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Summary Clinical Neuropsychology

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  • April 1, 2022
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  • 2021/2022
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Summary Clinical Neuropsychology
General concepts
Ipsilateral; structures/projections to the same side
Bilateral; structures/projections to both sides involved
Unilateral; structures/projection on one side involved
Contralateral; structures/projections to opposite side
Ventral; side to belly, in brain; bottom
Dorsal; side to back; in brain; top
Anterior; in brain front
Posterior; in brain back
Lateral; in brain to the side
Medial; in brain to the middle
Superior; (relative) above
Inferior; (relative) below
Sagittal; section or view from side
Coronal; section or view from front/back
Axial/horizontal/transverse; section or view from above/below

Week 1; chapters 1, 2 and 3
History;
Cell theory; three types of cells, humans have all three; basis for cognitive psychology
Physiognomy; individual differences in personality and character
Descartes; res extensa (body) and res cogitans (mind), connected through the pineal gland
Gall; phrenology, all psychological functions are innate with specific organs for all features
Clinico-anatomical method; (Gall) cognitive loss of function as a result of brain damage
studied in patients and analyzing the brain after death, location of lesion related to type of
functional impairment, the mind is on the outside of the brain; the cortex
this method was later used by Broca and Wernicke
Locke; associationism; everything is learned
Holism; Gestalt movement, everything in the brain works together
Luria; focus on rehabilitation in soldiers, subcortical, posterior and anterior brain areas are
constantly communicating, within each area three different processes

Neuropsychology in practice;
Diagnostic cycle;
1. Complaint analysis
2. Problem analysis
3. Diagnosis
4. Indication for treatment
forming of hypothesis during each step, test these hypothesis with information from client
Anamnesis; complaints, education, work, medication, history etc.
Heteroanamnesis; information from inner circle of patient (partner, parents etc.)
Reliability of test; accuracy
Validity of test; face, content, construct, criterion, ecological

Scientific approach;

,Clinical neuropsychological examinations; focus on characterization of clinical picture and
analysing course of the disease
Fundamental research; focus on increasing understanding of disorder and related brain
structures
Subtraction method; used in imaging research
Single dissociations; selective dropout for a task, but not for another task
Double dissociations; two independent tasks are impaired
Studying disease course;
- Longitudinal study
- Cross-sectional study
- Treatment study; pre- and post-measure
- Control task; look for placebo and Hawthorne effect
- Cross-over design; only improvement in trained function should be seen
- Item-specific training
- Randomization test; random test samples per patient
- Test-retest problem/learning effect
- Generalization with norm-group

Week 2 – Chapters 6, 8, 12, 19, 20 and 23
Visual perception
Physical energy is converted by receptors into physiological activity
Lower-order visual information; e.g. perception of colour
Higher-order visual information; e.g. recognizing objects

1. Retina captures light
- Cones; colour perception
o Short wavelength; blue
o Medium wavelength; green
o Long wavelength; red
- Rods; more sensitive for light information, used when it’s darker
2. Information passes through ganglion cells
- Magnocellular cells (M cells); motion-related information
- Parvocellular cells (P cells); small receptive field, colour perception
3. Axons of ganglion cells bundle together in optical nerve
4. Nerve pathways cross in optical chiasma; left and right part form retina in each eye
5. Optic nerve transmits information to NGL (nucleuss genicalatus lateralis) in thalamus
and processed
6. Visual information is projected via optical radiation to the primary visual cortex, V1

What-route; occipito-temporal (ventral), receives information from parvocellular system of
NGL  recognition of objects, processing colour, shape and texture (V1-V2-V4)
Where-route; occipito-parietal (dorsal), receives information from magnocellular system of
NGL  visuospatial processing, location in space and guiding of visually controlled
movements to objects (V1-V2-V3-V5)

V3; perception of form
V4; perception of colour

, V5; (MT) perception of movement

Functional model for visual perception;
1. Primary sketch, grouping of basic information to distinct background and foreground
2. Perspective-dependent representations convert into perspective-independent
representations, object constancy
3. Internal representations are linked to semantic knowledge

Impairments;
1. Visual field defects
- Damage before optic chiasm; impairment in one eye
- Damage after optic chiasm; homonymous impairment
o Hemianopsia; blindness in half of visual field
o Quadrantanopsia; blindness in quarter of visual field
o Scotoma; blindness in small part of view
2. Lower-order visual disorders, impairment in primary processing (anopsia)
- Disorder in visual acuity, contrast sensitivity and light-dark perception
- Impairment in colour perception (achromatopsia = bilateral damage to V4)
- Impairment in movement perception (akinetopsia)
3. Higher-order disorders, cognitive impairment in area outside primary visual cortex
(agnosia)
a. Apperceptive agnosia; percept cannot be formed, not copy object
o Visual form agnosia; not recognize, match, copy, discriminate stimuli
o Ventral stimulation agnosia; cannot merge parts into one percept
b. Associative agnosia; formed percept cannot be associated with semantic
knowledge, not naming/categorizing object
o Colour agnosia
o Brightness agnosia
o Object agnosia
o Optic aphasia; recognizing letters
o Pure alexia; reading
Prosopagnosia; cannot recognize faces, bilateral lesion of occipital-temporal region, or
unilateral lesion in right hemisphere
- Apperceptive; cannot recognize a face as being a face
- Associative; cannot distinguish familiar from unknown face
Blindsight; loss in visual field, can sometimes still perceive and unconsciously process
information
Visual hallucinations and illusions;
- Charles Bonnet Syndrome; hallucinations
- Anton’s syndrome; deny of blindness and experience a vivid visual world
- Parkinson’s disease; complex visual hallucinations
- Stroke with damage in visual cortex; see stimuli for a longer time after they’re gone




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