Psychological Science Flashcards
What percentage of brain volume is frontal lobe?
30%
What are the 3 different ways of subdividing the brain?
Cytoarchitectonic
Thalamic connections
Functional properties, e.g. primary, secondary, association areas.
What is the major form of cytoarchitectonic classification of the brain?
Brodmann’s areas
What does neuropsychology study?
Brain-behaviour relationships
Who was Phineas Gage?
Patient who had:
Penetrating head injury involving at least the left frontal lobe in 1848
Dramatic changes in personality with relative intact intellectual ability
“…his mind was radically changed, so decidedly that his friends and acquaintances said he was no longer Gage.”
What does Luria’s functional systems described the anterior unit as being concerned with?
Planning, executing and verifying behaviour
What is meant by “executive function?”
Umbrella term
Describes inter-related processes responsible for goal directed, purposeful behaviour
Includes emotional and social behaviour as well as cognition
Often considered a ‘frontal lobe’ function
What are the 3 major functional subdivisions of the pre-frontal cortex?
Dorsolateral, medial and orbital pre-frontal cortex
What are the functions of the dorsolateral pre-frontal cortex?
“ Traditional” executive functions:
Working memory
Response selection
Planning and organising
Hypothesis generation
Flexibly maintaining or shifting set
Insight
Moral judgment
Which part of the pre-frontal cortex is concerned with “traditional” executive functions?
Dorsolateral pre-frontal cortex
Which artery supplies the dorsolateral pre-frontal cortex?
Middle cerebral artery
What are the functions of the medial pre-frontal cortex?
Emotional – motivational interface:
At most extreme: akinetic mutism (systems are all intact but lack of motivation to initiate)
Apathy
Initiative
Indifference
Which part of the pre-frontal cortex is concerned with emotional functions?
Medial pre-frontal cortex
Which artery supplies the medial pre-frontal cortex?
Anterior cerebral artery
Where does the site for self-awareness sit in the brain?
In the medial pre-frontal cortex and anterior cingulate cortex
What is the orbitofrontal cortex highly connected to?
Limbic areas
What functions has the orbitofrontal been associated with?
Inhibition - emotional, cognitive and social
Impulsivity
Which artery supplies the orbitofrontal cortex?
Anterior and middle cerebral arteries
Which area of the pre-frontal cortex has “opposite” functions to the medial pre-frontal cortex?
Orbitofronal cortex
What will lesions in the orbitofrontal cortex result in?
Social disinhibition.
Patients taking less time to complete a task but they make the most errors.
Which area of the brain is the last to develop and first to degenerate with age?
Frontal lobe
Which functions are the last to reach maturity?
Executive functions
What is the progression of development of the pre-frontal cortex?
‘Lower order’ functions develop first
‘Higher order’ eg. set shifting and reasoning develop later
Which positive and negative processes take place during frontal lobe maturation?
Positive processes: eg. Neuronal proliferation
Negative processes: eg. “pruning”
Is executive dysfunction a unitary disorder?
No
Where in the brain may executive dysfunction occur?
At any level
What is the role of the pre-frontal cortex in relation to executive functioning?
Coordinator
What are the positive symptoms of executive dysfunction?
Distractability
Social disinhibition
Emotional instability
Perseveration
Impulsivity
Hypergraphia
What are the negative symptoms of executive dysfunction?
Lack of concern
Restricted emotion
Deficient empathy
Failure to complete tasks
Lack of initiation
What do formal neuropsychological tests tend to be most sensitive to?
Dorsolateral pre-frontal cortex lesions
What can mask the difficulties of a dorsolateral pre-frontal cortex lesion?
Structured environment
Which lesions are difficult to formally assess?
Medial and orbitofrontal lesions
What are 3 formal neuropsychological tests?
Tower of London
Stroop test
Rey complex figure test
What are some common causes of executive dysfunction?
Closed Head Injury - Motor vehicle accidents, falls, assaults
Stroke - Middle and anterior cerebral artery, Anterior communicating artery
Psychiatric conditions - Schizophrenia, mania
Dementias - Fronto-temporal dementia, Alzheimer’s disease, Huntington’s disease
Focal lesions - Tumours, abscess, cortical malformations
Inflammatory - Multiple sclerosis o Encephalitis
Developmental - Autism
What is aphasia?
A disturbance in language as a result of brain damage.
What are the 3 different causes of aphasia?
Acute onset
Stroke
Penetrating head injury
Surgical resection
Insidious onset-progressive
Dementia
Neoplastic change
Paroxysmal-episodic
Focal seizures
Migraine
Which hemisphere is home to language?
Left hemosphere
What role does the right hemisphere play in language?
May play a role in non-propositional speech, prosody and paralingistic aspects of speech
What are the 2 branches off the middle cerebral artery?
Superior and inferior divisions.
What does the superior division of the middle cerebral artery supply?
Sensorimotor cortex and ventrolateral prefrontal cortex.
What does the inferior division of the middle cerebral artery supply?
Temporoparietal cortex and visual tracts.
What are the 2 different functional divisions to the language system?
