicit reading

A

some patients may show implicit reading - reading through the right hemisphere

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33
Q

implicit reading

A

comprehension of words they cannot explicitly identify

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34
Q

neglect dyslexia

A

patients commit consistnely lateralized letter omission, addition, substitutuion errors when reading individual words

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35
Q

left-sided neglect dyslexia

A

failure in the identification of the initial portion of the letter string (“lend” for blend)

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36
Q

right-sided neglect dyslexia

A

opposite of left-sided

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37
Q

neglect dyslexia - different subtypes

A

retino-centric, stimulus, center, word-center

attentional impairments that maybe specific for words

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38
Q

attentional dyslexia

A

relative preservation of single-word reading in the context of a gross disruption of reading when words are presented in a text/surrounded by other words or deficiency in identifying letters within a word

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39
Q

how is attentional dyslexia interpreted

A

as a pre-lexical reading deficit

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40
Q

deep alexia - reading real words

A

semantic errors (‘knight’ for castle, or ‘canary’ for bird)

visual errors (‘scale’ for skate)

morphological errors – prefix/suffix is added/deleted/substituted (‘government’ for governor)

better reading for high frequency and high imaginable words

part-of-speed effects – nouns > adjectives/adverbs > verbs

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41
Q

deep alexia - impaired reading of nonwords

A

deficit to print-to-sound conversion –> lexicalization (‘flag’ for flig)

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42
Q

Coltheart el al. 1980, Saffran et al., 1980

A

following a large left perisylvian lesion extending into the frontal lobe = residual reading ability mediated by the right hemisphere (?)

Could be associated with Broca or global aphasia

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43
Q

phonological/sublexical alexia - reading real words

A

only mildly impaired (85 – 95% correct), not impacted by regularity of print-to-sound correspondence

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44
Q

phonological/sublexical alexia - reading nonwords

A

Deep deficit in reading nonwords: almost 90% of errors, patients usually substitute the target with a real word (ex. ‘phone’ for phope)

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45
Q

phonological/sublexical alexia - what can it not simply be attributed to

A

Can not simply be attributed to a broader deficit in phonology (dissociation with aphasic symptoms)

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46
Q

phonological/sublexical alexia - hypothesis

A

Hypothesis of a continuum with deep dyslexia: milder form, similar sites but more restricted lesions (left superior temporal lobe, angular, and supramarginal gyri)

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47
Q

surface/lexical alexia - reading real words

A

reading regular word is spared (state, hand, mosquito), reading irregular words is deeply impaired (yacht, island, have)

Pronunciation cannot be derived by sounding-out strategies

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48
Q

surface/lexical alexia - spared reading of nonwords

A

spared

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49
Q

surface/lexical alexia – observation of patients

A

Usually not observed in patients with focal lesions but in those with semantic dementia (variant of frontotemporal dementia) –> (progressive degenerative disease)

Progressive loss of semantic knowledge as well

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50
Q

surface/lexical alexia - atrophy

A

Atrophy in the anterior temporal lobe, sometimes left-sided predominance

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51
Q

Right hemisphere is classically considered

A

Right hemisphere is classically considered

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52
Q

example of reading abilities in right hemisphere

A

patient with left hemispherectomy, received at age 15 for epilepsy treatment, was able to read about 30% of single words after operation, exhibited an effect of part-of-speech, and was unable to apply grapheme-to-phoneme conversion —> like deep dyslexia

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53
Q

split-brain patients with reading in right hemisphere

A

performance of split-brain patients (resection of corpus callosum) in case of lateralized word presentation: unable to determine the sound of words presented in the left hemifield (to the right hemisphere) - ex. Impairment in rhyme task, BUT were able to match the word to appropriate object, the right hemisphere lexical-semantic system primarily represents high frequency and high imaginable nouns

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54
Q

the lexical system _______ unless _______

A

dominates the output unless it is dysfunctional

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55
Q

Deficits in the orthographic (or graphemic) buffer - WM

A

working-memory deficit

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56
Q

Deficits in the orthographic (or graphemic) buffer

A

impairment in ability to temporarily store letters, which is a required step for letter selection and association

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57
Q

Deficits in the orthographic (or graphemic) buffer - errors

A

substitutions, deletions, transportations, insertion of single letters

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58
Q

Deficits in the orthographic (or graphemic) buffer - not affected by

A

linguistic factors (word class, regularity of spelling, imaginability)

