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Neuropsychology and Psychopharmacology > Neuropsychology: The Executive Brain > Flashcards

Neuropsychology: The Executive Brain Flashcards

1
Q

What are executive functions?

A

-Needed to optimize performance in situation requiring coordination between cognitive processes
-Supervisory, controlling or meta-cognitive, rather than 1 specific domain (memory, perception, language)
-Linked to distinction between automatic and controlled behavior: controlled behavior requires executive functions (ex: SAS model)
-All linked to prefrontal cortex

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2
Q

Which evidence is there for a link between executive functions and prefrontal cortex?

A

-Most anterior part of frontal cortex
-Region present in different species: relative size changed due to evolution, in humans much larger than in other animals
-PFC damage: personality changes (no inhibitions)
–>Phineas Gage

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3
Q

What is the case of Phineas Gage?

A

-Prefrontal cortex damage: left orbitofrontal/ventromedial region and anterior region in prefrontal cortex
-Personality changes: fitful, irreverent, profane, showing little deference, impatient, obstinate, capricious (wispelturig), vacillating (besluiteloos), unable to settle on any of devised plans for future action

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4
Q

What is the anatomy of the prefrontal cortex?

A

-Lateral surface
-Medial and orbital surface
(image)

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5
Q

What are characteristics of the lateral surface of the prefrontal cortex?

A

-Receives input: form visual cortex, somatosensory cortex, auditory cortex, multi-motor regions, etc.
-Implicated in cognitive aspects of executive functions

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6
Q

What are characteristic of the medial and orbital surfaces of the prefrontal cortex?

A

-Connected to medial temporal lobe
-Important for long-term memory and processing emotions: amygdala and hippocampus
-Implicated in emotional/social regulation of behavior

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7
Q

Which Brodman areas are there?

A

-45, 47, 44
-46, 9
-10
-24, 32 (both dorsal)
-11,12,13,14

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8
Q

What are characteristics of Brodman’s areas 45, 47 and 44?

A

-Other names: ventro-lateral prefrontal cortex (VLPFC)
-Possible functions in left hemisphere: retrieval and maintenance of semantic and/or linguistic info
-Possible functions in right hemisphere: retrieval and maintenance of visual and/or spatial info

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9
Q

What are characteristics of Brodman’s areas 46 and 9?

A

-Other names: dorso-lateral prefrontal cortex (DLPFC)
-Possible functions in left hemisphere
–>Selecting possible range of responses and suppressing inappropriate ones
–>Manipulating contents of working memory
-Possible functions in right hemisphere
–>Monitoring and checking of info held in mind, particularly in conditions of uncertainty
–>Vigilance and sustained attention

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10
Q

What are characteristics of Brodman’s area 10?

A

-Other names
–>Anterior prefrontal cortex
–>Frontal pole
–>Rostral prefrontal cortex
-Possible functions in both hemispheres
–>Multi-tasking
–>Maintaining future intentions/goals whilst currently performing other tasks or sub-goals

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11
Q

What are characteristics of Brodman’s areas 24 and 32?

A

-Both dorsal
-Other names
–>Anterior cingulate cortex (dorsal)
–>Pre-SMA
-Possible functions in both hemispheres: monitoring in situations of response conflict and error detection

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12
Q

What are characteristics of Brodman’s areas 11, 12, 13 and 14?

A

-Other names: orbito-frontal cortex
-Possible functions in both hemispheres: executive processing of emotional stimuli

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13
Q

What are characteristics of executive functions in (clinical) practice?

A

-Working memory
-Task-setting (open-ended) and problem-solving
-Overcoming prepotent or habitual responses
-Task switching
-Multi-tasking
-Planning of (unstructured) activities in daily life

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14
Q

What is working memory?

A

-Important executive function
-Distinction between 2 working memory processes
–>Maintaining and retrieving info in ventro-lateral prefrontal cortex (VLPFC)
–>Manipulating info in dorso-lateral prefrontal cortex (DLPFC)

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15
Q

What are characteristics of task-setting and problem-solving?

A

-Related to notions of (fluid) intelligence
-Open-ended task-setting: typical for solving problems: solution not given, participant has to come up with it
-Different tasks
–>Lesions to left prefrontal cortex: clinical symptoms of poor task-setting and problem solving

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16
Q

Which tasks are associated with task-setting and problem solving?

A

-Tower of London task
-Cognitive estimates
-Cognitive fluency (FAS test)

17
Q

What is the Tower of London task?

A

-Associated with task-setting and problem solving
-Nonverbal task
-Generate solution (strategy) to reach end point
-Healthy participants activation in dorsolateral prefrontal cortex
–>Damage in left prefrontal cortex: need more time and moves
(image)

18
Q

What is the Cognitive Estimates task?

A

-Associated with task-setting and problem solving
-Verbal task
-Questions of which unlikely to know exact answer, but possible to infer approximate answer by using other relevant knowledge
–>Left prefrontal cortex damage: impaired

19
Q

What is the Cognitive Fluency task (FAS test)?

A

-Associated with task-setting and problem solving
-Generate as much words as possible beginning with particular letter in 1min
-Left prefrontal cortex damage: low output, shaky script, break rules (only particular amount of letters)
-Requires strategies on how to generate novel words, select between alternatives, remembering words already said, etc.

20
Q

What are characteristics of overcoming prepotent or habitual responses?

A

-Tasks with problem in overcoming habitual responses in patients with prefrontal lesions
-Examples: Stroop Test (concept of inhibition) and Go/No Go Test (concept of inhibition)

21
Q

What is the Stroop Test?