Production: producing an appropriate output sequence
Selection: choosing appropriate content
Which language disorders to problems with production give rise to?
Non-fluent language disorders
Which language disorders to problems with selection give rise to?
Fluent language disorderse
How will an anterior lesion affecting Broca’s area affect language?
Loss of grammatical (sequential) structure
Intact selection of content
How will a posterior lesion involving Wernicke’s area affect language?
Impaired selection of content
Intact grammatical (sequential) structure
What is the hypothetical tract running between Wernicke’s and Broca’s areas?
Arcuate fasciculus
What are the features of Wernicke’s aphasia?
Fluent jargonistic language output: neologisms, paraphasic errors, e.g. boap for boat
Impaired comprehension
Right quadrantanopsia
No motor weakness
What are the features of Wernicke’s aphasia?
Non-fluent, highly effortful language output
Telegrammatic
Preserved comprehension
Right face and arm weakness
What are some other aphasic syndromes?
Conduction aphasia:
Fluent aphasia, but more meaningful than Wernicke’s type
Relatively intact basic auditory comprehension
Poor repetition of words
Transcortical motor aphasia:
Non-fluent aphasia
Muteness at most severe
Repetition is preserved
What are the 2 potential mechanisms of recovery from aphasias?
Contralateral transfer and ipsilateral re-organisation.
What is cognition?
Cognition is the process of knowing (“thought”) arising from awareness, perception, judgement and reasoning.
What is the frontal lobe associated with?
Planning, execution and regulation of behaviour
What is the temporal lobe associated with?
Audition, language, music, memory and emotion
What is the parietal lobe associated with?
Somatic & visuospatial representations
What are Luria’s 3 basic units of the CNS for the Brain-Behaviour Theory?
- Regulation of arousal and muscle tone
- Brainstem and associated areas
- Reception, integration and analysis of sensory information
- Posterior and cortical regions
- Planning, executing and verifying behaviour
- Frontal and prefrontal lobes
What are Luria’s posterior cortical zones?
See image
What are Luria’s anterior cortical zones?
What is the vertical (modular) view of cognitive architecture?
Mental faculties are:
- Domain specific
- Genetically determined
- Neurologically distinct
What is the horizontal view of cognitive architecture?
- Mental faculties are not domain specific
- Mental processes interact between faculties that are not domain specific
- Some possible candidates: attention, working memory function, judgement, problem solving and decision making
- E.g. a patient complaining of memory problems, however that could actually be an attention problem. Thus, the entire hierarchy of cognitive function must be considered.
What are Luria’s 3 principles of functional systems?
- Each area of the brain operates in conjunction with other areas
- No area is singly responsible for voluntary human behaviour
- Each area may play a specific role in many behaviours
What is the role of perception?
To extract meaning from the continuously changing, often chaotic sensory input from external energy sources and organise it into stable, orderly percepts.
What are the 2 different components of perception?
- Perceptual organisation
- “What does the object look like”
- Synthesis and integration
- Auditory and visual scene analysis
- Identification and recognition
- “What is this object”
- Assign meaning: link to cognition
What are the 4 principles of perceptual organisation?
- Exclusive allocation
- Perceptual completion or ‘closure’
- Common fate
- ‘Gestalt grouping principles’
What is the principle of exclusive allocation?
- Based on the fundamental principle of belongingness
- Sensory elements are properties of a percept
- A sensory element should not belong to more than one percept at any given time, e.g. the vase-face illusion
What is the principle of perceptual completion or ‘closure’?
- Most relevant when the perceptual environment is ambiguous or incomplete, e.g. camouflage
- Use of top-down processing to make inferences about the environment
- Knowledge gained from evolution and learning
What is the principle of common fate?
- Elements that move together are most likely connected
- Visual domain: apparent motion
- Auditory domain: auditory streaming (e.g. picking out a single voice in a noisy room)
What is the ‘Gestalt grouping principles’?
- The perceptual ‘whole’ is more than the sum of its parts
- The principles of auditory and visual scene analysis
What is agnosia?
- ‘Loss of knowledge’ - Inability to recognise objects, sounds, faces (prosopagnosia)
- Not due to a sensory, memory or language impairment
- Usually occur due to damage to parietal/occipital junction
What is apperceptive agnosia?
Impaired perceptual organisation - E.g. inability to copy an image
What is associative agnosia?
Impaired identification and recognition - e.g. image copying is intact
What are the 2 different tpes of memory?
- Immediate memory (short-term memory)
- Erasable whiteboard
- E.g. digit span
- Working memory
- Long-term memory
- Storing information over minutes, hours, years for later retrieval
- E.g. list learning retrieval
What are the different memory systems?
- Declarative
- Episodic (events)
- Semantic (facts)
- Non-declarative
- Skills and Habits
- Priming and Classical conditioning
What is procedural memory?
- Long term, implicit memory
- Skill acquisition - Automatized, slow accretion
- “It’s like learning to ride a bicycle-you never forget”
- Often doesn’t break down in disorders – can be used clinically for rehabilitation
What is episodic memory (declarative)?