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59
Q

Deficits in the orthographic (or graphemic) buffer - affected by

A

word length (long word = more errors)

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60
Q

Deficits in the orthographic (or graphemic) buffer - lesions

A

Lesions in fronto-parietal networks

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61
Q

apraxic agraphia

A

praxic deficit

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62
Q

apraxic agraphia - definition

A

inability to correctly (plan and) perform the movements required for forming written letters (graphemes), without a peripheral motor impairment (no apraxia)

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63
Q

apraxic agraphia - lesion

A

parietal damage

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64
Q

apraxic agraphia - symptoms

A

Illegible handwriting BUT correct spelling while using keyboard

Oral spelling is preserved = non-linguistic deficit

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65
Q

spatial agraphia

A

visuo-constructive deficit

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66
Q

spatial agraphia - definitions

A

impairment in visuo-spatial skills –> produce malformed letter components

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67
Q

spatial agraphia - symptoms

A

impairment in visuo-spatial skills –> produce malformed letter components

Correct spelling while using a keyboard

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68
Q

spatial agraphia - lesion

A

Associated with nondominant parietal or frontal damage

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69
Q

spatial agraphia may be apart of what

A

neglect syndrome

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70
Q

orthographic output lexicon

A

posterior inferior frontal gyrus

71
Q

phoneme-grapheme conversion

A

network of perisylvian areas

anterior: inferior frontal gyrus, precentral gyrus, insula

posterior: superior temporal and supramarginal gyri

72
Q

graphemic buffer

A

posterior superior and middle frontal gyri, pre- and postcentral gyri

superior and inferior parietal gyri with or without angular gyrus

73
Q

orthographic output lexicon

A

posterior inferior temporal gyrus, fusiform gyrus

74
Q

phonological/sublexical agraphia - spelling real words

A

is spared/only mildly impaired, not influenced by the regularity of print-to-sound correspondence –> regular and irregular spelling is preserved

75
Q

phonological/sublexical agraphia - spelling nonwords

A

Deep deficit in spelling nonwords: patients usually substitute the target with a real word

76
Q

phonological/sublexical agraphia - lesion

A

Associated with lesion in perisylvian regions and frequently co-occurs with aphasia but may dissociate

77
Q

phonological/sublexical agraphia - shares features with

A

Shared many features with phonological dyslexia: when they co-occur it may be due to the same impairment in the conversion mechanism, BUT when they dissociate the deficit may be due to lesions that disrupt information as it enters/exits the conversion system (this would affect reading or writing in isolation)

78
Q

lexical/surface agraphia - spelling real words

A

is spared for regularly spelled words, impaired for words with irregular spelling (regularization errors, ex. Yacht -> yat)

79
Q

lexical/surface agraphia - spelling nonwords

A

Spared spelling of nonwords

80
Q

lexical/surface agraphia - lesion

A

Associated with more posterior lesions: left posterior angular gyrus or parieto-occipital lobule

81
Q

lexical/surface agraphia - sharing features with

A

surface dyslexia

82
Q

how does elxical/surface agraphis share featuers with surface dyslexia

A

may co-occur due to the same impairment in the lexical route

disrupted flow of info out of the orthographic lexicon would produce lexical agraphia while disrupted flow of info into this system would produce surface dyslexia in isolation

83
Q

semantic agraphia - definition

A

lose ability to write with meaning —> disconnection of the lexicon with semantic system (or semantic deficit itself)

84
Q

semantic agraphia - patients

A

Patients with dementia – semantic dementia or Alzheimer’s disease

85
Q

semantic agraphia - symptoms

A

Able to spell nonwords and irregularly spelled words but impaired comprehension

86
Q

semantic agraphia - association

A

Association with aphasia and/or alexia

87
Q

deep agraphia - spelling real words

A

semantic paragraphic errors, better spelling for high frequency and high imaginable words, part-of-speech effects more problems in writing function words and grammatical suffixes

88
Q

semantic paragraphic errors

A

writing semantically related but not visually similar word instead of target [‘knight’ for castle or ‘canary’ for bird]

89
Q

part-of-speech effects more problems in writing function words and grammatical suffixes examples

A

‘eating’ but not ‘ceiling’

90
Q

deep agraphia - spelling words

A

Impaired spelling of words

91
Q

deep agraphia - When comprehension is spared

A

the deficit is interpreted as a disruption in the lexical route (access from semantic to orthographic output lexicon)