A

-Concept of inhibition, overcoming prepotent or habitual responses
-Participants have to name color of word and ignore reading word, which is color itself
–>Functional imaging and lesion studies
-Results: healthy participants can do task with errors, patients with damage in anterior cingulate cortex impaired on task
–>So suggests involvement of anterior cingulate cortex
–>Pre-SMA (supplementary motor area) also seems involved
-Conclusion: word is read in automatic way, generates response conflicts difficult to overcome

22
Q

What is the Go/No Go Test?

A

-Concept of inhibition, overcoming prepotent or habitual responses
-Participants presented fast with series of stimuli and have to respond to most of stimuli (go-trials) but not to other stimuli (no-go-trials)
-Results: healthy participants can do task with errors, patients with damage in anterior cingulate cortex and pre-SMA (supplementary motor area) impaired on task
–>So these regions are involved in inhibition
-Conclusion: response usually not inhibited when no-go presented

23
Q

What are characteristics of task switching?

A

-There are tasks with problem in task switching in patients with prefrontal lesions
-Needing ability to discard previous schema and establishing new one
-More simple studies developed: isolating different aspects of switch, used more in healthy participants (rather than patients), switch cost (related to suppressing/inhibiting old task, greater when switching from hard to easy (ex: 2nd language to 1st, colour naming to word naming in Stroop))
-Importance of lateral PFC and medial surface PFC (anterior cingulate and pre-SMA (supplementary motor area))
-Example: Wisconsin Card Sorting Test (WCST)

24
Q

What is the Wisconsin Card Sorting Test (WCST)?

A

-Task switching task: requires rule inference and unpredictable switches
-Participant presented with 4 cards and have to link given card with presented cards according to similarity
-Feedback given after card is sorted and rules can be changed over course test
-Results: patients with PFC damage impaired on task
-Conclusion: requires rule inference and unpredictable switches

25
Q

What are characteristics of multi-tasking?

A

-Carrying out several tasks in succession
-Complex form of task-switching: constantly switching between tasks
-Requires task switching and maintaining future goals while current goals are dealt with
-Lesions to PFC: poor multi-tasking
-Example: Six Elements Task

26
Q

What is the Six Elements Task?

A

-3 sub-tasks, each divided in 2 parts, all in 15 minutes: verbal dictation, picture naming and arithmetic problems
-Participants receive rules about task execution: each task attempted at least once and some tasks should be finished first and some tasks have to be performed next, etc.
-Results: patients with PFC damage impaired on task

27
Q

What are characteristics of planning of (unstructured) activities in daily life?

A

-Patients with prefrontal lesions also have difficulties with planning activities in daily life
-Example: Birmingham Cognitive Screen Test

28
Q

What is the Birmingham Cognitive Screen Test?

A

-Planning of (unstructured) activities
-Patient receives instructions to make torch work and gets several tools: necessary or irrelevant
-Results: patient does relatively well on easy task, but slower than expected in coming up with actual action

29
Q

What kind of organization is there of executive functions?

A

-Emotional vs cognitive control
-Multiple-demand network
-Posterior vs anterior lateral PFC
-Left vs right lateral PFC
-Anterior cingulate vs lateral PFC

30
Q

What brain regions are involved in emotional vs cognitive control as organization of executive functions?

A

-Orbitofrontal and ventromedial PFC: control of affective or reward-related stimuli
–>Lesion: acquired sociopathy (anto-social personality disorder)
-Lateral PFC: control of purely cognitive stimuli
–>Lesion: dysexecutive syndrome
(image)

31
Q

What is acquired sociopathy or anti-social personality disorder?

A

-Lesions in orbitofrontal and ventromedial prefrontal cortex
-Unable to control social behavior, irresponsible, unreliable behavior, no long-lasting commitments, egocentrism, impulsivity

32
Q

What is the multiple-demand network as an organization of executive functions?

A

-Tests of executive function and fluid intelligence (ex: Ravens matrices) uses same brain regions (“multiple demand network)
–>Regions: lateral prefrontal cortex, anterior cingulate cortex, intraparietal sulcus
-Prefrontal cortex damage: impairs performance on both measures, but NOT on crystallized intelligence (ex: WAIS)
(image)

33
Q

What are characteristics of organization of executive functions in terms of posterior vs anterior lateral prefrontal cortex?

A

-Anterior lateral PFC: involved when multiple tasks need to be coordinated
-Posterior lateral PFC: involved in complicated tasks with single goal
(image)

34
Q

What are characteristics of organization of executive functions in terms of left vs right lateral prefrontal cortex?

A

-Left lateral PFC: involved in task-setting
–>Tower of London, open-ended (standard) version of Wisconsin Card Sorting Test
–>Task switching: much slower to switch
-Right lateral PFC: involved in task monitoring and sustained attention
–>Predictable version of Wisconsin Card Sorting Test impaired
–>Task-switching: more likely to revert to previous rule

35
Q

What are characteristics of organization of executive functions in terms of anterior cingulate vs lateral prefrontal cortex?

A

-(Dorsal) anterior cingulate cortex: detection of errors and detection of response conflict (ex: potential errors)
-Evidence in monkey studies

36
Q

What evidence for the role of the anterior cingulate cortex is found in monkeys?

A

-Monkeys with lesions in anterior cingulate cortex don’t trouble shoot after making error (error+1 trial worse than correct+1)
-Might be source of error potential: error-related negativity
-fMRI: activity greatest on error trial, but lateral prefrontal cortex greatest on error+1 trial
-Suggests anterior cingulate cortex detects, but doesn’t correct errors

37
Q

What summary of the organization of executive functions is there?

A

-Converging evidence to suggest that prefrontal cortex is not single source of “executive control” over brain
-Generally accepted division between functions of orbital and lateral surface
-Growing consensus over anterior vs posterior functions
-Less consensus over left-right functional differences and differences between anterior cingulate cortex and lateral prefrontal cortex

Neuropsychology and Psychopharmacology (21 decks)

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