Neuropsychology Flashcards
What is the difference between sensation and perception?
Sensation refers to the sensori-neural encoding of incoming physical information, whilst perception involves the meaningful transformation and interpretation of that information
What does “cognition” mean in the field of neuropsychology? Give some examples
Refers to information processing and application of knowledge (e.g. memory, speed of processing, language, planning, problem solving, attention)
How is function lateralised in the brain in most people?
Left hemisphere: language
Right hemisphere: visuospatial functioning
Describe the localisation of function in the four lobes of the brain
Frontal: planning, execution and regulation of behaviour
Temporal: audition, language, music, memory, emotion
Parietal: somatic and visuospatial representations
Occipital: vision
What are the three basic “units” of the CNS in Luria’s brain-behaviour theory and what are their associated roles?
Brainstem and associated areas: regulation of arousal and muscle tone
Posterior cortical regions: reception, integration and analysis of sensory information
Anterior cortical regions (frontal and prefrontal lobes): planning, executing and verifying behaviour
What is the role of the primary zones in the posterior cortical regions?
Responsible for basic level processing of sensory information
Zones are topologically organised with high modal specificity (somatosensory, auditory, or visual)
What is special about the tertiary zones of the posterior cortical regions?
They are only evident in humans
When do the tertiary zones of the posterior cortical regions mature?
At ~7 years of age
What is the role of the secondary zones in the posterior cortical regions?
Involved in perception (“gnosis”) of sensory information
Decreased modal specificity
What is the role of the tertiary zones in the posterior cortical regions?
Integrates information across multiple sensory modalities
“Supramodal” (association cortex)
Add meaning to information coming in
What is the predominant afferent layer of the primary zones of the posterior cortical regions?
Layer IV
What is the predominant afferent layer of the secondary zones of the posterior cortical regions?
Layers II, III
What is the role of the primary zone in the anterior cortical regions?
Execution of movement (motor cortex)
Zone is topologically organised
What is the role of the secondary zone in the anterior cortical regions?
Organisation of movement (premotor cortex)
What are the 4 main roles of the tertiary zone in the anterior cortical regions?
Prefrontal cortex, involved in higher level cognition, including: Planning goal-directed activities Intent and behaviour programming Self-monitoring and regulation Cortical alertness
When does the tertiary zone of the anterior cortical regions mature?
In ~adolescence
Describe the 3 aspects of “pluripotentiality” in terms of Luria’s principles of functional systems
1) Each area of the brain operates in conjunction with other areas
2) No area is singly responsible for voluntary human behaviour
3) Each area may play a specific role in many behaviours
What neural systems are involved in emotion?
The limbic system, a circuit of structures including the hippocampus, cingulate gyrus, hypothalamus, amygdala, septal area, nucleus accumbens and orbitofrontal cortex
What is the amygdala and what is its role?
The amygdala is an almond-shaped structure located in the medial temporal lobe
Involved in implicit emotional learning
What is Kluver-Bucy syndrome?
A behavioural syndrome resulting from bilateral anterior temporal lobectomy
Symptoms include tameness or loss of fear, hypersexuality, inability to differentiate food from other objects
List 3 conditions possibly associated with amygdala dysfunction
Kluver-Bucy
Depression
Anxiety
What is the main role of the orbitofrontal cortex?
Identification and expression of emotion
What do lesions of the orbitofrontal cortex result in?
Reduced facial expression and affect
What conditions is the hippocampus linked to and why?
Affective disorders (volume reduction in depression, core structure links serotonin abnormalities and stress hypotheses of depression)
What are the 2 main theories regarding the emotion-cognition interface?
James Lange theory: we experience emotion in response to physiological changes (e.g. feel sad because we cry)
Cannon Bard theory: can experience emotion without expressing it physically (e.g.in case of spinal cord lesions)
How can psychological interventions be used to influence emotional responses?
Cognitive appraisal directly impacts the physiological stress response and can influence the type of emotional response
Psychological interventions should consist of an approach designed to reduce the physiological response (e.g. relaxation), THEN tackle the cognitive underpinnings (e.g. cognitive behavioural therapy)
What are the 3 hallmarks of Erikson’s theory of psychological development?