- Autobiographical
- Events in personal context
- Association between a personal event and a specific temporal, spatial, and emotional context
- Unique, personal episode
What is semantic memory (declarative)?
- General facts
- Not specific to the individual and is ‘shared knowledge’
- Not contextual
- Examples:
- Knowledge that a banana is usually yellow
- Knowledge of general word meanings
What is the material specificity of the left hippocampus?
- Verbal memory
- List learning
- Paired associate learning
- Story recall
What is the material specificity of the right hippocampus?
- Non-verbal memory
- Visuo-spatial associations
- Face recall
What are some causes of memory impairment?
- Degenerative disorders
- Alzheimer’s Disease (a primary dementia)
- Chronic alcoholism (a secondary dementia)
- Cerebrovascular disorders
- Bilateral thalamic infarction
- Cardiogenic cerebral anoxia
- Paroxysmal/transient Disorders
- Transient global amnesia (TGA)
- Temporal lobe epilepsy/Transient epileptic amnesia
- Post-traumatic amnesia
- Surgical resection
What is the neuropathology of temporal lobe epilepsy?
- Hippocampal sclerosis
- Cell loss in hippocampus (CA1 particularly affected)
- Gliosis (“scar tissue”)
- “Hardening of the hippocampus”
- Clinically, present with declarative memory disturbance
What are the 3 transient memory disorders?
- Transient global amnesia (TGA)
- Transient epileptic amnesia (TEA)
- Post-traumatic amnesia (PTA)
What is transient global amnesia (TGA)?
- Precipitating events include: sexual intercourse, immersion in cold water, emotional stress
- Striking anterograde amnesia
- No disruption to ‘self-identity’
- Underlying cause remains unknown – possibilities include vascular, migraine, epileptic event, drug effects.
What is post-traumatic amnesia (PTA)?
- Can only happen if there’s a trauma injury!
- Key predictor of outcomes after the traumatic event.
- Patient can’t form memories after direct injury to the brain
What is the major risk factor for Alzheimer’s disease?
Age
What is the most common cause of dementia?
- Alzheimer’s Disease.
- ~50% of all cases of dementia
What is mild cognitive impairment (MCI)?
- Subclinical
- “Transitional phase between normal aging and dementia”
- Self-reported memory complaint - History of six to 12 months
- Objective memory impairment (-1.5 SD)
- Unaffected general cognitive functioning
- Normal capacity to perform activities of daily living
What is the transentorhinal cortex (TEC)?
A primate-specific transition zone between the entorhinal allocortex and the temporal isocortex
What is the Braak and Braak staging of Alzheimer’s disease?
See image
What are some early memory complaints in MCI?
- Name-face association - “What’s his name?”
- Object-place association - “Where did I leave my glasses?”
What part of the brain is implicated in language impairment in Alzheimer’s disease?
- Temporoparietal region
- Fluent, empty language
- Circumlocution
What can diagnostic assessments of cognition include?
Cognitive complaints – what is the person or their loved one concerned about?
Time frames – is the condition sudden onset, gradual
Good interviewing and observation
Assessment of key domains of cognition (Can be brief or very comprehensive depending on setting and needs)
Incorporate knowledge acquired by other medical professionals (E.g. imaging results, OT assessments, nurses observations)
What is cognitive rehabilitation?
The application of techniques and procedures and the implementation of supports to allow individuals with cognitive impairment to function as safely, productively and independently as possible in their environment.
What is the goal of cognitive rehabilitation?
To enable people to do what they would like and need to do to be successful, but what they find difficult because of their cognitive disability.
What is the active participation model of cognitive rehabilitation?
Cognitive rehabilitation takes place in real world contexts where the person is most likely to use/need these skills
Cognitive interventions focus on enhancing participation and reducing functional limitations - Shift away from impairment model
What will have the greatest effect on the success of cognitive rehabilitation?
The quality of the relationship that you have with the individual
What are cognitive interventions linked with?
Emotional and behavioural reactions
High rates of depression and anxiety
Changes in emotional regulation post-injury
What are the 2 categories of cognitive intervention?
Environmental modifications
Compensatory strategies
What happens in environmental modification?
Change the physical and social environment to facilitate greater independence and to reduce the impact of a person’s cognitive and behavioural difficulties
Remove or manipulate precipitating environmental factors, e.g. Providing low stimulus environments
When is environmental modification useful?
When people have:
Reduced insight
Reduced self monitoring and regulation
Significant/catestrophic attentional, memory and executive deficits
What are some examples of environmental modifications?
Reduced stimulation, quiet environments
Left neglect – place items in right visual field, reorganise rooms
Declutter, orientation information on walls, calendars
Set routines
What is compensatory cognitive intervention?
Training/teaching clients to use behaviours or processes that circumvent difficulties caused by cognitive deficits
Internal strategies: improvement of skill set/learn to utilise other skills e.g. use of mnemonic strategies, metacognitive strategies
External strategies: use cues and aids to assist compensation of deficit, e.g. Diaries, smartphones, apps now available