92
Q

deep agraphia - association

A

Often associated with deep dyslexia (left perisylvian lesion)

93
Q

Graphemic buffer - definition

A

temporary store for letters; responsible for letter selection and association

94
Q

Graphemic buffer - impairment

A

spontaneous writing, writing to dictation, writing naming, delayed copy, at the end of the word (especially if long). Substitutions. Deletions, transportions, insertion of single letters

95
Q

Graphemic buffer - influence

A

Influence by word length

96
Q

Graphemic buffer - lesions

A

in fronto-parietal network

97
Q

assessment - agraphia and alexia

A

consider premorbid abilities

linguistic components

motor components

semantic components

other components

98
Q

assessment - agraphia and alexia - consider premorbid abilities

A

(as reported by patients and family members): may be inferred from developmental problems, lack of opportunities to learn reading and writing, academic records, knowledge on patients’ occupation and job responsibilities

99
Q

assessment - agraphia and alexia - lingustic components

A

for dyslexia and dysgraphia = read aloud and write

Letters, Real words (familiar and unfamiliar), irregular words, Nonwords, Phrases and sentences

100
Q

assessment - agraphia and alexia - motor components

A

for writing:

Spontaneous writing, Writing to dictation, coping

101
Q

assessment - agraphia and alexia - semantic components

A

Word-picture or picture-picture matching

102
Q

assessment - agraphia and alexia - other components

A

Length, lexical status (real/nonwords), frequency of use, grammatical category (nouns, verbs. Adjectives, etc.), imageability (concreteness vs. Abstract), orthographic regularity

103
Q

main goal of treatment for alexia and agraphia

A

Recover skills already acquired and widely used by the subject in the past

104
Q

Two main rehabilititation programs:

A

(1) specifically aimed at reading or writing whole words or (2) directed at the damaged lexical component

105
Q

Phonological treatment approach

A

aim is to reconstruct ability to transform single phonemes or single syllables into graphemes (or vice versa)

106
Q

Lexical treatment approach

A

Activities like: tachistoscopic presentation of letter, word or phrases of increasing difficulty, identification of irregular groups within words, recognition of parts of words, division of compound words, completion of words

107
Q

Semantic treatment approach

A

Activities: matching written word ot a picture (alexia) or to write words for a presented picture (agraphia)

108
Q

Treatment with advanced techniques – alexia:

A

randomized trial of iReadMore word reading training and brain stimulation in central alexia

109
Q

iReadMore participants and methods

A

Participants: 21 chronic stroke patients with central alexia

Methods: ‘on’ protocol = ‘iReadMore’ mobile training app + anodal tDCS or sham tDCS over the left inferior frontal gyrus for a 4 week treatment period

110
Q

iReadMore results

A

Results: iReadMore training ALONE improved reading accuracy and reaction times for trained words, BUT did not generalize to untrained words, reading accuracy gains were still significant 3 months after training cessation

Anodal tDCS facilitated reading accuracy for trained and untrained words = improve generalization

111
Q

Treatment with advanced techniques – agraphia:

A

DUAL-tDCS Treatment over the Temporo-Parietal Cortex Enhances Writing Skills: First Evidence from Chronic Post-Stroke Aphasia

112
Q

DUAL tDCS participants and methods

A

Participants: 14 chronic Italian post-stroke aphasics

Methods: ‘on’ protocol = bihemispheric tDCS or sham tDCS with anode and cathode over the left and right temporo-parietal cortex and writing task for 10 working days

113
Q

DUAL tDCS results

A

bihemispherical tDCS improved the writing task and results generalized to different language tasks not directly treated

114
Q

Acalculia - definition

A

an acquired neuropsychological condition in which patients with previously normal calculation abilities develop impairments in processing numbers because of an acquired brain dysfunction

115
Q

acalculia - lesion and association

A

Left inferior parietal lobule lesion often in association with aphasia

116
Q

acalculia - common in patients with

A

Impairments in calculation are very common in patients with focal lesions (occurring in ~30% of stroke patients with left hemispheric damage) and are frequent in some types of dementia (ex: early symptom in Alzheimer’s disease)

117
Q

two types of acalculia deficits

A

primary (pure) and secondary

118
Q

Primary (pure) deficits

A

acalculia cannot be accounted for by deficits in other cognitive domains, usually associated with left parietal damage –> anarithmetria

119
Q

Secondary acalculia

A

calculation disturbances are attributable to deficits in attention, memory or language –> (1) acalculia with alexia or agraphia for numbers, (2) acalculia of the spatial type