Step-by-step
Critical time periods
Importance of pyschosocial crises as a driving force
What is the basis of Havighurst’s theory of psychological development?
Task-based; move through stages associated with tasks
What is the transactional model of psychological development?
That development takes place through various transacting factors (e.g. genetic, constitutional, biological/biochemical, psychological, environmental) that operate dynamically and bi-directionally
What is the genetic contribution to behavioural traits and psychiatrics?
Variable within a range of 30-80%
What were the results of a study involving deprivation of early maternal care in non-human primates?
Lifelong derangement of monoamine transmitter systems
What is multifinality?
One risk factor associated with many different outcomes
What is equifinality?
Many possible pathways to the one outcome
What is temperament?
The automatic associative responses to basic emotional stimuli that determine habits and skills?
What are the 4 dimensions of temperament?
Harm avoidance
Reward dependence
Novelty seeking
Persistence
How can anxiety be ruled out as a cause of poor performance on a cognitive examination?
If anxiety is accounting for deficits there will be a similar rate of error across all domains, not just one
What are 3 common characteristics of patients presenting with MCI?
ADL not impaired
Often self-report
Issues primarily with episodic/biographical memory
Describe Luria’s concept of “functional adaptation”
Use of an intact skill to compensate for a damaged one
What is the modern “active participation” model of cognitive rehabilitation?
Cognitive rehabilitation takes place in real world contexts where the person is most likely to need to use these skills
What are the 2 categories of cognitive interventions?
Environmental modifications
Compensatory strategies
What do environmental modifications involve?
A change in the physical and social environment to facilitate greater independence and reduce the impact of a person’s cognitive and behavioural difficulties
Often involves the removal or manipulation of precipitating environmental factors (e.g. common to provide a low stimulus environment early post-injury)
When are environmental modifications most useful?
When patients have reduced insight, reduced self monitoring and regulation, and significant/catastrophic attentional, memory and executive deficits
How are moderate vs. severe left neglects treated?
Moderate: want to encourage scanning, place objects in left visual field
Severe: place items in right visual field
Differentiate between internal and external strategies in terms of compensatory strategy interventions
Internal: improvement of skill set or learning to use other skills (e.g. use of mnemonics in memory loss)
External: use of cues and aids to assist compensation (e.g. diaries, smartphones, apps)
Do brain training programs work?
A paper by Owen et al. found no evidence of transference of skills from training
What is procedural memory?
Long term implicit memory related to skill acquisition
What is episodic memory?
Form of declarative memory that is autobiographical and involves the associations between a personal event and a specific temporal, spatial and emotional context
What is semantic memory?
A form of declarative memory related to general facts or “shared knowledge” which is not contextual (e.g. bananas are yellow, knowledge of general word meanings)
Which ypes of memory is the left hippocampus believed to be most involved in?
Verbal memory (e.g. list learning, paired associate learning, story recall)
Which types of memory is the right hippocampus believed to be most involved in?
Non-verbal memory (e.g. visuospatial associations, face recall)
What kind of memory disturbance do patients with temporal lobe epilepsy often present with?
Declarative memory deficits
What are the 3 types of transient memory disorders?
Transient global amnesia (TGA)
Transient epileptic amnesia (TEA)
Post-traumatic amnesia (PTA)
What are the 4 criteria for MCI?
Self-reported memory complaint with a 6-12 month history
Objective memory impairment
Unaffected general cognitive functioning
Normal capacity to perform ADLs
What are the 6 stages of AD in Braak and Braak’s classification system, and what parts of the brain undergo a neurofibrillary change for each? What is the progression of symptoms with each stage?
I-II: transentorhinal (asymptomatic)
III-IV: limbic system/entorhinal (incipient)
V-VI: neocortical association cortex (fully developed AD)
What are the most common early memory complaints in MCI?
Name-face association
Object-place association (e.g. where did I leave my keys)
What are the characteristics of the language impairment observed in AD? What is the region of the brain affected to cause these abnormalities?
Dysnomia (difficulties with recall) with fluent, empty language and circumlocution
Due to temporoparietal effects