120
Q

Acalculia with alexia and agraphia for numbers - definition

A

can be associated with aphasia; impairments in reading or writing numbers

121
Q

Acalculia with alexia and agraphia for numbers - lesion

A

left inferior parietal lesions

122
Q

Acalculia of the spatial type - definition

A

deficit in spatial organization of numbers

123
Q

Acalculia of the spatial type - lesion and association

A

right hemisphere lesion, association with neglect

124
Q

acalculia number processing

A

Although acalculia often co-occurs with other cognitive deficits (language first) …
calculation and numbers

125
Q

acalculia calculation

A

is an independent and multicomponential cognitive function

126
Q

acalculia numbers

A

represent a highly specific semantic category

127
Q

arabic code

A

(4): numbers as sequences of digits

128
Q

verbal code

A

(four): numbers as sequences of letters or words

129
Q

each code has

A

its own lexicon (basic meaningful elements) and syntax (how elements can be combined)

130
Q

transcoding rules exist to…

A

transform a number from one to the other code

131
Q

Triple Code Model

A

argues for the existence of three representational codes for number (each subserved by functional dissociated neural substrates: ara bic digits, verbal number words and analogue non-symbolic magnitudes representations

132
Q

arabic digits - triple code modeal

A

numbers as sequences of syntactically organized digits

133
Q

verbal number words - triple code model

A

numbers as sequences of syntactically organized words

134
Q

analogue non-sym - tiple code model

A

Analogue non-symbolic magnitude representations numbers located along a mental number line

135
Q

Neurophysiological bases of calculation

A

discrepancies between functional neuroimaging studies (bilateral fronto-temporo-parietal networks) and data from patients (left posterior parietal regions are crucial)

136
Q

arabic digits - nuero location

A

superior temporal lobe

137
Q

verbal number words - neuro location

A

perisylvian areas (ONLY LEFT HEM)

138
Q

analogue non-sym - neuro location

A

IPS

139
Q

Errors made by patients with Acalculia

A

inability to read, write and understand numbers and numerical quanitties and the inability to perform calculation tasks

140
Q

patients with acalculia - Deficits can be very selective: ex.

A

Disturbances of processing arithmetical signs as only symptom OR specific deficits in calculation in contact of intact number and magnitude knowledge, Or inability to complete multiplication and division but not addition or subtraction, etc

141
Q

acalculia Errors in processing numbers: lexical

A

errors in selecting correct elements (‘sixteen’ –> 18)

142
Q

acalculia Errors in processing numbers: syntactic

A

inability to identify the correct sequence in order to express magnitude (‘twohundredseventyfour’ –> 200740

143
Q

acalculia Errors in processing numbers: mixed errors

A

‘fourhundredeight’ –> 3007

144
Q

acalculia errors in calculation

A

Deficits in numerical facts (ex. Multiplication tables) stored in long-term memory

Deficits in arithmetic comprehension (concepts, the commutative property, etc)

Deficits in arithmetic procedures (how to carry the amount over in addition, etc)

145
Q

Neuropsychological assessment of acalculia

A

Consider premorbid abilities (as reported by patients and family members)

Explore different areas that may be impaired:

Always include a qualitative analysis (classification of error types)

Results must be interpreted in the light of the other deficits shown in patients (in attention, visuo-spatial skils, language, working memory, etc)

The numerical activities for Daily Living (NADL) battery

146
Q

Neuropsychological assessment of acalculia - Explore different areas that may be impaired:

A

Written and auditory comprehension and production

Use of both verbal and Arabic code

Transcoding of numbers and calculation performance for all operations

147
Q

Neuropsychological assessment of acalculia - Results must be interpreted in the light of the other deficits shown in patients (in attention, visuo-spatial skils, language, working memory, etc)

A

Gerstmann syndrome (digital agnosia, dysgraphia, acalculia, and right-left disorientation

148
Q

Neuropsychological assessment of acalculia - The numerical activities for Daily Living (NADL) battery

A

the way the NADL allows to collect info about the degree of awareness of the deficit by the patient and by their caregivers is divided into four parts:

149
Q

Daily Living (NADL) battery

A

(a) The patients interview (5 minutes),

(b) the caregiver interview (5 minutes),

(c) the Informal Test (10 minutes which is a brief clinical assessment to determine whether the Formal Test of numerical abilities needs to be administered,

(d) the Formal Test (30 minutes) which is a detailed and formal assessment of numerical abilities

150
Q

Daily Living (NADL) battery - The Formal Test of numerical abilities includes four sections:

A

(1) number comprehension (ex: numerosity comparison, number line marking and digit comprehension),

(2) reading and writing arabic numbers,

(3) mental calculation,

(4) written calculation

151
Q

acalculia - treatment - Restitutive approach

A

re-learning through intense practice (relearning arithmetic factors or making the recovery process automatic again)

152
Q

restitutive approach - hypothesis

A

Basic hypothesis that there is a deficit in retrieving from the long-term memory store the procedures and the practice can favor the recovery of functionality of the damaged components

153
Q

acalculia - treatment - Compensatory approach

A

promoting the use of “back-up” strategies based on the patients’s residual strategies

154
Q

example of treatment of acalculia

A

patient with impaired ability to retrieve arithmetic facts

Restitutive approach: the patient has to re-learn the information or re-automates the preocess of recovering the arithmetic fact

Compensatory approach: rehabilitation could be based on counting procedures (ex: 6 * 5 would become 6 + 6 + 6 + 6 + 60

155
Q

Specific Learning Disabilities (SpLDs)

A

refer to a group of specific lifelong cognitive impairments identified through the unexpected underachievement in a range of learning processes involving the skills of listening, speaking, spelling, written expression, mathematics, understanding, or reading including decoding and comprehension.

156
Q

Specific Learning Disabilities (SpLDs) - key facts

A

Are distinct from intellectual disabilities since they are specific and not global impairments

Dyslexia is the msot common SpLD comprising 80% of all diagnosed SpLDs

Aside from academic barriors, people with SpLDs can also experience barriers in time management, organizational skills social perception and social interactions

SpLDs have a variety of presentations and range in severity

The experience of SpLD varies from person to persona and can be more disabling when there are greater barriers in the learning environment

International estimated indicated that SpLDs impact approximately 10% of the population

157
Q

Dyslexia - definition

A

associated with specific barriers in reading, writing, spelling or comprehension

158
Q

whats the most commmon SpLD

A

dyslexia

159
Q

what so special about dyslexia

A

Because it’s related to literacy skills, it is most evident in educational settings: students can experience barrior in one or more of the following symptoms

Visual perception of letters and words and their corresponding sounds and phonemes, memory, vocabulary, spelling of spoken words, comprehension

160
Q

dyslexia - white matter tracts

A

White matter tracts are abnormally organized in dyslexic brain

161
Q

phonological and orthographic scores - neuro locations

A

arcuate fasciculus and inferior fronto-occipital fasciculus respectively associated with phonological and orthographic scores on standardized tests

162
Q

dyslexia - left-hemispheric cortical regions

A

Left-hemisphere cortical regions have consistent structural (both in grey and white matter) and functional abnormalities

163
Q

Dyscalculia - definition

A

associated with barriers in understanding numbers and mathematical concepts

164
Q

Dyscalculia - %

A

Occurs in up to 3% of population

165
Q

Dyscalculia - may be difficult to

A

May be difficult to visualize patterns, different parts of a math problem or identify critical information needed to solve equations and more complex problems

166
Q

Dyscalculia - can affect

A

Can affect a person’s ability to think quantitatively, do arithmetic, understand and measure time and space, remember timetables and perform basic calculations

167
Q

Dysgraphia - definition

A

associated with restrictions in handwriting tasks

168
Q

Dysgraphia - affect skills

A

Affects skills associated with holding a pen or pencil (drawing shapes, numbers or letters)

169
Q

Dysgraphia - typically appears

A

Is a neurological disorder that typically appears when suing the complex collection of motor and information processing skills involved in the activity of writing

170
Q

Dysgraphia - required ability to…

A

Is a neurological disorder that typically appears when suing the complex collection of motor and information processing skills involved in the activity of writing

171
Q

Dysgraphia - what kind of disorder

A

EXECUTIVE-MOTOR DISORDER

172
Q

Dysorthography - definition

A

difficulty in correctly translating the sounds that make up words in graphic symbols (phoneme-grapheme conversion)

173
Q

Dysorthography - errors

A

Phonological and morphological errors, most common:

Omissions of graphemes or parts of words, substitutions of graphemes, inversions of graphemes

174
Q

Dysorthography - associated and deficits

A

No motor deficits but associated with dysgraphia

neuropsych (25 decks)

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